Registration Speaker Neil Arculus Job Title Local Area Manager Overview and Scrutiny Committee, 25 th March 2010
What is registration?
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 Adult social care 1 registration Single set of standards 2 Registration NHS Strengthened 3 and extended Independent enforcement powers healthcare
What’s changing? A single way of judging quality Organisations Standards/ Enforcement requirements Providers of adult social National Minimum Care Standards Act care (ASC) registered Standards (ASC and PVH) enforcement action limited Old system - different regulation and to statutory notices and NMS for each setting closures Private and voluntary healthcare (PVH) providers registered Standards for Better Limited enforcement Health considered as part powers for NHS NHS providers were not of annual health check providers registered (HCAI in 2009) New system All providers of health Single set of essential Strengthened and and adult social care standards of quality and extended range of registered with CQC safety for all settings enforcement powers for providers from all sectors
Registration timeline ( subject to legislation ) April NHS Trusts 2010 Adult social care and independent healthcare Oct providers (CSA) 2010 Primary dental care (dental practices) and private April ambulance services 2011 April Primary medical services (GP practices) 2012
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
The five phases for Adult Social Care and Independent Healthcare
CQC’s guidance about compliance The regulations mapped to six Our focus: outcome headings: Involvement and information Plain English Personalised care, treatment and support Safeguarding and safety People focussed Suitability of staffing Quality and management Outcome Based Suitability of management
CQC’s guidance about compliance documents
CQC’s guidance about compliance: example of an OUTCOME Safeguarding people who use services from abuse Plain English OUTCOME 7 What should people who use services experience? People using the service: People focused • Are protected from abuse, or the risk of abuse, and their human rights are respected and upheld That is because providers who are compliant with Outcome Based the law will: • Take action to identify and prevent abuse from happening in a service • Respond appropriately when it is suspected that abuse has occurred or is at risk of occurring • Ensure that Government and local guidance about safeguarding people from abuse is accessible to all staff and put into practice • Make sure that the use of restraint in a way that respects dignity and protects human rights, and where possible respects the preferences of people who use services • Protect others from the negative effect of any behaviour by people who use services
Registration: the cycle Application made Completing Application assessed registration Judgement made Judgement published Information capture Information analysis Ongoing monitoring Judgement on risk of compliance Regulatory response Regulatory judgement
Applying for registration: what CQC will do Assess applications 3 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 Make judgement 4 Using the guidance about compliance - Essential standards of quality and safety and Judgement framework - 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
Applying for registration: adult social care and independent healthcare 1 Prepare to apply From now: Take time to understand the requirements of the new regulations and our guidance about compliance Consider evidence needed to demonstrate outcomes and experiences of people using services Apply for registration 2 April - Sep 2010 (exact dates to be confirmed) Complete the application and declaration - online is preferred - details about providers and locations - declaration of compliance at each location
Applying for registration: what CQC will do Assess applications 3 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 Make judgement 4 Using the guidance about compliance - Essential standards of quality and safety and Judgement framework - to decide to: - register or - register with conditions or - refuse registration Notify provider of decision and give information about right to make representations and appeals Issue certificate Publish register
information and work How we share with others
How we monitor compliance We will hold a Quality and Risk Profile on each provider summarising all relevant information. The Quality and Risk Profile will enable us to assess where risks lie and prompt front line regulatory activity , such as inspection. As new information arrives, it will be added to the profile and assessors 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 Providers services, families and carers Other regulatory Staff and other bodies and professionals Information Centre Other bodies CQC eg. Ombudsman, Assessors and commissioners Inspectors
Information capture Active voice People who use Third party voice - eg. LINks & Providers services, families OSC and carers Surveys: - health - social care Direct voices from visits Other regulatory Staff and other bodies and professionals For future development: Information Individual voices from web Centre Other people’s surveys CQC Other bodies Assessors and eg. Ombudsman, Inspectors commissioners
Information capture Working with others People who use Memorandum of Providers services, families understanding and carers Information feeds Active discussion currently: - NPSA - Monitor Other regulatory - ADASS Staff and other bodies and - NHSLA professionals Information Centre For future development: Accreditation schemes Joint working with Other bodies CQC commissioners eg. Ombudsman, Assessors and commissioners Inspectors
Information capture Providers People who use Notifications Providers services, families Requests for further and carers information Provider compliance assessments Information in public domain Other regulatory Staff and other bodies and professionals Information For future development: Centre Link with quality accounts Other information flows Other bodies CQC eg. Ombudsman, Assessors and commissioners Inspectors
Information capture Staff and others People who use Staff surveys Providers services, families Direct voices from visits and carers For future development: Develop other mechanisms Other regulatory for gathering information Staff and other systematically bodies and professionals Information Centre CQC Other bodies Assessors and eg. Ombudsman, commissioners Inspectors
Information capture CQC Assessors and Inspectors People who use Local relationships and Providers services, families knowledge and carers Direct from people using services, families and carers Site visits: - responsive Other regulatory - planned Staff and other - random bodies and professionals Information Centre For future development: Ratio of responsive to planned work may change over time CQC More time spent on direct Other bodies observation of care, gathering Assessors and eg. Ombudsman, views and experience of Inspectors commissioners people using services, their families and carers.
Reviews of compliance Responsive Planned A responsive review of compliance : A planned review of compliance : is triggered by specific information Looks across all regulated activities that raises concern about at a location to assess compliance compliance with all 16 outcomes (for the core is not a full check of compliance for 16 quality and safety standards) all 16 outcomes (for the core 16 Will take place at intervals of 3 quality and safety standards) months to no less frequent than 2 is targeted to the area (s) of years concern Will be proportionate , with additional activities focused on Depending on the concern, may focus gaps on information on: - the whole provider May include a site visit - one or more locations All findings will be published - one or more regulated activities - a particular service - one or more outcomes May include a site visit All findings will be published
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