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Information for adult social care services during the coronavirus (COVID-19) outbreak
We're publishing the answers to questions adult social care providers have asked us during the coronavirus outbreak. We've dated our answers so you can see how recent they are. We'll continue to update this page as things change.
Equipment and food
How can we obtain personal protective equipment (PPE)?
We know this is an anxious and challenging time, and getting access to PPE can be difficult. If you have immediate concerns about supplies of PPE, there's a dedicated number you can call.
The National Supply Disruption line
Tel: 0800 915 9964
We also suggest contacting your local authority. They may be considering local solutions to make sure services are getting access to PPE when they need it.
On 1 April 2020, the Department of Health and Social Care sent a letter explaining how to get hold of PPE.
Is there any guidance available on the use of PPE?
We have had food deliveries cancelled and we cannot order food. Can CQC help?
We know this is a problem for some care services and have made the government aware of this.
While we cannot approach supermarkets on your behalf, we encourage you to consider doing this.
What should we do if our registered manager is absent for 28 days or more because of COVID-19?
We'll need you to tell us about your registered manager's absence by submitting a notification. You should set out the steps you are are taking to make sure adequate management cover and safe systems of care are in place.
What will CQC's response be to serious injury or specific incidents while staff levels are likely to be low?
We'll consider serious injury notifications according to our current guidance on the type of incident you're reporting. We'll make sure our judgements about what counts as avoidable harm or a provider failure are proportionate. And we'll consider the pressures on providers and staffing levels, and whether you are taking sufficient action to ensure your care is safe and effective.
Is CQC likely to relax its regulations?
We cannot change our regulations, which are set out under the Health and Social Care Act 2008. But the way we apply the standards during this difficult time will be proportionate and we'll consider the burden on providers of COVID-19. We are also moving to a risk-based methodology.
Have you extended the time we're given to respond to CQC's draft reports? Are you planning to extend it?
While we appreciate this is a particularly difficult time, we also think it's important the public has an up-to-date view of quality.
If you need more time to respond to an inspection report, we recommend you contact your local inspection team. The team will deal with each request in a proportionate way.
Do I still need to fill in a provider information return (PIR)?
No, we've suspended PIRs for now. We will not ask you to fill one in.
I've been asked to fill in an online form to update CQC on the impact of coronavirus (COVID-19) - or I've been asked to complete the 'capacity tracker'. What are these?
There is some information we’d like you to send us regularly.
Emergency support framework: our interim approach during the pandemic
What is the emergency support framework (ESF)?
Will we get any notice? How often will the ESF calls be?
The call will be arranged in advance with your inspector. The notice period will vary but they will try to hold the call at a convenient time for you and your team.
The frequency of calls will depend on what kind of risks and issues you're managing. We understand many problems are caused by things beyond your control. Providers dealing with higher levels of risk will hear from inspectors more than others. We're making these calls to help us stay in touch, support you and help make things easier for you.
What if our registered manager is not available?
If there is no registered manager in post or they are not there when we call, our inspectors will speak with the most senior person on duty at the service.
However, we will arrange the call in advance, so our inspector will book it for when you tell us the registered manager is available.
What if I don’t agree with the summary record? Can I challenge it?
Our interim emergency support framework is a flexible, supportive approach that sits alongside our inspection processes. Its aim is to look for areas where providers need support and help them find it, and to help us tell system partners about the tensions and innovations we are finding. It is not an inspection - and therefore does not follow the same factual accuracy and other processes.
We want inspectors and providers to work together to increase mutual understanding of the challenges of the pandemic and how we can work together to meet them.
Will findings from the ESF be used in the future?
The outcome of the ESF and the conversations will form part of our monitoring information about a service - like all information we receive about services such notifications.
Is it okay to cancel training or deliver it online?
We recognise that during this period your priority is to provide care to people and this may mean training is delayed. However, it's important you make every effort to ensure your staff are competent, confident and skilled in providing safe care to the people using your service.
Skills for Care has recently updated its guidance about this.
