DON’T FORGET TO READ THE FULL

VERSIONS OF THESE EXCERPTS ONLINE AT WWW.CODEUK.COM!

WHAT’S NEW IN COMPLIANCE ................................01TOP 10 TIPS FOR AVOIDING STAFF DISPUTES ..................................02SPARE US THE PORRIDGE ...............02HELP! MY PRACTICE MANAGER IS LEAVING! .........................................03BEWARE THE DREADED DENTAL DILAPIDATIONS .................03ARE YOUR TEAM CONTRACTSUP TO DATE? ........................................04 A NEW QUALITY STANDARDIN DENTISTRY .....................................04

IN THIS ISSUE

ACCESSIBLE INFORMATION STANDARDFrom 1 August 2016, all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. The practice must ask every patient at their fi rst or next appointment for their communication and information needs where they relate to a disability, impairment or sensory loss, with the aim of fi nding out whether an alternative information format and/or support is required. These needs should be recorded and kept in a patient’s records. With the permission of the patient, these needs should also be shared when making a referral.CODE and iComply members can use the new Accessible Information Policy (M 233-ACI).

THE PROFESSIONAL DUTY OF CANDOURThis was originally part of the new fundamental standards introduced in 2015 and was only applicable in England, but it is now a GDC standard and applies in all regions of the UK. If you’re in Wales, Scotland or Northern Ireland you need to check that you have an appropriate policy in place.

FGM REPORTING REQUIREMENTSThe new duty applies where a dental professional, in the course of their work, either is informed directly by a girl that an act of female genital mutilation (FGM) has been carried out, or observes physical signs that appear to show an act of FGM has been carried out.If a GDC registrant is told or suspects an act of FGM has taken place then they must report directly to the police rather than report to a practice safeguarding lead.CODE and iComply members can use the FGM Reporting Policy (M 233-FGM).

WORKING WITHOUT CHAIRSIDE SUPPORTThe CQC has started to look more closely at situations where hygienists and therapists are routinely working without a nurse.Inspectors will expect to see that a risk assessment has taken place for each surgery where a provider may work without chairside support. You should discuss the assessment with the individuals involved, agree control measures to reduce risks,

put those measures in place and make sure that team members and patients would know what to do if there was a medical emergency.Members can download the new CODE guidance (M 297) and risk assessment (M 297B) to help meet the standards.

SAFER SHARPSThe regulations state that practices must reduce the use of sharps as much as possible and replace traditional sharps with safer sharps where reasonably practicable to do so. Cost and lack of training on safer sharps cannot be used to justify the use of traditional sharps. It should also be noted that nurses should never handle sharps.Practices need to have a very clear policy that explains the types of sharp they use and why. They must also have a sharps risk assessment in place. To help practices CODE updated the sharps policy (M 233-SHP) and general risk assessment (M 250B).

BEING WELL LEDThe Care Quality Commission key line of enquiry, ‘Is the practice well led?’ is the area where most practices in England fail at inspection time. An area of particular signifi cance is external risk assessments and audits including routine X-ray testing and legionella reports. It is not enough to simply have these carried out and placed on fi le, the inspectors look for follow up actions. Another top tip is to make sure that roles – such as safeguarding, decontamination leads, etc – are clearly and consistently defi ned in your practice documents as well as being communicated to the whole team. With so many areas of compliance to cover, and lots of updates to keep on top of, investing in a CODE Practice Health Check can prove to be really worthwhile. A consultant will review all of your compliance in depth over a day and provide an action plan highlighting areas that require improvement. Read more about compliance health checks here :www.codeuk.com/consultancy. Book by calling 01409 254 354 or email info@codeuk.com

NEWSLETTERMARCH 2017

codeuk.com

WHAT’S NEW IN COMPLIANCE

A look at the important changes that occurred in 2016

A lot happened in compliance last year, so we have provided a round up of some key topics to help you make sure you didn’t miss anything.

and lots of updates to keep on top of, investing in a CODE Practice Health Check can prove to be really worthwhile. A consultant will review all of your compliance in depth over a day and provide an action plan highlighting areas that

Read more about compliance health

. Book by calling

Whether you’re a foodie or not, the emphasis we now place on a dining experience is almost becoming more important than the food itself.

