Caring about CQC Compliance

CQC Compliance isn’t just about ticking the boxes for sector standards and regulations. Ultimately, it’s about safe, high-quality care for everyone.

DKJ can help you with

CQC Registration - Full Registration Process

Support new and emerging organisations and services with preparing documentation, including statements of purpose, policies and procedures, governance documents and full registration process.

CQC Registration - Registered Manager

Support new and emerging organisations and services with preparing for the Registered Manager's process, including applying for a counter-signed DBS and obtaining relevant information such as references.

CQC Mock Inspection and Deep Dives

Undertake service/organisation health checks aligned to the CQC KLOEs, prepare RAG reports and action plans highlighting areas of best practice and areas for improvement. Support organisations to implement and embed the actions before their inspection, including monthly assessments.

Responding to CQC Inspections

Work with organisations to respond to warning notices or actions arising from a CQC inspection, including action planning and ensuring the organisation can implement these before the deadline.

Health Inequalities

Support organisations to understand the different health needs within local populations and how that impacts on local health services as well as supports CQC compliance. Helping teams to connect with hard to reach groups and people living with long term conditions.

CQC Compliance Packages

While CQC compliance responsibility truly falls with teams and how they perform their jobs as well as the leadership, the actual paperworkof compliance generally falls to one person. Thats a lot of pressure on somebodys shoulders. Even more so when you throw audits and CQC registration into the mix!

Release some pressure with a package of support from DKJ:

  • Prepare all relevant documentation including Statement of Purpose, policies and procedures, staff files and processes, governance documentation, quality assurance documentation and any other relevant documentation.
  • Undertake and complete the online new provider application process.
  • Support with the Registered Manager Process.
  • Full Management of the online process including follow up questions.
  • Prepare all relevant documentation including Statement of Purpose, policies and procedures, staff files and processes, governance documentation, quality assurance documentation and any other relevant documentation.
  • Undertake and complete the online new provider application process.
  • Support with the Registered Manager process
  • Counter-signed DBS process
  • Support with the Registered Manager questions for interview
  • Full Mock Inspection based on 5 KLOEs including policy and procedure review and ensuring all evidence is available and up to date.
  • RAG Report and Action Plan.
  • Implementation, embed and monitor actions identified ready for CQC inspection.
  • Follow up support after CQC inspection
  • Full Mock Inspection based on 5 KLOEs including policy and procedure review and ensuring all evidence is available and up to date.
  • RAG Report and Action Plan.
  • Deep Dive into a specific KLOE if there is a particular area of concern for example CQC are focusing on Safe in their new regime.
  • Policy and procedure review Action plan and RAG rating
  • Focused look at the monthly assessment data which CQC are using to monitor practices including an overview of what this assessment is.
  • Provide an ‘as is’ position statement with recommendations.
  • Support with data sources and how to get the best from them.
  • Detailed Assessment of your policies and procedures as a practice.
  • Update all policies and procedures so that they meet statutory and national policy guidelines.
  • Arrange policies and procedures in evidence files ready for CQC
  • GP to GP Peer Support for GPs to understand from a clinical point of view what is required for CQC inspections.
  • Provision of GP Partners advice and guidance focusing on questions, searches and themes coming from CQC inspections.
  • CQC in The Past – what worked and how you can bring this to the new world of CQC inspections.
  • CQC in The Present – looking at the current themes CQC inspectors are looking at including data, searches and questions that are being asked. A focus on the monthly assessment and how this can invoke an inspection. A look at the change in focus for CQC following the pandemic.
  • CQC in the Future – what does CQC inspections look like for general practice from April 2022 and what you should be prepared for.
  • Discussion with key stakeholders to understand the operational delivery of your organisation
  • Undertake a CQC checklist to determine CQC perimeters.
  • Discuss the what is required for the CQC Registration Process including relevant documentation and personnel.
  • Undertake a service health check which will be aligned to CQC themes of Safe, caring, Effective, Responsive and Well Led.

Case Studies

We have a lot of experience supporting health and social care teams with their compliance. Read about some of our projects below:

In 2021 we supported several GP practices rated as ‘required improvement’ to ensure they were CQC ready. By utilising the GP Resilience Funding, available to all practices, DKJ associates worked with GP partners and their practice managers to complete a thorough mock inspection of their practice.

They developed an action plan and helped implement any immediate actions that may be required. We have added value to the process by providing peer support to practice managers and GP partners.

We have set up and facilitated meetings between the practice GP partners and DKJ GP partners who run a ‘Good’ practice.

Our clients have found this process extremely positive and have been delighted with the peer to peer support they have received as this has provided assurance to them. This work is ongoing.

In early 2020, DKJ were commissioned by a CCG to undertake a 2-day mock inspection for each of their 24 GP practices. Many were at risk of either being rated inadequateor requiring improvementtherefore the aim of the project was to work with each practice to make sure that they would rate as goodor outstanding.

Due to the pandemic, we were only able to complete 11 of the mock inspections. However, the feedback we received from each of the practices was that they had found the targeted approach to the onsite visit extremely helpful and the follow up action plan useful.

Some of those initial GP practices have since gone on to be rated as Good.

In late 2020, we were commissioned by a  London-based clinical lead to support them with setting up a primary care service within their local area.  We worked with the clinician to set up a limited company so they can now bid for contracts, registered them with the CQC and developed all their key policies, procedures and protocols.  This work is still ongoing.

In late 2021, we supported an online personalised healthcare organisation in establishing whether they were required to register with CQC.  We designed a workshop which focused on the services which the organisation provided to determine whether they were defined as registered activities and focused on governance requirements needed for registration.

We have conducted many Health Needs Assessments (HNAs) for diverse communities including gypsy and traveller populations, BAME communities and LGBTQI+ communities, for local authorities and clinical commissioning groups.

Our aims are always to achieve the following outcomes for each HNA:

  • raise the profile of the health needs of the community group in order to inform and influence commissioners
  • describe what is currently understood about the health needs of this client group
  • determine what the gaps in information are and make recommendations to improve local understanding of health needs
  • to make recommendations to improve health and access to health care for the community groups and populations.

DKJ was brought in to conduct social engagement with Hard to Reach communities including BAME women, LGBT older community, people living a learning disability, those with partial or full hearing loss, religious groups and wider BAME and LGBT groups within the Hull and East Riding area.

We have been able to engage these groups and communities to provide feedback on several health care service changes including a response to the Urgent Care Strategy and internal public sector working practices. We have also supported these groups, working with Humberside Police, in reporting hate crimes and incidents.

In early 2022, we were commissioned by 7 GP practices in the South East who are merging to become one practice to register the new entity with CQC.  As part of this support, we have prepared all relevant documentation including a new statement of purpose, policies and procedures, de-registered the individual practices, undertaken the Registered Manager process and provided full management of the online process.  This project is ongoing.

In early 2022, we were commissioned by a community health service in London to undertake a review of their policies and procedures to ensure that they were fit for purpose, robust and CQC ready.  As part of this project, we reviewed over 100 policies and procedures which may be required under the 5 KLOEs and provided feedback where amendments or developed new policies and procedures were required.

Dr D Kaushal, Broughton House Surgery, West Yorkshire.

We initially needed a CQC audit for a GP Practice which we had taken on under an APMS contract and contacted DKJ Support Services to deliver this piece of work I late 2019.  Following the development of the CQC action plan, we engaged the services of Kiran Johnson to support us with all aspects of practice management including further CQC registration activities, finance, HR and business services for a further 12 months.  We have been pleased with the level of support provided by DKJ Support Services and professionality, knowledge and expertise provided by Kiran Johnson in her role as an interim Practice Manager

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