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Agenda item8 Ref CM/09/07/62 Annex 1
Registration Linda Hutchinson Director of
Registration CQC Board, 10 December 2009
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Objective - at all points of care

• People can expect services to meet essential
  standards of quality, protect their safety and
  respect their dignity and rights.

Single system of registration Single set of
standards Strengthened and extended enforcement
powers
Adult social care
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Registration
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NHS
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Whats changed?
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Registration timeline(subject to legislation)
NHS Trusts
April 2010
Adult social care and independent healthcare
providers (CSA)
Oct 2010
Dental practices and private ambulance services
April 2011
Primary medical services (GP practices)
April 2012
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The difference registration will make

• All health and adult social care providers are
  meeting a wide range of essential standards of
  quality and safety
• Standards are focused on what is needed to make
  sure people who use services have a positive
  experience - a direct result of what people said
  they wanted
• A single regulatory framework across health and
  adult social care people get safe and quality
  care no matter which part of the care system they
  experience and where

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Benefits of registration

• Earlier identification and swifter action to
  follow up concerns to remove poor practice
• Reduction of unnecessary costs associated with
  regulation, releasing resources for other
  priorities
• Services will be known to be providing essential
  standards of quality and safety providers
  reputation benefits from increased compliance
• A more efficient, speedy and user-friendly
  process, fewer appeals and tribunals
• Managers, care professionals and clinicians will
  be able to compare their own performance public
  and people using services will have clear,
  accessible and relevant information
• Less regulation of process, more regulation of
  outcomes, will give providers and clinicians more
  scope for innovation for improvement and quality

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CQCs guidance about compliance
The regulations mapped to six outcome
headings Section 1 Involvement and information
Section 2 Personalised care, treatment and
support Section 3 Safeguarding and safety
Section 4 Suitability of staffing Section 5
Quality and management Section 6 Suitability of
management
Our focus
Plain English
People focussed
Outcome Based
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Registration the cycle
Application made
Application assessed
Completing registration
Judgement made
Judgement published
Information capture
Information analysis
Ongoing monitoring of compliance
Judgement on risk
Regulatory response
Regulatory judgement
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Applying for registration what providers will
need to do (NHS)
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• Prepare to apply
• In December
• We will provide you with your application log-in
  and password
• You will need to complete your pre-registration
  form between 14 and 18 December 2009
• In the pre-registration form, you will need to
• - decide who will complete your trusts
  application form
• - tell us the locations within your trust

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• Apply for registration
• In January
• Submit your online application between 4 and 29
  January 2010
• - details about providers and locations
• - declaration of compliance at each location

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Applying for registration adult social care and
independent healthcare
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Applying for registration what CQC will do
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• Assess applications
• Screen for completeness and absence of
  confidential information
• Cross check declaration of compliance with other
  available information
• Request or seek further information if there is a
  risk of non-compliance

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• Make judgement
• Using guidance, Judgement Framework and Setting
  the Bar to decide to
• register or
• register with conditions or
• - refuse registration
• Notify trust of decision and give information
  about right to make representations and appeals
• Issue certificate
• Publish register

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Applying for registrationnew providers
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Applying for registration new providerswhat CQC
will do
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• Make judgement
• Using guidance, Judgement Framework and Setting
  the Bar to decide to
• register or
• register with conditions or
• - refuse registration
• Notify of decision and give information about
  right to make representations and appeals
• Issue certificate
• Add to register

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How we monitor compliance
We will hold a profile on each provider
summarising all relevant information As new
information arrives, it will be added to the
profile and inspectors will be alerted and will
take action proportionate to the risk.
DRAFT
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Information capture
New information can come from a variety of
sources
DRAFT
People who use services, families and carers
Providers
Other regulatory bodies and Information Centre
Staff and other professionals
Other bodies eg. Ombudsman, commissioners
CQC Assessors and Inspectors
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Information capture
Active voice
People who use services, families and carers

• Third party voice - eg. LINKs
• Surveys- health- social care
• Direct voices from visits
• For future development
• Individual voices from web
• Other peoples surveys

Providers
Other regulatory bodies and Information Centre
Staff and other professionals
CQC Assessors and Inspectors
Other bodies eg. Ombudsman, commissioners
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Information capture
Working with others
People who use services, families and carers

• Memorandum of understanding
• Information feeds
• Active discussions currently- NPSA- Monitor-
  ADASS
• - NHSLA

Providers
Other regulatory bodies and Information Centre
Staff and other professionals
Other bodies eg. Ombudsman, commissioners
CQC Assessors and Inspectors
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Information capture
Providers
People who use services, families and carers

• Notifications
• Requests for further information
• Provider compliance assessments
• Quality accounts and other information in public
  domain

Providers
Other regulatory bodies and Information Centre
Staff and other professionals
Other bodies eg. Ombudsman, commissioners
CQC Assessors and Inspectors
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Information capture
Staff
People who use services, families and carers

• Staff surveys
• Direct voices from visits

Providers
Other regulatory bodies and Information Centre
Staff and other professionals
CQC Assessors and Inspectors
Other bodies eg. Ombudsman, commissioners
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Information capture
CQC inspectors
People who use services, families and carers

• Local relationships and knowledge
• Direct from people using services, families and
  carers
• Site visits- unannounced- planned- random
• Inspectors will review every profile against all
  quality and safety regulations at intervals
  determined by risk (inherent, situational,
  absence of data)
• These planned reviews of compliance may be as
  frequent as 3 monthly and will not be longer than
  2 years
• Planned reviews may include site visits

Providers
Other regulatory bodies and Information Centre
Staff and other professionals
CQC Assessors and Inspectors
Other bodies eg. Ombudsman, commissioners
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Monitoring ongoing compliance
Judgement on Risk
Regulatory Judgement

• Using the Guidance about Compliance and Judgement
  Framework
• No concern
• Minor concern
• Moderate concern
• Major concern
• Follow up enquiries will be targeted

• Maintain registration
• Improvement actions
• Improvement letter
• Enforcement actions
• Statutory warning notice
• Imposition or variation of conditions
• Fines
• Prosecution
• Suspension of registration
• Cancellation of registration

Regulatory Response

• Using framework
• Translates minor, moderate or major concerns
  into regulatory action
• Takes account of the providers capacity to
  improve
• Action will be proportionate

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Objective - at all points of care

• People can expect services to meet essential
  standards of quality, protect their safety and
  respect their dignity and rights.