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

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

2. 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 Single system of registration Single set of standards Strengthened and extended enforcement powers 1 Registration 2 3

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

4. 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

5. Earlier identification and swifter action to follow up concerns to remove poor practice Services will be known to be providing essential standards of quality and safety; provider’s reputation benefits from increased compliance Reduction of unnecessary costs associated with regulation, releasing resources for other priorities A more efficient, speedy and user-friendly process, fewer appeals and tribunals Less regulation of process, more regulation of outcomes, will give providers and clinicians more scope for innovation for improvement and quality 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 Benefits of registration

6. 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 Section 4: Suitability of staffing Section 5: Quality and management Section 6: Suitability of management Our focus: Plain English People focussed Outcome based

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

8. Applying for registration: what providers will need to do (NHS) 2 • 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 1 • Prepare to apply • In December: • We will invite you to obtain your application log-in and password • You will need to complete your pre-registration form;. • 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

9. Applying for registration: what CQC will do 4 • 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 3 • 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

10. 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.

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

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

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

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

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

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

17. 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 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 Monitoring ongoing compliance

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