Responding to feedback about care services

The importance of hearing about concerns about the care people receive

Throughout the COVID-19 crisis, our regulatory role has not changed. We continue to ensure that health and social care services provide people with safe, effective, compassionate, high-quality care. At the start of the pandemic we moved quickly to support providers to keep people safe.

While routine inspections have been paused, we have never stopped regulating. We have continued to inspect in response to immediate risks and concerns about safety, we have engaged with providers constantly, and we have continued to monitor services to identify where extra support is needed.

Staff have been going to extraordinary lengths to deliver good, safe care during this global crisis. Their voices are crucial to understanding the quality of care on the frontline and listening to them is key to keeping people safe and well cared for.

We have strengthened our processes to help ensure that we can listen and respond as effectively as possible. Our contact centre automatically allocates calls from care workers who have concerns about the safety or quality of care to an inspector or senior member of the team to investigate so these calls are fast-tracked, offering a quicker resolution to the issues raised.

We reported in mid-June about the increase in calls to CQC’s national contact centre from staff raising concerns about care, many of which related to issues with PPE, infection control and the challenges posed by social distancing.

We have now carried out 50 inspections in adult social care services since 16 March; 24 of these were as result of concerns raised by staff or members of the public, and the remainder were in response to concerns we identified through our Emergency Support Framework, notifications from the provider or information from key stakeholders. Our decisions to inspect have been informed by very heightened risks to people using those services, based on both the previous history of some services and new concerns raised with us. Often these have reflected the key failures of care found before the pandemic.

The reasons included indications of closed cultures, where we were not able to get the information we needed to assure us of people being safe in a service. We found that in some of the services where we had concerns about safety, there had been a recent change of manager or no current registered manager. Reports of poor infection prevention and control also alerted us in a small number of cases, both in services where there had been an outbreak of COVID-19 and in those without active cases.

In some cases we were alerted to instances of extremely poor and unsafe care, with people’s most basic needs not being met – specifically in relation to falls management, nutrition and hydration, and wound and pressure area care. This was underpinned by staff not assessing and supporting people safely and a lack of oversight by the registered provider – resulting in, for example, poor medicines management and reports of staff not responding appropriately to incidents.

Where appropriate we are taking urgent action to protect people using services (including stopping new admissions and on rare occasions closing services), and we will publish individual inspection reports on our website.

We have also now carried out 20 inspections in hospitals (including mental health and independent services) since 16 March, of which 10 were as result of concerns raised by staff or members of the public, and five inspections of primary medical services, of which three were as result of concerns raised by staff or members of the public.

We need your feedback on care

We continue to place huge emphasis on hearing the experiences of both people who work in health and care services, and the people who use those services, their families, carers and loved ones.

Because We All Care is a new campaign led by CQC and Healthwatch England in response to COVID-19. As the country pulls together to recover from the impact of coronavirus, Because We All Care aims to encourage more people to share their experiences of care to help the NHS and social care services identify and address quality issues and provide the best care possible.

Our research shows that more than two-thirds of people are more likely to act to improve health and social care services since the COVID-19 pandemic, with close to two thirds saying they would be more willing since COVID-19 to support NHS and social care services by actively providing feedback on their care.

Through the campaign, we are encouraging people to feedback on care, both good or bad, as this information supports our ongoing monitoring of services. Everyone can play a part in improving care by directly giving feedback to services, and by sharing information and experiences with us so that we can take action when we find poor care and highlight good care.

#BecauseWeAllCare about NHS and social care – share your feedback with @CareQualityComm

Section 3: Financial viability and stability in the adult social care sector