The Care Quality Commission recently revised its safeguarding protocol setting out how its staff will respond to safeguarding concerns and issues.
While the changes to the previous protocol are not significant, the revised version includes two additions that care providers should be aware of: the course of action that the CQC will take when inspectors witness concerns of an actual or suspected safeguarding incident during an inspection, and the CQC’s role in serious case reviews (SCRs).
The primary responsibility for making a safeguarding referral to the local authority or the police lies with the provider, including when a CQC inspector witnesses a suspected safeguarding incident during an inspection. When this happens, the inspector would normally expect the provider to make the referral there and then and, where this is not possible, to report back to the CQC on their actions within an agreed timescale (normally 24 hours).
But the revised protocol sets out five criteria for when the CQC will make the referral itself:
• where it is the first recipient of the relevant information;
• where the provider or manager of the service is implicated in the potential safeguarding incident;
• where the CQC is aware that the provider or manager has not made the referral or has not informed the CQC of their action within the agreed timescale;
• where the CQC is concerned about the capability of the provider or manager;
• where the CQC has evidence of potential institutional abuse.
“Where we witness an incident, if appropriate we will draw it to the attention of the provider or manager and we will take immediate action that may include a safeguarding referral,” says Louise Lawton, the CQC’s national adviser on safeguarding.
“The revised protocol makes it clear what we expect our compliance inspectors to do and we expect providers to respond to that concern and confirm with us what action they have taken, normally within 24 hours. Where they fail to inform us we will make a referral to the local authority or the police if appropriate.”
The protocol also changes the CQC’s procedure for serious case reviews, says Lawton. “CQC is not routinely involved in all serious case reviews but other agencies were telling us that we needed to have a more contributory role.”
The CQC will now attend the first panel meeting of an SCR, even when it is not required to participate any further in the process. “This is an important change,” says Lawton. “We need to be consistently involved from the beginning so that there is a better understanding of our role and the part we can play in proceedings. It will also establish more realistic expectations of our role.”
“We have on a few occasions had panels misunderstand our responsibilities and consequently set recommendations for us which are beyond our regulatory remit. We are committed to creating a greater understanding of our role in the safeguarding process and this is one way of doing this.”