Curo Health Limited Also known as Dewsbury Health Centre

Updated 12 April 2022

Curo Health Limited, established in January 2014, is a GP Federation serving the needs of the population of North Kirklees. The Federation is made up of all 27 general practices spanning four primary care networks (PCNs) in the Kirklees Clinical Commissioning Group.

Curo Health Limited is responsible for delivering extended access services to patients from all participating GP practices; approximately 195,000 patients.

The focus of this inspection was the extended access service, which has been operational since August 2018.

Curo Health Limited’s administrative centre operates from Woodkirk House, Dewsbury and District Hospital, Halifax Road, Dewsbury WF13 4HS. The service is led by a Medical Director and a Managing Director (Co-Chair), a Finance Director and six board members of whom four represent the PCNs.

Patient care for the extended hours service is delivered at three locations in the district, which we visited during our inspection:

• Dewsbury Health Centre, Wellington Road, Dewsbury WF13 1HN
• Liversedge Health Centre, Valley Road, Liversedge WF15 6DF
• Broughton House Surgery, 20 New Way, Batley WF17 5QT

The extended access service is open between 6.30pm and 9.30pm Monday to Friday, between 9am and 4pm on Saturdays, between 9am and 1pm on Sundays and 10am to 2pm on Bank Holidays.

At the time of our inspection, the extended access service at the three locations is provided by 13 GPs, 10 advanced nurse practitioners/advanced clinical practitioners, two practice nurses, three healthcare assistants, five reception supervisors and 17 receptionists. Some staff work at multiple sites and some at one site. We saw that two receptionists were located at each of the three patient facing sites during operational hours.

At our previous inspection, the provider also delivered an ear care (microsuction) service. Microsuction is a wax-removal technique which uses a binocular operating microscope to look straight into the ear canal, wax is then removed from the ear canal using a suction device at low pressure. The service has currently been paused and did not form part of our inspection.

Curo Health Limited is registered with the Care Quality Commission to deliver the regulated activities diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 12 April 2022

We previously carried out an announced comprehensive inspection of Curo Health Limited on 14 November 2019 when the provider was rated requires improvement overall and for the key questions safe, effective and well-led, and good for caring and responsive.

We then carried out an announced focused inspection on 25 May 2021 to follow-up on the inspection undertaken in November 2019. At that inspection the provider was rated as inadequate overall and for the key questions safe, effective and well-led. We did not inspect, or rate, the caring and responsive domains. A Warning Notice was served on the provider for the breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Regulation 17 - Good governance.

A further announced focused inspection was carried out on 14 September 2021 to check that the provider had responded to the Warning Notice dated 7 June 2021 and had met the legal requirements in relation to the breach of Regulation 17 – Good governance. We did not review the ratings awarded to the provider at this inspection. At the inspection we found the provider had reviewed their systems and processes and had made improvements in the areas of concern identified at our inspection on 25 May 2021.

The full report for the previous inspections in November 2019, May 2021 and September 2021 can be found by selecting the ‘all reports’ link for Curo Health Limited on our website at www.cqc.org.uk.

Why we carried out this inspection

This focused, rated, inspection was carried out to follow-up on concerns and issues identified at our previous inspection on 25 May 2021. We inspected and rated the safe, effective and well-led domains. We did not inspect, or rate, the caring and responsive domains.

How we carried out the inspection

Throughout the 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:

• Conducting staff interviews using video conferencing
• Requesting feedback from staff through a questionnaire
• Requesting evidence from the provider
• A site visit

As part of this inspection we interviewed by video conferencing the Managing Director, the Finance Director, four GPs, an advanced nurse practitioner, an advanced clinical practitioner, a healthcare assistant, three reception supervisors and two receptionists.

On the day of the inspection we visited three operational sites and interviewed the Medical Director, the GP Clinical Lead, the Lead Nurse, the Federation/Operations Support Manager and the Rota Coordinator. In addition, we sent out feedback questionnaires to all staff who were not interviewed using video conferencing. We received 12 completed questionnaires.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this provider as good overall and good for the key questions safe, effective and well-led.

We found that:

• The provider had been responsive to the findings of our previous inspection and we found continued improvement in systems and processes seen at our follow-up inspection in September 2021 to demonstrate safe, effective and well-led care.
• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• There was an open and transparent approach to safety and systems were in place for recording, reporting and sharing learning from significant events.
• The service reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence-based guidelines.
• There was a programme of quality improvement, including clinical audit.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Leaders demonstrated they had the capacity and skills to deliver a high-quality service.
• Improvements had been made to the systems and processes to communicate with staff and keep them informed of safety and quality outcomes.
• The provider engaged with patients and staff to improve the service. Patient feedback had been positive about the service in relation to access and care provided.
• The provider continued to contribute to the local health agenda and work in partnership with stakeholders to deliver patient care during the challenges of the COVID-19 pandemic.

Whilst we found no breaches of regulations, the provider should:

• Continue to review and update any gaps in training records for all current staff.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care