REGISTRATION WITH THE CARE QUALITY COMMISSION (CQC) INFORMATION EVENT Thursday 21 October 2010 Carole Heiriss Clinical G

1. REGISTRATION WITH THE CARE QUALITY COMMISSION (CQC) INFORMATION EVENT Thursday 21 October 2010 Carole Heiriss Clinical Governance Manager

2. 6.50 – 7.00 pm Welcome and Introduction Melanie Smoker, Head of Primary Care Contracting and Commissioning and Jonathan Mynors-Wallis, Chairman of Dorset LDC 7.00 – 7.20 pm Introduction to CQC Registration for Primary Dental Care Providers Carole Heiriss – Clinical Governance Manager, NHS Dorset 7.20 – 7.35 pm Safeguarding and Safety Outcomes 7 and 12 Regulations 11 and 21 Janet Bowen, Designated Nurse Consultant for Safeguarding Children 7.35 – 7.45 pm Cleanliness and Infection Control Outcome 8 Regulation 12 Tracey Stevenson, Infection Prevention and Control Facilitator 7.45 – 8.00 pm Management of Medicines Outcome 9 Regulation 13 Caroline Crouch, Medicines Management Pharmacist 8.00 – 8.10 pm LDC Update Jonathan Mynors-Wallis, Chairman of Dorset LDC 8.10 – 8.30 pm Questions Panel AGENDA

3. Following this presentation Dentists will: Have an understanding of the CQC registration requirements for providers of primary dental care services Understand the basics of the CQC registration process Be in a position to complete and submit their application for registration with the CQC Aims and objectives:

4. The PCT is only the messenger! Please note: Please don’t shoot me!

5. What is it? • A new system of regulation that is required by law (Health & Social Care Act 2008) • Legislation sets out the requirements of the essential standards of quality and safety – they are NOT aspirational best practice • Acceptable level below which performance must not drop • The standards are about people’s experiences of care – it is NOT about: • Checklists, or • Policy checking

6. Parliament Dept of Health CQC Care Quality Commission (Registration) Regulations 2009 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Legislation and standards

7. Provider‘s responsibility to apply for registration • If not registered on 1 April 2011 you will be providing your service illegally

8. Objective – at all points of care WHAT FOR? People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights.

9. CQC will allocate a 28 day window to submit your application:

10. Registration process pointers • Web-based application form, but can apply on paper • Types of legal entities which must register: • An individual (sole trader) • A legal partnership (sharing both liabilities and profits) • Organisation (registered company, a limited liability partnership [LLP] or other corporate body

11. NOTE The CQC is clear that any provider that declares the wrong legal entity in an attempt to avoid payment of fees, for example, may be subject to prosecution

12. Regulated activities to be registered: For primary dental care providers, these will normally (but not always) be one or all of the following: • Treatment of disease, disorder or injury • Diagnostic and screening procedures • Surgical procedures (if general anaesthetic administered)

13. Service Type Dental services (DEN) CQC definition: These services involve registered dentists and dental care professionals usually working in premises designed for consultation and treatments but can also be provided in a person’s place of residence. Consultations and examinations will involve discussion of the treatment options with the patient and may include dental radiography. Treatment is usually provided in a dedicated room and, in consultation with the patient, may be under local anaesthetic or laser. Medicines may be prescribed as part of the treatment.

14. Service User Band • In this section, you need to select the primary needs of the people who use your services. [LD, older people, younger adults, 0-3 years, 4-12 years, 13-18 years, mental health, physical disability, sensory impairment, dementia, people detained under the MHA, people who misuse drugs and alcohol, people with an eating disorder, whole population] • If you run a service that caters for everybody rather than a specialist one, you should just tick the ‘Whole population’ box. Otherwise, you should tick as many as apply to you.

15. Declaration of compliance • You are asked to declare if you comply with all the Regulations for each regulated activity that you carry on at each location at the point in time when you complete your application. • You are not required to submit evidence however need to have evidence available to support your declaration, demonstrating that people who use your services experience the outcomes set out in the Guidance

16. All service providers are required by law to have a Statement of Purpose for each of the regulated activities they are registered for It will inform the CQC of the kind of services you provide and the locations at which you provide them The information required is set out in the Act and guidance and a template is available Statement of Purpose

17. Fees • There are no fees to apply to register with the CQC • Annual fees will be payable • The CQC will hold a consultation on the fees scheme starting in October 2010 • The interim fee scheme for NHS trusts DO NOT provide a blueprint for future fees.

