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CM031010_Scheme_of_delegation

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					                                                                Agenda Item: 13
                                                                 Ref: CM/03/10/10




                 BOARD MEETING - 15th SEPTEMBER 2010

            AMENDMENT TO THE SCHEME OF DELEGATION

   PURPOSE

1. To seek a) the Board’s endorsement of the Chair’s recent urgent action to
   amend the Scheme of Delegation and separately b) make further changes to
   the Scheme to take effect from 1st October 2010.

   RECOMMENDATION

2. That the Board ENDORSE the Chair’s urgent action and AGREE to the further
   amendments.

   BACKGROUND

3. The Board has agreed previously to amendments to the Scheme of Delegation
   to allow for the changes to powers required to bring the NHS into registration.
   It was flagged at that time that further changes would be necessary following
   the re-registration of adult social care and independent health care providers.

4. Powers need formally to be delegated otherwise the power to make regulatory
   decisions would be vested only in the Board of Commissioners.

5. Attached as Annex 1 to this paper is Appendix D of the Scheme of Delegation
   with proposed changes highlighted in red. These amendments have been
   reviewed and approved by the CQC legal adviser and are required to reflect
   the legislative changes and the new roles within the CQC field-force.

6. Also attached to this paper, at Annex 2, are the changes, in blue, to the current
   Appendix D signed off by the Chair under Chair’s action. This change was
   made to increase temporarily the number of staff authorised to sign off Notices
   of Decision and Notices of Proposal in order to deal in a timely manner with the
   large numbers of such notices being processed as part of re-registration.

7. The Executive may request at the meeting that the effect of the amendment in
   Annex 2 be carried forward for a further period to allow swift processing of any
   remaining re-registrations after 1sT October. If so then a suitable form of words
   – reflecting also the changed field force titles and role from 1st October - will be
   tabled at the meeting.

   GOVERNANCE ROUTES

8. The Executive Team has agreed that the proposed changes be presented to
   the Board for agreement.



                                   1
                                                          Agenda Item: 13
                                                           Ref: CM/03/10/10

   LINK TO STRATEGIC AND CORPORATE PRIORITIES

9. An appropriate Scheme of Delegation is necessary to allow CQC to regulate
   effectively.

   NEXT STEPS

10. Once the amendments to the Scheme of Delegation have been approved the
    revised Scheme will be published on the intranet and CQC website.

   Louise Guss
   Director of Governance and Legal Services
   9 September 2010




                                2
                                                                              Agenda Item: 13
                                                                               Ref: CM/03/10/10
Annex 1

APPENDIX D - ARRANGEMENTS FOR THE EXECUTION OF THE COMMISSION’S INSPECTION, REGISTRATION AND
ENFORCEMENT FUNCTIONS (REGISTERED SERVICES), AND REVIEW, PERFORMANCE ASSESSMENT AND INSPECTION
WORK (LOCAL AUTHORITY SOCIAL SERVICES) FOR USE FROM 1ST OCTOBER 2010

SUBJECT                                                                LEVEL OF DELEGATION                    PARENT LEGISLATION

Registration, Inspection and Enforcement (registered
services)

1     The issue of Notices of Proposal to grant or refuse an           Regional Registration Manager   Section 26(2) and (3), Health and
      application to register and the determination of conditions                                      Social Care Act 2008
      which are to be attached (if any) to a proposed grant of an                                      Health and Social Care Act 2008
      application to register (or transitional Notices of Decision).                                   (Commencement No.16, Transitory
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010.

