CQC Update

15 February 2021

A regular update for providers and professionals working in adult social care, sharing the latest guidance on COVID-19 and CQC's approach during this period.

Message from Kate Terroni, Chief Inspector of Adult Social Care

We recognise that many people will have had a terrible time, being unable to visit and spend important time with their loved ones for many months, and how this has had a significant impact on mental health and well-being of people in care services and their families. When thinking about visiting, for those entering care homes and those leaving to visit other places, providers must start with a focus on the individual and how their needs will be met. Blanket bans, where there is no active outbreak, are unacceptable and people should follow Government guidelines, give sufficient weight to local risks and advice from their Director of Public Health as well as giving consideration to the home environment. The individual must be at the centre of the decision. All decisions need to stay under review as circumstances change. Where CQC are aware of blanket visiting bans in homes with no outbreaks, this may trigger an inspection.

 The majority of providers are continuing to do extraordinary work, even when faced with workforce shortages, increased testing and the roll out of a national vaccination program. However, we are aware that in some places blanket decisions are continuing to be made against government guidance. Where decisions are being made, whether that is for visiting, testing or vaccination, the focus must always be on the individual needs of the person. 

 Person centred care has never been more important and recognising that part of people’s identity and wellbeing comes from their relationships is critical. Meeting people’s holistic needs means an individualised approach. The distress caused by not having important relationships well maintained can be as devastating to mental health as when physical health is not attended to – both need to be a priority.

Designation settings update

CQC is continuing to work with the Department of Health and Social Care (DHSC), local authorities and individual care providers to provide assurance of safe and high-quality care in designated settings, which are part of a scheme to allow people with a COVID-positive test result to be discharged safely from hospitals.

Several weeks after we've assured the Infection Prevention and Control (IPC) practice in a designated setting, we’ll be giving them a supportive phone call. You can read the questions inspectors will use to guide their conversation here.

Since the start of the scheme we’ve received numerous freedom of information requests (FOIs) for more information. As all assured designated settings are now identified on the CQC website, we've supplied a list of the settings taking part. Please do talk to your local inspector if you have any concerns.

You can read more information about designated settings on our website.

National testing programme care home staff user research recruitment

NHS Digital and the Department for Health and Social (DHSC) care are looking to interview care home staff to understand more about care home staff testing with the new rapid lateral flow tests (LFD).

They’d like to hear about your experience of testing and hear your feedback on some proposed ideas for how staff testing could work in the future. The interviews are 45 minutes and gift vouchers are available for your time.

If you’d like the opportunity to help improve the service sign up through their survey.

Launch of standards of education and practice for nurses working in care homes 

The first ever standards for nurses working in residential care homes have been published by community nursing charity, The Queen’s Nursing Institute (QNI) and Skills for Care. The standards are enhanced by a Practice Portfolio. 

The care required by those who live in care homes is becoming more complex and technologically sophisticated. The QNI worked with a representative group of care home providers and commissioners to address and identify specific education and practice standards. The resulting standards include a set of benchmarks that can be used to assess the skills and knowledge that a registered nurse will need to demonstrate in a care home setting. 

You can read and download the standards on the Skills for Care website.

Call to Care 

The Department of Health and Social Care (DHSC) have launched a national Call to Care campaign to encourage the public to register for short-term paid work in adult social care. All applicant information is being sent to local authorities and they are responsible for ensuring that applications are fed into local recruitment systems.

As social care employers you’ll be responsible for training and vetting new staff in accordance with CQC regulation, organising DBS checks for new staff, and providing appropriate induction training for the roles new staff are matched to. Staff recruited under this scheme are also eligible for the Covid-19 vaccine. More information can be found in the standard operating procedures for vaccine deployment. 

You can read more information on Call to Care on the GOV.UK website.

Enabling innovation and adoption in health and social care: Developing a shared view National bodies working across the health and care system have come together to develop a shared understanding of what providers need to do to innovate well and how regulators and other national bodies can support them to do this. This work has pointed to 6 principles that are crucial for providers to be more effective at innovating. The principles are based on reviews of the literature on innovation, CQC reports and engagement with over 60 health and social care organisations. You can read more about the principles on the CQC website.

Infection prevention and control, including flu Good infection prevention and control management is essential to ensure people receive safe care and support in care settings. It also ensures safe practice. All staff play an important role in the prevention and control of infection in their individual actions and in the workplace. Care Provider Alliance (CPA) have developed guidance which can help you to plan and manage infections - including outbreaks of flu and other viral and bacterial infections. You can read the guidance on the CPA website.

Read DHSC's coronavirus social care update

The latest edition of the Department of Health and Social Care's coronavirus social care update includes a message from the Chief Nurse for Adult Social Care, Deborah Sturdy, vaccination and guidance updates and more messages on workforce capacity, staff recruitment and personal experiences of vaccination. Read the update.

