PIR guidance: Quality assurance and risk management

This is about all types of infection. Include things that you have learnt from the coronavirus (COVID-19) pandemic.

This is a yes or no answer.

Count all meetings that have been held in the 12 months up to the date of this return.

Count all approvals granted in the 12 months up to the date of this return.

For de-approvals, state the number of Shared Lives carers that the panel have removed carer approval from.

There is no further guidance.

Give reasons for carers whose approval status was removed in the 12 months up to the date of this return.

If a panel is not in place, provide details of how these functions are currently being managed.

Find out more about Regulation 20 and the duty of candour.

Answer 'yes' if you administer drugs to people receiving regulated activities.
(If your service does not administer medicines, medicine-related questions will not appear.)

A ‘controlled drug’ is any medicine listed under the schedules defined by the Misuse of Drugs Act 1971. By ‘administer controlled drugs’ we mean that you hold, store or give these to people receiving regulated activities at your service.

This is a yes or no answer.

A person has the right to refuse treatment including medicine. If medicines are being administered covertly they are given disguised in food or drink and it can only be authorised if the person lacks capacity to understand the consequences of not taking the medicine.

This is a yes or no answer.

Chemical restraint is the use of a medicine which is prescribed and administered for the purpose of controlling or subduing disturbed/violent behaviour, where it is not prescribed for the treatment of a formally identified physical or mental illness. Chemical restraint is unlawful unless justified for purposes set out within the legal framework. Chemical restraint should only be used as part of an agreed support plan and should be delivered in accordance with evidence-based best practice guidelines and by staff with the relevant qualifications, skills and experience to administer it.

Psychoactive medicines, or psychotropic substances are often used as a chemical restraint. These are chemical substances that alter brain function, resulting in temporary changes in perception, mood, consciousness and behaviour. These include groups of medicines such as antidepressants, antipsychotics, antiepileptics, mood stabilisers (including sodium valproate and carbamazepine), anxiolytics (benzodiazepines), and central nervous system stimulants.

For Shared Lives schemes, this question is about people in the scheme who have support with their medicines.

A medication review:

• is a structured, critical examination of a person’s medicines by a healthcare professional
• includes the persons’ views and understanding about their medicines
• where appropriate, includes family members or carers
• answers concerns, questions or problems with the medicines, including side effects or reactions
• should occur at least once a year but more often if the health and care needs of the person dictate.

Enteral feeding tubes provide access to the stomach or jejunum (small intestine).

They are used in cases where there is an obstruction or difficulty in swallowing. Medicines administered via enteral feeding tubes are often done so 'off licence' and have not been designed to be administered this way. Responsibility for giving off license medicine lies with the prescriber, consulting pharmacist and the person/service administering the medicine.

This is a yes or no answer.

Providers should have robust processes for identifying, reporting, reviewing and learning from medicines-related problems. Research has shown that where rates of incident reporting are high there is more likely to be a better culture of safety and risk management.

We would like you to include the number of medicine errors that have occurred in the 12 months up to the date of this return. The following are examples of errors (non-exhaustive list):

• not recording when you have administered medicines, for example not signing MAR charts
• not recording why doses have been missed
• using the wrong key code for non-administration
• signing for medicines you have not administered
• inaccurate or unclear records
• not enough information to administer medicines safely, for example instructions about taking medicines with or after food
• a dose has been missed
• too much or too little of the medicine was given
• the wrong medicine was given
• it was given to the wrong person
• it was administered in a manner that did not follow your medicines procedure or prescribing requirements.

Count every single incident.

A ‘controlled drug’ is any medicine listed under the schedules defined by the Misuse of Drugs Act 1971. We would like you to include the number of medicine errors that have occurred in the 12 months up to the date of this return. Errors could be in relation to ordering, storing, recording, prescribing, administering and destructing controlled drugs.

We will only ask you this question if you have administered controlled drugs in the past 12 months.

Count every single incident.

Count all complaints made in the 12 months up to the date of this return.

Give specific examples of action you have taken which has resulted in making a difference for the people involved.

This question is for residential services only.

Since 11 November 2021, registered persons of all CQC registered care homes have been required to ensure that they only deploy people, and allow entry to visiting professionals, within the premises who have been fully vaccinated against COVID-19 (unless exempt). This applies to services registered with CQC for the regulated activity of providing accommodation together with nursing or personal care and is subject to certain exemptions. This question is asking how you assure yourself that this requirement is met. The requirement forms part of the fundamental standards and is monitored and enforced in appropriate cases by the Care Quality Commission. The requirement is part of the Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 (‘the Regulations’). Further information is available in the DHSC operational guidance.

A DSCR allows the digital recording of care plans and care received by an individual.

We would like to know if you operate a digital social care record system (DSCR) at this location; you might know this better as an electronic care plan. This question helps us to understand the level of adoption of DSCRs in the social care sector. These systems will also allow you to send information and generate reports more easily helping you to demonstrate quality assurance and risk management where requested by a CQC inspector. (Yes/No)