20 February 2012
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Setting the bar : A framework for our regulatory response for existing providers
In considering a provider’s application for registration CQC will have reached a decision about whether or not the location is fully compliant. The flowchart below demonstrates how CQC will look at the situation. From this it can be seen that a provider declaring non compliance has a better outcome than one who does not declare. However CQC has stated that it will always take enforcement action where it has major concerns about a provider’s non-compliance (regardless of whether they have declared non-compliance or not).
Where CQC has minor or moderate concerns about a provider, its regulatory response will consider whether the provider declared non-compliance. In this way CQC is providing an incentive to providers and encouraging them to identify and own necessary improvements, rather than CQC having to enforce action.
Outcome 12 (Regulation 21 – Requirements relating to workers)
CQC give the following example:
A safeguarding concern has been raised about Woodside Dental Practice, caused by serious failings in recruitment procedures.
It is clear that staff have been employed without CRB and ISA checks being undertaken. The practice treats adults and children.
Step 1:
Using the judgement framework, CQC identified the following:
- This is a high impact for people as there are no checks to ensure that people being employed are safe to work with children.
- The likelihood of it recurring is almost certain as there are significant problems with the recruitment process.
- This means that it is a major concern.
Step 2:
Using the ‘setting the bar’ guidance, CQC identifies that this places the service provider below the bar and it need to register it with compliance conditions.
Step 3:
As the concern means that the location is providing a service that is below the bar, CQC makes additional checks on recruitment procedures at other locations within the service provider’s application, and finds that failings in recruitment are a systemic problem.
Step 4:
CQC uses the guidance on conditions and impose condition(s) for the regulated activity at the provider level.
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Criminal Record Bureau checks
CQC has now added more information regarding CRB checks on its website
In general, providers and managers of regulated health and adult social care services have to ensure that all staff, including those granted practising privileges and volunteers who have contact with the people who use their service or who are undertaking a regulated activity, have a satisfactory CRB check. There is also a CQC guidance document on CRB checks, A new system of registration
A registered provider must have an enhanced CRB disclosure that is countersigned by CQC unless a provider already has an enhanced CRB that is countersigned by a PCT, in which case CQC has stated that it will accept that and not require an additional disclosure certificate. CQC does not require the PCT to have countersigned within a specific period.
This applies to different types of provider as follows:
- Where the provider is an individual, that individual must either have an enhanced CRB in place that has been countersigned by the PCT with which they have a contract, or obtain an enhanced CRB disclosure with CQC as the countersignatory.
- Where the provider is a partnership, each partner must either have an enhanced CRB in place that has been countersigned by the PCT with which they have a contract, or obtain an enhanced CRB disclosure with CQC as the countersignatory.
- Where the provider is an organisation, the nominated individual for each regulated activity where these are different must either have an enhanced CRB in place that has been countersigned by the PCT with which they have a contract, or obtain an enhanced CRB disclosure with CQC as the countersignatory.
If the provider does not have an enhanced CRB disclosure countersigned by the PCT, the provider must apply for an enhanced CRB disclosure to be countersigned by CQC, and confirm in their application that this has been done. It is only necessary to have started the process at the point of submitting an application. However, CQC will not make a decision on an application until it has received the disclosure.
Where a registered manager is required, he or she must have an enhanced CRB disclosure that is countersigned by CQC. The only exception to this requirement is where the role of registered manager is carried out by a person who is also:
a) one of the partners in a partnership registered as the provider; or
b) the nominated individual in an organisation registered as the provider.
In these two situations only, and where there is already a CRB disclosure certificate in place countersigned by the commissioning PCT, CQC does not require a further CRB certificate be obtained in relation to the registered manager application.
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What are CQC’s requirements for CRB checks for other people who work for a provider?
Providers must consider the need for CRB checks for all the people who work in their service, on a case-by-case basis. CQC does not have a blanket requirement, but has published guidance on its website. There is also guidance on CRB’s website.
Outcome 12 of the Essential Standards Document reflects regulation 21 (reproduced below for reference), which states that the information in schedule three should be available for all staff (including practitioners working under practising privileges).
Although not as a result of CQC’s requirements, most staff within a dental practice are likely to carry out regulated activities as defined in the vetting and barring scheme that came into force in October 2010. Where this is the case, their employer would be required to obtain an enhanced CRB check. Please see guidance on CRB’s website.
Where providers need to obtain CRB disclosure for other staff, this does not need to be countersigned by CQC, nor do CQC have any requirements for PCT involvement.
Extract from Health and Social Care Act 2008 (Regulated Activities) Regulations 2010
Schedule 3 Regulations 4, 5, 6 and 21
Information required in respect of persons seeking to carry on, manage or work for the purposes of carrying on, a regulated activity:
1. Proof of identity including a recent photograph.
2. Where the certificate is required for a purpose referred to in:
(a) section 113A(2)(b) of the Police Act 1997(a), a criminal record certificate issued under section 113A of that Act together with, after the appointed day and where applicable, relevant information relating to children or vulnerable adults; or
(b) section 113B(2)(b) of the Police Act 1997, an enhanced criminal record certificate issued under section 113B of that Act together with, where applicable, suitability information relating to children or vulnerable adults.