We carried out an announced comprehensive inspection on 04 July 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 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.

Dr Stephen Alex Bobak is the registered manager at Soho Square. 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.

Soho Square is an independent travel clinic in London and provides travel health services including vaccinations, medicines and advice on travel related issues to both adults and children. Prior to our inspection patients completed CQC comment cards telling us about their experiences of using the service. There were 13 responses, all providing wholly positive feedback about the service.

Our key findings were:

• There were limited systems in place to keep patients safeguarded from abuse. Information about who to contact with a concern was not accessible to staff. Clinical staff had received safeguarding training however not all non-clinical staff had received training on safeguarding children relevant to their role.
• There was minimal evidence that risks were assessed and well-managed; the service did not have an effective system of health and safety and premises checks.
• The premises were clean; however, no infection control audits had been completed and infection control risks were present which had not been addressed.
• Procedures for managing medical emergencies were lacking.
• Policies and procedures were generic and did not reflect day to day practice at the service.
• The complaints system was not advertised but the service would provide patients with an email address which they could contact after their appointment, to provide feedback.
• The service had systems in place to respond to incidents. When incidents did happen, the service learned from them and improved.
• The service reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines. However, there was no evidence of activity which aimed to improve the quality of clinical care provided.
• 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.
• The service did not have an effective system to gather patient feedback.
• Staff felt involved and supported and worked well as a team.
• There was a lack of effective managerial oversight and some areas of governance were not sufficient to ensure safe care and that quality of services improved.

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.

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

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

• Establish processes for sharing information with private patient’s GP in absence of patient consent.
• Review and improve, as far as is practicably possible, the accessibility of the premises for patients with mobility difficulties.