We carried out an announced comprehensive inspection on 19 July 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.

Nuffield Health Fitness and Wellbeing Centre Farnham is part of Nuffield Health, a not-for-profit healthcare provider. They provide health assessment that include a range of screening processes. Following an assessment and screening process, clients undergo a consultation with a doctor to discuss the findings of the results and any recommended lifestyle changes or treatment planning. The health assessment clinic is based within the fitness centre. Clients seen in the centre are either private clients or employees of organisations who are provided with health and wellbeing services as part of their employee benefit package. The services are provided to adults privately and are not commissioned by the NHS.

The service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. For example, physiotherapy, nutrition and lifestyle coaching do not fall within the regulated activities for which the location is registered with the CQC. Nuffield Health Fitness and Wellbeing Centre Farnham is registered with CQC to provide the regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury.

The general manager of the fitness centre 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 last inspected Nuffield Health Fitness and Wellbeing Centre Farnham in November 2014. We found the clinic had met all the standards expected of them.

We received 11 completed CQC comment cards from service users. Feedback was very positive about the service delivered at the clinic.

Our key findings were:

• Health assessments were offered on a private, fee-paying basis to adults only.
• All health assessment rooms were well-organised and well-equipped.
• Clinicians regularly assessed clients according to appropriate guidance and standards, such as those issued by the National Institute for Health and Care Excellence.
• Staff were up to date with current guidelines and were led by a proactive management team.
• Staff maintained the necessary skills and competence to support the needs of clients.
• There were effective systems in place to check all equipment had been serviced regularly, including blood screening equipment.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.
• The provider had an effective system for ensuring the identity of clients who attended the service.
• Risks to clients were well-managed. For example, there were effective systems in place to reduce the risk and spread of infection.
• Clients were provided with information about their health and received advice and guidance to support them to live healthier lives.
• Information about how to complain was available and easy to understand.
• Systems and risk assessments were in place to deal with medical emergencies and staff were trained in basic life support.

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

• Review the content of emergency medicines held on site.

It was not possible to speak to people who used the service as no one suitable was available during the inspection.

People were given all the information they needed to make an informed decision about their assessment. Staff were observed to be respectful and helpful when speaking to people on the telephone and at the main reception.

Assessments were delivered in a way to meet the needs of people who used the service. People were involved in discussions about their health and were able to make informed choices about their assessment.

The provider had quality assurance processes in place to ensure that equipment was maintained.

There was a complaints procedure in place that was accessible to people using the service.

During our visit we managed to speak with one person who had visited the Fitness and Wellbeing Centre. They told us they were pleased with the service they had received. They said “A very efficient and professional service. The staff are very good and know their jobs.”

The provider was transparent regarding the fees people had to pay for the service. The person we spoke could not recall receiving a list of fees or terms and conditions. However they told us they spoke with the booking team and had access to a secure email system whereby they could access information about the service.

Infection prevention measures were in place and the centre was clean and hygienic. The person we spoke with said “Oh yes no worries on that front at all.”

People were cared for, or supported by, suitably qualified, skilled and experienced staff and staff had undergone the required checks prior to them starting work.

The arrangements in place for the management of records were robust and people's confidential information was kept securely.

On the day of the inspection appointments had not been made for clients due to staff training. Therefore we were unable to speak with people or observe care at the time. Following the inspection we contacted six people who had used the service in the preceding two weeks. Two people agreed to provide us with feedback. They told us they “received information about their appointments and treatments prior to their treatment", and "staff were good at discussing issues and concerns with them prior to their assessments", they told us "treatment and discussions were provided in consulting rooms" and "staff were polite and knowledgeable and professional", they told us they had been asked for their consent prior to their treatment.

We also looked at some client feedback included in the quality assurance paperwork. Positive comments included, 'The doctor contacted me to explain unexpected results', 'I was very impressed with their communications and professionalism'. Negative comments included, 'The charts in the report were not that easy to understand as there is no reference or target for comparison”, and 'Unfortunately, the lab computer system was not working and I could not discuss and lab results with the doctor, I would say that there is too much discussion on diet with the physiologist and not enough time with the doctor'.