Is the CQC Genuinely Assessing Leadership With the Well-led KLOE?

October 31, 2016

Is the CQC Genuinely Assessing Leadership Within the Well-led KLOE?

I visit many dental practices in my role as a practice management and compliance consultant. Some have passed CQC inspections under the new regime. For those that have passed, it should mean that they have ticked the key line of enquiry (KLOE) boxes for being safe, effective, caring, responsive and well-led. Unfortunately, it can often be glaringly obvious that there are deficiencies within the well-led element. The atmosphere in the practice can be the first thing that gives the game away. Sullen faces on reception and a greeting that lacks warmth and sincerity can be the first tangible evidence. The decon’ nurse that scurries around silently, the raised voices in the staff room and the mismatched, over-zealous greeting from the practice manager are all further signs of a culture where the foundations are potentially flawed. How can CQC assess these issues when everyone is on their best behaviour during an inspection? How do CQC assess the ‘soft’ skills owned by management teams? How do CQC assess behaviours and attitudes of individuals? The answer is that they don’t.


What does the Well-led KLOE Assess?

The well-led key line of enquiry asks whether good leadership, good management and good governance arrangements are in place in your practice. Good management and good governance are system based and with the correct training a practice manager or principal dentist can learn the hard skills necessary to implement them. These skills are quite straightforward to monitor and the results can be measured quite readily. On the other hand, good leadership relies heavily on the intrinsic characteristics of individuals and ‘soft’ skills of the provider and/or registered manager. These interpersonal skills are more difficult to learn and most definitely difficult to measure.


Are there Flaws in the System?

What happens if good leadership and much needed soft skills are not present? Well, unfortunately, the cultural ground can start to shake and dysfunctional cracks can appear. The American team management guru, Patrick Lencioni, explains what these are in his book The Five Dysfunctions of a Team:-

Dysfunction #1: Absence of Trust

The fear of being vulnerable with team members prevents the building of trust within the team.

Dysfunction #2: Fear of Conflict

The desire to preserve artificial harmony stifles the occurrence of productive, ideological conflict.

Dysfunction #3: Lack of Commitment

The lack of clarity or buy-in prevents team members from making decisions they will stick to.

Dysfunction #4: Avoidance of Accountability

The need to avoid interpersonal discomfort prevents team members from holding one another accountable.

Dysfunction #5: Inattention to Results

The pursuit of individual goals and personal status erodes the focus on collective success.

These flaws can undermine robust compliance and the ultimate success of a practice. I believe that well-led means dealing with underperformance and poor behaviours in a consistent manner, nurturing positive attitudes and ultimately laying the foundations for teamwork and a strong culture.


Learn ‘Soft’ Skills

My belief is that the new CQC regime gives us a positive framework for delivering best practice in both clinical and managerial areas of work. What it does not give us is the guidance to nurture a strong culture or develop the interpersonal skills that are necessary to gain commitment from our teams and lead them to success. If you want to develop and build on your current ‘soft’ skills, attend one of our courses in London on either 19th November or 2nd December 2016.  You will learn many strategies to tackle dysfunctions within your dental team and to be sure that your practice is well-led! Click here for full details -