The Buckingham Centre Also known as Slough Travel Clinic

This service is rated as Inadequate overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

We carried out an announced comprehensive inspection at The Buckingham Centre as part of our inspection programme. The service was registered with the Care Quality Commission (CQC) in January 2018 and is the only registered location of the provider Collingwood Health Ltd. We carried out this first rating inspection on 18 October 2022 as part of our regulatory functions.

This location is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some general exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Buckingham Centre is registered with CQC to provide the following regulated activities:

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

The director of Collingwood Health Ltd is the registered manager. A registered manager is a person who is registered with CQC 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 did not have an effective system in place to ensure appropriate pre-employment checks were carried out to assure themselves they had safely recruited a new member of staff.
• Staff had completed some training however, there was a lack of oversight to ensure all staff had completed the provider’s mandatory training relevant to their role and in line with their own policy. For example, not all clinical staff had completed training in anaphylaxis, basic life support or infection prevention control.
• There was no record to demonstrate clinical staff had received the appropriate immunisations to ensure they and their service users were safe in line with national guidance.
• There was a lack of oversight of infection prevention and control and a regular audit to identify and mitigate any possible risks was not taking place.
• Policies were in place to review and monitor risk but these were not fully embedded into service.
• Cold chain protocols were not being effectively followed. During the inspection, we found temperatures for the vaccine fridge were being checked regularly but this was not in line with the provider’s own policy. We also found no actions were being taken when fridge temperatures were found to be out of range.
• Staff were destroying vaccines that had reached their expiry date, however, there was no written process or policy to follow.
• There was no checklist or process to check what emergency medicines or equipment the service kept onsite and not all staff knew where these were stored.
• Patient Group Directions for the administration of travel vaccines were not in place.
• Patient safety alerts were shared with staff but there was no central record of these alerts.
• The provider had verified staff qualifications and ensured where appropriate, they had a current registration with a professional body.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to service users.

• 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 their duties.

In addition, the provider should:

• Review the accessibility and availability of service information for service users with language and communication barriers.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services