2.    The hearing of written representations following the issue       Regional Director or            Section 27, Health and Social Care
      of a Notice of Proposal to grant an application subject to                                       Act 2008
                                                                       Head of Operational Risk or
      disputed conditions or to refuse an application to cancel
      registration, or to impose a condition                           Head of Statutory Inspection
                                                                       and Mental Health Operations

3.   The decision to refuse to grant an application (after hearing     Regional Director               Section 28, Health and Social Care
      written representations) or to grant an application subject                                      Act 2008
                                                                       Head of Statutory Inspection
      to conditions which have not been agreed (after hearing          and Mental Health Operations
      written representations)


4.    The decision to grant an application for registration            Regional Registration Manager   Section 28, Health and Social Care
      without conditions, or subject to conditions which have                                          Act 2008
      been agreed with the applicant                                                                   Health and Social Care Act 2008
                                                                                                       (Commencement No. 16, Transitory

                                                                        3
                                                                             Agenda Item: 13
                                                                              Ref: CM/03/10/10
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010

5.   The issue of a registration certificate including the signing    Regional Registration Manager    Section 12, Health and Social Care
      and dating of such certificate and checking to ensure that                                       Act 2008
                                                                      Compliance Manager or
      it is in proper form                                                                             Health and Social Care Act 2008
                                                                      Performance Assessment
                                                                                                       (Commencement No.16, Transitory
                                                                      Manager
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010.

6.   Issue a penalty notice                                           Compliance Manager or            Section 86, Health and Social Care
                                                                                                       Act 2008
                                                                      Performance Assessment
                                                                      Manager                          Health and Social Care act 2008
                                                                                                       (Commencement No.16, Transitory
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010

7.   Decisions to grant an application by the registered person       Regional Registration Manager    Section 19(5) and (6), Health and
      for variation or removal of conditions, cancellation of         or                               Social Care Act 2008
      registration or cancellation or variation of any suspension     Compliance Manager or            Health and Social Care Act 2008
      of regulation                                                                                    (Commencement No.16, Transitory
                                                                      Performance Assessment
                                                                                                       and Transitional Provisions) Order
                                                                      Manager
                                                                                                       2010.

8.    Notice of proposal to refuse an application for registration;   Regional Registration Manager    Sections 26 and 19(1)(a), (b) and (c),
      to cancel registrations; to suspend registration or extend a    or                               Health and Social Care Act 2008
      period of suspension; to vary or remove conditions in           Compliance Manager
      relation to the registration or to impose any additional
      conditions

9.    Consideration of any representations made to the                Director of Operations Deliver   Sections 27 and 28, Health and Social
      Commission with respect to any notice of proposal made          or                               Care Act 2008
      under 8 and the taking of any decision consequent upon
                                                                      Regional Director
      those representations.

                                                                       4
                                                                            Agenda Item: 13
                                                                             Ref: CM/03/10/10
10.   Issuing a notice of decisions on an application for           Compliance Manager or              Section 28(1), Health and Social Care
      registration granted unconditionally or where conditions                                         act 2008
                                                                    Regional Registration Manager
      are agreed

11.   Issuing a notice of decisions on an application for           Compliance Manager or              Section 26(2), Health and Social Care
      registration granted conditionally where the condition(s)                                        Act 2008
                                                                    Regional Registration Manager
      have not been agreed in writing

12.   Consideration of any representations made to the              Regional Director or               Section 27, Health and Social Care
      Commission with respect to the notice of decision made                                           Act 2008
                                                                    Head of Statutory Inspection
      under 11 and the taking of any decision consequent upon       and Mental Health Operations
      those representations

13.   Issuing a warning notice where it appears a registered        Regional Director or               Section 29, Health and Social Care
      service provider has failed to comply with the relevant                                          Act 2008
                                                                    Head of Statutory Inspection
      requirements                                                  and Mental Health Operations

14.   Consideration of written representations made to the          Regional Director (independent     Schedule 2 Part 2 Para 13(2)
      Commission with respect to the issue of a warning notice      from original decision)            The Care Quality Commission
      (13 above) where information contained is to be made                                             (Registration) Regulations 2009
      public, and the taking of any decision consequent upon
      those requirements