Staff movement: a risk management framework

This Care Provider Alliance (CPA) have developed a briefing which outlines a risk management approach (developed by CPA member, the Registered Nursing Home Association) that care homes can use to manage restrictions on staff movements. The briefing relates to CQC registered care homes with or without nursing in England.

You can read the briefing on the CPA website here. 

Important information about registering Lateral Flow Device (LFD) test results

All care homes in England should have received their deliveries of LFD’s from the National Testing Programme and are now able to place their own orders here. 

LFD’s should be used for additional staff testing, and testing of essential visitors and visiting professionals. Our inspectors have been advised not to take these tests as they’re already part of a regular testing regime.

Registering all LFD test results (negative, positive and void results) is a requirement and you can register your LFD results here. Understanding results, and the prevalence rate is crucial for public health teams to understand the prevalence of coronavirus in care homes across the country and be able to support the care sector appropriately.

It's therefore very important that care homes have made the necessary arrangements with staff self-testing at home to ensure that all results from lateral flow device tests are registered online.

Registration should be done within 24hrs to ensure that results can assist NHS Test and Trace in understanding transmission and prevalence.

Working together to build a sustainable workforce

Last year the Department of Health and Social Care (DHSC) ran their recruitment campaign, Care for others. Make a difference. The campaign helped to increase national interest and applications for adult social careers. This month DHSC have launched the next phase of the campaign which is a great opportunity to increase your workforce through the campaign coverage.

Below are some quick and easy ways that you could take part in the campaign and make sure your organisation is visible to potential applicants: 

• Upload your vacancies to DWP ‘Find a Job’
• Find expert resourcing advice and templates here
• Use the badging device to co-brand your own materials and show a link between your activity and the national campaign.
• Use the free campaign assets to make sure that you are attracting the best candidates when recruiting. You can use them at any time, not just when the campaign is running.

You can keep up-to-date with the campaign by signing up to the campaign newsletter.

Culturally appropriate care

We’ve created draft website guidance on culturally appropriate care based on our key lines of enquiry, and examples of good practice seen by inspection staff and colleagues across CQC. We’d welcome your feedback on this guidance to ensure it’s  a useful resource for all social care providers.

Culturally appropriate care can be described as care that is alert, considerate and responsive to the attitudes, feelings and or circumstances of the individual that has a distinctive racial, national, religious, linguistic or cultural heritage.

When reading the draft  guidance, it may be useful to consider that people using services may have:

• Less contact with others affirming their culture – e.g. family and friends
• No opportunity to have contact with their culture or community outside their home
• More time spent with people who do not share their culture – e.g. if living in a care home
• More life events that have cultural significance – e.g. end of life

Our intention is to help you ensure the quality of care for people is in line with their lived experiences.

You can access the draft guide and share your views through our digital participation platform by signing up or logging in.

Help us to make services better for you We 're working on improving the way providers send us notifications and registration changes.  To help us understand any challenges or updates needed to these processes, we'd like to speak to people that work in health and social care. This might be through a quick chat, or a more in-depth interview about you and your work. Due to COVID-19, we're running all our research online or over the phone. You can sign up here if you’d like to take part. If you have any questions, you can contact the user research team on experience.research@cqc.org.uk.

LGBT+ History Month

For the first time, CQC’s LGBT+ Network is marking LGBT+ History Month in February, following a successful first CQC Virtual Pride in July 2020. The network wants to show support to colleagues as well as providers and the public, reinforcing that CQC strives for equal and good quality care for everybody.

Throughout February the following sessions are open to anyone who wishes to attend. All sessions will be approximately an hour. For more information and to sign up please contact ray.mason@cqc.org.uk

• Pride in Practice gold award
  Tuesday 23 February, 1-2pm
• 'Curing Queers' talk with Dr Tommy Dickinson
  Thursday 25 February, 2-3pm
• CQC ‘Twitter Takeover’ by the LGBT+ Network
  Friday 26 February, all day 

CQC's future strategy consultation is now live

Feed back now on our future strategy

On 7 January we published a formal consultation on our future strategy. The draft strategy is the product of over 10,000 interactions with stakeholders and sets a bold ambition for CQC over the next five years. 

Our strategy is built on four themes that together determine the changes we want to make. Running through each theme is our ambition to improve people’s care by looking at how well health and care systems are working and how they’re acting to reduce inequalities.

The consultation will run for eight weeks, closing on 4 March 2021.

Your views and feedback have been invaluable as we’ve developed our draft strategy. We’d now like to hear what you think to our proposals so we can make sure it works for everyone.You can to this by either submitting a consultation response or adding a response on our digital participation platform CitizenLab.

Ian's latest blog Ian Trenholm, Chief Executive of CQC, has blogged about the proposed changes in our strategy and the current context in health and social care. We want our regulation to be more relevant and continue to work in a flexible way to manage risk and uncertainty.