So what about something completely out of the ordinary that guarantees to wow pals and colleagues alike? That’s where The Clink in Brixton comes in. With fi ve private dining rooms available for exclusive hire, all with plasma screens and AV facilities, this venue can also be ideal for meetings, conferences and presentations.But what’s so diff erent about it? Well, The Clink is based inside HMP Brixton, giving your and your guests the chance to dine within the walls of a category C prison. The food here is prepared and served by prisoners who are on an innovative rehabilitation programme, which allows them to work towards City & Guilds NVQs and leads to employment in the UK hospitality industry upon release.The Clink Brixton is the fourth site to be opened since Alberto Crisci, the manager of a prison kitchen, came up with the ingenious idea and opened the fi rst one in 2009. Since then, more than 800 people have graduated from the project and The Clink Charity aims to open 20 more sites by 2020. Boasting an impressive 87.5% success rate in reducing reoff ending, we’d say they’re defi nitely doing something right.Prepared using the latest cookery techniques, the menu is seasonal with dishes on the winter menu including venison and ox cheek, as well as delightful vegetarian options to boot. There is also an afternoon tea menu, should you prefer something lighter. For further information, or to book, please visit www.theclinkcharity.org.

SPARE US THE PORRIDGETreat yourself to a

dining experience with an added twist

2

1 HAVE REALLY GOOD CONTRACTS

Contracts are the foundation of a good employer/employee relationship, they outline the rights of each party and set the tone from day one. They should clearly state roles, responsibilities and employment status to ensure that everyone knows what is expected of them at all times during employment. CODE members have the latest contracts at their fi ngertips.

2 HAVE GOOD POLICIES AND PROCEDURES

A staff handbook is a great way to keep all of your policies and procedures in one spot and helps to keep your team on the same page. Go through this during new staff inductions and carry out refresher sessions with all staff at regular intervals. CODE policies and procedures have been developed from the experience of owning and running 50 practices and can provide you with excellent templates to use within your business.

3 TRAIN YOUR STAFFIt is not enough to simply have good

policies and procedures, you need to provide training so that your staff fully understand them and are implementing and following everything correctly. This will ensure consistency, fairness and compliance.

4 COMMUNICATE STANDARDS AND

EXPECTATIONSAs a dental practice owner or manager, lead by example in order to set the level of standards you expect from your team. Communication is key for this, we recommend having regular team meetings and morning huddles, as well as an open door policy so that employees feel they can always speak to you.

5 ENCOURAGE A POSITIVE CULTURE

The atmosphere of your practice starts with you so once again, lead from the top! Being positive and upbeat is infectious and your staff will follow suit.

Ensure a stable work environment with these handy hints

TIPS FOR AVOIDING STAFF DISPUTES

6 DO NOT IGNORE GRIEVANCES

Act swiftly and directly when any grievances are brought to you, to avoid escalation. You should have a zero tolerance policy on workplace bullying and potential discrimination issues. Our top tip is to train your staff to pick up on these issues.

7 HIRE GOOD PEOPLE Your recruitment procedures

should be robust and compliant with CQC expectations, this is an area that is looked at during an inspection so it is vital that various important checks are carried out prior to the start of employment. You should also follow up with appropriate training and probationary reviews and keep all of this information in the employee’s record. We are in the process of introducing a handy pre-employment checklist to iComply.

8 DEVELOPMENT AND ONGOING SUPPORT

Put together a training plan, and identify areas where your employees need support. This will help your employee to get the most from their career, while your business benefi ts from getting the best from its staff .

9 INVEST IN YOUR EMPLOYEESDeveloping and praising your

employees makes good business sense. Not only does it help to keep staff happy by keeping them interested in the their role while aspiring to achieve more, it means that your practice will have highly skilled staff that provide an excellence service to patients.

10 TREAT EMPLOYEES FAIRLY AND ETHICALLY

Always do things the right way and treat people how you would like and expect to be treated yourself, especially when it comes to redundancies and dismissals – think about your reputation as an employer.

iComply application members have access to a wealth of resources, including the latest associate and team contracts, up to date policies and a complete set of procedures. Not only does this help with compliance, it can also protect your business from suff ering as a result of staff disputes. For more information, call 01409 254 354 or visit www.icomply.cc.

