Nuffield Health Bromley Fitness and Wellbeing Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture

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

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. There was a culture of continuous improvement with staff given time and resources to try new ideas.

This service scored 71 (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 shared vision, strategy and culture. The values of the service were Connected, Aspirational, Responsive and Ethical. Staff understood these values and these were reflected in the delivery of the service.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff told us leaders in the practice were approachable and responded to any concerns raised.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

There was a whistleblowing policy which outlined the processes for raising concerns but did not name a Freedom to Speak up Guardian. Staff were able to explain the process they would follow to raise concerns but were not aware of a named individual to whom they could speak. Leaders at the service told us the names of Freedom to Speak up Guardians but advised that these arrangements were not yet embedded throughout the service. Staff told us they were able to raise concerns with the leadership team and felt confident any issues would be appropriately addressed.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. Staff completed pre-employment occupational health assessments. As a result, reasonable adjustments could be made to support staff where required.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took confidentiality and information security seriously. Staff described a supportive working environment and good relationships between managers and staff.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people.

The provider worked with the local community, for example offering free activity classes for girls at a local school. The provider participated in charity events at local sports groups.

The service focused on continuous learning, innovation and improvement across the organisation. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. Feedback was used from people using the service and staff to drive improvement. For example, we saw all snacks containing nuts had been removed from the clinic following staff feedback.

The practice had a quality improvement plan in place to help drive improvements in services. We reviewed a clinical audit which identified that not all people with a raised fasting glucose had been referred for an HbA1c test as per the provider’s guidance (HbA1c shows the average blood glucose levels for the previous 2 to 3 months and can be used to diagnose diabetes). This was discussed in a clinical meeting with feedback given to health assessment doctors. This audit was repeated the following year and found that all persons with a raised fasting glucose had received an HbA1c test.