Nuffield Health Bristol Fitness and Wellbeing Centre

Updated 3 June 2019

Our inspection team was led by a CQC lead inspector. The team included a specialist adviser.

Nuffield Bristol Fitness and Wellbeing Centre is part of Nuffield Health a not-for-profit healthcare provider. The health assessment clinic is based within the centre. Over 90% of patients seen in the clinic are employees of organisations who are provided with health and wellbeing services as part of their employee benefit package. Services are predominantly for those over 18 years of age with some activities open to children, however health assessments are not available to children. Health assessments are available to both members and non-members.

This service 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 exemptions from regulation by CQC which relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Nuffield Health Bristol Fitness and Wellbeing Centre provides a range of fitness activities, for example, personal training, fitness suite, exercise classes, physiotherapy, swimming pool and café which are not within CQC scope of registration. Therefore, we did not inspect or report on these services. The service is registered with the CQC to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury in relation to the health assessment services offered.

Patients have access to a range of health assessments:

• General lifestyle health assessment for patients wanting to reduce health risks and make lifestyle changes.
• A female assessment covering all aspects of female health including a cervical smear test and mammogram carried out by a clinic doctor.
• Male specific testing includes testicular examination and prostate testing.
• A ‘360’ health assessment which is an in-depth assessment of a patient’s health and wellbeing and includes a review of diabetes and heart health risks.
• A ‘360 plus’ health assessment which is the most in-depth assessment with an extra focus on cardiovascular health in addition to bespoke health assessments focusing on weight management and resilience.

The organisation promotes involvement in the local community and the centre supports local community events such as the Park on Park Street and Bristol Sports Day by offering free health advice sessions and information.

The centre is open for fitness between 6am and 10pm Monday to Friday and between 8am and 9pm on weekends and bank holidays. The core opening hours for the health clinic are Monday to Friday 8.30am-5.30pm. Pre-booked appointments for patients are carried out during this time.

The staff team at the health clinic consist of a senior general manager, reception staff, a full-time health screening doctor and three physiologists (a physiologist is a graduate in exercise, nutrition and health sciences, and are full professional members of the Royal Society for Public Health (RSPH). They are trained to carry out health assessments, give advice and motivate lifestyle changes affecting areas such as exercise, nutrition, sleep and stress management. The team undertook the planned health assessments.

The service does not provide monitoring and treatment for people with long-term health conditions as this falls under the remit of their own GP and NHS Primary Medical Services. This is explained to people using the service at the point of booking and during consultation with the clinic doctor.

How we inspected this service

The service provider sent us pre-inspection information, which we reviewed before the inspection. Prior to the inspection we reviewed the last inspection report from 15 January 2016, any notifications received, and evidence provided from the pre-inspection information request.

At the inspection we received five comment cards and spoke with three people using the service, interviewed staff, observed interactions and reviewed documents.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 3 June 2019

This service is rated as Good overall. (Previous inspection January 2016 - independent healthcare services were not rated at that time)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced inspection at Nuffield Health Bristol Fitness and Wellbeing on 3 May 2019. This was a routine inspection with the purpose of rating this independent health service for the first time.

The Senior General Manager 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.

Eight people using the service provided feedback about their experiences at Nuffield Health Bristol Fitness and Wellbeing Centre during the inspection. Their comments were strongly positive about the quality of the service and appointment length and scope. Staff were described as engaging and motivating providing helpful guidance and a supported plan for the person to improve their health and wellbeing.

Our key findings were:

• There was positive patient satisfaction about all aspects of the service.
• Organisational safety systems facilitated oversight of reporting, recording and learning from incidents.
• Information about services and how to complain was available and easy to understand.
• All three health assessment rooms were well organised, equipped and clean.
• The service had systems in place to check all equipment was serviced regularly, including the blood screening equipment.
• Clinicians referred to appropriate guidance and standards such as those issued by the National Institute for Health and Care Excellence providing a framework for assessment of patients.
• Staff worked within their competencies and demonstrated they maintained the necessary skills and competence to support patients.
• Experiential learning was used to raise awareness about safety and emergency events, without notice. These were evaluated with the team so learning could be used proactively to improve quality and safety at the service.
• The provider worked with other NHS organisations and charities to provide services to vulnerable or hard to reach individuals.
• Quality assurance systems were monitored through clinical and non-clinical audit and provided assurance of adherence to policy and reduced potential risks to patients.
• Staff were highly motivated, and patients said they were kind, caring, competent and put them at ease.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.

The areas where the provider should make improvements are:

Review safeguarding competencies and training with all staff to ensure these are in line with national guidelines.

Review the standard operating procedure covering duty of candour to ensure patients receive a written apology after verbal contact when affected by an incident.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care