We carried out an announced comprehensive inspection on 8 March 2018 to ask the service the following key questions: Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was not providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Hampshire Travel and Vaccinations Clinic provide pre-travel assessment, treatment and travel advice.

A nurse is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of our inspection we asked for Care Quality Commission comment cards to be completed by clients prior to our inspection visit. We received seven comment cards, all of which were positive about the standard of care received.

Our key findings were:

• The service did not always have clear systems in place to keep patients safe and safeguarded from abuse. There was no documentation in place to show staff employed by the service had received the required training in safeguarding.
• Policies were in place to review and monitor risk but these were not fully embedded into practice. There was a lack of documentation around processes to evidence that cleaning checks had been completed and audits undertaken; some medicines and emergency equipment had passed their expiry date.
• The services last documented water testing was in 2016. There was no legionella testing certificate.
• In the event of an emergency there was no defibrillator on site and no risk assessment in place to mitigate this.
• There were systems in place to ensure that staff received the most up to date evidence based guidance.
• Patients were given a comprehensive travel health passport which contained a record of vaccinations, useful information and contacts for when they were abroad.
• Consent to treatment was only documented for flu vaccinations. Verbal consent was sought for all other vaccinations.
• All seven Care Quality Commission comments cards were positive about the service, care and treatment received.
• The service had a clear vision and values in place and provided input into the wider provider level strategy.

We identified regulations that were not being met and the provider must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed by the service receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.

Additionally the provider should:

• Review the risk assessment regarding the provision of equipment in the case of an emergency where life support could be required.
• Review systems to check and verify a patient’s identity

You can see full details of the regulations not being met at the end of this report.

We looked at treatment records for four people, spoke to three people who had used the service by telephone, observed a consultation for one person, spoke with the manager and one staff member. We found that people were involved in their care and were supported to make their own decisions. People we spoke with told us the service “was really good”. People told us they were given lots of information and “spent time discussing their options”. One person told us that they were made to feel at ease.

We found that current recruitment practices meant people could not be assured that all relevant checks had been completed for all staff who worked in the Travel and Vaccination Clinic.

The service had a clear complaints procedure in place to be able to respond and learn from these. One of the three people we spoke to told us they had seen the complaints procedure, however the other two told us they had “not looked for it”.

The provider had a variety of quality assurances processes in place which had yet to be used as the service had not been operating for very long. This meant the quality of the service would be monitored and people had the opportunity to influence and provide their feedback.