On the 16 March 2020, the Care Quality Commission ("CQC") wrote to all registered health and social care providers about how they were adapting their regulatory approach in response to the COVID-19 outbreak (the "CQC Guidance").
In summary changes they set out included:
- stopping routine inspections;
- shifting towards other, remote methods of inspection to give assurance of safety and quality of care;
- only carrying out physical inspections in a small number of cases, for example where there are allegations of abuse; and
- giving extra support to registered managers in adult social care.
The CQC Guidance followed on from Public Health England's ("PHE") guidance released on 13 March 2020 (updated 19 March 2020) on residential care provision for local authorities, clinical commissioning groups and registered providers of accommodation for people who need personal or nursing care ("PHE Guidance").
PHE Guidance details steps care home providers are being advised to take in relation to working with local authorities to establish plans for mutual aid and how they should work with other service providers across local areas wherever possible to avoid disruption.
Although it goes without saying, this is a rapidly changing area of policy and all due care and attention should be given to new announcements from PHE, the CQC and any other regulatory/government bodies as and when they are released.
As set out in the CQC's Guidance, their fundamental objective during this period of unprecedented social disruption is to support registered providers and to keep the users of these services safe. Given the burden that a full CQC inspection can place on a registered provider (including managers and members of staff), the CQC announced that from Monday 16 March, all inspections would be halted, save for where it is considered absolutely necessary for the CQC to use their inspection powers.
This will only be in a very small number of cases where there are serious concerns of harm. This ultimately means that all routine rating inspections have been paused. No guidance has yet been provided on new entrants to the market who are currently going through the registration process, although the CQC have been keen to emphasise that a dialogue should be opened as soon as possible with all interested parties.
The CQC was also keen to emphasise that any inspection carried out would not be in the traditional format and, where a physical inspection is still deemed to be appropriate/necessary, providers will now be issued advanced warning that an inspection will take place. This is a completely novel step for the CQC to take and may reduce the CQC's ability to detect more serious offences taking place on a routine basis, and, given that the intention is to only inspect where it is seen as critically necessary anyway, there is naturally a broader question of what kinds of more routine breaches of CQC requirements may be let go, at least temporarily, during this period of disruption. This should be read in the context of the fact that notification requirements are not being reduced at this stage.