15.   Urgent cancellation of registration – application to a justice Director of Operations Delivery   Section 30, Health and Social Care
      of the peace                                                   or                                Act 2008
                                                                    Regional Director
                                                                    with the agreement of the Head
                                                                    of Legal Services and
                                                                    Information Governance or
                                                                    their representative
                                                                    (In urgent circumstances falling
                                                                    outside of normal business
                                                                    hours such action may be

                                                                     5
                                                                          Agenda Item: 13
                                                                           Ref: CM/03/10/10
                                                                   authorised by the Director of
                                                                   Operations or the Head of
                                                                   Legal Services and Information
                                                                   Governance alone)

16.   Urgent decisions to vary or remove a condition on            Director of Operations Delivery    Section 31, Health and Social Care
      registration or impose an additional condition; to suspend   or                                 Act 2008
      registration or extend a period of suspension                Regional Director
                                                                   with the agreement of the
                                                                   Head of Legal Services and
                                                                   Information Governance or
                                                                   their representative
                                                                   (In urgent circumstances falling
                                                                   outside of normal business
                                                                   hours such action may be
                                                                   authorised by the Director of
                                                                   Operations or the Head of
                                                                   Legal Services and Information
                                                                   Governance alone)

17.   The authentication and issue of an authorisation to enable   Compliance Manager or              Section 62, Health and Social Care
      inspectors and/or other to enter premises, request                                              Act 2008
                                                                   Performance Assessment
      documents or exercise inspection powers                      Manager or
                                                                   Regional Registration Manager

18.   Authorisation of the institution of prosecutions for         Regional Director or               (see below)
      offences:                                                    Head of Statutory Inspection
                                                                   and Mental Health Operations
                                                                   or
                                                                   Head of Operational Risk
                                                                   with the agreement of the Head
                                                                   of Legal Services and

                                                                    6
                                                                              Agenda Item: 13
                                                                               Ref: CM/03/10/10
                                                                       Information Governance or
                                                                       their representative

     (a)   carrying on any establishment or agency whilst not                                           Section 10(1), Health and Social Care
           being registered so to do                                                                    Act 2008

     (b)   failure to comply with conditions of registration                                            Section 33, Health and Social Care
                                                                                                        Act 2008

     (c)   breach of Regulations                                                                        Section 35, Health and Social Care
                                                                                                        Act 2008

     (d)   deception and/or the making of false statements                                              Section 36 and Section 37, Health and
                                                                                                        Social Care Act 2008

     (e)   carrying on a registerable activity during suspension                                        Section 34, Health and Social Care
           or registration or following cancellation of registration                                    Act 2008

     (f)   obstruction of inspectors and failure to comply with                                         Sections 63,64 and 65, Health and
           requests requiring information, documents or                                                 Social Care Act 2008
           explanation

     (g)   offence committed by bodies corporate in relation to                                         Section 91, Health and Social Care
           a Part 1 offence                                                                             Act 2008

     (h)   offences committed by unincorporated associates in                                           Section 92, Health and Social Care
           relation to a Part 1 offence                                                                 Act 2008

19. Authorisation of a simple caution in lieu of prosecution in        Regional Director or
    the circumstances set out in 18(a)-(h) above                       Head of Statutory Inspection
                                                                       and Mental Health Operations
                                                                       both with the agreement of the
                                                                       Head of Legal Services and
                                                                       Information Governance or
                                                                       their representative

                                                                        7
                                                                           Agenda Item: 13
                                                                            Ref: CM/03/10/10
20.   Authorisation to enable Inspectors and Assessors and/or       Regional Registration Manager   Section 64, Health and Social Care
      others to require information                                 or                              Act 2008
                                                                    Compliance Manager or           Schedule 3, Health and Social Care
                                                                                                    Act 2008
                                                                    Performance Assessment
                                                                    Manager                         Section 120(4)(b), Mental Health Act
                                                                                                    1983
                                                                                                    The Mental Capacity (Deprivation of
                                                                                                    Liberty; Monitoring and Reporting; and
                                                                                                    Assessment and Amendment)
                                                                                                    Regulations 2009

