CQC notifications – increased scrutiny of safety culture

CQC have announced changes to the notification forms providers need to submit in relation to deaths, serious injuries, and allegations of abuse relating to service users.  Whilst, on the face of it, this is an administrative change, it is further evidence (coupled with recent enforcement action in relation to the Duty of Candour) of the regulator's increasing scrutiny of providers' safety culture and their ability to learn from incidents. 

The new forms, rather than simply asking for 'any other relevant information' relating to the incidents, now include specific prompts for the providers to address.  For instance:

• The notification for serious injuries asks providers to confirm:
  • whether the person was known to be at risk of this type of incident/injury;
  • what risk assessment had been carried out in relation to that incident; and
  • what plan was in place to mitigate the risk (in terms of the use of equipment and input from staff or other specialist teams).
• Similarly, the notification in relation to allegations of abuse asks providers to confirm:
  • whether the service user was known to be at risk of that type of harm;
  • if so, what was the risk assessment; and
  • for details of any protection plan in place.
• The prompts also ask providers to confirm what immediate actions they have taken:
  • in relation to any members of staff involved in the incident; and
  • to mitigate the risk of further harm not only to the service user involved, but also others.

CQC states that the change in the form is intended to reduce the need to ask providers to provide additional information following the initial notification, so that CQC “have all relevant facts at the earliest opportunity”.  It appears clear, however, that the change is part of the regulator's increasing focus on safety and ensuring that providers are taking appropriate steps to deliver safe care and treatment; the vast majority of prosecutions which CQC bring under the Fundamental Standards relate to the requirement to provide 'Safe care and treatment' under regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

It is clearly good practice, in any event, for providers to take appropriate action in response to accidents/incidents and allegations of abuse.  However, the need to spell this action out on CQC notification forms further emphasises the need to learn from and respond to incidents in order to:

• safeguard the service user involved in the incident;
• consider whether action also needs to be taken to safeguard other service users from the same risks; and
• take appropriate action in relation to staff involved where necessary.

What is more, the fact that providers are required to set out this information on notification forms which are required to be submitted “without delay” emphasises the need for providers to act not only responsibly, but also quickly, in response to incidents.