Transcript CQC - Warwickshire LDC

Regulating the dental
sector
Tracy Norton
Compliance Manager (Central
Region)
4 October 2012
Role of a regulator
People can expect services to meet
essential standards of quality,
protect their safety and respect
their dignity and rights, wherever
care is provided and wherever
they live, despite changes in the
system
CQC – what CQC does and does not do
CQC’s role
Register – inspect – enforce –
publish
CQC registers care providers
then checks whether they are
meeting essential standards
What CQC does not do
We do not make assessments
of commissioning – although
we can comment on
shortcomings via themed
reviews and investigations
If not, we take action – they
must put problems right or face
enforcement action
We do not assess quality above
essential standards
We publish what we find as
quickly as possible
We only promote improvement
by focusing on noncompliance
We share what we know with our
partners
We put a premium on users/
whistleblowers
We monitor the care of those
detained under the MHA
Inspectors are encouraged to
describe what they see,
comment on good practice and
reference it
Scale of CQC regulated care
Primary medical
services
Independent
healthcare
Independent
ambulances
9,000 locations
2,500 locations
300 locations
NHS Trusts
Adult social
care
Primary dental
care
2,500 locations
24,500 locations
10,000 locations
Combined outpatients
and inpatients
People using adult
social care services
Dental appointments
77.4 million
1.75 million
36.4 million
Our approach to inspections
Unannounced
We do not notify providers before
we carry out inspections
Flexible
We can use different
types of inspection to
respond to concerns
Principles of
inspection
Focused
Inspections will focus on
outcomes that are important
to people using services
Timely
At least once a year or
once every two years
depending on the
provider
What can you expect at a dental
inspection?
• A scheduled inspection will check compliance against five regulations
(from across the five domains).
• Inspectors will use information we already hold to plan which
regulations will be inspected – and also extend the range of inspection
on the day if it becomes apparent there may be non-compliance in
other regulations.
• We have to inspect the 16 essential standards across a period of five
years.
• We will always inspect Regulation 9 (Outcome 4 – Care and welfare of
people who use services) at every inspection.
• At first inspections we will usually inspect regulation 12 (Outcome 8 –
cleanliness and infection control) using the HTM01-05 Essential
Quality Requirements to look for expected practices.
What can you expect at a dental
inspection?
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•
We will want to speak with patients using the service where possible
We will want to speak with the registered manager
We will look at a surgery
We are unlikely to observe treatment but may wish to observe the
initial dialogue (relating to medical history etc)
• When inspecting Regulation 12 we will want to speak with the dental
nurses and ask them to show us the procedures for cleaning and
decontamination
• We will ask for documentary evidence where necessary ( if records
are computerised we will look at those)
• We will not be giving you advice about how to comply – we are an
arms length regulator and therefore that is not our role
Compliant or non-compliant?
•
If we find that you are compliant with each of the regulations we inspect
against then you will usually not receive an inspection for two years (unless
we receive information which requires us to bring forward our next scheduled
inspection or carry out a responsive inspection).
•
If we find you are non-compliant we will use our judgement framework
(published) to judge the impact on people using the service (minor, moderate
or major).
•
We will take compliance or enforcement action according to the criteria within
the judgement framework (minor impact = compliance action; moderate =
compliance action or warning notices; major = warning notices).
•
If we find non-compliance across a number of regulations we will use our
regulatory escalator model to help determine our regulatory response.
Following up non-compliance
• If we have set compliance actions we will ask you to submit a report
describing how and when you will return to compliance.
• We will re-inspect within three months of the date at which you tell us
you will be compliant.
• If we have issued warning notices we will give you a date by which we
expect you to be compliant. We will re-inspect shortly after that date.
• If we find further evidence of non-compliance in the same part of the
same regulations we will consider and use our enforcement powers.
Reporting our findings
• You should receive a draft report within 10 working days of the site
visit (or the last day we gather evidence). The report will have been
through our quality monitoring procedures. Reports are sent to the
Nominated Individual and the Registered Manager.
• You will have an opportunity to comment on the factual accuracy of
the report.
• The final report will be published on our website.
• If you have received warning notices you may make representations
against the publication, but not the issuing of the warning notices.
Guidance and the appropriate form are on the CQC website.
What have we learned?
NHS trusts – April 2010, 400 providers
Adult social care – October 2010, 12,500 providers
Private healthcare – October 2010, 1,500 providers
Dental care – April 2011, 8,200 providers
c
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Early engagement is vital
No two sectors are the same
Tailored approach to registration for each sector
Partnership approach to guidance
What have we learned?
• Different risk in different sectors
• Tailor our approach to compliance
• Journey of improvement, continue to work
with each sector
• Sectors are dynamic, important we are
dynamic and responsive
• Open dialogue
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The future
Inspection of each dental provider every two
years at least
Cover a wide range of regulations
Inspectors to access dental specialists
Improved registration process
CQC strategic review – What should successful
regulation by CQC look like?
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Consultation on fees
Share your views on the fees that registered health and social care
services should pay.
We have launched a consultation on the fees that we propose to charge
health and social care services that are registered with us.
The changes for the fees in 2013/14 include:
redefining fees categories.
a change to the banding of fees for primary dental services.
Send us your responses
Send us your feedback online.
Email us at [email protected].
The consultation closes on Friday 21 December 2012.
Closing comments
The public puts its faith in those who run and
work in care services
There must be a culture that won’t tolerate
poor quality care, neglect or abuse – and
encourages people to report it
The regulator cannot be everywhere, so we
need to regulate with others
We remain cost blind in checking standards
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Questions
CQC – Helping make care better for people
www.cqc.org.uk
Questions?
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