Archived: Vaccination UK Limited

We carried out an announced focused inspection on 20 November 2018 to ask the service the following key questions; Are services safe 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 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.

CQC inspected the service on 27 March 2018 and asked the provider to make improvements. Requirement Notices were served in relation to breaches identified under Regulation 12: Safe Care and Treatment, Regulation 17: Good Governance and Regulation 18: Staffing. We checked these areas as part of this focused inspection and found they had been resolved and that the regulatory requirements were now being met.

Vaccination UK Limited is a private clinic providing travel health advice, travel and non-travel vaccines, blood tests for antibody screening and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a licence to administer yellow fever vaccines.

Vaccination UK Limited is also commissioned to the NHS in the provision of child immunisation services.

This location is registered with CQC in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of travel health.

The clinic is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury.

The Clinical Director 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.

Our key findings were:

• Lessons were shared to make sure action was taken to improve safety across the service.
• There were risk assessments in relation to safety issues.
• Staff recruitment checks, induction, essential training, appraisals and supervision was recorded and undertaken in a timely manner, in most cases.
• There was a leadership structure and staff felt supported by management.
• Structures, processes and systems to support good governance and management were clearly set out, understood and effective.

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

• Continue to review the system in place to ensure documentary evidence of appropriate recruitment checks for staff members has been obtained.
• Continue to review the system in place to ensure personal developments plans are in place for all appropriate staff members.
• Continue to develop positive relationships between senior staff and teams and establish clear methods of communications across all staff locations.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

We carried out an announced comprehensive inspection on 27 March 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.

Background

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.

Vaccination UK Limited is a private clinic providing travel health advice, travel and non-travel vaccines, blood tests for antibody screening and travel medicines such as anti-malarial medicines to children and adults. In addition, the clinic holds a licence to administer yellow fever vaccines.

Vaccination UK Limited is also commissioned to the NHS in the provision of child immunisation services.

This location is registered with CQC in respect of the provision of advice or treatment by, or under the supervision of, a medical practitioner, including the prescribing of medicines for the purposes of travel health.

The clinic is registered with the Care Quality Commission under the Health and Social Care Act 2008 to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury.

The clinical director 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.

As part of our inspection we asked for Care Quality Commission comment cards to be completed by clients prior to our inspection. We received seven completed comment cards which were all positive about the standard of care received. Clients told us staff were kind, knowledgeable, friendly, professional and caring.

Our key findings were:

• The provider had systems, processes and practices in place to keep people safe and safeguarded from abuse.
• Lessons were shared to make sure action was taken to improve safety in the practice. However, the service did not always record and investigate incidents.
• Staff had the information they needed to deliver care and treatment to clients.
• The service had reliable systems for appropriate and safe handling of medicines.
• There were risk assessments in relation to safety issues. However, some assessments required strengthening.
• Staff were aware of current evidence based guidance and had access to the most up to date information.
• Clients received an individualised travel risk assessment, health information including additional health risks related to their destinations and a written immunisation plan specific to them.
• Staff recruitment checks, induction, essential training, appraisals and supervision was not always recorded or carried out in a timely manner.
• Staff worked together and when necessary with other health professionals to deliver effective care and treatment.
• We saw staff treated clients with kindness and respect, and maintained client and information confidentiality.
• Information for clients about the services available was easy to understand and accessible.
• The provider understood its client profile and had used this to meet their needs.
• Information about how to complain was available and evidence from examples we reviewed showed the practice responded quickly to issues raised.
• The service had a clear vision and strategy and staff were clear about the vision and their responsibilities in relation to it.
• There was a leadership structure and staff felt supported by management. The practice had policies and procedures to govern activity and held regular governance meetings. However, not all governance structures, systems and processes were effective in enabling the provider to identify, assess and mitigate risks to patients, staff and others.

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
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

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:

• Review infection prevention and control systems and processes to ensure audits are undertaken on a regular basis.
• Review the management of clinical waste.
• Review the risk assessment in place for not having a defibrillator on the premises.
• Review the risks associated with staff driving to and from locations.
• Review the process and record keeping for staff induction.