The Buckingham Centre Also known as Slough Travel Clinic

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed all 8 quality statements for this key question to determine if the provision of services were safe. There had been improvements in the operation of safety systems since the previous inspection. There was a positive learning culture and systems designed to keep patients safe. The provider’s systems for safeguarding concerns, the management of risks, the environment, staffing levels, infection prevention and control, and the management of medicines (specifically travel vaccinations) were effective. These actions were now ensuring that requirements relating to Regulation 12 (safe care and treatment) were now being met.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patient feedback collected for this assessment had no specific views or concerns regarding the learning culture at the service. The provider advised as per their complaints policy, they would, contact patients who were affected by an incident to offer a verbal or written apology and an explanation.

There was a proactive approach to patient safety and learning. This included reflection, learning and improvements made following the March 2023 inspection. Feedback from staff and leaders confirmed the service had new and improved policies and procedures in place for monitoring significant events and incidents. Where improvements were required, information, advice and guidance were shared amongst staff to improve patient care. Leaders within the service were aware of and complied with the requirements of the Duty of Candour.

Whilst no significant events or incidents had occurred within the regulated service, there were processes to record and act on significant events. There were also processes in place to enable learning to be shared with relevant staff to reduce the risk of reoccurrence. This included learning from developments within the wider travel health sector. There was an effective system for acting on patient safety and medicine alerts. If a complaint or patient feedback required action, there were processes to investigate in a timely and appropriate manner and where appropriate channels to share lessons learnt and reflection points to improve the service.

Patient feedback collected for this assessment had no specific views or concerns regarding movement between different services. If required; the provider would signpost patients to other services.

Staff told us there were systems in place which ensured safety and continuity of care for patients, including patients on a schedule of travel vaccinations. The clinicians advised they had made appropriate and timely referrals and signposted patients to alternative services on presentation of clinical symptoms in line with protocols and up-to-date evidence-based guidance.

We did not receive any feedback from partners regarding systems and pathways as part of this assessment.

Individual care records were written and managed in a way that kept patients safe. The care records we saw showed that patients completed a health information form prior to their appointment. There were improved processes and templates for staff to record accurate travel plans including destinations, timescales and the reason for travel. From our review of the 5 random care records, we also saw the care records were completed and included additional details to allow the clinicians to record the consultation accurately, this was an improvement since the last inspection.

All staff we spoke with were aware of their responsibilities in reporting safeguarding concerns. Staff were also aware of high-risk travel destinations for Female Genital Mutilation (FGM) and their legal responsibilities to alert authorities of suspected FGM activity.

There were effective systems and processes, and staff were aware how to make sure people were protected from abuse and neglect. The service had processes to safeguard patients from abuse. This included a safeguarding policy which provided appropriate guidance for staff and appropriate processes to support the use of chaperones. Whilst the service had not seen children as patients, there were systems in place to assure and record that an adult accompanying a child had parental authority. Staff received up-to-date safeguarding and safety training appropriate to their role.

Patient feedback collected for this assessment had no specific views or concerns about their involvement in risk. However, we saw patient survey results which indicated all patients had received aftercare advice post vaccination which included how to manage any potential side effects and travel health promotion, for example water safety and disease prophylaxis.

Staff understood their role in managing risks within the service, this included health and safety risks, travel health risks and potential post vaccination risks to patients. Staff knew their responsibilities to manage potential emergencies, such as allergic reactions to travel vaccinations.

We found that appropriate emergency equipment and medicines were kept at the service and staff were aware of how to find these. We found that systems for checking emergency equipment, and the expiry dates of medicines were effective. The service ensured they had adequate knowledge of people’s health and their medical history before administering any vaccination. The provider had risk assessed the different treatments they offered. For example, there were individual risk assessments for patients accessing travel vaccinations via an accelerated schedule.

