The Care Quality Commission (CQC)

As a dental practice you must be registered with the CQC, believe it or not there are still practices that aren’t. They are becoming less, thankfully.

Despite the requirement for CQC registration since 2012, not all practices have been inspected; but almost 70% have. Inspections rates have been boosted through the transfer of ownership of practices, which generates a reason to visit a practice.Originally, CQC inspections were not as thorough as they are now. These days, you can expect a team of individuals to attend an inspection, one of which will be a dentist.

The CQC aim to inspect 10% of practices per annum. With 10,000 practices across UK that give a target of 1,000 per year less the 300 that may be new providers. So, 700 existing practices are likely to be inspected.

How do they choose who they are going to inspect?

Ideally, the CQC will want to inspect all practices on their patch but will prioritise:

  • Those that have had issues reported either to themselves, GDC or NHSE
  • Practices who haven’t been inspected for 4 years +.

In the age of whistleblowing, these tip offs can come from disgruntled staff or patients.

Conduct of Inspections

Inspections are usually announced, with at least 2 weeks’ notice, initially by telephone then followed up in writing.

The lead inspector usually helps to prepare you for the day by asking you for certain evidence and what to expect. Some inspectors like to address questions to staff members so it’s important to share and prepare the whole team for an impending inspection. Their comments and contributions will be incorporated into their findings and it is important that they are aware of this and prepared accordingly.

Unannounced inspections usually occur when there have been concerns about the practice. On arrival the inspector will ask to meet with the practice owner or whoever is the most senior person on duty at the time.

Key Lines of Enquiry (KLOE)

The inspection will look for evidencing that your practice follows the KLOE:

  1. Caring
  2. Safe
  3. Effective
  4. Responsive
  5. Well Led

Most dental practices receive a good rating overall especially for Caring, Safe and Effective.
The areas that most practices get ‘Needs Improvement’ are for being Responsive and Well Led.

What are CQC looking for?

EVIDENCE, EVIDENCE, EVIDENCE!

  1. Caring
  • Demonstrate your practice treats all patients as individuals, with dignity and respect, privacy and confidentially.
  1. Safe
  • Evidence that staff are qualified and trained appropriately and sufficient in numbers.
  • Well maintained premises and equipment, complete records, medicines and prescription pads managed.
  • Radiation protection.
  1. Effective
  • Appropriate treatment planning, audits of clinical records, peer reviews.
  1. Responsive
  • Complaint handling, duty of candour, policies for welcoming vulnerable people (staff understanding of safeguarding and signs and symptoms to look out for).
  • Translation services? Hearing loop?
  • Patient feedback and surveys and then acting upon suggestions (evidence).
  1. Well- Led
  • Good practice owners appoint leads to assist/ensure a safe and effective service. Effective staff recruitment and retention policies.
  • Encourage team members to step up and attend courses and bringing back ideas/taking them on board to continuously improve the service.
  • Staff meetings led by different team members.
  • Good systems to ensure staff training is completed timely/monitored.
  • Scenario role plays of emergencies.
  • Governance meetings.

CQC will check with your team, the patients and other outside bodies who interact with your services to collate the evidence, so keeping on top of NHS choices, Google Reviews and other social media and your website is imperative as this is the very public window into your practice.

Any improvements or changes that you implement following an incident or suggestion/feedback should be recorded, annotated and used as evidence to CQC. They love this and it demonstrates you and your team care.

Keeping on top of all the new legislation, regulation and guidance is sometimes difficult so having an online compliance system is a great way of being able to see that everyone is doing what they should be doing and evidencing the same to CQC. It is more cost effective than having a team member reviewing and rewriting policies and is visible and easy to monitor and manage. CQC also are very happy as this makes their jobs a lot easier.

Guest Author – Laura Graham, Managing Director of Business Help for Healthcare. 
Laura is founder of Business Help for Healthcare, a business that supports busy dental clinicians. Laura works with dentists particularly with CQC, from registration support to ongoing compliance. Laura offers bespoke solutions to meet practice owners and practice’s individual needs.  CQC can sometimes seem like a minefield but Laura’s understanding of the requirements can reassure practitioners. Her background of working with dentists for over 20 years has given her insight and breadth of knowledge of the dental sector, how it operates, and the professionals who support dentists. laura@businesshelpforhealthcare.co.uk

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