Debbie Ivanova’s blog

Debbie Ivanova, Deputy Chief Inspector of Adult Social Care updates on our managed return to inspection, making regulatory contact with all services and what we are doing in areas of local lockdown.

We have adapted how we work throughout the coronavirus pandemic to have an ongoing view of care and risk across adult social care and we want that to continue. We have increased our oversight in various ways including; gathering and analysing information, working collaboratively with partners such as Trade Associations and hosting online events.

We have heard through our engagement that you have valued the supportive role CQC has played alongside our regulatory role during the coronavirus pandemic.

This support will continue as we increase inspections of services where we have identified immediate risks and when we begin to widen the scope through our new transitional regulatory approach. It is unlikely we will return to our published frequency of inspection, but we know the challenges you are facing and will make regulatory contact with every adult social care service by the end of March 2021.

‘…..we know the challenges you are facing and will make regulatory contact with every adult social care service by the end of March 2021.’

Our understanding of risk is dynamic, based on feedback from the public, families and carers via Give Feedback on Care, whistleblower concerns, safeguarding alerts, information from stakeholders and outcomes of Emergency Support Framework (ESF) conversations. To ensure we understand what is happening in services we’ll be in touch with all providers, whether this is an ESF conversation, a risk based inspection, an IPC thematic review which will involve a visit or our emerging transitional regulatory approach.

Currently our inspectors are prioritising their inspections based on risk. Providers have told us that they would like to show CQC they have improved and for us to re-rate them. At the present time this is only possible under certain circumstances. The reasons where we re-rate are where it is in the public interest, for example where we think the current rating and report are misleading and do not reflect the actual quality and safety of the service, especially where the current published rating doesn’t reflect newly evidenced risks to people using services. This includes where we identify through intelligence and planning that a service is becoming inadequate, where there have been significant improvements to warrant a move from inadequate or where a service does not have a rating and we have concerns about quality and safety.

As we increase this on-site activity, we have been considering the precautions our inspection teams should take. You can read our latest update on testing and personal protective equipment (PPE) here. Since the introduction of new Public Health England (PHE) guidance for PPE in Health & Social Care settings, we have revisited the guidance originally published for our inspectors. We will use this to inform our decisions of what PPE is appropriate for the different circumstances.

‘As we increase this on-site activity, we have been considering the precautions our inspection teams should take.’

We have also been reflecting on what our approach should be in circumstances where there are local lockdowns. Government alert levels are only one influence on our regulatory activity. Alongside this we are applying wider context and knowledge; for example, the issues and risks associated with the subsector and of any local or regional factors. Where there is a local lockdown we will continue our regulatory assessments, but on-site activity would be by exception. In areas where there is enforced social distancing, we will continue our regulatory assessments, including on-site activity where required.

As we engage with you to shape our next strategy, we are learning and building on different ways of working so that we regulate in the best way for the future. There will be lots of opportunities over the coming months to get involved so sign up to our bulletins and digital participation platform to make sure you hear about these.