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Applying to remove or vary conditions of registration Guidance

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					A new system of registration

Applying to remove or vary
conditions of registration
Guidance for providers and registered managers




October 2010

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PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                             1
Introduction
This guidance is for providers and managers, to give you an overview of how you can apply to
vary or remove a condition of registration.

Other guidance that you need to read with this are:

•    Guidance about locations.
•    Guidance about registered managers.
•    Guidance for providers about how we use conditions of registration in ongoing monitoring
     of compliance.
•    Guidance for providers about how we use conditions of registration in new applications.


Main points
1.     It is the responsibility of the applicant to provide evidence that their services can meet the
       needs of the people using them, that they will be compliant with relevant regulations, and
       that they will be able to carry on or manage the regulated activity they wish to provide
       successfully.
2.     We will manage and process applications, and make decisions in a rigorous, consistent and
       lawful way.
3.     So that we do not hold back the diverse and innovative health and social care providers,
       we will make sure that any conditions of registration we apply or agree are consistent and
       proportionate.
4.     We can vary, remove or add to the conditions applied to a provider or registered
       manager’s registration.
5.     A service provider or registered manager may also apply to have a condition varied or
       removed. They will need to provide evidence that their service can meet the needs of the
       people using it and that it is compliant with relevant regulations
6.     Where the provider or manager is applying to vary or remove only a part of a condition, it
       is their responsibility to clearly specify in the application the part that they are applying to
       have varied or removed.
7.     Where a registered manager is applying to remove a condition placed on their registration,
       they will need to provide clear evidence to support their application. They will also need to
       confirm that they will be able to comply with regulatory requirements without the
       condition.
8.     When processing applications, we will use previous information about why the conditions
       were made. We will assess the impact that removing or varying a condition or part of the
       condition will have on that service. For example, we will look at whether the application is
       for:
       •   An additional location
       •   Removal of a compliance condition
       •   Removal or variation of a restrictive condition
       •   Removal of a condition placed on a registered manager.



PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                       2
General guidance

 When does CQC                 When we register a provider we will always apply conditions of
 apply conditions to           registration.
 my registration?
                               When we register a manager we may apply conditions.
                               We will apply some conditions to providers routinely. We call these
                               ‘routine restrictive conditions’. For example, we will always make the
                               location or locations of a regulated activity a condition of registration of
                               the provider.
                               We may also use ‘restrictive conditions’ where either we or the applicant
                               identify that their ability to carry on the regulated activity is limited. For
                               example, an applicant may tell us they will not perform surgery on
                               children under the age of three, or that they will only accommodate 40
                               people.
                               We may also use ‘compliance conditions’ for some providers and
                               registered managers. These are conditions that we use in order to make
                               a requirement for improvements to the way the regulated activity is
                               carried on if we have moderate or major concerns that it will not be
                               carried on in accordance with relevant regulations and other legal
                               requirements. We have used conditions in this way for existing providers
                               who are applying to the new registration system under transitional
                               arrangements, and we may use them for ongoing compliance.


 What changes to my            You can make an application to vary or remove:
 conditions can I
 apply for?                    •     Routine restrictive conditions − for example, a location.
                               •     Restrictive conditions − for example, a limit on the number of
                                     people you can provide a service to.
                               •     Compliance conditions – for example, if you become compliant with
                                     a regulation that you were formerly not compliant with.
                               If you are making other changes, such as your business address or your
                               contact details, you need to complete a notification form, as these are
                               not conditions of your registration.


 Can I add a                   No. You need to complete a full application to register a new regulated
 regulated activity to         activity.
 my registration with
 a variation                   This is because the law requires you to register each regulated activity
 application form?             separately.
                               Please see our website for guidance and application forms.
                               Note: You must have your application approved before you can start to
                               provide the regulated activity that you are applying for.




PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                            3
 How does CQC make             There are two ways for conditions to be varied or removed:
 changes to the
 conditions applied             •    you can apply to us to have the condition varied or removed, or
 to my registration?            •    we can vary, remove or add conditions.
                               If you are applying, you need to complete the appropriate application
                               form (see the list below).
                               You may need to submit supporting evidence with your application, so
                               you should check the appropriate form for details.
                               We will consider removing compliance conditions when a provider can
                               demonstrate that compliance has been achieved and that it can be
                               maintained.
                               Some registered managers will also have conditions placed on their
                               registration, for example, where a qualification has to be achieved
                               within a given timeframe. Similarly, it will be appropriate for them to
                               apply to remove this condition as soon as the qualification is obtained.


 Which application             There are eight application forms to vary conditions. You should ensure
 form should I fill in?        that you complete the correct form for the change you are applying for:
                                •    Application to vary or remove an existing condition of registration
                                     on a regulated activity: Provider application.
                                •    Application to vary or remove an existing condition of registration
                                     on a registered manager: Registered manager application.
                                •    Application to vary an existing condition of registration by adding a
                                     new location: Provider application.
                                •    Application to vary an existing condition of registration by adding a
                                     new location: Registered manager application.
                                •    Application to vary an existing condition of registration by
                                     removing one or more locations: Provider application.
                                •    Application to vary an existing condition of registration by
                                     removing one or more locations: Registered manager application.
                               There are two other forms available:
                                •    Application to vary the period of, or remove, a suspension of
                                     registration of a regulated activity: Provider application.
                                •    Application to vary the period of, or remove, a suspension of
                                     registration of a regulated activity: Registered manager application.

                               These two are not conditions of registration.




PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                         4
 If I want to operate          The locations that you are registered to operate from are listed in one
 my service from               condition.
 either:
                               You can apply to vary this condition in the following ways:
 • fewer locations
                                •    add locations to this condition
 • different
   locations, or                •    remove location.
 • a new location              You must have your application approved before you can instigate the
 What do I need to             changes you have applied for. For example, you cannot start to provide
 do?                           a regulated activity from a new location until your application has been
                               approved, and you have received a notice of decision to confirm this.
                               If you are adding a new location, or changing the location to another,
                               you will need to provide us with information about this. We may need to
                               make a site visit as part of considering your application.
                               If the location is being sold, you must submit an application, as you will
                               remain responsible for it while it is part of your conditions of
                               registration. The registration for the new provider of the location and
                               the removal of your condition needs to happen at the same time. Our
                               registration teams will work with you through this process.


 How do you vary               The application form helps you to do this.
 part of a condition?
                               It asks you to state the exact words of the condition you are applying to
                               vary.
                               For example, if you are registered to carry on surgical procedures and
                               diagnostics, but have a condition placed on your registration that means
                               you may only carry them on at one of your three locations, you would
                               ask for the address of the other two locations to be added to the
                               condition.
                               In the application, you must tell us about the other locations and about
                               your plans for carrying on the regulated activities involved at those extra
                               locations.
                               This would give us the information that we need to decide whether the
                               other locations are suitable for you to provide the regulated activities
                               you are registered to carry on.
                               You may not provide the regulated activity at the locations until we
                               have approved your application.


 If I have a manager          A manager will have their own registration. Any conditions applied to
 with a condition on          them will be placed on their personal registration.
 their registration,
 how do I get this            It is always up to CQC to vary or remove a manager’s condition of
 removed?                     registration, but where a registered manager seeks to change the terms
                              of their personal registration, they will need to apply to have any
                              conditions varied or removed themselves. This cannot be done for them


PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                         5
                              by their employer (the provider).
                              If the condition in question relates to the manager’s compliance with
                              requirements, they will need to provide evidence that the requirement
                              included in the condition has been met. For example, evidence that a
                              relevant training course has been completed.
                              If the condition contains a restriction, for example about the location at
                              which the manager may operate, they will need to provide evidence that
                              the restriction is no longer appropriate. For example, if their terms of
                              employment have changed and they are now going to manage a
                              different service, at a different location.
                              Note: If a registered manager is required for either a regulated activity or
                              at a specific location, there will be a condition placed on the provider’s
                              registration to have a registered manager. Such a condition is mandatory
                              for certain types of service, and a variation of that condition would not
                              be appropriate unless the service changes into one that no longer
                              requires a manager.


