We carried out an announced focussed follow up inspection on 3 December 2018 to ask the service the following key questions; Are services safe, effective and well-led?

Our findings were:

Are services safe?

We found this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this service was providing effective care in accordance with the relevant regulations.

Are services well-led?

We found 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, in respect of issues we found at the previous inspection.

CQC inspected the service on 28 June 2018 and as a result asked the provider to make improvements regarding: staff training; policies were not personalised for use at the service and were not accessible to staff; there were no regular risk assessments including infection prevention and control and legionella testing; there was no defibrillator available in the event of an emergency; the recently introduced IT system did not allow staff to access all information they needed; and there was a lack of clinical audits or other quality improvement activity. We issued requirement notices for breaches of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We checked these areas as part of this focussed inspection and found the service had resolved most issues and were working on those remaining..

The report for our previous inspection in June 2018 can be found on the CQC website by selecting the Reports tab from: https://www.cqc.org.uk/location/1-1818533366.

King’s Cross is a private clinic providing travel health advice, travel and non-travel vaccines. It is operated by London Travel Clinic Limited, which currently has four other locations around London registered with the Care Quality Commission. The business was acquired by Vaccination UK Limited in March 2018. However, the registered legal entity remains London Travel Clinic limited (the provider) which is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the regulated activity Treatment of disease, disorder or injury.

There is a registered manager, who 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.

Our key findings were:

• The provider had updated most policies to standardise them across its group of locations, and was developing standard operating procedures (SOP) specifically for the service. This covered some areas and was in development with additional information being added to enable staff to carry out all location specific activities.
• The service had not undertaken a recent fire drill. The building management had organised a full evacuation fire drill, which the service’s receptionist had taken part in.
• The service was undertaking regular infection prevention and control audits, and was acting on any identified issues.
• We saw evidence all staff had received appropriate training in health and safety, infection prevention and control, fire safety and confidentiality.
• All staff had received appropriate training in safeguarding of vulnerable adults and children to an appropriate level.
• The service had a defibrillator in the treatment room, for use in a medical emergency, and it was regularly checked to ensure it would be functional if needed.
• Regular record keeping audits contributed to more accurate patient’s records held by the service.

There were areas where the provider could make improvements and should:

• Continue to review and update its policies and to develop the standard operating procedures to provide location specific guidance for staff.
• Ensure water temperature and legionella testing are regularly conducted so the enclosed water supply in the treatment room remains safe to use.
• Conduct fire drills on a regular basis to ensure all staff benefit, add fire marshal names and evacuation procedures to the SOP.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection on 28 June 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.

London Travel Clinic Limited – King’s Cross is a private clinic providing travel health advice, travel and non-travel vaccines. It is operated by London Travel Clinic Limited, which currently has four other locations around London registered with the Care Quality Commission. The business was acquired by Vaccination UK Limited in March 2018. However, the registered legal entity remains London Travel Clinic limited (the provider) which is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the regulated activity Treatment of disease, disorder or injury.

There is a registered manager, who 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 comments cards from six patients who had used the service. All were positive about their experience and the service they had received.

Our key findings were:

• Systems to keep patients safeguarded from abuse were not fully effective. Procedural guidelines were generic and had not been adapted for specific use at the location. We did not see evidence that all staff working at the location had received safeguarding training appropriate to their role.
• The provider’s procedural guidelines relating to health and safety issues were not followed. These stated that various health and safety risk assessments should be undertaken and a risk register maintained, but the provider did not provide evidence of this. We identified concerns relating to infection prevention and control and fire safety.
• The provider told us of a range of training, such as safeguarding, health and safety, infection prevention and control, fire safety and confidentiality, was given to staff. However, it did not provide evidence of this in relation to all staff working at the location.
• The provider had systems to ensure that care and treatment was delivered according to evidence-based guidelines.
• A recent takeover of the provider’s business had led to problems with integrating the IT systems and introducing new governance procedures. However, work was ongoing to address these issues.
• The provider had systems in place to respond to incidents. When incidents did happen, the provider learned from them and improved.
• The appointment system reflected patients’ needs. Patients could book appointments when they needed them.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff felt involved and supported and worked well as a team.

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.

There was an area where the provider could make improvement and should:

• Review how information about the complaints procedure is made available to patients.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice