Inside CQC
Joyce Frederick

In this month’s Care Quality Commission column, Deputy Chief Inspector for Registration Joyce Frederick talks about CQC’s work to improve registration.

Hot on the heels of last month’s update from our Chief Inspector, Andrea Sutcliffe CBE on the key changes CQC is making to improve registration, I would like to thank Care Management Matters for the opportunity to bring you more detail about why we are doing this work and what we aim to achieve.

Here at CQC, our registration function is essential to making sure those organisations who intend to provide care, or wish to vary the way existing care services are delivered, understand their legal responsibilities. This is to ensure people always experience good quality and safe care.

Since our new approach to inspection was first introduced in 2014, we have already strengthened our registration work by making the checks we carry out as robust as possible, being satisfied that those who want to register or change services with us are fit to do so and taking action against unregistered services. So, what’s next for the future of registration?

In 2017, we formally consulted on our next phase for registration which led us to set out four key outcomes.

Registration is a quality test

We want to build on making sure that registration is a barrier to poor care. Registration is the first port of call for those wishing to deliver regulated care activities, so we need to be confident that we only register services which are Good. We will do this by making consistent, proportionate and risk-based decisions about which providers to register – and by being clear to providers that we expect them to be able to demonstrate good, safe and person-centred care for people, their families and carers, who rely and depend on these vital services. Registration inspectors will use the same assessment framework as inspection based on the five key questions, and registration teams will work closely with inspection teams to identify the findings at registration (ie what a provider said they would do) and align this with the findings at the point of first inspection to ensure providers maintain their standards.

The register will enhance public confidence and accountability

We are looking to use our website to share clear, accessible information about who is accountable for the quality of care across provider organisations, and the nature of those services. We will also ensure that services do not lose their ratings and inspection history when their ownership changes or when there are other registration changes. This transparency is vitally important because it helps people make more informed choices about their care. It also links to our aim to make registration a quality test – if we get that right then appearing on the register will serve as a badge of quality.

Registration supports innovation

We are already seeing, and will continue to see, new care models and marketplace innovation; CQC needs to reflect this change by enabling all types of providers to register with us as they emerge. To do this, we are working to make it clearer what the legislation means by ‘carry on’ a regulated activity (ie providing a service). We will also define providers, not only those that deliver care but those responsible for ‘directing and controlling’ systems of care. This will support us to hold the right people to account for care quality and help the public understand who this is.

Registration will have open, transparent streamlined processes

We will improve our registration processes so that we target our assessment approach to the level of risk. We want to reduce the burden on good providers, for example, by developing a more streamlined registration application process. We are also developing a digital service to make the process of understanding what standards are required and submitting a registration application easier and more efficient. Our registration inspectors and providers know how frustrating it is when applications are rejected due to simple form-filling errors and the digital service will help make this a thing of the past.
These are big ambitions. By making these changes and getting them right we can make sure registration is at the cutting edge: maturing the national understanding of what are expected standards of care and what are unacceptable risks.

To make sure we get this right, we are involving providers at every step, through co-production of our approach and testing of our digital products. We are also going to introduce changes gradually, so while you will begin to see some over 2018/19, it won’t be a case of everything suddenly changing at once.
Keep an eye out for our monthly newsletters to stay up-to-date with changes and find out about opportunities to get involved in testing the service. You can sign up by going to the ‘News’ page of our website.

Joyce Frederick is Deputy Chief Inspector for Registration at the Care Quality Commission. Missed Andrea Sutcliffe’s column? Read it now. Sign in required. Not a member? Sign up today, it’s FREE for care providers.

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