Nuffield Health Bromley Fitness and Wellbeing Centre

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 looked for evidence that people were protected from abuse and avoidable harm.

This is the first rated inspection for this service. At our last inspection in July 2018, we found the provider was providing safe care in accordance with the relevant regulations. This key question has been rated as good.

The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care.

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.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learned to continually identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learned from incidents and significant events. Staff felt there was an open culture, and that safety was a top priority. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Referrals and test results were managed in a timely way.

The service worked with people to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Safeguarding policies were in place and known to staff, who were appropriately trained in safeguarding procedures. Safeguarding processes were in place at all stages of the health assessment, including when people completed their initial online questionnaire, whilst attending the service, and following their assessment thorough referrals and test results.

The service always worked well with people to fully understand and manage risks by thinking holistically. They provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. There were processes to flag concerns raised in people’s questionnaires, which were completed and submitted prior to attending health assessments. For example, if a person raised concerns about their mental health in their questionnaire, a duty doctor would contact the person prior to their assessment. If the person could not be contacted, the person’s own GP could be contacted to share these concerns and ensure the person was offered appropriate support. We saw examples of where action taken by the provider had protected people from the risk of harm.

Emergency equipment was available and maintained. Staff could recognise a deteriorating person and knew of action to take. There were regular training sessions involving example scenarios, such as responding to someone experiencing a cardiac arrest. These training sessions were used to check if staff knew how to respond in such scenarios and identify any areas for improvement.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed. There was a business continuity plan in place which was monitored and reviewed.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We found training was up to date, including fire safety, learning disability and autism, and basic life support. Learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence. Safe recruitment practices were followed.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.

Emergency medicines were held on the premises and were stored securely and at appropriate temperatures. Staff regularly checked the stock levels and expiry dates for emergency medicines. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. The provider had effective systems to manage and respond to safety alerts.