Registration Linda Hutchinson Director of Registration Provider Advisory

Registration Linda Hutchinson Director of Registration Provider Advisory Group, 10 December 2009

Objective - at all points of care People experience services that meet essential standards of quality, protect their safety and respect their dignity and rights. Adult social care NHS Independent healthcare 1 Registration Single system of registration 2 Single set of standards 3 Strengthened and extended enforcement powers

Registration timeline (subject to legislation) April 2010 NHS trusts Oct 2010 Adult social care and independent healthcare providers (CSA) April 2011 Dental practices and private ambulance services April 2012 Primary medical services (GP practices)

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

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; provider’s 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

CQC’s guidance about compliance The regulations mapped to 6 outcome headings: Section 1: Involvement and information Section 2: Personalised care, treatment and support Section 3: Safeguarding and safety Our focus: Plain English People focussed Section 4: Suitability of staffing Section 5: Quality and management Section 6: Suitability of management Outcome based

Registration: the cycle Application made Completing registration Application assessed Judgement made Judgement published Information capture Information analysis Ongoing monitoring of compliance Judgement on risk Regulatory response Regulatory judgement

Applying for registration: what providers will need to do (NHS) 1 Prepare to apply In December: • • You will need to complete your pre-registration form; . • 2 We will invite you to obtain your application log-in and password In the pre-registration form, you will need to: decide who will complete your trust’s application form tell us the ‘locations’ within your trust 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

Applying for registration: what CQC will do 3 Assess applications Screen for completeness and absence of confidential information • Cross check declaration of compliance with other available information • 4 • Request or seek further information if there is a risk of non-compliance 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

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.

Information capture New information can come from a variety of sources: People who use services, families and carers Other regulatory bodies and Information Centre Other bodies eg. Ombudsman, commissioners Providers through notifications and other Staff and other professionals CQC Inspectors

Information capture Active voice • • People who use services, families and carers Third party voice – eg. LINKs Surveys health social care other people’s Other bodies eg. Ombudsman, commissioners Direct voices from visits • Other regulatory bodies and Information Centre • Individual voices from web Providers through notifications and other Staff and other professionals CQC Inspectors

Information capture Providers through notifications and other People who use services, families and carers Working with others • Other regulatory bodies and Information Centre Other bodies eg. Ombudsman, commissioners • • Memorandum of understanding Information feeds Active discussions currently: NPSA Monitor ADASS NHSLA Staff and other professionals CQC Inspectors

Information capture Providers People who use services, families and carers • • Other regulatory bodies and Information Centre Other bodies eg. Ombudsman, commissioners Notifications Requests for further information Provider compliance assessments Quality accounts and other information in public domain Providers through notifications and other Staff and other professionals CQC Inspectors

Information capture People who use services, families and carers Other regulatory bodies and Information Centre Other bodies eg. Ombudsman, commissioners Staff • • • Staff surveys Direct voices from visits Individual voices from web? Providers through notifications and other Staff and other professionals CQC Inspectors

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

Monitoring ongoing compliance Judgement on risk Using the Guidance about Compliance and Judgement Framework: No concern Minor concern Moderate concern Major concern Follow up enquiries will be targeted Regulatory response Using the Setting the Bar framework: • Translates minor, moderate or major concerns into regulatory action • Takes account of the provider’s capacity to improve • Action will be proportionate Regulatory Judgement Maintain registration Improvement actions: Improvement letter Enforcement actions: Statutory warning notice Imposition or variation of conditions Fines Prosecution Suspension of registration Cancellation of registration

Objective - at all points of care People experience services that meet essential standards of quality, protect their safety and respect their dignity and rights.