20 February 2012
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Regulation
The Health & Social Care Act 2008 (Regulated Activities) Regulations 2009.
Click here to read what the regulations say about complaints.
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Guidance
The CQC Guidance about compliance is contained in Essentials of Quality and Safety. This document is designed to help providers comply with the regulations.
CQC will use this guidance to decide whether to register a provider, and also when monitoring the service after registration.
CQC has produced guidance for providers about what kind of evidence can be used to demonstrate that the outcomes described in the Essential Standards of Quality and Safety document are being met: Using evidence of outcomes to demonstrate compliance
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Outcome
This is what the CQC expects people using a service will experience when the provider is meeting the essential standards.
What should people who use services experience? People who use the services, or others acting on their behalf:
- Are sure that their comments and complaints are listened to and acted on effectively.
- Know that they will not be discriminated against for making a complaint.
They can expect this because providers who comply with the regulations will:
- Have systems in place to deal with comments and complaints, including providing people who use services with information about that system.
- Support people who use services or others acting on their behalf to make comments and complaints.
- Consider fully, respond appropriately and resolve, where possible, any comments and complaints.
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Prompts
CQC has produced prompts to help providers achieve this outcome. A provider will not need to provide evidence for the prompts. It is for a provider to decide how it demonstrates that it is achieving the outcomes, and most importantly, complying with the Regulations.
Prompts for all providers to consider
- Effective complaint management.
People who use services and those acting on their behalf can be confident that their comments and complaints are listened to and dealt with effectively.
- Click here for a list of key elements within the process.
People who use services whose care, treatment and support is shared with more than one provider, or has been transferred to another provider, know that their comments and complaints are listened to because:
- The provider has agreed protocols in place to ensure that the services cooperate to provide one complete and coordinated response.
Providers who are registered with Care Quality Commission:
- Will produce a summary of complaints at a time and in a format set out by CQC and then send the summary within the time frame specified.
People who use services benefit from a service that:
- Takes into account relevant guidance, including that from CQC’s Schedule of Applicable Publications.
Promote rights and choices
- Click here for a list of people who use services or those acting on their behalf are able to use the comments and complaints process because of the following considerations.
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Compliance
When completing an application for registration a provider must declare compliance or non-compliance with each Regulation, eg, Regulation 19 - Complaints. For obvious reasons it is important that the information in the application is true and accurate.
If a provider is non-compliant this must be declared and at the same time a compliance plan must be submitted with details of how the provider will become compliant and the timescale.
A provider who demonstrates insight in identifying and declaring non-compliance and submitting an appropriate compliance plan is likely to be in a better position than a provider who declares compliance and is later found not to be in a position to demonstrate compliance.
In order to demonstrate compliance members may want to put themselves in the position to demonstrate:
- That they have an appropriate and effective complaints procedure in place which takes into account the GDC guidance and, where appropriate, the NHS complaints Regulations and the Ombudsman’s Principles
- How the complaints procedure is brought to the attention of patients
- How patients can obtain support and assistance in bringing a complaint
- That their team is appropriately trained in complaints handling
- That the practice learns from complaints.
Using evidence of outcomes to demonstrate compliance
When CQC monitors your compliance with the Essential Standards, it will check that you are meeting these outcomes. CQC will focus on evidence which demonstrates that people who use services:
- Have good outcomes and experiences, meaning that their care is effective and that they are safe.
- Are involved in their care and that their views are listened to and acted on.
By focusing on outcomes rather than looking only at a provider’s policies and procedures, CQC states that it can assess health and social care services in a way that is centred on people who use services. This means actually considering the effect that a service has on people.
The evidence a provider uses may be influenced by the factors in the service it provides.
For example, you could use evidence directly from people who use services and those acting on their behalf, such as:
- Surveys of people who use services, their carers and families.
- Complaints and feedback from people who use services.
- Patient reported outcome measures (PROMs).
- Feedback from other sources eg local groups.
Many dentists are used to collecting feedback from patients. In reality patient feedback is a valuable practice development tool. It collects the views and opinions of patients and service users on the care they have experienced. There are different ways of collecting feedback including the use of anonymous feedback forms, comments books, audits, complaints and compliments. Some practitioners have also used, one-to-one interviews and focus groups. Once you have collected the feedback you need to review it and decide how to use it to continue to develop your practice. A useful next step is to then inform patients of how their feedback has been used and what changes have been made. This could be done in the practice newsletter or by way of information in the waiting room. In this way patients feel more involved in the practice.
When you evaluate your own compliance, CQC expects you to focus on evidence that relates to outcomes for people. However, CQC recognises that you may not be collecting direct outcome evidence for all services or all outcomes. Therefore, it anticipates a greater initial emphasis on evidence from policies, procedures and systems. It is therefore appropriate to consider this in relation to the impact that they have on people who use your service.
As the system for ongoing monitoring of compliance is embedded, CQC will increasingly expect you to gather and use evidence that directly demonstrates outcomes or comes directly from people who use your service. This will mean that you can be in a position to demonstrate your compliance.
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Resources
Available from CQC
Click here for a list of documents suggested by the CQC in Appendix B.
Members may also find it helpful to review additional appropriate information when developing and reviewing their complaints procedure and ensuring that all staff are appropriately trained.
Available from the GDC
All GDC registrants should follow the appropriate GDC guidance. The GDC standards guidance, Standards for Dental Professionals sets out the principles a dental professional should follow.
Give patients who make a complaint about the care or treatment they have received a helpful response at the appropriate time. Respect the patient’s right to complain.
Make sure that there is an effective complaints procedure where you work and follow it at all times. Co-operate with any formal inquiry into the treatment of a patient.
The GDC has also produced guidance specific to complaints handling - Principles of Complaints Handling
It is part of your responsibility as a dental professional to deal properly and professionally with complaints. Click here to read more.
Complaints arise when people don't get the service they expect. Patients often complain about service issues, such as lack of politeness or poor communication, as well as clinical issues. Click here to read more.
Available from Dental Protection
Dental Protection’s Dental Advice Booklet on Handling Complaints provides advice on:
- understanding complaints
- designing an in house complaints procedure
- basic skills
- how to successfully respond to a complaint
- ten step process for responding to a complaint
- NHS complaints procedures
- private complaints procedures.
Click here to read DPL's series of Dental Advice Booklets.