We carried out an announced comprehensive inspection on 6 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 The London Travel Clinic at London Bridge. 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.

The London Travel Clinic at London Bridge 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 six 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. Staff had received safeguarding training.
• Not all risks were assessed or well-managed.
• 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.
• There was no information available to tell patients how to make a complaint and the service did not have an effective system to gather or act on patient 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.
• 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:

• Advertise the service’s complaints procedure and keep appropriate records of complaints received.
• Review staff training needs.

Establish processes for sharing information with a patient’s GP in absence of patient consent.  

We spoke with the member of staff providing the service and with two of the providers` directors.

We spoke with the people using the service that day who all praised the efficiency and delivery of the treatment and advice given. Patient records were up to date and people were provided with information leaflets on different diseases.

The people said that they were not pressured to have any particular treatment and advice was given on precautions to take whilst travelling. One of the people using the service said “I am scared of needles, and he made it very relaxing and it was fine”

another person said "it`s a very good all round service".

We inspected the medicines and these were all found to be in date and stored correctly.

The provider had an adequate process to manage risks and measure the quality of the service provided.