21.   Authorisation to enable Inspectors and Assessors and/or       Regional Registration Manager   Section 65, Health and Social Care
      others to require an explanation                              or                              Act 2008
                                                                    Performance Assessment
                                                                    Manager or
                                                                    Compliance Manager

22.   Authentication and issue of authorisation to enable           Regional Registration Manager   Section 120(4)(b), Mental Health Act
      inspectors and / or others to enter premises, request         or                              1983
      documents and exercise inspectors powers                      Compliance Manager or           Sections 62, 63 and 65 Health and
                                                                                                    Social Care Act 2008
                                                                    Performance Assessment
                                                                    Manager

23.   Referral of Care Workers to the Secretary of State as a       Compliance Manager or           Section 45 of the Safeguarding
      result of misconduct causing harm or the risk of harm to a                                    Vulnerable Groups Act 2006
                                                                    Performance Assessment
      vulnerable adult
                                                                    Manager

24.   Referral of Care Workers to the Secretary of State where      Compliance Manager or           Paragraph 1 of Schedule 4 to the
      an individual has been guilty of misconduct which harmed                                      Safeguarding Vulnerable Groups Act
                                                                    Performance Assessment
      a child or put a child at risk of harm after 1st April 2002                                   2006
                                                                    Manager
      and the individual has not been referred to the Secretary

                                                                     8
                                                                        Agenda Item: 13
                                                                         Ref: CM/03/10/10
      of State by the Child Care Organisation

25. Authorisation to visit and interview relevant patients in    MHA Commissioners              Section 120(3)(a) Mental Health Act
    private                                                                                     1983
                                                                                                Schedule 3 Health & Social Care Act
                                                                                                2008
                                                                                                The Mental Capacity (Deprivation of
                                                                                                Liberty; Monitoring and Reporting; and
                                                                                                Assessment Amendment) Regs 2009

26. Authorisation to investigate any complaint as to the         Head of Statutory Inspection   Section 120(1)(b) Mental Health Act
    exercise of the powers of the discharge of duties            and Mental Health Operations   1983
    confirmed of imposed by the Mental Health Act in respect                                    Schedule 3 Health & Social Care Act
    of a relevant patient                                                                       2008

27. Authorisation to direct a person to publish a statement as   Head of Statutory Inspection   Section 120(1)(b) Mental Health Act
    to the action the person proposes to take as a result of     and Mental Health Operations   1983
    review or investigation under Section 120(1) Mental                                         Schedule 3 Health and Social Care
    Health Act 1983                                                                             Act 2008

Other

28.   Ministerial briefing/Handling serious cases                Regional Director

29.   Notifications to DH/DCSF in which the Commission plays     Regional Director
      a part in receiving and handling

30.   Review of decisions to withhold correspondence             MHA Commissioner               Section 134 Mental Health Act 1983
                                                                                                Schedule 3 Health & Social Care Act
                                                                                                2008

31.   Part IV Mental Health Act 1983 – safeguards relating to    Second Opinion Appointed       Sections 57, 58(a) and 58(3)(a)
      Consent to Treatment for people who are detained or on     Doctor (acting as an           Mental Health Act 1983


                                                                  9
                                        Agenda Item: 13
                                         Ref: CM/03/10/10
supervised community treatment   independent professional)




                                 10
 Periodic Review and Performance Assessment

32.   The determination and award of adult social care annual        Chief Executive (with              Section 46, Health and Social Care
      periodic review                                                recommendation from Written        Act 2008
                                                                     Representations Process
                                                                     where necessary)

33.   Hearing of written representations (where made) before the     CQC Written Representations        Section 46(9), Health and Social Care
      award of an adult social care or healthcare periodic review    Panel                              Act 2008

Other Reviews and Investigations

34.   Consideration of commencing a review or investigation on       Chief Executive after receiving    Section 48, Health and Social Care
      the provision of English Local Authority Social Services or    advice from Director of            Act 2008
      the provision of health care by and for English NHS bodies     Operations Delivery/Regional
      and cross-border SHAs                                          Director