TOP10

3

Most dental practice leases describe in detail the obligations placed upon tenants to keep the premises in good repair and decorative condition throughout the term of the lease. ‘

Dental tenants should be fully aware of these obligations before taking or renewing a lease and should try to limit their obligations at that stage. Ideally, the condition of the property should be recorded prior to entering into the lease in a Schedule of Condition. Photographic evidence at the commencement of the lease is invaluable. Dilapidations’ is the legal term to describe the repair works that have not been undertaken by the tenant despite their obligations under the lease. They represent a breach of lease if not remedied.

When a dental tenant (or any commercial

tenant) seeks to vacate premises, their landlord will inspect the premises and serve upon them a Schedule of Dilapidations. This will list all the repairs that need to be carried out and will detail any alteration works carried out by the tenant that need to be reinstated.

The landlord is entitled to fi nancial compensation equal to the cost of the repairs or dilapidations, plus loss of rent during the period needed to carry out those works. The Schedule will therefore include an estimate of the cost of each repair or reinstatement. As the Schedule is prepared by or on behalf of the landlord, inevitably the costs sought are premium prices.

Quite frequently, dilapidation claims run into tens of thousands of pounds. Tenants often claim landlords abuse their rights and attempt to profi t from the dilapidations process by making improvements to their

premises at the tenant’s expense. Tenants must be alert to this.

Fortunately, there are a number of arguments that can be raised to limit a tenant’s liability. An experienced surveyor and solicitor can guide dentists through the whole process and in many cases, the savings gained from their involvement exceed their professional fees many times over.

Dilapidations are like cavities, sometimes a sign of neglect, sometimes just unfortunate. However, by seeking timely professional advice, they need not be painful.

For any further advice regarding dilapidations or legal disputes, contact Heidi Berry, specialist litigation solicitor at Rudlings Wakelam, on 01284 755771 or at heidi.berry@rudlings-wakelam.co.uk. Benefi cial rates are off ered to all CODE members.

BEWARE THE DREADED DENTAL DILAPIDATIONSUnderstanding your obligations as a dental practice tenant can ease the pain

We often receive queries about where to begin with compliance when the person who has been dealing with this vital area of the business leaves; it is very common for the practice manager to be the only person with working knowledge of the practice’s compliance system. Worse than that, often this system is usually a rough schedule in a personal diary, or more commonly, inside the practice manager’s head!

More often than not, this means starting from scratch but this isn’t necessarily a bad thing; you can use this as an opportunity to take control and lead your practice with a culture of compliance.

If possible, ask your current manager to train your new one on your practice’s compliance system as part of their induction. We recommend either sitting in on this training yourself, as practice owner, or selecting another member of staff to. This will mean that there are more people who understand how to manage the compliance of your practice. If your manager has left before you employ a replacement, CODE off ers two-hour online training sessions to give your

new team member the knowledge they need to keep on top of your compliance.

If you are already using the iComply application, update your practice manager details and also allocate any outstanding tasks to other relevant team members. This will help to build your culture of compliance by getting your team more involved with the necessary activities, giving everyone a deeper understanding of what’s necessary while also helping to keep things on track. Carrying out a compliance analysis will also help you to spot areas that may have been neglected in the past, allowing your new practice manager to create a plan of action.

Going forward, the most important thing is to have an independent compliance system, so that it is not dependent upon one person. There are a number of ways to achieve this. Firstly it’s best if more than one person at the practice is involved with compliance, the more the merrier. Secondly, have a standardised fi ling system for all of your compliance evidence, policies and procedures. Thirdly, have a company providing you with all of the latest compliance advice, keeping you up to

date. Remember that compliance is much more than CQC, here are a few more areas that you need align with:• GDC• Employment law• Health and safety• Infection prevention (HTM 01-05)• NHS contract and infection prevention• MHRA• X-ray safety (The Ionising Radiations

Regulations 1999, (IRR99)• The Ionising Radiation (Medical

Exposure) Regulations 2000 (IR(ME)R 2000)

• Guidance Notes for dental practitioners on the safe use of X-ray equipment, (Department of Health)

• AND MOREFortunately, iComply meets all these requirements, you can delegate to the team and it tells you what to do, when to do it, and where to fi le everything. For more information about iComply please visit www.icomply.cc or call 01409 254 416 to request a demonstration.

