The new CQC Fundamental Standards will take effect from October 2014, and be in place for all providers by April 2015.
The fundamental standards are:
- Person-centred care
- Dignity and respect
- Need for consent
- Safe care and treatment
- Safeguarding service users from abuse
- Meeting nutritional needs
- Cleanliness, safety and suitability of premises and equipment
- Receiving and acting on complaints
- Good governance
- Fit and proper persons employed
Plus two new regulations:
- Fit and proper person requirement for directors
- Duty of Candour
Fit and proper person requirement for directors
The fit and proper person requirement for directors makes it clear that directors and people in positions of authority are personally responsible for the overall quality and safety of care.
This has been broadened, and as well as the requirements of good character, health, qualifications, skills and experience, the regulation now also bars individuals who are prevented from holding the office (for example, under a directors disqualification order) and excludes people who:
“have been responsible for, been privy to, contributed to or facilitated any serious misconduct or mismanagement (whether unlawful or not) in the course of carrying on a regulated activity, or discharging any functions relating to any office or employment with a service provider.”
What do you have to do?
It is the responsibility of the provider to ensure that all directors meet the fitness test and do not meet any of the ‘unfit’ criteria.
You must carry out all the necessary checks to ensure that anyone you appoint as a director or manger, fits the criteria, and be able to demonstrate that you have carried out the checks with ‘due diligence’, that you have “ – in effect, make all the checks you can, and keep records of the checks you have made.
The CQC will require the chair of the provider’s board of directors to:
- Confirm to them that the fitness of all new directors has been assessed in line with the regulations.
- Declare to them in writing that they are satisfied that they are fit and proper individuals for that role.
They may also ask the provider to check the fitness of existing directors and provide the same assurance to us, where concerns about them come to our attention.
Duty of Candour
The aim of the regulation is to ensure that providers are open and honest with people who use services when things go wrong with their care and treatment.
The regulation applies to the person themselves and to people acting on their behalf, if something happens to a child or to a person over the age of 16 who lacks the capacity to make decisions about their care.
To meet the requirements of the regulation, a provider has to:
- Make sure it has an open and honest culture across and at all levels within its organisation.
- Tell people in a timely manner when particular incidents have occurred.
- Provide in writing a truthful account of the incident and an explanation about the enquiries and investigations that they will carry out.
- Offer an apology in writing.
- Provide reasonable support to the person after the incident.
The provider also has to supply the patient or representative with the results of any further enquiries into the incident and to keep records of all correspondence and notifications in person.
If the provider fails to do any of the things above, CQC can move directly to prosecution without first serving a warning notice.
What do you have to do?
The provider should adopt a culture of openness, honesty and candour, in line with the general obligation on CQC registered persons to “act in an open and transparent way in relation to service user care and treatment”.
You should build requirements to inform residents or their representatives in all relevant procedures, such as health and safety incident procedures, training and guidance for staff and safeguarding procedures. You should also ensure that you keep good records of incidents and your response to them.
The CQC have issued new guidance on the Fundamental Standards for Health and Social care services: Fundamental Standards and Enforcement Consultation (pdf)
And are asking for feedback on the guidance: Give feedback