Curo Health Limited Also known as Dewsbury Health Centre

We carried out an announced focused inspection at Curo Health Limited on 25 May 2021. Overall, the provider is rated as inadequate.

Safe - inadequate

Effective – inadequate

Caring - not inspected or rated

Responsive - not inspected or rated

Well-led - inadequate

Following our previous inspection on 14 November 2019, the provider was rated requires improvement overall and for the key questions safe, effective and well-led, and good for caring and responsive. We issued a Requirement Notice for a breach of Regulation 17 – Good governance. The full report for the previous inspection on 14 November 2019 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 inspection was carried out to follow-up on concerns and issues identified at our previous inspection on 14 November 2019. We inspected the key questions safe, effective and well-led. The ratings in relation to caring and responsive are carried forward from the inspection undertaken in 2019 and remain good.

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 evidence from the provider
• A site visit

As part of this inspection we interviewed by video conferencing the Chief Executive Officer (CEO), the Managing Director, the Finance Director, two GPs, one advanced nurse practitioner, three practice nurses, two healthcare assistants and four receptionists. On the day of the inspection we interviewed the Medical Director, the GP Clinical Lead, a GP working in the extended access service and both practitioners for the microsuction service.

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 inadequate overall and inadequate for the key questions safe, effective and well-led.

We found that:

• The provider was open and transparent about the challenges of the past year. The service had stepped-up during the pandemic to provide temporary primary care COVID-19 assessment sites to provide core GP services for COVID-19 diagnosed or suspected patients. In addition, the provider had collaborated to support Primary Care Networks (PCNs) and GP practices vaccinate registered patients and health and care staff.
• Patient feedback had been positive about the service in relation to access and care provided.
• The provider had not addressed the findings from our previous inspections, and we continue to have concerns in relation to leadership, governance, the management of risk and performance, and continuous improvement and learning to drive patient safety. In particular, there were gaps in systems and processes in relation to safeguarding, recruitment, premises and equipment oversight, incidents, patient safety alerts, staff induction, training and appraisals.
• There was limited evidence of quality improvement, including clinical audit.
• The provider had undertaken a staff survey, which showed positive feedback from all grades of staff in relation to working for the service and the support provided.
• Staff involved and treated people with compassion, kindness, dignity and respect.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Establish clear systems and processes to keep patients safe and safeguarded from abuse.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care