In her last CHP column of 2020, Chief Inspector of Adult Social Care, Kate Terroni, provides an update on the CQC’s Infection Control inspections programme and promoting healthy sexual relationships in care.
I want to start by saying thank you for what you and your teams continue to do across the country. As we face winter with COVID-19 figures rising, you continue to do extraordinary work. Making sure that people in your care are healthy, stimulated and as independent as possible, whilst keeping family members and carers informed and involved. We always knew we had an incredible sector and workforce, but you have done more than we could ever have imagined.
Infection prevention and control (IPC) has always been important but never more so than now. In response to the challenges of the COVID-19 pandemic, we introduced IPC inspections to share good practice, uphold high quality care and ensure services are safe.
We have seen some fantastic IPC practice out there, especially around safe admission and IPC for visiting and access to testing. During August 2020, we carried out a programme of IPC inspections in 301 care homes where there were good stories to tell and share. We published our findings in our report: ‘How care homes managed infection prevention and control during the coronavirus pandemic 2020’, where we share what we have seen and what care home providers have told us has worked, and what has caused them challenge through the pandemic.
Between October and the end of November we will have completed over 500 IPC inspections and over 900 risk-based inspections. This includes approved designated locations that are measured against our ‘eight ticks’ of IPC assurance
From December and into the new year we will continue to look at IPC on risk-based care home inspections, including where there is a COVID-19 outbreak and in response to whistle-blowing or information of concern. 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 are something we shouldn’t stop talking about.
We are looking at IPC on inspections of designated settings for people leaving hospital who have tested positive for COVID-19. When CQC is notified of a proposed setting by the local authority we call the provider within 24 hours and if the provider is ready, we inspect within 48 hours, informing them and the local authority if they are assured. We have assured over 90 locations so far on the scheme.
I am still hearing concerns around admissions. I want to reassure that you should only admit someone when you are confident you can meet their care needs, including having good infection prevention and control, the right PPE and the right workforce. We’ll absolutely support you to say you can’t admit someone if those elements aren’t in place.
While COVID-19 is dominating both media headlines and our lives at the moment, that doesn’t mean we can ignore other important issues in health and social care. In February this year, we published our report: ‘Promoting sexual safety through empowerment’. This report has recommendations that include Skills for Care updating their guidance on supporting personal relationships. We’ve worked together with them and Supported Loving (a human rights-based campaign, with associated network meetings, hosted by choice support) and this updated guidance is now available. I would encourage you all to read it.
An open culture is crucial for allowing people to express sexuality and promote healthy sexual relationships in care, as well as helping to spot where there may be risks of abuse. One of the key things we found was the importance of empowering people to speak about relationships and sexuality in order for them to articulate their needs and feel valued.
While we are aware that sexual safety incidents in services are not common. We know from speaking to those affected that the impact and consequences can be life-changing. It is not good enough to put this issue in a ‘too difficult to discuss’ box. It is particularly because these topics are sensitive and complex that they should not be ignored.
It’s also important that CQC inspectors are enabled to feel confident to deal with this topic when out on inspections. We are planning coaching events early in the new year for inspectors. As we approach the one-year anniversary of this report in February 2021, we will continue to work with Skills for Care and Supported Loving to develop resources for you. These resources will help you deliver the principles in the supporting personal relationships guidance.
Thank you again for everything you are doing. As we look forward to 2021, CQC will continue to call for a new deal for the care workforce, which develops clear career progression, secures the right skills for the sector, better recognises and values staff, invests in their training and supports appropriate professionalisation.