This service is rated as Good overall. (Previous inspection 27 March 2018).

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 Warwick Fitness and Wellbeing Centre on 16 May 2019 as part of our inspection programme.

Nuffield Health Warwick Fitness and Wellbeing Centre is a purpose-built facility offering a full range of fitness and wellbeing activities including physiotherapy, health assessments emotional wellbeing services, nutritional therapy, personal training, fitness suite, exercise classes, swimming pool, creche and café.

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 14 completed CQC comment cards. Completed cards indicated that patients were treated with kindness, dignity and respect. Patients were consistently positive about the service and experience received. Staff were described as professional, knowledgeable, friendly and respectful. In addition, comment cards described the environment as relaxing, clean and tidy.

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 clearly defined processes and well embedded systems in place to keep patients safe and safeguarded them against abuse.
• There was evidence to support that staff assessed patients’ needs and delivered care in line with relevant and current evidence-based guidelines and standards.
• The information needed to plan and deliver care and treatment was available to staff in a timely way. There was evidence to demonstrate that the service operated a safe, effective and timely referral process.
• The continuing development of staff skills, competence and knowledge was recognised as being integral to ensuring that high quality care was delivered by the service.
• There was evidence of continuous quality improvement in line with key performance indicators. The service completed a number of clinical and non-clinical audits to assess performance and to ensure safe care was provided.
• Patients were treated with dignity and respect and were involved in decisions about their care and treatment.
• The service worked with local charities to support people with disabilities. The centre had established links with local schools to deliver health lessons.
• Members of staff we spoke with were positive about working at the service and the support from leaders. An induction programme was in place for staff specific to their role. There was a comprehensive training programme 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.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

We carried out an announced comprehensive inspection on 27 March 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.

Summary of Findings

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 Warwick Fitness and Wellbeing Centre provide health assessments to adults that include a range of testing and screening processes carried out by a physiologist and a doctor. 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 clinic.

Our key findings were:

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.

Health assessments and physiotherapy are delivered in a purpose built clinic located in the health and wellbeing centre. There are two doctors, two physiology staff and three physiotherapists who work at the centre. Patients can choose to see a female or male staff member when booking in for health assessments and physiotherapy. In addition, patients can choose to be seen at one of the

other nearby or wider health and wellbeing centres in the UK.

Health assessments are categorised and promoted as:

• A lifestyle health assessment, for patients wanting to reduce health risks.
• A female assessment, for all aspects of female health.
• A 360 health assessment which includes a review of diabetes and heart health risks.
• A 360+ health assessment which focussed on cardiovascular health.
• Bespoke health assessments were also available for areas such as cancer and weight management.

We received 13 completed CQC comment cards. Completed cards indicated that patients were treated with kindness and respect. Staff were described as friendly, caring and professional. Some patients commented how the service and staff were excellent and how they had helped them with their individual care needs. In addition, comment cards described the environment as welcoming, clean and tidy.

Our key findings were:

• The service had clearly defined processes and well embedded systems in place to keep patients safe and safeguarded them from abuse.
• There was evidence in place to support that the service carried out assessments and treatment in line with relevant and current evidence based guidance and standards.
• The information needed to plan and deliver care and treatment was available to staff in a timely and accessible way. There was evidence to demonstrate that the service operated a safe, effective and timely referral process.
• The provider operated safe and effective recruitment procedures to ensure staff were suitable for their role.
• Arrangements were in place for planning and monitoring the number of staff and mix of staff needed to meet patients’ needs.
• The continuing development of staff skills, competence and knowledge was recognised as being integral to ensuring that high quality care was delivered by the service.
• There were consistently high levels of constructive staff engagement and there were high levels of staff satisfaction rates. During our inspection staff expressed pride in working for the organisation.
• There was evidence of continuous quality improvement across various areas such as key performance indictor KPI monitoring, adherence to regulatory and best practice standards and quality audits.
• The process for seeking consent was monitored through patient records audits. Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
• Completed CQC comment cards were very positive and indicated that patients were treated with kindness and respect. In addition, results of the services 2017 customer satisfaction survey highlighted positive satisfaction rates with regards to the service provided.

During the visit to this provider we reviewed five outcomes which we have found to be compliant. We found that people's needs had been assessed and care and treatment planned and delivered in line with their needs. We found this was reflected in the healthcare records we reviewed during the visit. We saw systems in place to protect people from abuse and discussions with staff confirmed they were aware of who to approach and what to do should they have any concerns in this area.

Although we found this provider to be compliant against the outcomes we have inspected we have asked them to take note of some findings which relate to the availability of specific policies and guidance at the clinic.

There were people using the service on the day of the inspection. We made ourselves available to speak with these people but people chose not to speak with us. As we have not been able to speak with people using the service we gathered evidence of people's experiences by reviewing satisfaction surveys completed by people who had used the physiotherapy and health assessment services at the clinic.