26 May 2021
During a routine inspection
This service is rated as Inadequate overall.
Key questions are rated as:
Are services safe? – Inadequate
Are services effective? – Requires improvement
Are services caring? – Good
Are services responsive? – Good
Are services well-led? – Inadequate
We carried out an announced comprehensive inspection at Well-One Clinic on the 26 May 2021, as part of our inspection programme. We visited their site at Jacob’s Well Yard, Swinemoor Lane, Beverley, HU17 0JX.
The previous inspection and follow-up inspection in March and December 2018 were unrated. At the previous inspection in March 2018 we identified breaches of the regulations in respect of:
Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
Regulation 17 HSCA (RA) Regulations 2014 Good governance
At the follow up inspection in December 2018 we identified the breaches of the above Regulations had largely been addressed.
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.
Well-One Clinic is an Independent Health clinic. The clinic provides general practice, consultation and treatment without accommodation. The provider offers services across a range of areas but largely relating to Lyme disease treatment. Lyme disease, also known as Lyme borreliosis, is an infectious disease caused by the Borrelia bacterium which is spread by ticks. Well-One Clinic advertise on their website that they also provide a range of other services such as private GP services, private medical examinations and psychological therapies. We were told that the additional services currently being offered related to private medical examinations.
This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. This service is registered in respect of the following regulated activities; Transport services, triage and medical advice provided remotely, treatment of disease, disorder or injury, Diagnostic and Screening, Family Planning, Maternity and Midwifery Services, Services in slimming clinics and surgical procedures by, or under the supervision of, a medical practitioner. There are some exemptions from regulation by CQC which relate to types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At Well-One Clinic a service is provided called RIFE treatment. The machine delivers low electromagnetic waves, like radio waves. At Well-One Clinic the RIFE treatment that is provided is exempt by law from CQC regulation. Therefore, we were not able to inspect the RIFE treatment element of the service. It should be noted that RIFE forms part of the patient’s combined treatment package.
The GP at Well-One Clinic 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.
Five people provided feedback about the service. All the feedback was positive in respect of the impact attendance at the clinic had had on their lives in terms of their health and well-being. Patients were known to travel from all parts of the UK to attend the clinic.
Our key findings were:
- Systems and processes did not always ensure that care was provided in a safe way and that risks to patients were mitigated.
- There was insufficient assurance in place to demonstrate that people received effective care in line with current guidance.
- The provider was not actively involved in quality improvement activity.
- Staff did not always have the skills, knowledge and experience to carry out their roles.
- Patients told us and we saw evidence that patients were treated in a caring way.
- There was evidence the provider endeavoured and was passionate about providing a responsive service to meet people’s needs and preferences.
- Processes were not established to identify and monitor risks.
We found the service to be in breach of Regulation 12 Safe care and treatment, Regulation 17 Good governance and Regulation 18 Staffing of the Health and Social Care Act 2008
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure that care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
- 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.
I am placing this service in special measures. We are taking action in line with our enforcement procedures. The provider has 28 days to appeal the enforcement decision. At the end of that time we will publish a supplementary report detailing the action we have taken.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care