Registration Policy and Practice First Aid Forward Joan Plant Policy and Practice First Aid Forward Association of First Aiders 6 November 2010

People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights, wherever care is provided, wherever they live 2 2

Objective - at all points of care Single system of registration Single set of standards Strengthened and extended enforcement powers 1 2 3 Adult social care NHS Independent healthcare Registration 3

The essential standards of quality and safety Parliament Dept of Health Care Quality Commission (Registration) Regulations 2009 Health and Social Care Act 2008 (Regulated Activities) Regulations 2009 CQC Single system of registration Single set of standards Strengthened and extended enforcement powers 4 4

The essential standards of quality and safety Our focus: The 16 core standards are grouped to six outcome headings: Involvement and information Personalised care, treatment and support Safeguarding and safety Suitability of staffing Quality and management Suitability of management People focused Outcome based 5 5 5

Which regulated activities for Ambulance Providers? Transport services, triage and medical advice provided remotely Transport by means of a vehicle which is designed for the primary purpose of carrying a person who requires treatment Medical advice or triage by a body established for that purpose Treatment of disease, disorder or injury Treatment by a listed healthcare professional We have a proportionate approach to overlaps with other activities exceptionally in emergency situations http://www.opsi.gov.uk/si/si2009/draft/ukdsi_9780111487006_en_1 6 6 6

Essential standards of quality and safety 1 Respecting and involving people who use services 15 Statement of purpose 2 Consent to care and treatment 16 Assessing and monitoring the quality of service provision 3 Fees 17 Complaints 4 Care and welfare of people who use services 18 Notification of death of a person who uses services 5 Meeting nutritional needs 19 Notification of death or unauthorised absence of a person who is detained 6 Cooperating with other providers 20 Notification of other incidents 7 Safeguarding people who use services 21 Records 8 Cleanliness and infection control 22 Requirements where the service provider is an individual or partnership 9 Management of medicines 23 Requirements where the service provider is a body other than a partnership 10 Safety and suitability of premises 24 Requirements relating to registered managers 11 Safety, availability and suitability of equipment 25 Registered person: training 12 Requirements relating to workers 26 Financial position 13 Staffing 27 Notifications - notice of absence 14 Supporting workers 28 Notifications - notice of changes 7 7 7

Registration timeline NHS Trusts April 2010 Adult social care Independent healthcare Oct 2010 April 2011 Primary dental care (dental practices) Independent ambulance services Primary medical services (GP practices and out of hours) April 2012 8

The difference registration will make All health and adult social care providers are meeting a single set 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 receive safe and quality care no matter which part of the care system they experience and where 9

How the new system is different

Single long term fees scheme Registration fees NHS Trusts Interim scheme commenced on 1 April 2010. Outlines annual fees payable from April 2010 to March 2011. Adult social care and Independent healthcare New interim fees scheme will come into effect from 1 October 2010. Outlines annual fees payable from October 2010 to April 2011. Includes a flat rate fee system for those providers who were not previously required to register under the CSA Single long term fees scheme We will consult on a single scheme for all existing providers from October 2010. It also includes dental practices and independent ambulances. NEW, long-term scheme to take effect from 1 April 2011. 11

The registration cycle Registration application Information capture Judgement on risk Application made Information analysis Application assessed Judgement published Judgement made Regulatory judgement Regulatory response Monitoring of compliance 12 12

Applying for registration: New providers (first time operating) 1 Prepare to apply Take time to understand the requirements of the new regulations Get Criminal Record Bureau checks (CRBs) for nominated individuals and registered managers Consider evidence needed to demonstrate ‘outcomes’ and experiences of people using services Ensure new buildings are fit for purpose and ready to meet the needs of the people who are to use the service 2 Apply for registration Complete the online application and declaration Submit all additional documentation where required Submit correct fee 13 13 13

New Providers (first time operating) 3 Assess applications Screen for completeness Request further information and, where appropriate, arrange a site visit 4 Make judgement Using the Essential standards of quality and safety and Judgement framework, we will decide to: - register with conditions or - refuse all or part of your registration We will notify of proposed decision and give information about right to make representations and appeals Once registered, we will issue a Certificate of Registration The provider will be added to our register We will invoice for an annual fee 14 14 14

How we capture information Quality and Risk Profile We will hold a Quality and Risk Profile on each provider gathering all relevant information we have about a provider 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 It is used as a prompt, not a judgement 15 15 15

Where we receive our information New information can come from a variety of sources: People who use services, families and carers Providers Quality and Risk Profile Other regulatory bodies and Information Centre Staff and other professionals Other bodies eg. Ombudsman, commissioners CQC Assessors and Inspectors 16 16

Types of regulatory response 1 Maintain registration - no further action Improvement actions Enforcement actions: Statutory warning notice Imposition or variation of conditions Fines Prosecution Suspension of registration Cancellation of registration 2 3 17 17

All findings published Reviews of compliance All reviews: There are two types of reviews: Responsive review - Triggered when information, or an information gap raises concern about compliance - Targeted to the area of concern Planned review - Scheduled check of all core 16 quality and safety outcomes - Will take place no less than two years May include a site visit All findings published 18 18

People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights, wherever care is provided, wherever they live 19 19