35.   The production and publication of a report upon a review or    Regional Director                  Section 48(4), Health and Social Care
      investigation                                                                                     Act 2008

36.   Consideration of representations prior to the publication of a Regional Director                  Section 48(7), Health and Social Care
      report upon a review or investigation                                                             Act 2008

37.   Informing the Secretary of State of the failure to discharge   Chief Executive on advice from     Section 50(2)(a), Health and Social
      adult social services functions to an acceptable standard      Director of Operations Delivery    Care Act 2008
      following review under Sections 46 or 49 or investigation
      under Section 48

38.   The recommendation of special measures to the Secretary         Chief Executive on advice from    Section 50(2)(b), Health and Social
      of State where CQC considers that a local authority is          Director of Operations Delivery   Care Act 2008
      failing to discharge any of its Social Services functions to an
      acceptable standard

39.   Consideration of representations prior to the publication of a Chief Executive on advice from     Section 48(7) Health and Social Care

                                                                       11
      report issued under Section 48 of the Health and Social           Director of Operations Delivery   Act 2008
      Care act 2008

40.   Agreement in relation to the subject of special reviews and       Chief Executive on advice from    Section 48 Health and Social Care Act
      investigations                                                    Director of Operations Delivery   2008

41.   Making a report to the Secretary of State where CQC is of         Chief Executive on advice of      Section 48(5) and 53(2) Health and
      the view that there are significant failings in relation to the   Director of Operations Delivery   Social Care Act 2008
      provision of healthcare by or for an English NHS body or
      cross-border SHA, or in the running of such a body

General

5.    Sign-off of consultation responses                                Chairman and Chief Executive




                                                                         12
Annex 2

APPENDIX D - ARRANGEMENTS FOR THE EXECUTION OF CQC’S INSPECTION, REGISTRATION AND ENFORCEMENT
FUNCTIONS (REGISTERED SERVICES), AND REVIEW, PERFORMANCE ASSESSMENT AND INSPECTION WORK (LOCAL
AUTHORITY SOCIAL SERVICES) – (MINIMUM DELEGATED LEVELS SHOWN) - FOR USE FROM 17 MAY 2010 TO 30 SEPTEMBER
2010

SUBJECT                                                           LEVEL OF DELEGATION                        PARENT LEGISLATION

1.    Registration, Inspection and Enforcement (registered
      services)

1.1   The issue of Notices of Proposal to grant or refuse an      Regional Registration Manager       Section 17, Care Standards Act 2000
      application and the determination of conditions which are   or for the period of 8th            (Health and Social Care Act 2008
      to be attached to a proposed grant of an application to     September 2010 to 30th              (Commencement No.16, Transitory
      register (or transitional Notices of Decision).             September 2010 any persons          and Transitional Provisions) Order
                                                                  in the following additional roles   2010).
                                                                  identified and authorised by
                                                                  Regional Directors are
                                                                  authorised to sign Notices of
                                                                  Proposal and Notices of
                                                                  Decision issued in connection
                                                                  with Transitional Order No. 16
                                                                  relating to registration
                                                                  applications:
                                                                       Compliance Managers

                                                                       Performance Assessment
                                                                       Managers

                                                                       Compliance Inspectors

                                                                       Registration Assessors

                                                                       Performance Assessors

                                                                  13
                                                                          National Relationship
                                                                          Managers

                                                                          Regional Change
                                                                          Managers

                                                                          Local area managers

                                                                          Work-around team
                                                                          leaders




1.2   The hearing of representations following the issue of a      Regional Director                 Section 17(4) (a) and (c) and 18, Care
      Notice of Proposal to grant an application subject to                                          Standards Act 2000
      disputed conditions or to refuse an application, to cancel a
      registration, or to impose a condition

