Nuffield Health St Albans Fitness and Wellbeing Centre

Updated 2 November 2018

The Nuffield Health St Albans Fitness and Wellbeing Centre (the location) is operated by Nuffield Health (the provider) at Highfield Park Drive, St Albans, AL4 0AH. The provider is registered with the Care Quality Commission to carry out various regulated activities at numerous locations

across the country. The regulated activities relating to this location are Diagnostic and screening procedures and Treatment of disease, disorder and injury.

St Albans Health and Wellbeing Centre provides health and wellbeing, screening and physiotherapy services to people aged 18 years and over from a purpose-built facility which includes a full fitness suite, swimming pools and other sports facilities. At the time of our inspection, the Centre had a total adult membership of 4,650 and was open from 6am to10.30pm from Monday to Friday, from 7.30am to 9pm on Saturdays and from 8am to 9pm on Sundays. Health assessments were available from within the dedicated clinic from 8am to 4.30pm Monday to Friday.

The health assessments include 360 Health Assessments (comprehensive health reviews) and

Lifestyle Health Assessments. The purpose of the health assessments is to provide patients with a comprehensive review of their health. They cover key health concerns such as weight, diabetes, heart health, cancer risk and emotional wellbeing, and may involve a number of screening and testing procedures. There is a small laboratory onsite to process some blood tests. Following the assessment and screening process, patients have a consultation with a doctor to discuss the findings and to consider and plan for any required treatment. Patients receive a comprehensive report detailing the findings of the assessment. The report includes advice and guidance on

how the patient can improve their health together with information to support healthier lifestyles. Any patients requiring further investigations or any additional support are referred to other services.

At the time of our inspection the clinical team consisted of three female health assessment doctors

working at the location on a part-time basis and two physiologists. If patients prefer their health assessment to be undertaken by a male doctor, a male doctor can be allocated from the provider’s other locations or through use of a locum. Physiologists are full professional members of the Royal Society for Public Health (RSPH) and are trained to carry out health assessments, give advice and motivate patients to make lifestyle changes affecting areas such as exercise, nutrition, sleep and stress management. The location has a general manager, a clinic manager and a small team of administrators. Further corporate managerial and administrative support is operated from the provider’s other offices. We were advised by the management team that the service was actively recruiting to expand their clinical team within the location.

We inspected Nuffield Health St Albans Fitness and Wellbeing Centre on 18 September 2018. The inspection team included a Lead inspector and GP Specialist Advisor. Before inspecting, we reviewed a range of information we hold about the service, any notifications received, and the information given by the provider at our request prior to the inspection.

During our visit we:

• Spoke with a range of staff including the regional clinical lead doctor, a health assessment doctor, the general manager and clinic manager.
• Looked at the systems in place for the running of the service.
• Explored how clinical decisions were made.
• Looked at rooms and equipment used in the delivery of the service and made observations of the environment and infection control measures.
• Viewed a sample of key policies and procedures.
• Looked at a random selection of anonymised patient reports.
• Reviewed CQC comment cards which included feedback from patients about their experiences of the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 2 November 2018

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