Guidance Twenty Two - Role of CSCI and HC
Introduction
The Commission for Social Care Inspection (CSCI) and The Healthcare Commission (HC) each have a Safeguarding Adults Protocol and Guidance for staff which “demonstrates their commitment to working with agencies to ensure that people within regulated services/ healthcare services are appropriately safeguarded.”
The Role of CSCI and HC within Safeguarding Adults
Referrals
Where there is a concern or allegation of abuse, which may be through information that is presented by others, information that is sought as part of their inspection methodologies, both CSCI and HC will make a referral to the relevant Adult Social Care Department in line with the timeframes in this document.
Strategy Discussions
When the Safeguarding Manager makes the decision that a Safeguarding Assessment is required there will be a Safeguarding Strategy Discussion. The CSCI and HC Protocols both state that their role in relation to Strategy Discussions as follows:
“Whilst CSCI/ HC should always be made aware of any Safeguarding Adults concern within a regulated service, it is not necessary or appropriate for CSCI/ HC to attend all Safeguarding Adults Strategy Discussions. However, attendance (or other means of participation such as teleconferences) must occur where one or more of the following criteria are apparent:
- One or more registered people are directly implicated;
- Urgent or complex regulatory action is indicated;
- If any form of enforcement action has commenced or is under consideration in relation to the service involved.
CSCI/ HC would generally expect that relevant agencies and other relevant stakeholders such as registered providers and managers, people who use the service and/or their representatives are invited to attend the meeting/ participate in the discussion or be otherwise involved in the process. The general assumption is that where registered providers and managers are judged to be fit and not implicated in the alleged abuse then they will be pro-actively involved as partners in tackling the abuse. In some cases, particularly where allegations are made against a registered person, it may not be appropriate for the registered person to be involved - Information supplied by CSCI/ HC can assist the Chair in determining whether registered persons are included as a full partner in the strategy discussion.
The following must be supplied by CSCI/ HC to the chairs of all Safeguarding Strategy Discussions convened in relation to regulated services whether CSCI/ HC staff will be attending or not:
I. Name, address, telephone number of service
II. Name of registered provider/company (if applicable)
III. Name of registered manager (if applicable)
IV. Type of registration
V. No. of places registered (if applicable)
VI. Category(ies) of registration, with number of places
VII. Conditions of registration
VIII. Enforcement action underway or pending
IX. Complaints investigations underway or pending
X. Most recent inspection report
XI. Quality rating (when implemented)
XII. Any direct information relating to the allegation obtained through their inspection process
A form has been devised by CSCI and HC for this purpose.
Whether or not CSCI/ HC staff attend the Safeguarding Strategy Discussion, they must be supplied with copies of the minutes and agreed strategies formally by the chair of the meeting. Records relating to the safeguarding assessment may be subject to Freedom of Information Act requests; comments or actions attributed to CSCI/ HC should be checked for accuracy. CSCI/ HC are responsible for ensuring appropriate communication liaison is established.
CSCI staff must not chair or function as minute takers for Safeguarding Assessment strategy meetings.”
Investigations as part of the Safeguarding Assessment
Commission for Social Care Inspection
The Commission for Social Care Inspection state that:
”Where the allegation suggests breaches of regulations and standards, CSCI may conduct enquiries using their existing methodologies and/or initiate a Random Inspection and take appropriate regulatory action. (A ‘random inspection’ in this context is an unannounced inspection focused on the regulatory issues within the safeguarding referral).
The following criteria will be used to inform the decision:
- Allegations directly implicate one or more registered person;
- Current service quality rating and rationale, plus any links to risk for service users accommodate;
- Enforcement action has commenced in relation to the conduct of this service or one or more registered person in relation to risk for people who use the service;
- The allegations, if proven, indicate that urgent or immediate regulatory action may be necessary;
- Where the allegations relate to complex and serious conduct issues particularly those indicating possible institutional or cultural abusive or neglectful practice.
N.B. Where the above criteria do not apply and the allegation is investigated by another person/agency the Commission will consider what regulatory activity (if any) needs to follow once the investigation has been concluded and the outcome shared with CSCI under the Nottingham(shire) Information Sharing Protocol.
If concurrent investigations (from more than one agency) are taking place, any reports must be provided to the Safeguarding Manager for the case. The safety and welfare of the people who use the service is paramount. Any decision by CSCI to take regulatory action - as a result of an inspection or other information received - should not be unnecessarily delayed; however the Safeguarding Manager should be informed of any such decision and this should be discussed with the organisation leading the Safeguarding Assessment. For example, if this is the police it is important that any actions by CSCI do not adversely affect the gathering of evidence as part of a criminal investigation. The timing of feedback from regulatory action must be agreed with the relevant Regulation Manager or duty Regulation Manager in line with CSCI media protocol, but all efforts should be made for this to be coordinated with the actions of partner agencies.
Regulation Managers must ensure that workload management strategies ensure that all fieldwork inspections relating to Safeguarding Adults issues are completed as a matter of priority and in accordance with current methodologies.”
Healthcare Commission
The Healthcare Commission state that:
“The Healthcare Commission may complete an investigation into safeguarding issues that affect NHS patients in accordance with their published criteria:
Healthcare Commission NHS investigations criteria
Where the allegation suggests breaches of regulations and standards, the Healthcare Commission may conduct enquiries and/or initiate an unannounced or short notice visit and take appropriate regulatory action. The following criteria will be used to inform the decision:
I. Allegations directly implicate one or more registered person; or more than one NHS site
II. Current service quality rating and rationale, plus any links to risk for service users accommodated
III. Enforcement action has commenced in relation to the conduct of this service or one or more registered person in relation to risk for people who use the service; or NHS organisations have failed to take and/or sustain effective remedial action
IV. The allegations if proven, indicate that urgent or immediate regulatory action may be necessary
V. Where the allegations relate to complex and serious conduct issues, particularly those indicating possible institutional or cultural abusive or neglectful practice
N.B. Where the above criteria do not apply and the allegation is investigated by another person/agency the Commission will consider what regulatory activity (if any) needs to follow once the investigation has been concluded and the outcome shared with the Healthcare Commission.
If concurrent investigations (from more than one agency) are taking place any reports must be provided to the Safeguarding Manager for the case. The safety and welfare of the people who use the service is paramount. Any decision by the Healthcare Commission to take regulatory action - as a result of an inspection or other information received - should not be unnecessarily delayed; however the safeguarding manager should be informed of any such decision and this should be discussed with the organisation leading the safeguarding assessment. For example if this is the police it is important that any actions by the Healthcare Commission do not adversely affect the gathering of evidence as part of a criminal investigation. The timing of feedback from regulatory action must be agreed with the relevant assessment manager or senior assessment manager in line with the Healthcare Commission’s media protocol, but all efforts should be made for this to be coordinated with the actions of partner agencies.
Team leaders within the Commission must ensure that workload management strategies mean that all fieldwork inspections relating to Safeguarding Adults issues are completed as a matter of priority and in accordance with current methodologies.”