The Emergency Support Framework and latest CQC requirements

One of the goals of ESF is to collect information that can be used to identify key trends and inform policymaking, to help shape discussions and get providers the support they need. It is hoped that knowledge sharing with local and national care partners will help mitigate and manage risk, and mobile support where it’s needed most.

In practice, this means collecting and monitoring information through CQC’s usual data sources, increasing efforts to encourage feedback from the public and care staff, and introducing new sources, such as CQC’s daily tracker for care at home services.

Conversations with CQC inspections will focus on four areas. They may not need to cover all the questions as things may already be clear, but the four areas are:

• Safe care and treatment
• Staffing arrangements
• Protection from abuse
• Assurance processes, monitoring, and risk management

Within each area, there are a number of discussion questions and these vary depending on the type of health and social care provider you are. In essence, they aim to explore and discuss how prepared you are and how your service is managing in this pandemic.

Within the ‘safe care and treatment’ area for adult social care services, the first discussion question asks ‘Had risks related to infection prevention and control, including in relation to COVID-19, been assessed and managed?’

We recommend visiting CQC’s website to find a complete list of the discussion questions.

Inspectors will contact you first to arrange a date and time to make the call, to allow you to plan and make the best use of your time.

Expected to take no more than an hour, calls will be carried out through the Microsoft Teams platform where possible, requiring a computer and internet connection. Where Microsoft teams cannot be used, the call will take place over the phone.

In the event a manager is unavailable because of illness or emergency, the inspector can ask to speak to another appropriate senior member of staff.

Based on existing and new information, the CQC will prioritise providers who they believe most need to be called for a supportive consultation.

Where the inspector is confident that there is a lower risk level, they can decide not to call you, but they will remain available should you want support and can be called if you’d like advice.

Inspections will make note of the discussion around the four key areas and the challenges and stresses for your service, as well as the wider local care system.

To help share best practice, they will also note innovative ways you are responding to challenges.

An audio recording of the calls will not be made, as the call is not a regulatory process.

In some cases, CQC inspections may ask for evidence about specific risks and issues. The CQC may, therefore, ask you to ‘share your screen’ during the call or send an email attachment.

Following the conversation with an inspector, you will be sent an email with a summary record attached in a PDF format.

This will list:

• The short questions asked and the appropriate standard wording that reflects your answer
• A summary of the specific internal and external risks and challenges discussed
• Any sources of support suggested
• A short summary of whether the service is ‘managing’ or ‘needs support’

Details will also be included of any innovative practices you may have developed to manage the situation.

As this emergency process is not an inspection, the summary record is not an inspection report and so contains no rating. This means that usual steps such as the factual accuracy process do not apply.

Summary records will also not be published on their website. However, if CQC decides that they need to inspect a service, the inspection report will be published.

The information that the CQC gathers during ESF calls will help them to assess how you are coping during the pandemic. From this, your service will be identified as ‘managing’ or ‘needs support’.

If CQC receives information (both through ESF conversations as well as from external sources) that raises concerns about actual or possible avoidable significant harm, abuse, or breaches of human rights, they will assess the risk and either:

• Provide additional sources of support
• Arrange a follow-up call
• Use inspection and enforcement processes

Should the CQC feel the need to inspect, they will follow their existing approaches and processes tailored to the individual sector.

In the event of finding unsafe or poor care, CQC can use its power to take action. Enforcement processes can still be used and followed where needed; panels will review any proposals to take enforcement action and CQC Chief Inspectors will make final decisions.