Lauren Wilson, solicitor at Markel Law, argues the policy of not regularly testing CQC inspectors for COVID-19 poses a clear risk of spreading infection.
COVID testing for CQC inspectors
By way of update on 14 August 2020, the CQC confirmed that they will not be requiring their inspectors to undertake weekly testing for COVID-19.
As can be seen by the National Care Forum’s open letter to Matt Hancock, Secretary of State for Health and Social Care and Helen Whately, Minister for Care, this has caused shockwaves across the sector as the rationale is analysed.
As a regulator no one seeks to challenge the CQC’s need to fulfil their regulatory obligation and core purpose to keep people safe by conducting in-person visits. However, while the CQC will put in place some protective measures, including provision of PPE, risk assessments and training in infection prevention and control, is this really enough to protect the health and social care sector? By not carrying out regular testing will the CQC be placing the sector more at risk?
The CQC have stated: “We take our role in infection prevention and control (IPC) very seriously and have been considering the precautions our inspection teams should take as we increase our on-site activity.
“We have consulted with the Department of Health and Social Care (DHSC) about accessing COVID-19 tests for inspectors.
“DHSC have considered the matter carefully and have assessed that CQC inspectors do not meet the criteria for weekly asymptomatic testing, as inspectors are not required to undertake ‘hands on’ closer personal contact with people.”
Initially, the CQC paused their onsite inspections and issued the ‘Emergency Support Framework’ (ESF). In accordance with the guidance at that time, liaison was via telephone or online conferencing.
While advice and guidance have developed since March 2020 and in-person visits are becoming less limited, it can only been seen as inconsistent to allow inspectors on-site without regular testing compared to the measures to which any provider must still adhere.
It is a particularly surprising decision when you consider just how strict the guidance throughout the pandemic has been and the media interest in the negative impact on the care sector.
The current government’s “Update on policies for visiting arrangements in care homes” states: “The first priority must remain preventing infections in care homes and this means that visiting policy should still be restricted with alternatives sought wherever possible,” adding: “care homes can now develop a policy for limited visits”.
Additional explanation is given about any policies: “In addition, in making their decision about visiting policy, providers and the director of public health should, where possible, consider: results from weekly testing of staff and monthly testing of residents. This data will enable the risk assessment to be well informed.”
Therefore, visitors to homes are still severely limited in number, screened before entering and visits take place outdoors where possible. Providers have been under strict instruction to limit the movement of staff members within the homes, are guided to carry out regular testing of staff and residents and are under heavy responsibility to carry out risk assessments and robust infection procedures in place.
In addition to this the CQC’s guidance on “Infection prevention and control in care homes” asks: “Is there adequate access and take up of testing for staff and people using services?”
Within the guidance, the CQC state Good looks like: “Testing scheme for all staff and residents has been conducted – known as ‘whole home testing’”.
Therefore, to achieve good standards, Providers must ensure they have a good testing regime. This is to combat any individual who may be asymptomatic and/or have mild symptoms.
Both sets of guidance are completely at odds with the CQC’s decision not to conduct regular testing.
As is known, inspectors can spend up to two days on site during an inspection. They will usually speak with staff members and residents, many of whom are particularly vulnerable. They will visit numerous sites each week, in addition to their own personal and social lives.
Due consideration should be given to whether allowing individuals across numerous sites without regular testing increases the risk of transmission of the disease. Regular testing helps determine asymptomatic individuals and reduce the risk of spreading infection.
As the CQC recognise in their own guidance this is to “help you prepare for the risk of a second wave and the impact of winter pressures”.
We await a response to the National Care Forum’s open letter.
Lauren Wilson is a solicitor in the regulatory team at Markel Law and undertakes both regulatory and criminal work with a particular focus in health and social care regulation. Visit www.markel.co.uk