 What do I do when            Each regulated activity is legally a separate registration. Although, for
 the condition I              the purposes of initial registration you were permitted to apply for
 want to vary or              multiple regulated activities in one application, for all subsequent
 remove is applied            applications the regulated activities may be dealt with as separate
 to more than one             registrations.
 regulated activity?
                              We have reduced the burden on providers and managers by agreeing
                              that you can use one form:
                              • Where a condition is worded exactly the same across multiple
                                regulated activities.
                              • Where this involves closing a location.
                              • Where this includes opening a new location.

                              However:
                              • Where there are different conditions for different regulated activities,
                                these have to be identified using separate forms.
                              • Where you have multiple conditions that are worded exactly the same
                                across all your regulated activities, you must complete one form for
                                each condition.
                              • There will be a fee for each application.




PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                            6
 How does CQC                 Any application made must be relevant, and complete.
 decide whether to
 accept my                    Where we receive an application to vary or remove a condition of
 application?                 registration under the Health and Social Care Act 2008 we will review the
                              application form, and check the following:
                              •    Is it a variation or removal of a condition?
                              •    Has the form been fully completed?
                              •    Where supporting information is required, is it included or listed as
                                   available?
                              •    If a new location is to be added, do we have all the relevant
                                   information required about that location?
                              •    Has the correct person/people signed the form?
                              •    Is there any ongoing enforcement activity?


 How does CQC                 We will:
 make a decision
 about whether to             •    Review all supporting information sent with the application.
 agree my
                              •    Review the previous decisions as to why the condition was imposed.
 application?
                              •    Request further information where required.
                              •    Complete the assessment record - this will form the audit trail of our
                                   judgements, and will form the basis of evidence we need to justify
                                   the proposed change or removal to the conditions.
                              •    Undertake a site visit if required (additional locations may require a
                                   site visit).


 How will CQC let             We will send you a notice of proposal detailing the conditions of
 me know their                registration that we now consider should appear on your certificate.
 decision?
                              The notice will detail where we have accepted your application.
                              You then have the right to make written representations to us about any
                              aspect of our proposal within 28 days of receiving it.
                              If representations are made, we must consider them in accordance with
                              our written representations procedure.
                              Our final decision will be made when either:
                              •    Any representations made have been considered, or
                              •    If no representations are received, after the period during which they
                                   could have been made has expired (28 days).
                              Once we have finalised our decision about the conditions to be applied,
                              we will send you a notice of decision.



PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                         7
 When will the                If you agree with the changes, and do not make an appeal, the
 registration take            registration will take effect either:
 effect?
                              •    After the period during which you may appeal has expired (28 days),
                                   or
                              •    On the date we receive written confirmation that you do not intend
                                   to appeal.
                              If you decide to make an appeal to the First-tier Tribunal about our
                              refusal of your application to vary conditions, then the changes to the
                              registration will not take effect until the appeal has been determined or
                              abandoned.




PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                       8
Appendix: Standard wording used for some conditions you may see under a
regulated activity


 Location                      This Regulated Activity may only be carried on at the following
                               locations:
                                •    location 1 <address>
                                •    location 2 <address>

 Registered manager            < provider name>must have a registered manager in day to day charge
                               of <regulated activity> at <location>



 Number of people              <provider name> may only accommodate a maximum number of
 who can be                    <number> service users at <location>
 accommodated
 (care home only)

 Nursing care can not <provider name> must not provide nursing care under <regulated
 be provided          activity> at <location>
 (care home only)



Standard wording for conditions for a registered manager:

 Regulated activity            <name> is registered to carry on <regulated activity>
 and location
                               <name> is registered to carry on <regulated activity> at <location>




PoC1C 100067 3.00 Applying to remove or vary conditions of registration:
guidance for providers and registered managers                                                       9

				
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