We carried out an announced comprehensive inspection on 7 November 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 providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was 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 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.

Harrow Health Care Centre is a private clinic providing GP consultations, travel health advice, travel and non-travel vaccines and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a license to administer yellow fever vaccines.

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 general 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. Harrow Health Care Centre offers a range of occupational health services but these services were out of the scope of this inspection.

The principal GP 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.

We received 53 patient Care Quality Commission comment cards and spoke with two patients. All of the feedback we received was positive about the service. Patients said they were satisfied with the standard of care received and said the staff was approachable, committed and caring.

Our key findings were:

• The provider offered private GP consultations to adults and children. They offered gastric band adjustments (post-bariatric surgery patient aftercare) and acupuncture treatments (a form of alternative medicine in which thin needles are inserted into the body). They offered urine drug and alcohol tests service.
• The provider offered vaccination and travel clinic services to adults and children.
• Each travel clinic patient received an individualised travel health brief which was tailored to their specific needs and travel plans. The health brief outlined a risk assessment; all travel vaccinations that were either required or recommended, and specific health information including additional health risks related to their destinations with advice on how to manage common illnesses.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• There were arrangements in place to protect children and vulnerable adults from abuse.
• The provider ensured that care and treatment was delivered according to evidence based guidelines and up to date travel health information.
• There was evidence of quality improvement activity including the clinical audit.
• Consultations were comprehensive and undertaken in a professional manner.
• Consent procedures were in place and these were in line with legal requirements.
• Systems were in place to protect personal information about patients.
• Appointments were available on a pre-bookable basis.
• Staff had the relevant skills, knowledge and experience to deliver the care and treatment offered by the service.
• There was an infection prevention and control policy and procedures were in place to reduce the risk and spread of infection.
• Vaccines, medicines and emergency equipment were safely managed. There were clear auditable trails relating to stock control.
• Information about services and how to complain was available.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• There was a clear vision and strategy and staff spoke of an open and supportive culture.

The areas where the provider should make improvements are:

• Review systems to verify a patient’s identity on registering with the service.
• Consider ways to monitor antimicrobial prescribing.
• Consider how to improve access to patients with hearing difficulties.
• Ensure a response to complaints includes information of the complainant’s right to escalate the complaint if dissatisfied with the response.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice