CQC's 'back to routine inspections' plan

Regulating during COVID. CQC's second insight report.

The health and care regulator is to kick-start its routine inspections across England in the autumn with inspectors now scheduling inspections of higher risk services to take place over the summer.

While the CQC paused its inspections in March it continued to inspect in response to risk and concerns raised, with other healthcare services receiving calls as part of the new approach to regulation in the shape of its Emergency Support Framework.

CQC's latest insight report looks at the pressures health and care services and local systems have faced and the steps that have been taken to overcome them. The report covers three core areas, with a section on data.

Key figures from CQC's insight report

There has been a palpable increase in calls to CQC’s national contact centre from staff raising concerns about care - with the biggest increase from staff in the adult social care sector.

Adult social care stats
  • 55 per cent increase in adult social care staff raising concerns for the period 2 March to 31 May 2020 compared to the same period in 2019
  • 26 per cent of calls related to lack of PPE or other infection control products
  • 32 per cent of calls included concerns about how infection control or social distancing was being practised at the service 
  • 4 per cent of calls referred to quality of care being impacted by COVID-19

CQC comment that they have followed up with the providers directly in the cases highlighted – usually by phone as they have only carried out a small number of physical inspections since mid-March. However, of the 17 physical adult social care inspections conducted since 17 March, 11 have been as a result of concerns raised by staff or members of the public.

But what about people detained under the Mental Health Act

There has also been an increase in calls about, or from, people detained under the Mental Health Act – often expressing distress or confusion about why people are more likely to be confined to their rooms rather than being able to move around freely. 

In response, CQC have also changed the way they handle calls to help support people who complain to CQC about the Mental Health Act and care or treatment while detained during COVID-19. Of the eight mental health services the regulator has inspected since pausing routine inspections, five have been as a direct result of concerns raised with them by staff or members of the public.

Kate Terroni, CQC’s Chief Inspector of Adult Social Care, said: 

"It’s in everyone’s interests that staff are able to speak up freely and are not prevented from raising their concerns about quality and safety – and all providers have a responsibility to support their staff to share concerns safely without fear of reprisal. 

Staff have been going to extraordinary lengths to deliver good, safe care during this global crisis – if they are experiencing barriers to the delivery of that care, we want to hear from them and we are encouraged that so many staff have been brave enough to raise concerns with us."

CQC "should not rush to restart old inspection model" 

Responding to CQC's press release, Niall Dickson, chief executive of the NHS Confederation, said: “We need a new wave of inspections like we need a hole in the head. The NHS is embarking on what could well be the most challenging period in its history and this will not help."
 
On the future of regulation, Dickson suggests that now is the time to "learn the lessons of this period before jumping back into old inspection regime. Instead there is an opportunity to reset the way that we think about inspection, regulation and governance and it is an opportunity our members are keen to explore. Let’s not rush back to the way things were. We will seek to work with the CQC to make sure the views of our members inform their thinking on the future approach to regulation and inspection.”
 
A CQC spokeswoman responded to Niall Dickson's comments: “We are pleased that NHS Confederation are actively seeking to work with us on our future approach to regulation.” [Source: Health Service Journal article dated 17 June 2020].
We will continue to follow this development and update you recognising the challenges that lie ahead.
 
You can read the first issue of the CQC's insight report here. It looked at the adult social care, the impact of the pandemic on staff wellbeing and the financial viability.
 

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