We carried out an announced comprehensive inspection on 20 August 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 Victoria. 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.

Victoria 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 nine 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 accessible to staff and staff had received safeguarding training. However, the service did not have a safeguarding policy which was tailored to the site and one member of staff did not know who the service’s safeguarding lead was.
• Not all risks were assessed or well-managed.
• The premises appeared visibly clean; however, no infection control audits had been completed. The service had taken action to mitigate risks associated with infection control.
• The service had some systems in place to manage medical emergencies although had not risk assessed the need for recommended emergency medicines and we were told that two medicines were not currently available.
• There was information available to tell patients how to provide feedback but this did not specifically refer to complaints 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. There were different versions of policies and procedures, one set for Vaccination UK Limited (who recently acquired the provider), one for The London Travel Clinic and a separate standard operating procedure for the site. Staff were unclear as to which set of policies they should be using and none had been completed with all the required information.

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.

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

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice