The Inspectorate has various measures at its disposal to ensure compliance with legislation, (professional) standards and guidelines. It can offer advice and recommendations to encourage improvement. It can impose corrective or coercive measures. In the most serious cases, the Inspectorate can institute disciplinary or criminal proceedings.
The Inspectorate examines each case individually to determine which enforcement measure is likely to be most effective in both the short and longer terms. Usually, it will begin by applying a relatively ‘light’ measure (such as enhanced supervision), proceeding only to more stringent measures (e.g. a compliance order or fine) if unsatisfactory progress is made in resolving the situation. However, the Inspectorate will not hesitate to institute immediate disciplinary or criminal proceedings should the circumstances so demand.
When deciding upon the most appropriate enforcement measure, the Inspectorate will take the following variables into account:
- The five Ds: dissatisfaction, discomfort, disease, disability and death (internationally recognized criteria).
- The number of people at risk (i.e. a large, medium or small risk group).
- The manner in which care provision is organized and structured with a view to quality and safety outcomes (poor, moderate, good).
- The attitude of the care provider (ignorance, incompetence, non-compliance).
Supervisory and enforcement activities are generally conducted on the basis of trust. The Inspectorate assumes that care providers are motivated to perform their duties in the best manner possible. However, trust does not mean that the Inspectorate will fail in its own duty of verifying that quality and safety are indeed at the required standard. At all times, the Inspectorate pursues an appropriate balance between trust in care providers on the one hand, and supervision and inspection on the other.