CQC Duty of Candour

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CQC Duty of Candour

description

CQC & Key Lines of Enquiry (KLOE) - A guide for residential and domiciliary care providers in the UK

Transcript of CQC Duty of Candour

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CQCDuty of Candour

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Stephen WatsonPassionate about developing and delivering the very best in quality and service for care homes. Stephen has over 17 years’ experience in creating and implementing care home and domiciliary strategies that are truly transparent and highly effective.

Pauline GriffinWorked for the care quality commission as an inspector for 11 years. Pauline has managed domiciliary/ residential care and supported living at senior levels in both the public/private sectors and is a part of the Care Consort Team.

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Yours sincerely

Stephen WatsonCEO - Care Consort

[email protected] +442033897208

“Truth never damages a cause that is just.” - Gandhi

The following reference guide has been written to provide a general overview of the regulations and requirements relating to ‘duty of candour’. I hope you find this guide useful, and it assists you to manage an effective, safe and well led care service.

If you have any questions relating to this topic or require further guidance we would love to hear from you.

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This Regulation was included in the Health & Social Care Act 2008.Regulated Activities 2014 as a direct response to the ‘Francis Enquiry’ into the Mid Staffordshire NHS Foundation Trust - following serious failures and a lack of responsibility taken by staff.

In April 2015 it was extended to cover not just health services but all providers – stating the ‘fit and proper person’ requirement for directors and duty of candour for all providers (1st April 2015).

The Care Quality Commission require all staff to understand their responsibility under the Duty of Candour heading and it is now an integral part of registrations and inspections.

Services are now required to prove that they behave and run their undertakings openly, transparently and with candour, (candour is seen to mean honesty and frankness, as opposed to hiding things in this context).

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Openness – enabling concerns and complaints to be raised freely without fear and all questions asked must be answered.

Transparency – allowing information regarding performance and outcomes to be shared with staff, service users and/or their lawful representatives, the public and regulators.

Candour – any patient harmed by the provision of a healthcare service is informed of the fact and an appropriate remedy offered, regardless of whether a complaint has been made or a question asked about it.

www.careconsort.com0203 389 7208

The following describes the expectation under each of the three headings:

Duty of Candour

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Care Quality Commission’s Approach to the Duty of CandourRegistrationDuring the registration process – applicants will be tested on their knowledge of the requirements of the regulation and will be asked to describe the systems in place to meet the requirements. This will include a check that there are robust systems in place for compliance. If the CQC is not satisfied, the application for registration may be refused or conditions imposed on the registration.

InspectionAn inspection of services will assess whether the provider is delivering a good quality service. The five Key Lines of Enquiry (KLOE) used by the CQC to assess services (Safe, Effective, Caring, Responsive, Well Led) – will include the subject of Duty of Candour under both the areas Safety and Well Led.

Questions asked of Adult Social Care, Community Adult Services, Residential Adult Social Care Services and Specialist Mental Health Services:

Q) How are risks to individuals and the service managed so that people are protected and their freedom is supported and respected?

Q) Are there plans for responding to any emergencies or incidents and are these understood by the staff.

Q) How does the service promote a positive culture that is person-centred, open, inclusive and empowering?

Q) Is there an emphasis on support, fairness, transparency and an open culture?

Q) Are lessons learned and improvements made when things go wrong?

Q) Are people who use the service told when they are affected by something that goes wrong, given an apology and informed of any action taken as a result?

Q) How does the leadership and culture reflect the vision and values encourage openness and transparency and promote good quality care?

Q) Do leaders encourage appreciative, supportive relationships amount staff?

Q) Does the culture encourage candour, openness and honesty?

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How Companies Should Manage Responsibilities Under Duty of Candour

1) Registered persons must act in an open and transparent way with relevant persons in relation to care and treatment provided to service users in carrying on a regulated activity.

2) As soon as reasonably practicable after becoming aware that a notifiable safety incident has occurred a registered person must—a) notify the relevant person that the incident has occurred in accordance with paragraph (3), andb) provide reasonable support to the relevant person in relation to the incident, including when giving such notification.

3) The notification to be given under paragraph (2)(a) must—a) be given in person by one or more representatives of the registered person,b) provide an account, which to the best of the registered person's knowledge is true, of all the facts the registered person knows about the incident as at the date of the notification,c) advise the relevant person what further enquiries into the incident the registered person believes are appropriate,d) include an apology, ande) be recorded in a written record which is kept securely by the registered person.

4) The notification given under paragraph (2)(a) must be followed by a written notification given or sent to the relevant person containing—a) the information provided under paragraph (3)(b),b) details of any enquiries to be undertaken in accordance with paragraph (3)(c),c) the results of any further enquiries into the incident, andd) an apology.

5) But if the relevant person cannot be contacted in person or declines to speak to the representative of the registered person —a) paragraphs (2) to (4) are not to apply, andb) a written record is to be kept of attempts to contact or to speak to the relevant person.

6) The registered provider must keep a copy of all correspondence with the relevant person under paragraph (4).

The following is taken from Regulation 20 as a guide: (‘relevant person’ is usually the service user or their representative)

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9) In relation to any other registered person, "notifiable safety incident" means any unintended or unexpected incident that occurred in respect of a service user during the provision of a regulated activity that, in the reasonable opinion of a health care professional—a) appears to have resulted in—i) the death of the service user, where the death relates directly to the incident rather than to the natural course of the service user's illness or underlying condition,ii) an impairment of the sensory, motor or intellectual functions of the service user which has lasted, or is likely to last, for a continuous period of at least 28 days,iii) changes to the structure of the service user's body,

iv) the service user experiencing prolonged pain or prolonged psychological harm, orv) the shortening of the life expectancy of the service user; orb) requires treatment by a health care professional in order to prevent—i) the death of the service user, orii) any injury to the service user which, if left untreated, would lead to one or more of the outcomes mentioned in sub-paragraph (a).

How Companies Should Manage Responsibilities Under Duty of Candour (continued)

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Health and Safety ReportingIncident Logging - Risk AssessmentThe Duty of Candour responsibilities work in conjunction with the responsibilities under the Health and Safety at Work Act 1974 and associated regulations that require up-to-date risk assessments with control measures plus hazard and near miss awareness records with preventative actions. The responsible individual must ensure that staff members are familiar with the company policies and procedures.

Complaints both Formal and InformalThe Duty of Candour responsibilities also work in con-junction with company policy and procedures. The re- sponsible individual must ensure that staff members are familiar with company policies and procedures.

SafeguardingThe Duty of Candour also work in conjunction with the company policy and procedures regarding safeguarding. The responsible individual must ensure that staff members are familiar with company policies and procedures.

SummaryThe CQC expects providers to ensure that all staff, regardless of seniority or permanency, understand the organisation’s responsibility to be open and transparent in their communication with relevant persons in relation to a notifiable safety incident. It requires the provider to understand their own role and put policies and procedures in place to ensure staff are effectively supported to carry out this process.

Further InformationFurther information is available from the CQC’s ‘Guidance for providers on meeting the regulations’ and ‘Offences: The Health and Social Care Act 2008 (Regulated Activities Regulations 2014.)The registered person must also notify the CQC appropriately under the CQC’s ‘Statutory Notifications – guidance for registered providers and managers’.

These can be found on the CQC’s website.

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Call us on 0203 389 7208 to book a demo.

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Care Consort is a trading name of Plan XL Ltd

Contributors: Pauline Griffin, Dilruk Wiesinghe

Design/Artwork: Libby Lawrence