What types of role does the new DBS fast-track process apply to?
You must follow the guidance issued by the DBS. Their guidance Fast track service: eligible roles sets out the list of roles eligible for free-of-charge DBS checks and a fast-track barred list check.
Certain roles - such as nurses, midwives, social workers, care workers, healthcare assistants and others are included - if you are recruiting them in response to the COVID-19 pandemic.
Volunteer roles eligible for the interim process are set out in the Coronavirus Act – for those entitled to Emergency Volunteer leave.
Any other volunteer roles must be applied for and processed as normal. The DBS has issued a fact sheet to help you if you are recruiting to other volunteer roles.
There's more detailed information about this in our interim guidance.
Can I start someone in their new role before I receive information back from the DBS?
Staff you've hired in response to coronavirus (COVID-19), who are eligible for the new free of charge enhanced DBS check with fast track barred list check, can start in their role following the return of a satisfactory fast-tracked barred list check, while you wait for the rest of the DBS check to come through. The DBS will process the barred list information by the end of the following working day. The rest of the DBS check will be processed and will follow. This applies to people being recruited to work with children, as well as adults, during this period only.
If you recruit staff in response to coronavirus and feel you need to start them in their role before the DBS check has been returned, you must demonstrate that:
- to respond to coronavirus it is essential they start immediately
- you have evidence of the person's fitness to carry out their role
- you have risk-assessed the situation and put measures in place to mitigate any risks, as far as possible, where you believe that's helpful and practical.
For people being recruited outside of the interim DBS coronavirus eligible roles, providers should continue to follow the usual guidance and processes as set out by the DBS and CQC, including waiting for the DBS information to be returned and reviewed.
More information can be found in the CQC interim DBS guidance and on the DBS website.
If someone I want to employ already has an existing DBS certificate, do I still have to apply for a new one?
We'll take a pragmatic view on the portability of certificates for people you employ in emergency roles. While applying for a new check using the fast-track DBS system offers a greater level of assurance, we recognise that you might decide to use an existing DBS check, where this was for a similar role, at the right level and carried out within the past 3 years. You could consider if the applicant is subscribed to the DBS online update service with a relevant level of DBS check in place.
If you are recruiting for roles that are not in response to COVID-19, you must follow best practice and existing CQC guidance and DBS expectations.
Do I still have to do other recruitment checks, like get references?
We encourage you to continue with recruitment checks but we understand that, during this time, you may have to assess your situation and consider starting new staff or volunteers based on less evidence than you normally would. For example, if a single reference or telephone conversation with a previous employer gives you enough assurance to start the person in some capacity, we trust you to use your professional judgement and be pragmatic.
While we acknowledge that people may be started in their roles as an emergency, without all the usual checks and balances we see under ordinary circumstances, you must continue to use your judgement and take necessary action if concerns arise about a new member of staff or volunteer.
You should be clear on the rationale for your decisions, and record the decisions you have made, any risks you have identified and any measures necessary to mitigate those risks. If you end up deciding to keep the person longer term, you should ensure you have your usual assurances in place at a later date.
We will be as pragmatic and supportive as possible and will not be taking punitive action, now or retrospectively, unless you are obviously not risk-assessing your situations to make these decisions and people are being placed at risk.
Is it okay to share staff such as nurses with other services in our area?
You may need to work collaboratively with other providers in response to COVID-19. This may include pooling staff to respond to shortages. We support partnership working. The key thing is to make sure your staff are fit and proper persons, safe to deploy and competent to support the people who use your service.
Can we postpone induction training for new starters and arrange for them to work under supervision instead?
You must take reasonable steps to ensure your staff get the training and support they need to help them care for people safely and meet their needs. But we also recognise you'll need to be flexible, which might mean you need to adapt your usual practices.
You could consider offering some elements of your induction training online and others through shadowing. We'll be reasonable and proportionate in the way we assess your service and make regulatory decisions.
How can I access testing for staff and residents at my care home?
The government has launched an online portal for care homes to arrange deliveries of coronavirus test kits.