18. Enhanced CRB disclosure For the registration process: - Registered provider; - All partners of a legal partnership; and - The nominated individual of an organisation All require an enhanced CRB that has been countersigned by the PCT with which they have a contract; Or must obtain an enhanced CRB disclosure with CQC as countersignatory; NOTE: NHS Dorset will arrange enhanced CRB’s for all registered providers and all partners on NHS Dorset Performers List as per letter sent from PCT on 7 October NB ENSURE ENVELOPE ADDRESSED TO FHSA

19. Although not as a result of CQC’s requirements, most staff within a dental practice are likely to carry out regulated activities and therefore their employer, to be in a position to declare compliance with Regulation 21 would be required to obtain an enhanced CRB check: - NHS Dorset will arrange enhanced CRB’s for all dentists on their Performers List that do not yet have one, you may apply to the PCT during the first 2 weeks of November; - all other staff: dental nurse, hygienist, receptionist etc. the CRB does not have to be countersigned by the CQC nor is there any requirement for PCT involvement. Enhanced CRB disclosure?

20. CRB Application process for Registered Managers • Call CRB on 08709090811 • Quote the registered body name and number i.e Care Quality Commission 232 443 00 003 • Request a criminal record disclosure check at an enhanced level • The CRB will post an application form out to your home address • Take your completed form to a Crown Post Office (Westbourne or Yeovil) • Cheque payable to CRB for CRB fee £36.00 • Make payment of £20.05 in cash or card to Post Office for the service • Inform PO clerk to send Royal Mail Special Delivery to: CQC, Registrations CRB, Citygate, Gallowgate, Newcastle Upon Tyne, NE1 4PA

21. Scenarios

22. The PCT is only the messenger! Please note: Please don’t shoot me!

23. 3 dentists, each with own NHS contract, working in the same location TWO OPTIONS: 1. Register individually – pay separate fees; 2. Agree between them that one will take on the legal responsibility of registering as the provider (this dentist will be known as the ‘registered provider’), HOWEVER it is strongly recommended that this agreement is formalised; - the other 2 dentists will still have professional accountability and clinical responsibility for the patients that they treat, whilst the registered provider will have responsibility relating to the overall provision of service, of which the other 2 dentists are part; - the other 2 dentists will be considered as ‘employees’ for the purpose of registration -

24. If one of the dentists has a private practice and has registered his business at Companies House AND holds an NHS contract? The dentist will register separately as ‘an organisation’ and therefore will be required to declare details of the nominated individual and the registered manager. - This dentist can in effect be the Registered Provider; the Nominated Individual; and the Registered Manager. Is this dentist required to complete a separate Application for a Registered Manager?????

25. The dentist has an NHS code for one practice but also has a company for private practice, does he register twice? Yes, if the companies are truly separate and have separate company numbers registered at Companies House; BUT Where a provider has two separate practices (locations¹) but one carries out NHS work and the other location carries out private work this can be one registration (as previous slide) ¹ a primary dental service OR a place where regulated activities are managed from

26. Can an associate register as an individual? If an associate is self-employed and works across multiple providers they may register as an individual with multiple locations. The associate dentist my work privately across multiple locations and wish to retain their own autonomy and register separately. Will be liable for separate fee. However, they may want to be or automatically be covered by the registration of the providers at the locations they work, in which cases the dentist must have a conversation with those providers to ensure they are covered by those registrations.

27. The CQC website is the definitive source of information on the new registration system and is regularly updatedhttp://www.cqc.org.uk/guidanceforprofessionals/introductiontoregistration.cfm A micro site which allows you to select your service type/s and then be provided with guidance about compliance information based on the service types you’ve selected http://www.cqcguidanceaboutcompliance.org.uk The British Dental Practice Managers Association (BDPMA) has established a FAQ service for members Further information