How to keep your practice up to standard

Patricia Langley looks at how the CQC regulates dentistry and what you can do to ensure your practice complies.

Compliance is a critical part of running a dental practice. It covers a huge range of topics, but at its heart it is straightforward.

Put simply, compliance is about being able to consistently demonstrate that you operate a safe, well-run practice with well-informed patients who are fully involved in their treatment decisions, with whom you are striving to achieve a measurable health gain.

It is the role of the Care Quality Commission (CQC) to inspect practices and ensure that they meet these fundamental standards – but how does it do this?

As of 13 May 2024, the CQC started inspecting dental practices using its single assessment framework. The new framework retains the five key questions at its heart, meaning inspectors will continue to look for evidence that your practice provides care that is safe and effective, that you and your team are caring and responsive to your patients’ needs and that your practice is well-led.

Within the new framework, the key lines of enquiry (KLOEs) have been replaced by 34 ‘quality statements’, with practices being required to provide evidence of compliance with the relevant quality statement.

CQC inspections

For each evidence category, practices will be assessed as:

• Regulations met
• Regulations not all met.

The key areas of focus for inspectors are:

• Infection prevention and control
• Staffing – robust recruitment processes, sufficient competent staff, training and supervision
• Equipment and premises
• Delivering evidence-based care
• Good governance
• Safeguarding
• Consent and patient records
• Medicines management
• Complaints
• Caring and responsive care.

These are very similar to the previous areas of focus and, in practice, inspections are likely to look and feel much as they did before. The only exception is practices that were last inspected before April 2015, when the CQC last made significant changes to how it inspects and regulates.

Common areas on non-compliance

The areas most frequently found to be non-compliant at inspection predominantly fall into the ‘safe’ category or the ‘well-led’ category:

• Issues with practice policies and protocols (well-led)
• Issues with risk assessments (safe and well-led)
• Issues with infection prevention and control processes (safe)
• Out of date medicines and equipment to deal with medical emergencies (safe)
• Incomplete patient records (well-led)
• Evidence of effective complaints management processes (responsive, caring and well-led)
• Incomplete recruitment checks when employing staff, meaning there are gaps in mandatory personal records (well-led)
• Evidence of adequate supervision of and support for staff (well-led)
• Evidence of mandatory training for all team members (well-led).

Common issues with practice policies and protocols

The most common issues causing noncompliance are:

• Having policies and protocols that are generic and not tailored to your practice
• Having policies and protocols that are out of date. For example, team members who have left the business are named as the infection control or safeguarding leads, or you may have policies that do not reflect current thinking
• No evidence that policies and protocols have been read and are understood by all team members.

For all your practice policies and protocols, it is important to ensure that:

• They are tailored to your practice and up to date with an in-date review date
• They are understood by all your team members. The best way to do this is to discuss a couple of policies at each team meeting and test understanding using some form of policy training assessment
• Signed as having been read and understood by all team members. The simplest way to achieve this is to have a policy reading acknowledgement sheet that all team members sign that is kept with the policy.

Death by paperwork!

Apolline’s experience is that many dental practices have far too many policies, some (or many) of which may not be relevant to their practice or practising circumstances. Because of the need to keep all policies you do have up to date and understood by all team members, ‘policy overload’ can lead to a situation we sometimes refer to as ‘death by paperwork’!

The key to compliance and avoiding death by paperwork is to have the optimum number of policies that reflect what actually happens in your practice.

That means ensuring you have enough policies and protocols to ensure you are compliant, but not so many that it contributes to you being non-compliant because you can’t keep them all current and updated.

Or, to put it another way, only have policies you need and don’t have policies you don’t need. It sounds obvious, but many practices are persuaded to have policies ‘just in case’.

Get more guidance

To simplify the way that you integrate compliance management into your day-to-day business processes, it pays to seek expert assistance.

That way, you can concentrate on ensuring patient satisfaction and high standards of clinical care.

Fulfil all your compliance requirements with Dentistry Compliance, book a dental compliance health check with us today: