CQC guidance and what it means for care providers during the Coronavirus pandemic

The COVID-19 outbreak is new territory, not only for care providers working on the frontline, but also for regulatory bodies. Those that are responsible for caring for vulnerable service users must now do so in an increasingly challenging environment, whilst ensuring that they comply with their professional obligations.

In this blog, we look at the position for care/domiciliary homes, with the intention of providing some reassurance in these unprecedented times. This is obviously an evolving situation and regulators will undoubtedly review and update their advice in line with the UK government’s guidance as that inevitably changes.

Recent developments from the CQC

Prior to COVID-19 reaching pandemic status, the Care and Quality Commission (CQC) stated that it would be continuing to carry out inspections. However, on 16 March 2020, the CQC announced that they had suspended all routine inspections until further notice.

The key points from the CQC and what they mean for you

The CQC has issued the following guidance in relation to adult social care:

• The CQC encourages providers to act in the best interests of the health of the people they service, with the top priority being the protection of life, and also to use their discretion and act in the best way they see fit.
• It may be necessary for the CQC to use some inspection powers in a small number of cases, such as when there are concerns of harm (i.e. allegations of abuse). However, these inspections will not be conducted in their present form.
• If a physical inspection is required, the CQC anticipates that a conversation with the provider is likely to take place prior to the visit.
• There are no changes to the requirements to make notifications or the system used to make them. This includes letting the CQC know if a service operation is being negatively affected by COVID-19, but it does not mean that they need to be notified of every single COVID-19 related issue.
• The CQC will continue to request Provider Information Returns (PIRs) but they will not provide penalise providers for their late return.
• Given that inspections have been suspended, the CQC’s inspection team will be available to provide advice and guidance to registered managers.

To try and strike a balance between regulating care homes and adapting to the practical reality of the current situation, the CQC will continue to monitor care but also offer support to professionals as they navigate the unchartered waters ahead.

Further guidance on residential care, supporting living and home care provision during the COVID-19 outbreak is available on the government's website.  

COVID-19 Registration

To assist health and social care providers, the CQC has developed a special COVID-19 registration framework for providers responding to Department of Health and Social Care (DHSC) or Clinical Commissioning Group contingency planning.

The key points and what they mean for you

A COVID-19 registration is any ‘application’ from a health or social care provider where they:

• Intend to deliver services which provide additional health and social care capacity in the area; or
• Contribute to the control of the outbreak of COVID-19 or the treatment of people who have contracted the illness.

This covers both new registrations and changes to services that can be made by submitting an application online. Although some changes can be made by submitting a notification online and changing your statement of purpose, others may require a change to your existing registration. In those cases, you will need to submit an application. If it relates to COVID-19, the CQC says that it will prioritised. In urgent cases, the CQC is able to increase your capacity as soon as they are notified and can run the registration process at the same time as you make your changes.

The CQC has provided a list of common application types on their website to help you decide whether you need to apply.

If you are making changes that do not require registration, you can notify the CQC about changes to your statement of purpose through their website.

For new providers that are not related to COVID-19, registration applications are continuing as usual and follow the process set out on the CQC website.

Registering the loss of life with the CQC

Across the world, many have tragically lost their lives to this virus. In the event that someone does pass away, providers must ensure that they comply with their obligations in the same way they would do so before the outbreak of COVID-19. The CQC (Registration) Regulations 2009 continue to be in force and require that notifications are sent to the CQC without delay. Further guidance on this can be found here.

Service in care homes

Front line staff are facing unprecedented challenges in the provision of care. Care homes have come under increasing scrutiny after the media has reported incidents of providers in care homes failing to attend work and leaving vulnerable services user alone.

As key workers, and CQC regulated individuals, you remain subject to your core professional obligations at all times. If you do have concerns about the protection of front line workers, such as the availability of Personal Protective Equipment, these should be raised through the formal channels. You remain accountable to the CQC for decisions about care that could have an impact on service users.

Going forwards

It is clear from the advice provided to date that the CQC is committed to transparency during the outbreak and that their ultimate priority is the protection of life. In addition, the regulator has provided assurances that they will update their guidance as the situation progresses. Of course, the suspension of all routine inspections does not mean that standards in care homes should be allowed to deteriorate. The CQC has made it clear that it will continue to regulate practices and take action if standards fall short of what is expected. You must act in the same way you would otherwise do outside of such a crisis. While the CQC has specifically encouraged providers to exercise their discretion to protect life, you remain accountable for the decisions you make, and must be able to evidence the decision-making process in the same way. Internal processes, such as incident reporting, should be used where you are sufficiently concerned about issues which arise. Additionally, in its guidance, the CQC has encouraged providers to raise specific concerns or issues with them directly.

Should you be concerned about your professional practice or care home, please do not hesitate to get in touch.

About the authors

Shannett Thompson is a Senior Associate in the Regulatory team. She is a highly experienced lawyer taking the lead in defending health professionals before their regulatory bodies including the GMC. She has substantial experience in advising individuals in relation to their regulatory obligations in the wider context.  

Peta-Louise Bagott is an Associate in the Regulatory team. She is an experienced advocate in both criminal and regulatory proceedings, including cases involving healthcare practitioners before their regulatory bodies.