Regular column for providers and professionals working in adult social care from Kate Terroni, Chief Inspector of Adult Social Care

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It has been fantastic to hear from so many of you through our latest webinar series on our transitional regulatory approach and strategy. We have now finished this series but you can watch the recordings on our YouTube channel if you didn’t manage to get a place.

I thought it’d be helpful to use my blog to share the main themes we heard and answer some of your questions.

Emergency Support Framework Reflections

Throughout the pandemic our purpose is as vital as ever . When it started, as with everyone, we needed to rapidly think about how we do our job differently, but we’ve endeavoured to transform in the direction that our new strategy was already taking us.

Many of you spoke highly of your Emergency Support Framework (ESF) experience and talked about how beneficial, supportive, open and honest these experiences had been. We want this to continue.

What we’ve learnt through using this approach and your feedback on the ESF has helped us to develop our transitional regulatory approach which is now being used across adult social care.

We’ve taken regulatory action, whether that’s an ESF call, an inspection including infection prevention and control or transitional monitoring activity with over 70% of locations in adult social care. We’ll continue to provide this support to you through Winter.

Infection, Prevention and Control

There were lots of queries around our Infection, prevention and control (IPC) inspections. IPC has always been important but it’s under the spotlight more than ever before.

In our plan to monitor IPC over winter, we share our collective position on IPC, safe discharge from hospital, visiting and system working.

We’ve committed to complete 500 ‘stand alone’ IPC care home inspections by November using our IPC framework. These include;

  • Inspections of proposed designated facilities
  • Thematic inspections to look at and learn from good IPC practice
  • Inspections in response to whistle-blower or information of concern

This framework has a dual purpose, to outline what we expect to see and to help find, learn and share best practice. These inspections will be unannounced if risk based (or announced from the car park) and more notice given to those which are part of the thematic.

We’ve seen some fantastic IPC practice out there especially around safe admission, IPC for visiting and access to testing. However, we must all continue to be vigilant when it comes to PPE and making sure IPC policies are up to date. These areas are critical to keeping people who use services and staff safe and something we shouldn’t stop talking about.

We also heard your concerns about admissions. You should only admit someone when you are confident you can meet their care needs with good infection prevention and control, you’ve got the right PPE and you’ve got the right workforce. We’ll absolutely support you to say you can’t admit someone if those elements aren’t in place.

We continue to inspect high risk services in homecare, and we’ve started our care at home virtual inspection pilot which runs until the end of November. This involves a group of sixty services where we are replacing visits to offices with calls, screen sharing and secure file transfer.

We’re also using different ways of engaging with providers, people who use services and staff, by phone and video calls. The feedback has been really positive so far and we’ll share the learning from this pilot in a future blog.

Transitional Regulatory Approach

This approach is much more targeted and focused on where we have concerns and we will continue to inspect services where we have identified a risk, without returning to a routine programme of planned inspections. You can read our what to expect guidance and monitoring questions on the website.

We heard from providers who are currently requires improvement but have worked hard to improve and are understandably frustrated that they may not be inspected.

At the moment we absolutely have to prioritise based on risk, but we’ll support the system by rating services where there is clear evidence increased system capacity is needed. This includes rating new services, re-rating inadequate services where they have improved and where evidence indicates services are rated too positively.

Care home visiting

We know how important it is for people in adult social care to keep in touch with their friends and families, and how challenging it has been for providers to support this during the pandemic.

It’s important you seek to provide a proactive personalised approach to supporting contact with loved ones where it is safe to do so, within the framework of the latest government guidance and applying appropriate IPC measures

Our Strategy

We heard overwhelming enthusiasm for areas of our strategy such as us doing more with what we know to drive improvements across individual services and systems of care.

Please continue the conversation on our digital platform and share your views. We value these early conversations as many areas are not finalised, now is your opportunity to help shape the future of regulation.

I will end by saying a huge thank you for what you and your teams continue to do. Thank you to you as managers, as front-line workers, as people running care services for what you have collectively done to date. We always knew we had a incredible sector and work force, but you have done more than we could ever have imagined.

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