What to expect from a CQC inspection

When an inspector calls: the thought of a CQC inspection can cause worry for even the most experienced dental practice owner. Pat Langley shares an overview of what you can expect.

The Care Quality Commission (CQC) is primarily concerned with good outcomes for patients. This means its remit is to check that dental practices have the correct structure and processes in place and that patients are experiencing good outcomes as a result. And that is how it structures its inspection visits.

There are two types of CQC inspection: comprehensive and focused. Comprehensive inspections are usually announced two weeks in advance, while focused inspections are usually unannounced and take place in response to a specific concern.

Being faced with a CQC inspection can be a worrying time for any dental practice. Having a compliance management system in place can go a long way towards making sure you and your team are as prepared as possible, helping to ease some of the stress.

Dentistry Compliance is a complete end-to-end management solution that simplifies and integrates compliance into your daily business processes seamlessly, ensuring your practice meets current professional standards. For more information or to book a free demo, visit www.dentistry.co.uk/compliance.

Comprehensive inspections

These inspections are selected randomly, around 10% of registered practices will have a comprehensive inspection every year. It is worth noting that a practice that has not yet been inspected will always have a comprehensive inspection.

To limit disruption to patient care, most CQC inspections will be announced, and you will receive two weeks’ notice. You can expect to receive a telephone call from the inspector, as well as a letter, both of which will confirm the date of the inspection. You will have communication via letter, email and telephone providing support in preparing for the day and understanding what to expect. If concerns are raised about a service, short-notice or unannounced inspections may be carried out.

Comprehensive inspections are undertaken by a trained CQC inspector, who is usually accompanied by a specialist adviser who is a dentist or a dental care professional such as a hygienist, therapist or a dental nurse, ie a GDC registrant. The inspection itself will be very thorough and will take a whole day.

Inspectors will speak to all team members on the day, ie dentists (including associates), hygienists, therapists, dental nurses, receptionists and the practice manager. They tend to ask open questions that are designed to discover what kind of outcomes patients experience in your practice.

What does a comprehensive inspection look at?

The CQC has made strenuous efforts to introduce intra-inspector consistency but because every practice is different and every inspector is different it is inevitable that every inspection will be different.

All CQC inspectors will use an assessment framework that is based around key lines of enquiry (KLOEs) that aim to look at: are the services safe, effective, caring, responsive and well-led? The KLOEs can be downloaded from the CQC’s website at www.cqc.org.uk, and it is highly recommended that you read and understand them.

Broadly speaking, the following will apply to all comprehensive inspections:

  • Inspectors will have a strong focus on gathering feedback from your team members and also from your patients. This means they will want to know how you obtain feedback and how you can show that you have acted on it
  • There will also be a strong focus on looking for evidence that you involve patients in the treatment planning process and how you ensure you have valid consent prior to starting treatment. This means that patient records will be scrutinised
  • Inspectors will expect all team members to have an understanding of the Mental Capacity Act 2005
  • Staff personnel files will be scrutinised to ensure they are complete
  • Emergency kits and drugs will be checked to ensure they are complete, and all items are in date
  • Team meeting minutes will be scrutinised, and inspectors will want to see evidence that actions arising have been acted upon
  • Audits will be checked and again, inspectors will want to see evidence that actions have been followed up and completed
  • Inspectors will review your policies and your practice protocols, and they will expect them all to be up to date, in date, and have a review date. They will expect all team members to be familiar with your policies and to have read and understood them
  • It is imperative that your policies and protocols are tailored to your practice. They should describe how you do things in your practice and who does them. They should not be generic.

Focused inspections

Focused inspections are unannounced, in addition to comprehensive inspections and always in response to a concern. This could be whistleblowing from a current or previous team member, a patient or a member of the public.

It could also be as a result of a concern raised by the GDC or another regulatory body or as a result of a patient complaint.

Focused inspections usually only focus on the concern that has been raised, rather than the five KLOEs. However, if other concerns come to light during the focused inspection then these can trigger a further inspection, which would be comprehensive.

Preparation is key

Compliance is part and parcel of running a dental practice, and it should be within the very fabric of your business processes. However, receiving notice of an upcoming CQC inspection can feel unnerving, even for the most prepared dental practice, as the day-to-day running of your business will be under a microscope.

Making sure you have a robust system in place to govern your compliance is essential for all dental practices. This will enable you to clearly show an inspector how you manage your compliance on a daily basis, outlining what has been done, when, and by which team member.

This is something you can put in place yourself, but it can be time consuming making sure you are always up-to-date with all changes and updates.

Instead, incorporating expert-led software can take away a lot of this pressure, enabling you to delegate tasks to team members, and giving you the peace of mind that all aspects of your compliance will be taken care of just by simply following the prompts provided.

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