We carried out an announced comprehensive inspection on 8 January 2019 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with

the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Bupa Centre – Bristol is part of the Bupa Occupational Health Limited which provides private health assessments, occupational health service and an independent doctor consultation service.

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 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. At

BUPA Centre Bristol

services are provided to patients under arrangements made by their employer or an insurance company with whom the service user holds a policy. These types of arrangements are exempt by law from CQC regulation. Therefore, at

BUPA Centre Bristol

we were only able to inspect the services which are not arranged for patients by their employers or an insurance company with whom the patient holds a policy.

The centre 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.

Fifteen people provided feedback about the service. The feedback was positive and cited the good practice experienced by patients they described the service as being professional and friendly, with several comments about being listened to and feeling very comfortable with the approach and manner to them from the staff.

Our key findings were:

·        

There was a transparent approach to safety with demonstrably effective systems in place for reporting and recording incidents.

·        

Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

·        

Information about services and how to complain was available and easy to understand.

·        

All consultation rooms were well organised and equipped, with good light and ventilation.

·        

There were systems in place to check all equipment had been serviced regularly.

·        

Clinicians regularly assessed patients according to appropriate guidance and standards such as those issued by the National Institute for Health and Care Excellence.

·        

The staff team maintained the necessary skills and competence to support the needs of patients.

·        

The staff team were up to date with current guidelines and were led by a proactive provider.

·        

Risks to patients were well managed for example, there was a quarterly emergency scenario exercise, in addition to yearly training, to ensure all staff could recognise and respond effectively to medical emergencies.

·        

The provider was aware of, and complied with, the requirements of the Duty of Candour.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 9 December 2015 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe services in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective services in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive services in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well led services in accordance with the relevant regulations.

Background

BUPA Centre-Bristol is a private health screening centre. BUPA Centre-Bristol also provides an occupational health service to local companies and an independent doctor consultation service. There is a registered medical practitioner providing consultation and treatment which may include providing consultation and or treatment remotely. For example via the telephone or internet (including FaceTime or SKYPE).

The centre also has an in house dental suite offering general dentistry and a dental hygienist.

The service hosts various specialist health care consultant services such as dermatology and orthopaedics. There is a musculoskeletal service with a physiotherapy department able to offer a variety of services including ultrasound. They have an onsite biochemistry blood and urine testing service. The services are available to the wider population of Bristol and it undertakes between 200- 500 consultations per month.

The core hours for the service are :

Monday 8am-8pm

Tuesday 8am-6pm

Wednesday 8am-7.30pm

Thursday 7.30am-6pm

Friday 8am-6pm

Out of hours dental patients are advised to use the 111 service.

The staff employed at the centre included:

Health Screening Doctors (4 sessional doctors (female and male0 which offers choice to patients)

Health Advisers (6 staff trained in phlebotomy, ECG and to give health advice)

Dermatologist (sessional basis)

Musculo – skeletal Physician (3 sessional staff)

Physiotherapist

Chiropractor

Administration (7 staff)

Dentist (2 sessional staff)

Dental Nurse

Dental Hygienist (sessional basis)

The centre 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.We obtained feedback about the service from 12 comment cards where patients and members of the public shared their views and experiences of the service.

The observations made by patients on the comment cards were all positive and reflected satisfaction with the service.

We found the service had met the regulations and had in place robust systems and protocols for staff to follow which kept patients safe.

Our key findings were:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording incidents.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• All consultation rooms were well organised and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly, including the dental suite equipment and blood screening equipment.
• Clinicians regularly assessed patients according to appropriate guidance and standards.
• Staff maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines and were led by a proactive management team.
• Risks to patients were well managed for example, there were effective systems in place to reduce the risk and spread of infection.
• Staff were kind, caring, competent and put patients at their ease.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.

During our inspection we spoke with one person who was attending the centre for an assessment. The person said “I came with three questions but I was able to ask numerous questions and I did.” We were told that staff were “attentive” and “they were good.”

People were involved in discussions about their health and were able to make informed choices about what to do next. People told us that assessments and tests were explained and their consent was sought before they were carried out. People were satisfied with the service that they received. We were told by one person that they had attended this centre a number of times and “they ere spot on. Couldn’t ask for anymore.”

The provider had quality assurance processes in place to ensure that equipment was maintained and regularly checked. All consumables sampled were in date.

We saw that staff were respectful and supportive to people. Staff were qualified and trained to carry out their job. We were told that the system of keeping training records was under review to make the system more user friendly.

There was a complaints procedure in place. No one raised any concerns about the service at the time of our visit.

People were happy with the service that they received from the centre. We saw comments such as "Excellent service. I was treated like a VIP throughout" and "Thorough and professional staff". People were involved in discussions about their health and were able to make informed choices about what to do next.

Care and support was not always planned or delivered in a way that was intended to ensure people’s safety and welfare. Sterile supplies were not checked properly so that some of them had exceeded their "use by" date. We could see that people's dignity was maintained, their privacy protected and that they were protected from the risk of abuse.

Staff responded to people who used the service in a friendly and considerate manner. However, some staff did not receive an annual appraisal which meant that they were not appropriately supported in relation to their responsibilities. Staff were enabled to take part in learning and development that was relevant and appropriate.There was a system in place to monitor the quality of service provided. We saw evidence that comments were listened to and that further investigation took place if necessary. Information gained from audits was analysed and used to make any improvements indicated.