Last year saw the announcement by the CQC of Regulation 20: Duty of Candour as part of the Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2015. Although 18 months has passed since this this new regulation was introduced, many providers are still failing to meet the requirements of the Duty of Candour.
The CQC expects all providers to demonstrate compliance with this regulation at inspection and frequently includes reference to this requirement during suitable person interviews. Any lack of awareness of your responsibilities could affect your inspection report, create difficulties with registration or even lead to regulatory action being taken.
Read on to learn more about the steps you should take to ensure compliance with the Regulation 20: Duty of Candour.
Guidance from the CQC on the Duty of Candour states that to meet the requirements of Regulation 20, a registered provider has to:
- Make sure it acts in an open and transparent way with relevant persons in relation to care and treatment provided to people who use services in carrying on a regulated activity.
- Tell the relevant person, in person, as soon as reasonably practicable after becoming aware that a notifiable safety incident has occurred and provide support to them in relation to the incident, including when giving the notification.
- Provide an account of the incident which, to the best of the provider’s knowledge, is true of all the facts the body knows about the incident as at the date of the notification.
- Advise the relevant person what further enquiries the provider believes are appropriate.
- Offer an apology.
- Follow up the apology by giving the same information in writing and providing an update on the enquiries.
- Keep a written record of all communication with the relevant person.
5 Steps to Ensure Duty of Candour Compliance
- Communication: Communicate to all staff, irrespective of seniority, the importance of understanding their role in being open and transparent about any incidents or concerns and in sharing information with other relevant persons when things go wrong.
- Policies: Ensure that your policies are updated to encourage a culture of openness, honesty and transparence and that staff trust that they will be implemented in practice. Pay particular attention to protecting whistleblowers and taking action against any individual who obstructs an individual from exercising their duty of candour.
- Reporting: Regulation 20 sets out ‘harm thresholds’ to indicate what constitutes a notifiable safety incident. These are broadly in line with existing thresholds for the notification of deaths and serious injuries and include any incident which appears to have resulted in:
- 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,
- 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,
- Changes to the structure of the service user’s body,
- The service user experiencing prolonged pain or prolonged psychological harm, or
- The shortening of the life expectancy of the service user
- Professional regulation: Staff such as nurses who are professionally registered are subject to a duty of candour under their own code of conduct. If found to be in breach of this duty, you should be aware that you may need to refer the case to the relevant professional regulatory body.
- Further information: For full details of this new regulation including examples of reportable incidents, read the full guidance document entitled Regulation 20: Duty of candour – Information for all providers: NHS bodies, adult social care, primary medical and dental care and independent healthcare available from the CQC website.