Long waiting times, inadequate staffing levels, an ineffective triage system and worries over the care of children.
Their report, which has now been made public, found that during the inspection in October, the facility in Cottingham Road was inadequate in three out of five areas inspected. It required improvement in the other two.
Overall, the UCC was rated as inadequate. It's the first time the centre, known locally as the 8-8, has been inspected under the stewardship of Yorkshire-based One Medicare Limited who took over the running from Lakeside Healthcare in February 2019.
The site is much-valued by the people of Corby who took a hard-won campaign all the way to a judicial review in 2018 to ensure the centre did not move to an appointment-only system.
Funded as a key part of the county's primary care offer by NHS Northamptonshire Clinical Commissioning Group, it provides minor injuries care on a walk-in basis, 365 days a year from 8am until 8pm and takes the strain from busy A&E departments. It also has an x-ray machine, an observation bay and offers maternity and minor surgery functions.
But Care Quality Commission inspectors were called in to do an unannounced visit following concerns over safety and leadership.
Lead inspector Dr Rosie Benneyworth found that safeguarding processes needed strengthening; that infection control processes were not being consistently followed and that medicines were not being safely managed, posing a risk to patient safety.
She also revealed that staff were not being adequately supported; that there was no effective triage system in place and that privacy was not being respected.
Her report also states that despite the service reporting that 35-minute waiting times being met in October, this was not the case during her visit when patients said they had been waiting more than an hour.
She has now ordered the service to ensure that care and treatment is provided in a safe way and to establish effective systems to ensure governance is improved.
Her report states: "We found clinical records which indicated that safeguarding concerns which should have been acknowledged and explored by the clinician concerned had not been explored.
"Staff had not always taken steps to protect patients from abuse, neglect, harassment, discrimination and breaches of their dignity and respect. During our inspection, staff in senior roles explained safeguarding systems were being implemented; however, at the time of our inspection these were not embedded."
The report also raises issues over staffing levels. It states: "There were no clear accountability at a local level for planning and monitoring the number and mix of staff needed to safely run the service.
"Staff in managerial roles were not clear on how staff numbers and skill mix was determined, and we saw evidence of the impact of this, such as recorded significant events relating to when the service had been left short of staff.
"Staff we spoke with explained that there were times when the service had been left short staffed, and rotas we looked at confirmed this. There was no effective system in place or evidence of contingency plans for dealing with surges in demand. This exposed patients to potential risk and the provider did not demonstrate a process for managing this risk."
Inspectors also noted that the UCC 'did not have a good safety record,' and found opened medicines with no record of their expiry date.
And they also ordered the site to immediately implement a triage system because of a risk to patient safety.
The report continued: "Following our inspection, the provider submitted evidence demonstrating that a patient triage has been implemented.
"(But) we received further information from people who used the service sharing less positive views about the experience of care their children received.
"We found there was no children’s lead at the service and nursing staff we spoke with told us that they did not feel confident in seeing children as they had not had any training in the care of children. There was no designated area within the service for children and we had concerns about children who waited long period of time to be seen by a clinician.
"We also found that observations had not been performed on children we saw in the waiting room while they waited to be seen. We were unable to locate any guidelines for staff on treating children. We raised this with the provider who told us they would take immediate action to address this.
"Members of the nursing team we spoke with explained in the absence of a paediatric lead children were placed on a list to be seen by GPs."
Staff also told inspectors that staff meetings were not taking place, that they felt unsupported and under a great deal of pressure. The inspectors saw examples of 'very unwell' patients waiting for up to two hours due to the lack of triage and co-ordination.
Inspectors also discovered that 15 per cent of ambulances that attended the 8-8 were being turned away, against a target of five per cent, despite the hub's purpose being to take the pressure off A&E.
The UCC was judged to be inadequate in the areas of safety, effectiveness and leadership and to require improvement in the areas of being caring and responsive to patients' needs.
Two notices were sent which order One Medicare Limited to show the CQC how they are going to meet unmet legal requirements.
A spokesperson for NHS Northamptonshire CCG said: “We accept the Care Quality Commission report and its findings, which highlighted a number of areas requiring improvement with Corby Urgent Care Centre.
We understand patients using Corby Urgent Care Centre may be concerned by the report findings and would like to reassure them that their service is safe and continues to operate. Since the inspection in October the CCG has been working with the provider to make the required improvements as quickly as possible.”
William Dawson, CEO, of OneMedical Group - which is part of One Medicare Ltd - said: “OneMedical Group accept the findings of the CQC inspection of Corby Urgent Care Centre (CUCC) that took place in October 2021.
"This period was an extremely challenging time for the Centre as it delivered essential services during the pandemic and coped with the connected fluctuation of patient demand and staff absence. However, we acknowledge that some aspects of the service on the day did not meet the high standards expected.
"Immediately after the CQC inspection, OneMedical Group’s senior leadership team and the CUCC leadership team worked with the local Clinical Commissioning Group (CCG) quality team to initiate an Action Plan.
"This plan has been in place for over five months, and we can show demonstrable resolution and progress against the issues identified by the inspection.
"Our ongoing work has included a focus on governance structures, staff wellbeing and training, safeguarding policy and procedures, patient and medicine records, and triaging systems and training. We continue to be committed to embedding learnings and improvements in a sustainable way moving forward. A new Action Plan will be shared with the CQC in the coming days and we will continue to work closely with the local CCG on the ongoing delivery of this.
"As a group we are committed to delivering the very best care at our services. Whilst there have been significant challenges throughout the pandemic, we have taken every proactive step to learn from this report. Corby Urgent Care Centre remains a crucial and valued service to the residents of Corby and all services are continuing as normal."