Dear Sheila,

Happy New and was lovely meeting you at the Roadshow last year.

I have a question! I manage a disability service for adult with LD. On Christmas Day one of the resident fell and hit their head, which resulted in an injury to his head and also he ended up in A&E and received 2 stitches to the side of his head and was checked over and sent home immediately. I have notified CQC and they have responded by asking what will be my action and to ensure this does not happen again. I have no problem with our action and the action that needs to be put in place. The question is do I need to apply the Duty of Candour?

Thanks Sheila and looking forward to hearing from you.

Lorna Esterine

Answered by Sheila Scott

Dear Lorna,

The incident you describe is a notifiable incident. This you have done and I believe that it follows that the Duty of Candour applies.

You will have a policy and you should follow this.

You may well have read this my previous advice on this subject and these are the points I think you need to consider.

• Duty of candour only applies to the notifiable incidents that you already have a responsibility to inform CQC about, as specified by Regulation 18 ‘Notification of other incidents’, which came into effect in April 2010.
• As was previously the case, you must decide whether or not you should inform CQC of a particular incident, including: the death of the service user; an impairment of the sensory, motor or intellectual functions of the service user for a period of at least 28 days; changes to the structure of the service user’s body; the service user experiencing prolonged pain or prolonged psychological harm, or the shortening of the life expectancy of the service user. If you do then you must now take the duty of candour into account.
• It is the Registered Manager’s responsibility to notify CQC about any notifiable incident. This means that the Registered Manager will deal with the duties imposed by duty of candour regulations.
• There is a responsibility to issue an apology. The apology should regret that the incident has happened and what, if any, action will be taken. It should not be an admission of liability or an expression of opinion.  You may consider informing the service users next of kin which I suspect you will have already done.
• It seems to me that you have already undertaken an inquiry and you have taken any lessons learnt and included them in your training. This point should be part of your report on the Duty of Candour in this case to CQC.

Don’t forget that CQC has useful guidance on its website which can be found at http://www.cqc.org.uk/content/regulation-20-duty-candour

With best wishes.

Sheila