Staff were clear about their role and responsibilities in relation to environmental safety and who was responsible for oversight of specific areas, such as health and safety, infection prevention and control, and fire safety. Staff we spoke with told us they were trained in emergency procedures and were able to discuss the actions they would take if an emergency arose.

The service was provided from a purpose-built site located over 2 floors. The premises include 2 reception areas, a waiting area, an office and a nurse treatment room. The reception area overlooked the waiting area, allowing for clear monitoring of people sat there. We saw there were adequate safety notices throughout the practice apart from the room where medical oxygen was stored, which required oxygen signage on the door. Immediately following our assessment, the service sent evidence that this had been rectified.

The provider ensured that facilities and equipment were safe, and that equipment was maintained according to manufacturers’ instructions. We saw there were cleaning schedules and handwash facilities in the nurse treatment room. The provider worked with external specialists to complete appropriate health and safety risk assessments which took into account the profile of people using the service. These included gas, electrical safety, fire, legionella and infection, prevention, and control audit. At the time of this assessment, the provider was working with external contractors to make improvements and develop action plans to address electrical safety and water safety following a recently completed risk assessments.

Patient feedback collected for this assessment had no specific views or concerns about staffing. However, we saw patient survey results indicated high levels of satisfaction and professionalism of the team.

The provider carried out staff checks at the time of recruitment. We saw there were no new staff recruited at the service since the last inspection. Disclosure and Barring Service (DBS) checks were undertaken for all staff in line with the service’s policy. DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable. Leaders told us and we saw, following the March 2023 inspection, improvements had been made to the induction programme with the addition of a competency framework. This was confirmed by staff we spoke to. Staff whose role included travel immunisations had received specific training in providing travel health advice and vaccinations and could demonstrate how they stayed up to date. For example, those administering the yellow fever vaccination had been trained to the standard required by National Travel Health Network and Centre (NaTHNaC) and the Joint Committee on Vaccination and Immunisation (JCVI).

We saw safe recruitment practices to make sure all staff, were suitably experienced, competent and able to carry out their role. We found policies were regularly reviewed to ensure there was no disadvantage based on any specific equality characteristic. Records showed staff were up to date with mandatory training relevant to their role.

Patient feedback collected for this assessment reflected no concerns about infection prevention control.

Staff told us that they had received training in infection, prevention and control and had access to a designated lead member of staff who had additional training. Staff reported they had no concerns in relation to infection prevention and control.

The premises were clean and well maintained, however there were some non-clinical areas which required additional refurbishment. There were systems for safely managing the healthcare waste.

There was an effective system to manage infection prevention and control. A legionella risk assessment had been conducted in November 2024 and the provider was working with a water specialist to make improvements (Legionella is a term for a particular bacterium which can contaminate water systems in buildings). We noted that weekly cleaning schedules were in place for rooms and had been appropriately completed. Since the last inspection the service had undertaken a series of bi-annual infection control audits and had completed all actions.

Patient feedback collected for this assessment had no specific views or concerns about medicines optimisation.

Staff and leaders told us about the improvements the service had made to improve how they managed medicines. This included the storage of medicines via an improved cold chain process and improvements to how the service authorised staff to administer medicines via Patient Group Directions (PGDs). The ‘cold chain’ is a term used to describe the cold temperature conditions in which certain medical products need to be kept during storage and distribution. Staff spoke with confidence about the new arrangements to manage medicines and were aware of the processes if they found any medicines concerns. Staff also told us they kept up to date with the latest guidance on travel health by attending training and had access to The Green Book (a resource managed by the UK Health Security Agency containing the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK) and NaTHNaC.

We observed the improvements the service had made in the management of medicines. This included a review of 14 different PGDs which were all authorised correctly and observations regarding the storage of medicines which required refrigeration. We also found the emergency medicines and equipment held by the service was stored appropriately.

We saw that the service had implemented improved processes to manage medicines. There were also effective processes to receive, manage and respond to safety alerts and medicine recalls, this included specific travel medicine updates.