everythingCQC - CQC COMPLIANCE

DBS-CRB

On 1 December 2012, the functions of the CRB (Criminal Records Bureau) and the ISA (Independent Safeguarding Authority) merged and are now carried out by the DBS (Disclosure and Barring Service).

As part of your initial applications made to the CQC, you would have undergone a CRB Check (criminal records bureau check). Any change in registered manager will also require the person to now undergo a DBS check.

Who needs to complete the CQC DBS check

The following people are usually required to complete the CQC DBS check process:

Individuals applying for registration to carry on or manage a care service
All Partners
Registered Managers

Note:From 1 April 2013, all GP providers and registered managers that make an application to register with the CQC must have a CQC-countersigned DBS check. GMC numbers in lieu of a CQC-countersigned DBS check is no longer accepted.

Also note that Nominated individuals (usually a Practice Manager) do not need a CQC-countersigned DBS check. Providers must, however, carry out their own DBS checks on all their nominated individuals and may be asked to supply evidence of these.

DBS checks when employing new staff

The CQC say Health or Adult Social care service providers are responsible for checking the suitability of their own staff.

Whilst it is not a CQC requirement, the NHS Employment Check Standards, recommends that everyone employed for the purpose of carrying on a regulated activity under the Health and Social Care, ensure that they carry out appropriate DBS checks on all applicants for any position within their practice that qualifies for such a check. This should include health visitors, nursing staff, contracted & temporary staff, practitioners working under practising privileges, volunteers, students and so on.

The requirement for a check and level of check is dependent on the roles and responsibilities of the job and the type of contact with vulnerable groups.

If the practice only treats adults, then staff who actually provide healthcare will require DBS checks - not the receptionists, etc.
If the practice treats children as well, any staff member who potentially comes into contact with the children may be eligible for the DBS check.

DBS checks for Staff who have been employed for some time

There is no legal requirement to carry out retrospective or periodic DBS checks. Employers can ask staff to apply for a DBS certificate retrospectively whenever they think it is necessary.

If a staff member has been employed with the provider for a long time (and therefore may not have a DBS check), the appropriateness of retrospective checks might be considered if there are other concerns about the provider's recruitment procedures or if concerns are raised with regards to specific members of staff.

What actions will the CQC take when they find a breach of this regulation

"The action we [the CQC] take will be proportionate to the impact that the breach has on the people who use the service and how serious it is".

The key thing is that the provider must be able to demonstrate they have effective and robust recruitment procedures in place for all new staff, which will include identifying if staff are eligible for DBS checks, as well as checking their references, employment history etc.

How long is a DBS check valid for?

There is no requirement for a service that directly employs its own staff to repeat disclosure and barring checks within a set period. Further checks on staff will depend on the registered person judging that this is necessary or advisable after a certain period.

When making their decision they should take into account the work they do, the potential scope for abuse, and the stability of the workforce.

Applying for a DBS check

To register with the CQC disclosure service click on the link below:

_____________________________________________________________________________

CQC Guidance

DBS Checks Guidance for Providers

The way most practices work is that GP partners would delegate compliance to practice managers and not take an active role in compliance matters. The system would run on an element of trust, so if the manager says everything is fine, this is taken at face value.

The difference with CQC is that this time round your licence to trade is now dependent on meeting the regulatory standards and the partners are required to have a good handle on their level of compliance. GP Partners need to know they are compliant and ignorance of the law is no excuse.

As a partner you need to have a better understanding of operational issues and how everything works, or at least have good systems that make you aware of alerts and what outcomes are being achieved.

The BMA guidelines suggest that:-
" ..... we believe that for most providers it will be appropriate for a partner to be the registered manager, although in some cases you may decide that it is more appropriate for a practice manager to take this role. The registered manager role should certainly not be viewed simply as an administrative management role, due to the legal responsibilities involved."

In their FAQs, the CQC say
"In most partnerships, we would expect one of the partners to be the registered manager."

As a reminder, for CQC, a Registered Manager is the person registered with the CQC to be in day-to-day management of one or more regulated activities. The registered manager takes on special responsibilities and has a legal role in enabling and monitoring compliance with essential standards across your regulated activities.

If the partner takes on the role of a registered manager, they need to be much more hands on with compliance. If the day to day management is delegated to the practice manager, which it invariably will be, they need to have a good reporting system that allows them to be a full time physician as well as be able to manager compliance.

This all depends on whether you are a registered manager.

For CQC, a Registered Manager is the person registered with the CQC to be in day-to-day management of one or more regulated activities. The registered manager takes on special responsibilities and has a legal role in enabling and monitoring compliance with essential standards across your regulated activities.

If you are a practice manager who agrees to be the registered manager as well, your role will change from just administrative to that of being legally responsible for compliance. What this means is that if there are serious failures, you can be held responsible, fined and even prosecuted.

Alternatively, you could remain a practice manager and one of the partners might be appointed as the registered manager for the purposes of CQC, in which case nothing much changes for you in terms of your legal responsibilities as your role is seen largely as being administrative. In reality of course the practice manager will still manage all the compliance work and the GP will need to keep better informed on exactly what's going on.

Be careful
The Registered manager position is not just an admin job.
During our audits, we have found instances where practice managers have sometimes declared the practice to be fully compliant on QOF or GMS contract, even though they were not, with the intention of catching up a little later. This now becomes a criminal offence. This is why the CQC and the BMA suggest that the Registered Manager is likley to be a GP partner.

To be pragmatic, we don't think anyone will be prosecuted for minor things, but if things go drastically wrong, these little infractions will suddenly become a big deal. Why take a chance?

If you become a Registered Manager, we recommend that you take your responsibilities very seriously.

The provision of NHS Social Care and medical care are now regulated activities.
Regulated businesses
What this means is that to be able to practice in this arena, you have to apply for a licence to trade and you have to meet regulatory requirements the government has set out.

Registration is your licence to trade
If you don't have a licence, you cannot trade
If you trade without a licence, you are committing a criminal offence
An offence means you could be prosecuted, fined, or both

What does 'regulatory requirements' mean in practice
These are minimum standards set by the government, which every regulated organisation has to abide by to get the licence to trade. These requirements carry the force of law and must be followed.
Requirements usually follow in two parts:-

The law itself - The Regulation, which is embodied in the Statutory Instrument passed by Parliament. This is usually relatively brief and to the point.
Guidance - This is delegated to a regulatory body whose job is to explain the requirements in more detail and also enforce them. In this case, it is the Care Quality Commission (CQC)

The guidance is not in itself enforceable in law, although the regulatory body might use this as recommended best practice by which to measure your compliance.

Fees scheme for NHS GP practices.

Single location

Number of registered patients	Fee
Up to 5,000	£2,187
5,001 to 10,000	£2,574
10,001 to 15,000	£2,978
More than 15,000	£3,365

Multiple Locations

Number of locations	Fee
2	£4,761
3	£6,347
4	£7,934
5	£9,518
6 to 10	£11,900
11 to 40	£23,799
More than 40	£59,494

How often do I need to Pay?

This is an annual fee which will cover all registration and compliance requirements for all locations.

You will be sent your invoice in advance of your payment due date.

When is my fee due?

You will be invoiced on the same date each year. The date will depend on your specific circumstances, but is usually the anniversary of the date of your registration.

Providers that are new to registration will receive their first annual fee invoice once their registration has been completed and they have received their certificate of registration.