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

2. 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

3. 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

4. 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

5. 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

6. 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 6 6 6

7. Essential standards of quality and safety1
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

8. 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

9. 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

10. How the new system is different

11. 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 It also includes dental practices and independent ambulances.
NEW, long-term scheme to take effect from 1 April 2011. 11

12. 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

13. 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

14. 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

15. 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

16. 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

17. Types of regulatory response1
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

18. 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 quality and safety outcomes
- Will take place no less than two years
May include a
site visit
All findings published 18 18

19. 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