We carried out an announced comprehensive inspection on 1 June 2018 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 Nottingham is located on the periphery of Nottingham City in a first floor office building, which has been modified for use as a clinic. The clinic had a lift to the first floor and adequate parking immediately outside the building dedicated for staff and patients.

Patients are able to book appointments directly with the service, through a centralised process or online. There is a local management team comprising of a centre manager, lead physician, a health advisor team manager and a support and administration co-ordinator supporting six employed clinicians and a further six self-employed clinicians which included GPs. In addition to the local team there is regional and national support and oversight from further Bupa staff.

The clinic provides only general health assessments (that include a range of screening processes), specialised assessments, GP services, vaccinations and musculoskeletal services (this includes physiotherapy and specialist physician appointments for conditions such as back pain, sprains and sporting injuries) to people aged 18 years and above. The service opening hours are Monday to Friday 8am to 5pm.

The 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.

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 service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Nuffield Health Wellbeing Centre Nottingham, services are provided to patients under arrangements made by their employer with whom the service user holds a policy (other than a standard health insurance policy). These types of arrangements are exempt by law from CQC regulation. Therefore, at Bupa Centre Nottingham we were only able to inspect the services, which are not arranged for patients by their employers with whom the patient holds a policy (other than a standard health insurance policy).

The provider, which is Bupa Occupational Health Limited, is registered with the Care Quality Commission to provide services at 4 Millenium Way West, Phoenix Park West, Nottingham, NG8 6AS. The clinic has been used to provide services to patients since 2010.

We received 13 comment cards in the lead up to the inspection, the patients’ responses were entirely positive about their experiences at the service. Comments included that patients felt staff were very friendly and courteous, they felt listened to and their questions were answered in a way which was easy to understand, as well as being treated with dignity and respect.

Our key findings were:

• There was effective management of significant events at both a regional and local level.
• The clinic had a low threshold to recording incidents, irrespective of severity, to ensure everything was captured and learning opportunities maximised.
• There was an emphasis on quality within the clinic in both patients care and day to day roles.
• An effective induction process and a supportive mentorship program allowed new staff to become part of the local team with the understanding of the providers goals and code, which we saw was embedded amongst staff.
• The clinical staff used evidence based guidance to ensure appropriate and effective treatment and advice was given to patients.
• The clinic had engaged with the local community to improve awareness of both topical conditions and the clinic itself. For example, they ran a prostate health day with a free screening test, a breast awareness day with a free examination and attended local 10K runs to provide water and free physio for runners after completion.
• The lead physician had undertaken audits to ensure care was being delivered according to latest guidance and outcomes were shared openly with the clinical team to improve the service.
• We saw patients were treated in a friendly and professional manner and feedback from comment cards and patient survey supported this.
• Staff told us there was an open and inclusive culture of management and felt their views were listened to.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• There was an overarching provider vision and strategy and there was evidence of good local leadership bolstered by regional support when required.

There were areas where the provider could make improvement and should:

• Review the system currently in place to determine patients’ identity and age.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

We spoke with two patients who used the service, the centre manager and two health advisors.

We found that patients had given their consent before any assessment or treatment commenced. One patient told us, “I have signed a consent form for my records to be shared with my GP but they always check I am happy with anything they do.” They added, "Throughout the assessment, the doctor explains what is happening and what is going to happen next."

Both patients spoken with said they were asked whether they were happy for the treatment to proceed before it started. They also told us they had been treated with dignity and respect. One patient told us, "Everyone is very courteous and helpful."

Patients told us they were happy with the treatment provided by the service. They said it was always clean and staff wore appropriate gloves, masks and aprons.

Both of the patients we spoke with said they knew how to make a complaint and would not hesitate to do so if they had a problem.

We spoke with three people who use services. They told us they had received sufficient information and had time to ask questions before making a decision about their treatment. One person said, “It was clear what was going to happen.” All people told us they were asked whether they were happy for the treatment to proceed before it started. They also told us they had been treated with dignity and respect.

People told us they were happy with the treatment provided by the service and felt safe using the service. They told us staff appeared to be confident and trained to the appropriate level and they would be comfortable raising any concerns with the service if necessary.

We found that people were treated with dignity and respect and received care that met their needs. We found that people were safe and that staff received induction, training and appraisal. We also found that the provider took steps to assess the quality of the service being provided.