HELP! MY PRACTICE MANAGER IS LEAVING!Handy advice on how to cope if you are concerned about compliance

If you are already using the iComply application, update your practice manager details and also allocate any outstanding tasks to other relevant team members.

4

Not only does this create a sense of pride within your practice, demonstrating your quality can be very benefi cial when it comes to your CQC inspection, so how can you do this? The CODE Quality Practice Scheme (QPS) successfully launched at the end of 2016 and we’ve seen a raft of practices signing up to reap the benefi ts that is can bring. Not only does it help practices meet the necessary compliance requirements, it also off ers much more in the way of demonstrating a commitment to quality.

DEMONSTRATE YOUR DEDICATIONAchieving QPS membership is a display of your team’s dedication and hard work towards quality, safety, patient care and continuous improvement. Members receive a plaque fro the practice and a certifi cate for the reception area, both of which are visual demonstrations of the level of standard and quality you provide. This will resonate with patients and inspectors alike, as well as being something you can all be proud of achieving.Working together to boost your standards is something that the entire team can be involved in, which creates an increased sense of camaraderie and team spirit that will benefi t other areas of your business, too.

HOW DOES IT WORK?The QPS is considered to be an accreditation programme, something the CQC is very keen to see. It works alongside the iComply application, which leads subscribers through all aspects of their compliance over the course of a year, providing action prompts and templates for policies and procedures.

On top of this, QPS provides quarterly monitoring by the CODE team who will send a letter to the practice outlining any areas where steps need to be taken to keep things on track. At the end of this annual cycle, QPS practices will also benefi t from an inspection by the CODE team, if everything is shipshape membership will be awarded! If not, we will explain what needs to be done to boost your quality to the required standard.You can read more about the Quality Practice Scheme on the CODE website: www.codeuk.com/qps or you can email hello@icomply.cc or call 01409 254 354 to speak to an expert or arrange a free demonstration.

A NEW QUALITY STANDARD IN DENTISTRYMake a positive change to your dental practice

With more employment tribunals winning worker’s rights, do you need to revisit your agreements?

ARE YOUR TEAM CONTRACTS UP TO DATE?

In our last newsletter, we discussed the Uber ruling and what implications this may have on dental associates and hygienists/therapists, who have historically always been identifi ed as self-employed contractors. It seems that cases like this are on the rise, with a bike courier now also recently winning an employment rights case to be classed as a worker rather than self-employed.

Thanks to this ruling, Maggie Dewhurst, a courier with logistics fi rm City Sprint, would now be entitled to basic worker’s rights, including holiday and sick pay and the national living wage. In light of this, it is important for dental owners to consider the relationship between themselves and the self-employed associate or hygienist/therapist, as these cases are winning due to tribunals focusing not just on the contract agreement but whether the employer has too much control over the self-employed contractor. In an employer/employee relationship, the employer has

control over what work the employee does, when they do it and how, including when they take holidays, etc. It is important to have an agreement that is clear for both parties, but not too detailed or prescriptive to imply there is an employee/employer relationship.We thought it would be a good idea to look in some detail at Provider Performer Agreements as getting these right from the outset can help to set the right tone.

HOURS AND EMPLOYMENT STATUSYour agreement should set out the hours during which the Performer may provide non-emergency NHS treatment. The schedule should also set out the minimum number of hours per week that should be worked, as well as minimum and maximum monthly UDAs. This section should also cover non-clinical days, which is a day during which there will be no attendance at the practice for the purpose of CPD, administration or other activities. The agreement should state that the Performer is self employed and there should be a schedule of terms attached to this.

PATIENTS AND GOODWILLWithin the agreement we advise that it states that the goodwill of the patients belongs to the Provider and that the Performer shall not advise patients of any new working arrangements for a specifi ed period of time. It should also outline that there is no obligation on the Performer to accept patients referred by the Provider, if their professional judgement deems this inappropriate.

RESPONSIBILITIESThis is where it outlines the Performer’s responsibility for his or her own actions and omissions related to the treatment of patients, the keeping of records and compliance with dental regulations and legislations. It is not possible within the confi nes of this article to cover in depth every clause that a Provider Performer Agreement should include. CODE members and iComply application users have access to the latest versions of associate and performer agreements, private practice, UDAs, PDS+ and fee per item (Scotland). To fi nd out more about iComply, visit www.icomply.cc.