1.3   The hearing of representations following the issue of a        Registration Manager or         Article 8 of the Health and Social Care
      Notice of Decision in relation to a transitional application                                   Act 2008 (Commencement No.16,
                                                                     Compliance Manager
      for registration                                                                               Transitory and Transitional
                                                                                                     Provisions) Order 2010

1.4   The decision to refuse to grant an application (after          Regional Director               Section 19(3), Care Standards Act
      hearing representations), or to grant an application                                           2000
      subject to conditions which have NOT been agreed with
      the applicant (again, after hearing representations), or
      decision to impose conditions

1.5   The decision to grant an application for registration          Regional Registration Manager   Section 19(1), Care Standards Act
      without conditions, or subject to conditions which have                                        2000
      been agreed with the applicant
                                                                                                     (Health and Social Care Act 2008
                                                                                                     (Commencement No.16, Transitory
                                                                                                     and Transitional Provisions) Order

                                                                     14
                                                                                                       2010).

1.6   The issue of certificates of registration, including the      Regional Registration Manager      Section 13(4), Care Standards Act
      signing and dating of such certificates and checking to                                          2000
      ensure that all such certificates are in proper form                                             (Health and Social Care Act 2008
                                                                                                       (Commencement No.16, Transitory
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010).

1.7   The issue of Notices of Proposal relating to the variation,   Regional Registration Manager      Section 17(4)(b) and (c), Care
      removal or imposition of conditions of registration           or                                 Standards Act 2000
                                                                    Compliance Manager                 (Health and Social Care Act 2008
                                                                                                       (Commencement No.16, Transitory
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010).

1.8   The determination of applications to voluntarily cancel       Regional Registration Manager      Section 15(1) Care Standards Act
      registrations or vary conditions.                             or                                 2000
                                                                    Compliance Manager                 (Health and Social Care Act 2008
                                                                                                       (Commencement No.16, Transitory
                                                                                                       and Transitional Provisions) Order
                                                                                                       2010).

1.9   Authorisation of the commencement and prosecution of          Compliance Manager with the    Section 20, Care Standards Act 2000
      the Urgent Procedure for cancellation of registrations or     agreement of the Head of Legal
      for the variation, removal or imposition of conditions        Services or their
      relating to a registration.                                   representative.
                                                                    (In urgent circumstances falling
                                                                    outside of normal business
                                                                    hours, such action may be
                                                                    authorised by a Compliance
                                                                    Manager or the Head of Legal
                                                                    Services – or their
                                                                    representative alone)

                                                                    15
1.10 Authorisation of the cancellation of the registration of a   Compliance Manager               Sections 14(1) and 17(4)(a), Care
     person, including the issue of Notices of Proposal to                                         Standards Act 2000
     cancel

1.11 Referral of Care Workers to the Secretary of State as a      Compliance Manager or            Section 84(1) Care Standards Act
     result of misconduct causing harm or the risk of harm to a                                    2000 and when implemented, The
                                                                  Performance Assessment
     vulnerable adult                                                                              Safeguarding Vulnerable Groups Act
                                                                  Manager
                                                                                                   2006

1.12 Referral of Care Workers to the SofS where an individual     Compliance Manager or            Section 95 of the Care Standards Act
     has been guilty of misconduct which harmed a child or put                                     2000 amends the Protection of
                                                                  Performance Assessment
     a child at risk of harm after 1st April 2002 and the                                          Children Act 1999 by adding Section
                                                                  Manager
     individual has not been referred to the Secretary of State                                    2A to the same.
     by the Child care organisation (POCA)                                                         When implemented, The
                                                                                                   Safeguarding Vulnerable Groups Act
                                                                                                   2006

1.13 Designation of an inspector as competent to lead an          Regional Registration Manager
     inspection of a specific regulated setting                   or
                                                                  Compliance Manager or
                                                                  Performance Assessment
                                                                  Manager

1.14 Authorisation of the institution of prosecutions for         Regional Director or             (see below)
     offences:
                                                                  Head of Statutory
                                                                  Investigations or
                                                                  Head of Operational Risk
                                                                  with the agreement of the Head
                                                                  of Legal Services or their
                                                                  representative

