In January 2023, in recognition of the pressures faced by the NHS during the winter, the CQC published its ‘Response to winter pressures’ which involved the CQC adjusting its regulatory activity to, “enable health and social care staff to carry on providing safe, high-quality care over winter months in the face of existing pressures”. As a result, the CQC prioritised urgent registration applications which either increased capacity in the health and social care sector or helped the sector to recover from the COVID-19 pandemic.
During this period, the CQC set itself a target of undertaking 300 ‘increasing capacity’ inspections and many of the services to be inspected were recommended by Directors of Adult Social Services. The CQC also placed adult social care services that might increase capacity in a local system in its highest priority group for registration.
The CQC has since changed its position. From 1 April 2023, the CQC will prioritise applications from new services which will add capacity and continue its, “rigorous approach to registering services for people with a learning disability and/or autistic people in line with our Right Support, Right Care, Right Culture guidance”.
The CQC’s Registration Data
In the CQC’s recent March 2023 board meeting, the CQC explained that year to date, there had been a 10.9% increase in the number of applications it had received.
As of 16 March 2023, the CQC had undertaken 487 ‘increasing capacity’ inspections and had registered 109 residential care homes and 459 community services. During the board meeting, the CQC stated that early indications were that around half of its inspections were increasing capacity, with an average figure of 15 beds.
On 18 March 2023, the volume of applications in the registration system stood at 7,628 and the number of applications which had been in the system for over 28 days as of that date was 1,485. The CQC said in its February 2023 board meeting that reducing the number of applications in its system over 28 days would remain a key focus of the registration service going forwards.
General Information About CQC Registration
Any person (individual, partnership or organisation) providing a regulated activity in England must be registered with the CQC. Completing registration application forms can be quite an onerous task. Providers are required to complete a comprehensive application form detailing the kind of service that they wish to provide, where it will be provided and who will be the registered manager, amongst other things. The application process can be quite overwhelming particularly in respect of adult services, when a provider wants to operate from multiple locations.
As with everything, preparation is key. Before completing the CQC registration forms, it is important to understand the commercial structure of your business as different structures (such as partnerships and limited companies) have different legal implications. At Ridouts, we can help providers to understand some of these legal implications. Having this assistance at the outset of the registration process reduces the likelihood of mistakes being made in application forms which in turn can help to speed up the overall registration process.
By law, health and social care providers in England are required to register with the CQC for each of the regulated activities that are carried out. Regulated activities are listed in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Not all regulated activities will be relevant to the service being provided, so providers need to carefully determine which ones are relevant to the service they are providing. Providers also need to provide details of the locations where the regulated activities will be carried out. Again, this is something that the team at Ridouts can assist with as we understand the different regulatory requirements and so we can establish which regulated activities will be provided at which location. This helps to reduce the stress and frustration which providers sometimes face when registering their business for the first time or when having a company restructure.
What Happens When A Provider Submits Its Registration Application Forms?
Once providers have submitted their registration application, the CQC will review it and check for missing documents or incomplete information. CQC calls this process ‘validation’ and in its guidance for providers last updated in May 2022, it states that, “If your application is incomplete or is invalid for some other reason, then it will be rejected (i.e. returned to you) with a letter explaining why.”
The CQC then considers the provider’s registration application and either issues a Notice of Decision (“NOD”) to register or a Notice of Proposal (“NOP”) to refuse registration.
What Happens If The CQC Refuses A Registration Application?
The CQC might issue a NOP if it considers that the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 will not be complied with. For example, concerns might relate to staffing arrangements or the layout of the proposed premises.
If a provider is issued with a NOP it does not mean that this is the end of the journey. A NOP is only a proposal to refuse registration and providers have 28 calendar days in which to make written representations to the CQC setting out why the NOP should not be adopted and registration granted. If a provider receives a NOP, it is important to take it seriously and submit representations to the CQC as it can help to assure the CQC that any concerns have been addressed.
Once the CQC has considered a provider’s NOP representations it will notify the provider of its decision and issue a NOD. If the CQC upholds the NOP and refuses to grant registration, providers have the right to appeal to the Care Standards First-Tier Tribunal
Ridouts can assist providers with drafting representations to a NOP and appealing a NOD and has vast experience of doing this Submitting robust representations which have been carefully drafted by lawyers can be helpful as they ensure that the necessary arguments are made with reference to the regulations and CQC guidance.
At Ridouts we have a lot of experience in preparing a service for registration and are able to help negotiate the maze of regulation by supporting you every step of the way. If providers need any advice or assistance please contact us using the email address firstname.lastname@example.org or by calling 0207 317 0340.