Nuffield Health West Byfleet Fitness and Wellbeing Centre

Updated 15 June 2022

Nuffield Health West Byfleet Fitness & Wellbeing Centre is part of Nuffield Health, a not-for-profit healthcare provider. The service provides a variety of health assessments for both corporate and private clients. Services are provided to adults only. The service aims to provide a comprehensive picture of an individual’s health, covering key health concerns such as diabetes, heart health, cancer risk and emotional wellbeing. Following the assessment and screening process, patients undergo a consultation with a doctor to discuss the findings of the results and discuss any required treatment planning. Patients are provided with a comprehensive report detailing the findings of the assessment. The reports include advice and guidance on how the patient can improve their health and information to support patients to live healthier lifestyles. Health assessment clients are also provided with a free 30-day pass for the fitness centre. The service can also refer to on-site nutritionist and physiotherapist.

The Registered Provider is Nuffield Health.

Nuffield Health West Byfleet Fitness & Wellbeing Centre is located at Pyford Road, West Byfleet, Guildford, GU22 8UQ.

The core opening hours for health assessments at the service are Monday to Friday 7.30am-4.30pm.

The staff team consists of a clinic manager who is also a physiologist, two health assessment doctors and two physiologists. A physiologist is a graduate in exercise, nutrition and health sciences, and is a member of the Royal Society for Public Health (RSPH). They are trained to carry out health assessments, give advice and motivate lifestyle changes affecting areas such as exercise, nutrition, sleep and stress management.

The service is run from a suite of ground floor consulting rooms within a shared building, which is leased by the provider. There is a shared entrance and reception area to the premises. The service has its own reception and waiting area, separate to the main reception, and a laboratory for the processing of pathology samples. Patients are able to access toilet and shower facilities on the ground floor. Access to the premises is at street level for patients with limited mobility.

How we inspected this 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 15 June 2022

This service is rated as Good overall.

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 a comprehensive inspection of Nuffield Health West Byfleet Fitness and Wellbeing Centre on 22 April 2022 under Section 60 of the Health and Social Care Act 2008. 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. This was the first rated inspection of the service. The service was previously inspected in September 2018, when it was not rated but was found to be meeting all regulations.

Throughout the COVID-19 pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Speaking with staff in person and using video conferencing.
• Requesting documentary evidence from the provider.
• A site visit.

We carried out an announced site visit to the service on 22 April 2022. Prior to our visit we requested documentary evidence electronically from the provider. We spoke to staff using video conferencing prior to our site visit.

Nuffield Health West Byfleet Fitness & Wellbeing Centre is part of Nuffield Health, a not-for-profit healthcare provider. The service provides health assessments which include a range of screening processes. The health assessment service is based within the fitness centre. Patients are able to choose from a range of health assessments according to their need. Assessment and screening services are led by either a physiologist or a doctor. Following assessment and screening, patients undergo a consultation to discuss the findings and any recommended lifestyle changes or treatment planning. The service employs two doctors, a general manager, a clinic manager (who is also a physiologist), a physiotherapist and two physiology staff. Patients seen within the service are either private patients or employees of organisations who are provided with health and wellbeing services as part of their employee benefit package. Services are provided to adults only.

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.

Nuffield Health West Byfleet Fitness & Wellbeing Centre is registered with the Care Quality Commission to provide the following regulated activities: Treatment of disease, disorder or injury and Diagnostic and screening procedures.

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.

Our key findings were:

• Staff underwent comprehensive induction processes and had received training in key areas.
• Staff employed by the service had undergone appraisal, peer review and regular 1 to 1 review.
• There were records to demonstrate that recruitment checks had been carried out in accordance with regulations. However, document storage arrangements were not well managed and local managers did not always have oversight of those assurance checks.
• There were effective systems and processes to assess monitor and control the spread of infection.
• There were safeguarding systems and processes to keep people safe. Staff had received training in the safeguarding of adults and children.
• Arrangements for chaperoning were effectively managed.
• There were appropriate arrangements to manage medical emergencies and suitable emergency medicines and equipment in place.
• There were fire safety processes and health and safety risk assessments in place.
• Clinical record keeping was clear, comprehensive and complete.
• There was monitoring of patient related outcomes and auditing of clinical record keeping processes.
• Governance and monitoring processes provided assurance to leaders that systems were operating as intended. Risks were promptly identified and responded to.
• Best practice guidance was followed in providing treatment to patients. For example, urgent referrals were made in response to a suspected cancer diagnosis.
• Referral and signposting pathways were clearly documented, and referral processes were rigorously monitored. Signposting criteria relating to some patient test results were under review.
• There was open communication amongst the staff team which was well documented and monitored to ensure agreed actions were completed.
• Policies and procedures were monitored, reviewed and kept up to date with relevant and sufficient information, to provide effective guidance to staff.
• There was a range of local and national initiatives to support the well-being of staff.
• Service users were routinely asked to provide feedback on the service they had received. Complaints were managed appropriately.

The areas where the provider should make improvements are:

• Review arrangements for the storage of staff recruitment and personnel records, to promote ease of access and monitoring of compliance with organisational and regulatory requirements by local managers.
• Continue to review signposting criteria relating to the screening for diabetes and heart health.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care