      (a)   carrying on any establishment or agency whilst not                                     Section 11(1) Care Standards Act
            being registered so to do                                                              2000

                                                                  16
     (b)   failure to comply with conditions of registration                                            Section 24 Care Standards Act 2000

     (c)   breach of Regulations                                                                        Section 25(2) Care Standards Act
                                                                                                        2000

     (d)   deception and/or the making of false statements                                              Section 26 and Section 27 Care
                                                                                                        Standards Act 2000

     (e)   failure to display certificates of registration                                              Section 28 Care Standards Act 2000

     (f)   offences committed by the Directors or officers of                                           Section 20 Care Standards Act 2000
           Bodies Corporate (including local authorities)

     (g)   obstruction of inspectors                                                                    Section 31(a) Care Standards Act
                                                                                                        2000/ Section 87 of the Children Act
                                                                                                        1989

     (h)   failure by a local authority to comply with Regulations                                      Section 52(1) Care Standards Act
                                                                                                        2000

1.15 Authorisation of a simple caution in lieu of prosecution in     Regional Director with the
     the circumstances set out in 1.13(a)-(h) above                  agreement of the Head of Legal
                                                                     Services or their representative

1.16 The issue of Enforcement Notices requiring service              Compliance Managers                Regulations made under the Care
     providers to comply with relevant Regulations                                                      Standards Act 2000 and/or the
                                                                                                        Children Act 1989

1.17 The hearing of representations made in relation to              Regional Director                  Regulations under the Care
     Enforcement Notices required service providers to comply                                           Standards Act 2000 and/or the
     with relevant Regulations                                                                          Children Act 1989

1.18 Authentication and issue of authorisation to enable             Regional Registration Manager      Sections 31(2), 31(8) and 45(2) Care
     inspectors and / or others to enter premises, request           or                                 Standards Act 2000
     documents and exercise inspectors powers
                                                                     Compliance Manager or              Section 120(4)(b) Mental Health Act
                                                                                                        1983
                                                                     Performance Assessment
                                                                     17
                                                                  Manager                         Sections 62,63 and 65 Health and
                                                                                                  Social Care Act 2008

1.19 Authorisation to enable inspectors and/or others to          Regional Registration Manager   Section 31(1) Care Standards Act
     request information                                          or                              2000
                                                                  Compliance Manager or           Section 90 Health and Social Care
                                                                                                  (Community Health and Standards)
                                                                  Performance Assessment
                                                                                                  Act 2003
                                                                  Manager
                                                                                                  Section 120(4)(b) Mental Health Act
                                                                                                  1983
                                                                                                  Schedule 3 Health & Social Care Act
                                                                                                  2008
                                                                                                  The Mental Capacity (Deprivation of
                                                                                                  Liberty; Monitoring and Reporting; and
                                                                                                  Assessment Amendment) Regs 2009

1.20 Authorisation to visit and interview relevant patients in    MHA Commissioners               Section 120(3)(a) Mental Health Act
     private                                                                                      1983
                                                                                                  Schedule 3 Health & Social Care Act
                                                                                                  2008
                                                                                                  The Mental Capacity (Deprivation of
                                                                                                  Liberty; Monitoring and Reporting; and
                                                                                                  Assessment Amendment) Regs 2009

1.21 Authorisation to investigate any complaint as to the         Head of Mental Health           Section 120(1)(b) Mental Health Act
     exercise of the powers of the discharge of duties            Operations                      2983
     confirmed of imposed by the Mental Health Act in respect                                     Schedule 3 Health & Social Care Act
     of a relevant patient                                                                        2008

1.22 Authorisation to direct a person to publish a statement as   Head of Mental Health           Section 120(1)(b) Mental Health Act
     to the action the person proposes to take as a result of     Operations                      1983
     review or investigation under Section 120(1) Mental
                                                                                                  Schedule 3 Health and Social Care
     Health Act 1983

