DDU CQC compliance adviser and former CQC inspector Jodie Carr shares 10 practical tips to help you prepare for an inspection
Following widespread concerns about the single assessment framework inspection process, introduced in 2024, the CQC is piloting a new draft inspection framework for primary care. The pilot, which is due to be reviewed at the end of autumn, is running alongside existing inspections. Here is what you need to know.
- Demonstrate good governance
One area where practices can fall short is demonstrating effective governance (Regulation 17). This means having systems in place to ensure that care is safe, high-quality and compliant with regulations and demonstrating that those systems work in practice.
For example, how are risks identified, recorded and managed? Who oversees staff training? What procedures are in place to ensure fire safety? Are fire extinguishers serviced regularly, and are these checks recorded? Prepare an action plan to review key policies, including those covering complaints and accessibility, alongside supporting records such as staff training logs, equipment servicing records, fire risk assessments and complaints documentation.
The focus should be on demonstrating that processes are regularly reviewed and used to identify opportunities for improvement.
- Provide the evidence
You may know that your practice delivers high-quality care, but the CQC needs evidence that this is happening consistently, not just on inspection day.
For example, our analysis of recent dental inspections found that infection prevention and control (IPC) featured in a high proportion of reports, although concerns were not always related to cleanliness. In most cases, the issue was a lack of evidence demonstrating effective oversight, such as audits, cleaning schedules or records of staff training in infection control.
It’s equally important to highlight what your practice does well. Evidence might include positive patient feedback, additional staff training in specialist areas or community outreach initiatives supporting hard-to-reach patient groups.
- Patient feedback
Before the inspection date you will be sent a patient feedback form to print and a QR code to display. This will give patients the opportunity to feedback about your practice to CQC directly.
It’s equally important to highlight any evidence from patients or examples of good practice. This might include positive patient feedback over the year, additional staff training in specialist areas or community outreach initiatives supporting hard-to-reach patient groups. It’s useful to review all patient feedback via an audit to check for any trends and show what actions have been taken to improve.
- Be prepared
Of the approximately 12,000 dental practices in the UK, only around 10% are inspected each year. However, inspections can take place at any time, so it’s important to remain inspection-ready, with the relevant evidence readily available to demonstrate compliance.
Some inspections are unannounced, for example where the CQC has concerns about a practice, but most practices are generally notified by telephone or email in advance. Make sure the CQC has up-to-date contact details for your registered manager and/or nominated individual so that important communications reach the right people.
Once you receive notification, use the time wisely. Complete and return the Provider Information Request (PIR) within the specified timescale, which is generally five days. This may require information about your statement of purpose, leadership and governance arrangements, and other aspects of how your practice operates.
- Typical questions
Although it’s impossible to cover all the questions you might be asked, some areas of practice are likely to come up. For example, how do you ensure consent when treating patients who lack capacity, in line with the Mental Capacity Act? Can you give examples of incidents you have reported and explain what happened as a result? Can all staff who have contact with patients recognise the signs of sepsis and explain the appropriate response? What procedures do you follow when you have a safeguarding concern?
It’s worth reminding everyone in the practice refreshing their knowledge of relevant procedures and thinking about examples that demonstrate how these are applied in everyday practice.
Remember that the CQC may gather information about your practice from a range of sources, including social media, press coverage and publicly available online imagery. Reviewing your practice’s online presence yourself can help you anticipate questions and prepare appropriate responses.
- Involve the whole practice team
A CQC inspection involves the entire practice team, so make sure everyone understands what is happening and the role they play. Avoiding the inspection or staying in the background is not an option and could raise concerns for inspectors.
Reception staff should be prepared to welcome inspectors and follow the practice’s visitor procedures. The inspection team will typically include a CQC inspector and may include a clinical adviser.
During the inspection, the team will tour the practice, review documentation and speak to a range of people to build a comprehensive picture of how the practice operates. These conversations may include dentists, dental care professionals, administrative staff and patients.
Inspectors want to see a positive, supportive culture in which staff understand their responsibilities, feel able to raise concerns and are engaged in improving the quality of care.
- Be honest with inspectors
Inspectors don’t expect perfection. Every practice will have areas where it can improve. What matters is that you recognise any shortcomings, understand the associated risks and can demonstrate the steps you are taking to address them.
Inspectors may cross-check information with other members of the team, so honesty and openness are essential. Being defensive or providing misleading information is far more damaging than demonstrating insight, acknowledging challenges and showing a genuine commitment to improvement.
- Make compliance part of everyday practice
CQC compliance should not be something you focus on only when an inspection is approaching. Safe, effective, caring, responsive and well-led practice should be embedded in everyday working life.
Inspectors want to see that the team recognises shortcomings and takes appropriate action. This might include arranging additional training, replacing faulty equipment or updating a procedure. Evidence of these actions, alongside audits, training records and policies, helps demonstrate a proactive approach to quality and safety.
The aim is to show that your practice regularly reviews its performance, learns from experience and makes improvements where needed.
- First impressions count
Reception and support staff are often the public face of the practice and play an important role in patient safety. Inspectors may ask them about their responsibilities and how they contribute to safe, effective care, so it’s important that they feel confident discussing their work. For example, they may be asked about the appointment triage process or how to recognise signs of sepsis or a dental emergency. Ensure reception staff understand the relevant procedures and know who to approach if they need help or have concerns.
- Don’t overlook the post-inspection process
Once the inspection is over, you can breathe a sigh of relief, but there is still some further work to do. Practices are generally given a specified 10 working day period to comment on the factual accuracy of the draft report. Check the deadline stated in the accompanying correspondence, as well as the process for submitting comments.
Review the report carefully and involve relevant colleagues in checking its content. This is an important opportunity to correct factual errors, clarify information and ensure that the final report accurately reflects the evidence provided during the inspection. Although the CQC does not award dental practices an overall rating such as ‘Good’ or ‘Requires Improvement’, it publishes inspection reports on its website.
Most importantly, use the findings from the inspection to identify lessons to be learnt, address any outstanding issues and continue to improve the quality and safety of care at your practice. Don’t forget that CQC will review your previous inspection report during before their next visit. Any previously identified issues that remain unresolved could raise further concerns, so it is always best to take action promptly and keep a record of the steps taken.