We know the importance of visiting for many people drawing on care, and their loved ones, particularly over the Christmas and New Year period. As restrictions on care homes have been revised throughout the pandemic, we will continue to monitor the situation and support care homes to implement guidance, to ensure that visiting policies are person centred. We know the majority of providers are making every effort to follow the latest guidance and we have made clear to them that if something changes and they are no longer able to do this then they should speak with their CQC inspector as soon as possible.
We have continued to investigate concerns we hear about providers not following government guidance on visiting. Our regulatory approach is risk based so that we can focus on providers where we have reason to be concerned. We continue to monitor providers where we have information regarding concerns about visiting. Concerns have been raised with us in relation to 54 potential blanket bans, 19 of which have been raised in the last six months. We have taken action in every case, including following up with providers, inspecting, raising safeguarding alerts where applicable and following up with local authorities.
Kate Terroni, Chief Inspector of Adult Social Care at CQC, said:
"The pandemic has had an unprecedented impact on many people and we know it has been particularly difficult for those who are living in care homes and their families and loved ones. It is important that people are able to spend time with their loved ones over the festive season, including Christmas Day and New Year.
"We have taken decisive action throughout the pandemic to help keep people safe in care settings including undertaking almost 10,000 inspections, and making absolutely clear to providers that not following government guidance is unacceptable and may trigger an inspection. Where concerns have been raised with us in relation to visiting we have taken action in every case, including following up with providers, inspecting, taking regulatory action and where applicable, raising safeguarding alerts with local authorities.
"We continue to seek assurances from care home providers about how they are supporting visiting to happen and we are verifying this information when we go out and inspect and will continue to do so. We have introduced a mandatory question on each of our care home inspections which looks at how visiting is being supported to happen in a safe way."
Of the 54 concerns raised (50 unique locations), we gained assurance in all cases that visiting is now in line with guidance. In the case of 12 of the 50 locations we secured assurance by inspecting the service. In the other cases we were able to receive assurance by working with the service and key stakeholders. Of the 12 locations in which we conducted a site visit, we were only required to take action in two scenarios, both were reported as breaches of regulation.
We have received reports that some care homes have been issuing 'general policy' related to visiting. We expect providers to follow government guidance on visiting. This clearly sets out that all care home residents can choose to nominate an essential care giver who may visit the home to provide companionship and additional care and support. The essential care giver should be enabled to visit in most circumstances, including if the care home is experiencing an outbreak of COVID-19 infections. Where we have any evidence that this is not happening, we will continue to take action.
Going forward, we have also expanded our Infection, Prevention and Control (IPC) inspections to gather information on visiting practices, and we are set to increase the number of IPC inspections over the winter months.
CQC does not however have the power, under the legislation given to us by Parliament, to compel care homes to inform us of any changes to their visiting status. Similarly, under our legislation we do not have the power to require care homes to report live data on levels of visiting, neither do we have the power to take action against those care homes that are not reporting changes to their visiting status to us.
As part of our updated monitoring approach, we ask providers how they are facilitating visits to people living at the home in accordance with current guidance, or where this is not possible, how they are enabling other forms of contact. These questions focus on how the provider supports people particularly at risk from the impact of social isolation; asking how the provider has considered protected characteristics. To corroborate reports from providers we work with our Experts by Experience who talk to residents, their loved ones and friends, and help to enhance the evidence gathering performed by inspectors in their monitoring of a service.
Our Experts by Experience are members of the public from diverse backgrounds who play a vital role in our regulation of health and care services. They bring their personal knowledge and experience of services to help us with our inspections and other key aspects of our work.
If you, a loved one or someone you care for would like to raise a concern about visiting in registered care locations, or about any other matter involving a person's care, you can let us know by filling out our Give feedback on care form, or call our contact centre on 03000 616161.
It is important that people are able to spend time with their loved ones over the festive season, including Christmas Day and New Year.
Kate Terroni, Chief Inspector of Adult Social Care