                                                                  18
                                                                                            Act 2008

2. Other

2.1   Ministerial briefing/Handling serious cases               Regional Director

2.2   Notifications to DH/DCSF in which the Commission plays    Regional Director
      a part in receiving and handling

2.3   Review of decisions to withhold correspondence            MHA Commissioner            Section 134 Mental Health Act 1983
                                                                                            Schedule 3 Health & Social Care Act
                                                                                            2008

2.4   Part IV Mental Health Act 1983 – safeguards relating to   Second Opinion Appointed    Sections 57, 58(a) and 58(3)(a)
      Consent to Treatment for people who are detained or on    Doctor (acting as an        Mental Health Act 1983
      supervised community treatment                            independent professional)




                                                                19
      Core Businesses: Key Milestones/Decisions

SUBJECT                                                                 LEVEL OF DELEGATION               PARENT LEGISLATION

1.     Periodic Review and Performance Assessment

1.1    The determination and award of adult social care and             Chief Executive (with             Section 46, Health and Social Care
       healthcare annual periodic review                                recommendation from Written       Act 2008
                                                                        Representations Process
                                                                        where necessary)

1.2    Hearing of written representations (where made) before the       CQC Written Representations       Section 46(9), Health and Social Care
       award of an adult social care or healthcare periodic review      Panel                             Act 2008

2.     Service Inspection

2.1    Consideration and determination of written representations       Performance Assessment
       (where made) upon service inspection judgement                   Manager

3.     Other Reviews and Investigations

3.1    Consideration of commencing a review or investigation on         Chief Executive after receiving   Section 48 Health and Social Care Act
       the provision of English Local Authority Social Services or      advice from Director of           2008
       the provision of health care by and for English NHS bodies       Operations/Regional Director
       and cross-border SHAs

3.2    The production and publication of a report upon a review or      Regional Director                 Section 48(4) Health and Social Care
       investigation                                                                                      Act 2008

3.3    Consideration of representations prior to the publication of a   Regional Director                 Section 48(7) Health and Social Care
       report upon a review or investigation                                                              Act 2008

4.     Failing Bodies and Authorities


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4.1   Informing the Secretary of State of the award of lowest            Chief Executive                  Section 50 Health and Social Care Act
      performance judgement to a local authority following review                                         2008
      under Sections 46 or 49

4.2   Recommending any special measures to the Secretary of              Chief Executive on advice from   Section 50(2)(b) Health and Social
      State                                                              Director of Operations/Deputy    Care Act 2008
                                                                         Director of Operations

4.3   Referral to the Secretary of State where CQC considers             Chief Executive on advice from   Section 48(6) and 50 Health and
      that a local authority is failing to discharge any of its Social   Director of Operations/Deputy    Social Care Act 2008
      Services functions to an acceptable standard                       Director of Operations

4.4   The recommendation of special measures to the Secretary         Chief Executive on advice from Section 48(6) and 50 Health and
      of State where CQC considers that a local authority is          Director of Operations/Regional Social Care Act 2008
      failing to discharge any of its Social Services functions to an Director of Operations
      acceptable standard

4.5   Consideration of representations prior to the publication of a     Chief Executive on advice from   Section 48(7) Health and Social Care
      report                                                             Director of Operations/Deputy    Act 2008
                                                                         Director of Operations

4.6   Special reviews and investigations                                 Chief Executive on advice from   Section 48 Health and Social Care Act
                                                                         Director of Operations           2008

4.7   Making a report to the Secretary of State where CQC is of          Chief Executive on advice of     Section 48(5) and 53(2) Health and
      the view that there are significant failings in relation to the    Director of Operations/Deputy    Social Care Act 2008
      provision of healthcare by or for an English NHS body or           Director of Operations
      cross-border SHA, or in the running of such a body

General

5.    Sign-off of consultation responses                                 Chairman and Chief Executive



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