We carried out an announced comprehensive inspection on 6 April 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 Wellbeing Centre Nottingham provides health assessments that include a range of screening processes. 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. In addition to the GP, there is a general manager, a clinic manager, four physiotherapists and two physiology staff supporting the health assessment service.

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 Nuffield Health Wellbeing 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 Nuffield Health, is registered with the Care Quality Commission to provide services at Plains Road, Mapperley Nottingham NG3 5RH. The purpose built health and fitness facility has been used to provide services to patients since 2008.

We received 12 comment cards in the lead up to the inspection, the patients responses were entirely positive about their experiences at the service. Feedback on their care and treatment described the care received as being very professional, efficient and caring, as well as praising the time spent giving explanations and how informative the staff were.

Our key findings were:

• The clinic had a policy in place with clearly defined systems and processes in place to keep patients safe and safeguarded from abuse.
• The way in which care was delivered was reviewed to ensure it was delivered according to evidence- based guidelines and staff were well supported to update their knowledge through training.
• The service worked closely with local charities to help raise funds and awareness, for example Muted (Mental Health Charity) and Women’s Aid.
• We saw patients were treated with kindness and professionalism and patient feedback supported this.
• Patient feedback for the services offered was consistently positive and scored highly against the providers’ average.
• The centre enjoyed strong links with the community, working in partnership with local schools and cooperate businesses to promote healthy lifestyles and wellbeing.
• 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 within the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

At the time of our inspection there were no treatments being undertaken and we were unable to observe care. To gain the views of people who use the service we spoke to one person via the telephone and read completed service user's questionnaires.

We saw that feedback on assessment and treatment was positive which demonstrated that people were satisfied with the standard of the treatment they received. We spoke with staff who told us they were very proud of the professional and friendly service they offered. This was further evidenced by a written comment from a person who had used the service who stated, 'Very friendly and professional.' A person who had used the service told us, "They were very personal and professional."

From the treatment records we read, we concluded that service users received appropriate information on their treatment or care, were respected and fully involved in their care.

We found the standard of medicines management to be good and saw that medicines policies were in place.

The service had a robust complaints management system and the manager was pleased the service had not received any complaints. This was evidenced by us reading the complaints log for the last two years which confirmed that no complaints had been received.

Staff were recruited via a centralised human resources function and robust procedures were in place to ensure healthcare professionals registration status was up to date.

People who used the service were given appropriate information and support regarding their care or treatment.

The building was accessible to people using wheelchairs and there was a lift which serviced all floors.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We reviewed documents and action plans that showed the service carried out regular checks to see if infection control procedures were implemented properly.

We were shown a summary of the last month's feedback from people which included comments such as, “Excellent service” and “Brilliant, very thorough.” We were told these were discussed at the clinics management meetings and were shared across the wider organisation as part of its performance monitoring system.

We carried out an announced comprehensive inspection at Nuffield Health Wellbeing Centre Nottingham 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.

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 general exemptions from regulation by CQC which relate to particular types of service and these are set out in of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Nuffield Health Wellbeing Centre Nottingham services are provided to people under arrangements made by their employer with whom the servicer 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 Wellbeing 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.

We received 15 completed comment cards at the time of the inspection. The responses were entirely positive about their experience at the service. Feedback on the care and treatment provided described the care received as being excellent and professional, staff were helpful, friendly and caring, and all information was fully explained with sufficient time for people to ask questions.

Our key findings were:

• People had access to and received detailed and clear information about health assessments to enable them to make an informed decision. People were offered appointments between 8am and 6pm at a time convenient to them.
• Staff had access to information they needed to carry out assessments in a timely and accessible way. There was evidence to support that the service operated a safe, effective and timely referral process.
• The way in which care was delivered was reviewed to ensure it was delivered according to best practice guidance and staff were well supported to update their knowledge through training.
• There were effective procedures in place for monitoring and managing risk to people and staff safety.
• The service had clearly defined processes and systems in place to keep people safe and safeguarded from abuse.
• Staff were supported with their personal development and received opportunities for supervision, training and mentoring appropriate to their work.
• The service worked closely with local charities to help raise funds and awareness, for example Women’s Aid. The service had strong links with the local community, working in partnership with the local schools and businesses to promote healthy lifestyles and wellbeing.
• There were clear responsibilities, roles and systems for accountability to support good governance and management.
• There was evidence of continuous quality improvement across various areas which were regularly reviewed through a range of audit, monitoring of key performance indictors and adherence to regulatory and best practice standards.
• There was an overarching provider vision and strategy and evidence of good local leadership within the service.

The areas where the provider should make improvements are:

• Seek advice regarding the level of risk linked to taking blood samples in rooms that are carpeted and take any appropriate action.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care