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Preparing for an Emergency Support Framework call from your inspector

How to Prepare for an Emergency Support Framework Call from Your Inspector

I have been working in senior positions in the care industry since 2002.

Until 2014 I ran large psychiatric services and successfully dealt with many crisis management and turnaround situations. Towards the end of 2014 I established Care Ideals, which is a consultancy service that supports a variety of social care providers.

I have written this article to provide practical and helpful information to social care businesses and managers, especially those with little backoffice support or those with limited experience of the Care Quality Commission (CQC).

As a result of the coronavirus pandemic, the CQC has for the most part paused its on-site inspection agenda. For now, this has been replaced by the Emergency Support Framework (ESF). The ESF is a phone call with your inspector, where they ask you up to 15 key questions about your service. These key questions can be followed by supplementary questions, and the call can last up to two hours.

You’ll be contacted to arrange a convenient time for the actual ESF conversation. You will have time to prepare for the call. The CQC has said:

• The ESF isn’t an inspection.
• The summary record of the ESF conversation isn’t published.

However, providers must remember:

• You receive a summary record of the conversation in PDF format.
• The conversation becomes a record that the CQC retain.
• The ESF is an assessment of where you stand at the time of the call and how well you’ve managed the complications of the last few months.

I don’t think providers need to be concerned about the call. But you must prepare for it.

To help with your preparation, I have listed below questions you might be asked during your ESF call. I have compiled these questions according to issues you’ve likely had to deal with in recent months.

• How did you inform visitors that they couldn’t visit?
• Have you kept in contact with CQC, your local authority, Public Health England, your GP, etc to ask for assistance or to keep them up to date?
• Have relatives been kept fully informed during the period where they couldn’t enter the home?
• Did you put signage up on the front door?
• Did you communicate with staff as to what was happening, and what you were doing to help maintain their safety, and that of the residents?
• Did you explain to residents what was happening?
• Did you make sure that staff who were showing symptoms or were categorised as high-risk were self-isolating or shielding?
• What processes did you have in place for staff entering and exiting the home e.g. hand sanitiser, hand-washing facilities, donning PPE, doffing PPE, etc.
• Did you have signage around the home reminding staff they should wash their hands more frequently than normal?
• Did you have sufficient quantities of PPE? If you didn’t, how did you resolve this?
• Have any residents tested positive for coronavirus or shown symptoms? If so, how did you protect other residents from becoming infected?
• How would you contain and manage an outbreak?
• Did your domestic staff wipe down and disinfect parts of the home more frequently? How is this evidenced?
• Did you have issues with medication at any point (e.g. short supply)? If you did, who did you contact for assistance?
• If some staff were shielding or had been furloughed, did you ensure you had sufficient staff still working who could administer medication?
• Did you have enough staff in place to ensure that your residents were safely cared for?
• If you were short-staffed, how did you arrange cover? Agency staff? Bank staff? Existing staff worked additional shifts? Staff living at the home?
• If using agency or bank staff, were they block-booked? Could you ensure they weren’t doing shifts in other homes?
• When recruiting new staff did you maintain safe recruitment processes?
• Have you still monitored complaints and safeguarding issues?
• How have you ensured that staff maintained good practice?
• Have you been able to continue with your normal governance and quality assurance systems? If not, what is the plan to rectify this?
• Are all policies, contingency plans and action plans up to date with information relating to coronavirus? e.g. infection control policy, health and safety policy, business continuity plan, fire risk assessments, PEEP’s, etc.
• Are separate coronavirus care plans ready to use, complete with risk assessments?
• Do you have isolation care plans and risk assessments in place, or ready to use if needs be?
• Do PEEP’s incorporate coronavirus status and how to move infected residents, in case of evacuation?
• Are you monitoring the impact of the pandemic on the mental health of your staff? What are you doing to ease pressures and anxiety?
• Are staff aware of your whistleblowing policy and how to escalate concerns?

I would suggest that you have someone with you during the call taking notes. Email the inspector after the call detailing your understanding of the call and list any actions.

I would also recommend that providers put together a hardcopy file that evidences how you responded to issues created by the pandemic e.g. updated policies and procedures, invoices from PPE suppliers, letters to staff communicating about coronavirus, etc.

At some point, CQC will likely return to on-site inspections. You can hand this file to the inspectors when they arrive.

Please note the above list is a guide only and isn’t exhaustive. You must adapt the list according to your individual services e.g. some of the above won’t be relevant for domiciliary care providers.

Don’t worry about the ESF. Prepare for it.

(This article was first published in Caring UK in 2020)