We carried out an announced comprehensive inspection on 5 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 West Byfleet Fitness & 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. In addition to the GP, there is a general manager, a clinic manager (who is also a physiologist), two physiotherapists and two physiology staff supporting the health assessment service. 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 only and are not commissioned by the NHS.

The general manager is also 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.

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 eight completed Care Quality Commission comment cards. Feedback was very positive about the service provided and the professionalism and friendliness of the staff.

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.
• 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.

This was a follow up visit to check that the provider had achieved compliance with records following our previous inspection in July 2013. During this inspection we looked at this one non-compliant outcome. We spoke with staff but did not have an opportunity to speak with people who used the service on the day.

We found the arrangements in place for keeping people’s confidential records was more robust and people’s records were kept securely.

During our visit we did not speak with any of the people visiting the Fitness and Wellbeing Centre. However following our inspection we contacted four people who had used the service on the day of our visit. People told us they had been given enough information about their treatments.

People told us staff were good at discussing issues and concerns with them during their assessments. They told us treatment and discussions were provided in private in consulting rooms.

There were arrangements in place to ensure people were safeguarded from the risk of abuse. Infection prevention measures were in place and the clinic was clean and hygienic. One person said "it's spotless".

People were cared for, or supported by, suitably qualified, skilled and experienced staff. People were made aware of the complaints procedures.

People’s confidential information was not kept securely.