This service is rated as Good overall. (Previously inspection December 2017 where the practice was not rated but was found to be compliant in all areas)

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 comprehensive inspection at Nuffield Health Surbiton Fitness and Wellbeing Centre on 8 May 2019 as part of our inspection programme.

Nuffield Health Surbiton Fitness and Wellbeing Centre is part of Nuffield Health a not-for-profit healthcare provider. The centre offers a full range of fitness and wellbeing activities including physiotherapy and health assessments, personal training, fitness suite, exercise classes, swimming pool and cafe. The health assessment clinic is based within the fitness centre. Patients seen in the clinic are either private patients 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 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.

Our key findings were:

• The service had clear systems in place to manage and mitigate risks so that safety incidents were less likely to happen. The service had a clear reporting system and information was shared across all of the provider’s locations.
• All health assessment 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 blood screening equipment.
• The service completed a number of clinical and non-clinical audits to assess performance and ensure care provided was safe. These audits were reviewed and actions taken where necessary.
• Patient feedback obtained by the service through feedback forms was consistently positive about the experiences received.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• Members of staff we spoke with were wholly positive about working at the service and the support provided to them from leaders.
• The provider had clear systems and processes in place to ensure care was delivered safely and good governance and management was supported.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

​Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 13 December 2017 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.

Surbiton Fitness and Wellbeing Centre is part of Nuffield Health a not-for-profit healthcare provider. They provide health assessments that include a range of screening processes. Following an 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. The health assessment clinic is based within the fitness centre. Patients seen in the clinic are either private patients 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 and lifestyle coaching do not fall within the regulated activities for which the location is registered with CQC.

We obtained one completed Care Quality Commission comment card. Feedback was that the client was happy with the service provided.

Our key findings were:

• There was a transparent approach to safety with demonstrably effective systems in place for reporting and recording incidents
• The service was offered on a private, fee paying basis to adults only.
• Information about services and how to complain was available and easy to understand.
• All health assessment 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 blood screening equipment.
• Clinicians regularly assessed patients according to appropriate guidance and standards such as those issued by the National Institute for Health and Care Excellence.
• 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.
• Systems were in place to deal with medical emergencies and staff were trained in basic life support.
• Staff were kind, caring, competent and put patients at their ease.
• Patients were provided with information about their health and with advice and guidance to support them to live healthier lives.
• The provider was aware of, and complied with, the requirements of the Duty of Candour.

Professor Steve Field

CBE FRCP FFPH FRCGPChief Inspector of General Practice

We were unable to speak to any people during our inspection as there were no health assessments scheduled on the day of our visit. However, we asked the provider for any feedback that they had received from people. Some of the comments were "the experience was positive for me", "really impressed" and "professionally conducted".

There was a defibrillator and portable oxygen available in case of an emergency; Staff training records confirmed that first aid and CPR training had been delivered to staff in the past year.

The consulting rooms were large, modern and had good lighting. There were hand washing sinks and privacy curtains in each room. Medical equipment was checked regularly; and was all in working order.

Mandatory training was provided by the organisation and included Health & safety, Safeguarding children, manual handling, and medicines management.

Records were kept securely and could be located promptly when needed. All patient records were kept on an electronic system which only relevant staff had access to.

On the day of inspection we spoke to one person who had used the service. We also looked at the surveys that were completed every month to seek people’s view on the standard of service they had received.

The person that we spoke with told us that their visit to the service had been very efficient. They had been consulted throughout and felt fully informed about the procedures. We were told that “the doctor was excellent, probably the best that they’d had.”

Information is available for people who attend the centre. We found a variety of leaflets in the waiting room and treatment rooms. These informed people about the various tests that were available. We also saw lifestyle leaflets regarding alcohol, smoking and diet.

People have to complete a health assessment questionnaire prior to their appointment. People are required to fill out a variety of information relating to thier health. For example past medical history and any current medical problems.

Staff had knowledge of safeguarding procedures and we saw a flowchart which was available to instruct staff as to what to do in the event of a safeguarding issue.

We looked at the training available for staff. Staff told us that Nuffield supported them to achieve a variety of training topics.

We saw that the service took quality monitoring seriously and asked for feedback from the people who used the service every month. Quality audits were completed which included infection control.