Infection Prevention and Control (IPC) preparedness audit

It is inevitable that when CQC resumes inspections, after easing of lockdown rules, they are likely to focus on infection prevention and control and in particular the Department of Health Code of Practice and the Health and Social Care Act 2008. IPC Preparation (Infection Prevention Control) will be essential to ensure your care home maintains or improves your CQC rating. Many care homes seem to be in issues relating to the above with the CQC commenting:

“We have seen a 55% increase in calls from adult social care staff raising concerns, with the most common topics including lack of PPE or infection control issues.”

Care Quality Commission, June 2020

The Care Quality Commission’s (CQC) Emergency Support Framework (ESF) introduced in May 2020 in response to the COVID 19 pandemic had fallen short of expectations in reassuring consumers and users of care home services. One of the main reasons for this is because of the lack of an evidence-based approach. This is one of the reasons why CQC does not publish its ESF reports in the public domain. There is a need for a framework that can assure various stakeholders involved in a care home: buyers and users of care home services as well as staff working in care homes.

We at Fulcrum Care have developed an open four-point framework called TRST (The Responsive and Safe Treatment) with the collective inputs from current and former experts from the Care Quality Commission, Clinical Commissioning  Groups and Heads of Operations at care home groups.

An IPC Preparedness Audit based on the TRST framework will help the home manager and provider gain an independent view of the processes in place and to assess the preparedness of the care home should an outbreak occur. 


IPC Preparedness Audit*

Assessing Infection Control and Prevention Preparedness

An independent assessment based on the TRST framework will help care home providers and their management teams form a view of the processes in place and to assess the preparedness of their care home should any infectious outbreak occur in the future. 

It can also help them focus on infection prevention and control and assess their compliance against the Department of Health Code of Practice and the Health and Social Care Act 2008.e.g. The fitness for purpose of the Annual Infection Control Statement.


A Fulcrum IPC specialist will visit the home and spend a few hours at your home observing, reviewing documentation, talking to staff to evaluate what are the measures taken by the care home to:

  • Keep COVID-19 out of the home
  • Prevent the spread of COVID-19 within the service
  • Manage the PPE supplies
  • Manage any unexpected COVID-19 infection among staff or residents
  • Review the updates to Business Continuity plans in response to COVID-19

Benefits for the home

  • The manager will receive feedback at the end of the day highlighting areas for improvement
  • A written report of findings and actionable areas
  • Help evidence Good governance (Regulation 17) / Well-led


The TRST Framework in Brief

The framework spans four domains that are fundamental to the management of infection prevention and control in every care home

Safe Care

  • Clinical observations and daily care
  • Admissions management 
  • Discharge planning 
  • Advanced care planning for residents at end of life stages 
  • Visitor management 
  • Best practice in the management of residents with dementia
  • Meeting emotional needs
  • Medicines management in light of new guidance re. the temporary reuse of medicines


  • Housekeeping
  • Managing PPE stocks
  • Usage and deployment of PPE within the home
  • Managing waste 
  • Laundry 


  • Training and assessing competency 
  • Recognising early signs 
  • PPE
  • Hand hygiene 
  • Barrier care, isolation, etc
  • Waste disposal 
  • Recruitment
  • On-boarding 
  • Communication 
  • Well-being 
  • Movement between services 
  • Agency use


  • Policies, procedures, and systems
  • Managing testing for residents and staff
  • Accessing local support resources
  • Auditing
  • Analysing trends and learning lessons
  • Staying abreast of good practice and continuous improvement
  • Stakeholder communications

Rolling out TRST Framework

TRST framework assessors will have access to a cloud-based tool that will be used to capture the findings and upload the evidence (eg. documents, photos, videos). The data collected via this tool will be reviewed by a centralised quality and governance team which is fundamental to maintaining the integrity of the TRST framework and ensuring consistency of judgments. Subscribing to the online tool also enables care providers/managers to create and monitor any action plans arising from the TRST assessments.

* The cost of an IPC preparedness audit may be funded as part of the Infection Control Grant provided to care homes announced in May 2020 and disbursed in July and August.

We recommend that you verify this with your local authority in the first instance.


To arrange an Infection Prevention & Control Preparedness Audit at your care home, please

call us on 0203 411 4014 or 07921 214438 or email us at