Watch our strategy webinars Find out more about each of our strategic themes by watching the webinars our theme leads have recorded on our YouTube Channel. People and Communities Accelerating Improvement Safety through Learning Smarter Regulation

Listen to our strategy podcast series We have continued our strategy podcast series, you can find these on Soundcloud and most podcast providers. Our latest episode explores the strategy consultation with conversations on each of the themes, as well as looking at systems and inequalities.

All CQC offices are closed

Please do not send post - visit our website for details on how to contact us.

Useful guidance

• Arrangements for visiting out of the care home
• Updated support for care homes 
• Updated New national lockdown guidance
• Health and wellbeing of adult social care workforce
• New guidance on looking after people who lack mental capacity

• Guidance on lateral flow testing of visitors in care homes

• Coronavirus (COVID-19) testing for homecare workers
• Adult social care COVID-19 winter plan 2020/21
• Guidance on how to work safely in care homes
• Guidance on how to work safely in domiciliary care
• DHSC guidance for care staff supporting adults with learning disabilities and autistic adults during COVID-19
• Guidance on Infection prevention and control
• Updated guidance on admission and care of people in care homes
• Guidance for supported living services during coronavirus
• Updated guidance on testing and who is eligible 
• Guidance on management of staff and exposed patients and residents in health and social care settings.
• Guidance on IPC precautions for stepdown in hospital or discharge to home or residential settings.
• Guidance on ASC Infection Control Fund
• Guidance on steps to take following the death of a person who worked in adult social care in England
• Reducing risk in adult social care
• Updated guidance on the provision of home care 
• We have published guidance on how to get the most out of inspection, what a good inspection looks and feels like. 
• We have published our Infection, Prevention and Control questions and prompts for care homes
• We have updated our equality and human rights impact assessments
• Ethical framework for adult social care 
• We have published guidance on working within the Mental Capacity Act during the coronavirus pandemic
• The British Psychological Society has issued guidance on meeting the psychological needs of people with learning disabilities and their carers
• The Central Alerting System (CAS) (various updates) is an online cascading system for issuing patient safety alerts, important public health messages and other safety critical information and guidance to the NHS and others, including independent providers of health and social care. Providers can register to receive these alerts through the MHRA website (various updates)
• Interim guidance on DBS and other recruitment checks 
• Visit the GOV.UK website to apply for coronavirus tests for your service
• Guidance clarifying existing practice for verifying deaths outside of hospitals and providing a framework for safe verification of death
• CQC guidance for providers delivering antibody tests or blood tests
• The Nursing and Midwifery Council has an area on their website dedicated to information about COVID-19
• The Health and Safety Executive has published guidance on RIDDOR reporting of COVID-19

• The British Medical Association (BMA) and the Royal College of General Practitioners (RCGP)  have jointly produced a protocol that can be used by various groups of professionals to verify death remotely with a clinician

• The Enhanced health in care homes framework has been expanded to include oral health; falls, strength and balance; mental health; wound care; continence promotion and management; and flu prevention and management. The framework can be used to support your engagement with your aligned primary care network
• NICE COVID-19 rapid guidelines 
• Advice and information on looking after your mental health and wellbeing during the coronavirus outbreak from Updated NHS England and the Mental Health Foundation
• Investigation and initial clinical management of possible cases

Accessibility resources to help you communicate about COVID-19

• Resources explaining the flu vaccination, who should have it and why
• NHS COVID-19 app support translations
• Information on how to use the BLS Health Access service to help with communicating in British Sign Language while getting a test for COVID-19
  Guidelines for organisations booking communication professionals in healthcare settings during COVID-19
• Beyond Words is providing free picture stories and illustrated guides to support people with learning disabilities and autism through the coronavirus pandemic
• Imperial College London, in partnership with the BME Health Forum and the North West London Clinical Commissioning Groups have produced a series of videos aimed at encouraging people to continue to use health services if they are unwell. They are available in English, Arabic, Farsi, Kurdish and Sylheti. 
• Resources from Learning Disability England
• Signhealth has made their InterpreterNow remote BSL interpretation service available for free across all healthcare services
• Signhealth is providing a videos of summaries of key coronavirus guidance in BSL
• Public Health England stay at home guidance, translated and in easy read you'll have to login or create an account to access this guidance. 
• Updated NHS guidelines translated into up to 50 languages by Doctors of the World and find video advice here
• Easy read information on COVID-19 from Mencap
• Public Health England resources in accessible formats
• COVID-19 guidance for providers of services for people experiencing rough sleeping
• The handwashing rap, produced to help people who have a learning disability

Follow us on Twitter!  Keep up with our work with professionals and provider organisations in England by following us on Twitter @CQCProf.