All symptomatic and asymptomatic care home staff and residents in England are now eligible for testing. Testing will be prioritised for care homes that look after the over 65s.
The guidance on admission and care of people in care homes explains when people transferring from a hospital or being cared for in a care home will be tested.
Who is delivering the testing programme?
The Department of Health and Social Care (DHSC) is working with local authority Directors of Public Health, Directors of Adult Social Services and local NHS providers to deliver this testing programme for care homes.
I work in home care – how can I access testing?
Domiciliary care staff who need a test should continue to use the self-referral website to request a home test or book an appointment at a test site.
Hospital discharge, new admissions, GP visits and death certificates
A hospital wants to discharge someone with COVID-19 to our care home. Is there any guidance on this?
There's new guidance about safe discharge from hospitals to care homes.
It also gives guidance on social distancing in care settings.
It states that someone's COVID-19 status will be confirmed during the process of transfer from hospital to care home. It also says tests will primarily be given to:
- all patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu-like illness
- all other patients requiring admission to hospital for pneumonia, ARDS or flu-like illness
- where an outbreak has occurred in a residential or care setting, for example long-term care facilities or prisons
The guidance says: "negative tests are not required prior to transfers/admissions into the care home" and that those with COVID-19 may be safely cared for in a care home if the guidance is followed.
We encourage all partners to work as collaboratively as possible during these difficult times. If you have difficulties, you should contact your local authority to escalate to their local escalation meetings.
Do we need to carry out an assessment before accepting an admission or package of care for someone being discharged from hospital?
The guidance on admission and care of residents during the COVID-19 outbreak explains the process for discharge from hospitals to care homes. It recognises that you will not be able to carry out your usual assessments and that a Discharge to Assess (D2A) model will operate during this period. Please refer to annex D (page 13) of the guidance, which sets out what's required.
This allows you to use assessments by 'trusted assessors'.
You need to be confident that any legal requirements around assessment will be met.
If you feel you cannot meet a person's needs, you should raise your their concerns through the local area escalation routes, which every area must have in place.
Read our guidance on trusted assessors (PDF) and the supplementary guidance covering the COVID-19 incident period (PDF).
How should we obtain a death certificate if we do not have access to a GP?
It's important to note that there's a difference between 'confirmation that life is extinct' and 'certification of death'.
Confirmation that life is extinct is what is needed before a funeral director can remove a body from a care home.
You'll find more details in our information for GPs:
In summary, the law:
- does not require a doctor to confirm death has occurred or that "life is extinct"
- does not require a doctor to view the body of a deceased person
- does require the doctor who attended the deceased during the last illness to issue a certificate detailing the cause of death
If a death is expected, it's recommended that staff in the care service discuss and agree arrangements with the GP in advance. This would mean that when death occurred, staff could contact the funeral director to arrange the removal of the body, and ensure that the GP with whom the person was registered was notified as soon as is practical. The GP could provide a death certificate later.
In the event of a sudden or unexpected death, although it is not a legal requirement, a visit by the GP with whom the patient was registered is recommended - to examine the body and confirm death. In the event of an unexpected death out of hours, it would be helpful if an out-of-hours GP were to attend, so the emergency services are not called when this could be avoided. The GP should then report the death to the coroner. This is usually done through the local police.
People who use the service and visitors
What's the guidance on care homes restricting visitors?
You should tell family and friends not to visit your care home. In exceptional circumstances, next of kin may have to visit, for example when someone is at the end of their life.
You should take precautions, like ensuring there is good hand hygiene. You should make sure any visitors are observing social distancing guidelines. Where possible, look into alternatives to people visiting in person. You'll find more about this in the new admission and care of residents guidance.
Can we stop regular checks that could be considered low priority - for example diabetes and anticoagulant?
You must make sure people's holistic healthcare needs are met. Any change to how you monitor existing health conditions should be decided by the clinician managing the person's care.
It's important you continue to manage people's health conditions in a way that keeps them safe.
- Last updated:
- 27 May 2020