You might recall that on 26 August, NCF wrote an open letter to Matt Hancock, Secretary of State for Health and Social Care, and Helen Whately, Minister for Care, calling for a reversal of the decision to allow CQC inspectors into care homes without testing. It seemed like an extraordinary decision for a number of very important reasons:
- It undermines the current DHSC policy to limit the spread of DHSC
- It undermines care homes’ ability to manage visitors in a COVID-19 safe way
- It is fundamentally inconsistent with care homes’ existing infection prevention and control measures and policies
- It presents very significant credibility challenges for CQC
At all subsequent opportunities in conversation with both the DHSC and the CQC , we have continued to call for a reversal of this decision as it is fundamentally unhelpful and truly counter-productive position for the CQC to want to conduct on-site inspections in care homes without regular testing and clarity on the COVID status of the staff doing those inspections.
Testing capacity is no doubt a consideration here but, in reality, it will be a relatively small number of CQC staff who will be front facing and going into homes, perhaps 400 or thereabout. Including this small group of CQC staff in routine regular weekly testing will not have a significant impact on capacity, especially when we hear talk from the Secretary of State that mass population testing is on the cards, alongside extra testing for schools and possibly universities.
Conversations with members have looked, in some detail, at the best way to manage this very problematic curve ball from the CQC and DHSC, asking providers to allow CQC inspectors into their homes without testing or knowledge of their COVID status. CQC inspectors no doubt will want full access to all parts of the home, regardless of zoning and cohorting. They will want to move between different ‘bubbles’ of staff and residents, and they will want to talk directly to staff and residents, often confidentially, which will be very difficult in full PPE at a distance of 1 m. In addition, and crucially, they will also be moving between different care homes. Care providers are understandably very anxious about how to manage this, in line with their current IPC policies, visitor screening, visitor access and codes of conduct.
We were therefore very surprised to see the message last from Kate Terroni, Chief Inspector of Adult Social Care, to social care providers to state that policies providers have put in place “are attempting to restrict how our inspectors do their job” and that attempts “to prevent or limit our ability to fulfil our statutory responsibilities are unacceptable”.
At the NCF, we welcome scrutiny and oversight by the regulator and we all want the CQC to be able to regulate effectively. Surely, the most effective way to diffuse the very real and genuine anxiety of care providers about letting CQC inspectors in their care settings is to make sure that all inspectors are tested on a weekly basis so their COVID status – and risk – is clear.