We carried out an announced comprehensive inspection on 18 September 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 St Albans Fitness and Wellbeing Centre (the location) provides a range of health assessments to patients aged over 18 years. Assessments include a range of testing and screening processes undertaken by a doctor and/or physiologist as appropriate. Following the assessment and screening process, patients undergo a consultation with a doctor to discuss the findings of the results and any recommended lifestyle changes or treatment planning. Patients can also access physiotherapy at the centre.

The location 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, at Nuffield Health St Albans Fitness and Wellbeing Centre, 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 Nuffield Health St Albans Fitness and Wellbeing Centre 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). Physiotherapy services provided at Nuffield Health St Albans Fitness and Wellbeing Centre also do not fall within the regulated activities for which the location is registered with CQC.

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.

We received fourteen completed CQC comment cards. All the completed cards indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. In addition, comment cards described the environment as pleasant, clean and tidy. We spoke with one patient during the inspection, who was positive about the care and service they received.

Our key findings were:

• The provider had clear systems to keep people safe and safeguarded from abuse. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Staff assessed patients’ needs and delivered care in line with relevant and current evidence based guidance and standards.
• Patients were treated with dignity and respect and they were involved in decisions about their care and treatment. Treatment was delivered in line with best practice guidance and appropriate medical records were maintained.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• The service worked closely with local charities to help raise funds and awareness, for example Earthworks St Albans (a horticultural charity supporting people with learning disabilities) and Hope for Homes. The centre enjoyed strong links with the community, working in partnership with local schools to support charitable causes where possible and hosting a weekly ‘Evergreens’ social gathering for older members.
• The service actively sought feedback from patients and displayed the results and actions taken in response to feedback received.
• Systems were in place to protect patients’ personal information.
• Information about services and how to complain was available and easy to understand.
• An induction programme was in place for all staff and all staff received role specific training prior to treating patients.
• There was a comprehensive training programme and staff were well-supported with training and professional development opportunities. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The provider had a clear vision to provide a safe and high-quality service and there was a clear leadership and staff structure. This vision was adopted locally within the service through an effective leadership team. Staff understood their roles and responsibilities.
• There were clinical governance systems and processes in place to ensure the quality of service provision. Staff had access to all standard operating procedures and policies which were regularly reviewed and updated.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

People told us that they were happy with the service provided and that they were asked if they wanted to partake in each of the diagnostic or screening tests. We were told that if people were not able to undertake one of the tests due to health reasons that this was explained to them. Written or verbal consent was obtained from people who used the service depending on the type of test.

We were provided with the contact details of people who had used the service. We did not manage to get a response from most of the people, however, one person we spoke to told us that they were happy with the service they had received and had not got any concerns.

We were also told that where individuals were paying for the treatment themselves, the costs were clearly explained prior to agreeing to the consultation and that they were seen very quickly.

We were told that there had been no formal complaints about the service in the past 12 months. A complaints policy was in place but required some additional information.

We found that staff were well supported through supervisions and training sessions.

Overall we found that the provider was operating an effective service which was person centred.

People told us that they were happy with the service provided and that their dignity was maintained and their privacy protected. People were encouraged to ask questions and felt staff answered most of their questions, one person told us, “It was a really good service, I had a few abnormal results and for the majority of my test results I was given a detailed explanation and was advised what I needed to do and how the results would be followed up. However, I had one abnormal result which could have been explained a little better as I’m still not sure what it means”.

We were told that staff were good at keeping people informed about the tests and that, “staff were very professional and good at communicating and very friendly” we were also told that where individuals were paying for the treatment themselves, the costs were clearly explained prior to agreeing to the consultation and that they were seen very quickly.

Overall we found that the provider was operating an effective service which was person centred.