everythingCQC - CQC Registration

Changes to your CQC registration

You must inform CQC when:

The person who manages or carries on the service changes
There is a change to the registered details of the service and any individual, partnership or organisation who manage or carry it on
The registered person becomes financially insolvent
The service closes

You can notify the CQC by logging into your CQC online portal. To access your account CLICK HERE

As a provider or registered manager, this will enable you to view and change your registration details, such as:

add regulated activities to your registration.
change your contact details.
apply to be a registered manager.
notify the CQC of events and incidents at your practice e.g. Death of a person using the service or abuse or allegations of abuse.

How do I apply for a change of Registered Manager

If there is a change of Registered Manager at your organisation you need to inform the CQC of this as soon as you are aware of this.

For example, if the Registered Manager is retiring or leaving the organisation you should be making provisions for a takeover of the responsibilities a few months prior to the event. In the event that you have to have a change of a Registered Manager due to unforeseen circumstances you should notify the CQC as soon after the event as possible.

To do so you need to:

Fill out the Changes to a provider's or manager's registered details form and email a copy to This email address is being protected from spambots. You need JavaScript enabled to view it.. You can also notify the CQC by logging into your CQC online portal. To access your account CLICK HERE
The registered manager will need to undergo a CQC countersigned DBS check before they will be accepted by the CQC. (GMC numbers in lieu of a CQC countersigned DBS check is no longer accepted.) Click here to find out more.

What can the CQC do if a provider does not meet the required standards?

The CQC have a range of powers that they can use to enforce compliance. For example:

Issue a warning notice, asking for improvements within a short period of time.
Restrict the services that the care provider can offer.
Restrict admissions to the service
Issue a fixed penalty notice
Suspend the care provider's registration.
Cancel the care provider's registration.
Prosecute the care provider.

The CQC work with local authorities, regulators and agencies, and sometimes the police, to make sure the necessary action is taken.

Do I have to register every year?

No – you only have to register once, but you'll need to keep your registration up to date

This means that you will have to inform the CQC of any changes e.g. change of registered manager or changes to the services you provide, etc.

And of course, remain compliant with the outcomes.

To register all I need to do is fill out an application form?

The application form is exactly as it says, "your application for registration" and this is just the beginning of the process.

Your application may well be rejected if you do not meet the requirements, or delayed if the CQC feels they need further information. The application requires you to make a declaration that you are fully compliant at the time of this application, and NOT that you will be compliant at the time of the registration visit or interview.

If you fail to meet all the requirements, you will have to support this with a detailed action plan of how and when you expect to be fully compliant. It is clearly easier to just get compliant in the first place.

What this means is that there is a fair amount of work you have to do to get your affairs in order BEFORE you make the application.

Can I still register if I don't comply?

Yes, you should be able to.

When you fill in your registration application, the CQC will ask you to tell them why you don't comply, how you're managing the risks posed to patients and when you will become compliant.

They'll only refuse registration if they think patients are being put at risk. However to avoid delays in your registration we recommend that you apply when you are compliant.

CQC Action Plan Template (when declaring non-compliance for an outcome)

Do we have to change all our polices to comply with CQC?

Most good practices will have a competent range of policies to start with and there should be no need to revise these.

The CQC regulations do not focus on having the "ultimate collection" of policies, but rather on how effectively you put them to practice and the level of evidence you have to prove this to an independent auditor. Your focus should be more on the day to day process and evidence of compliance and good practice.

Are CQC and QOF the same?

We hear suggestions that CQC is no different from QOF, perhaps with a couple of more items on the list. This is absolutely incorrect. Whilst there is an overlap on some administrative compliance requirements, QOF predominantly concentrates on clinical performance whereas the CQC requirements cover the overall performance of the organisation, focusing more on the safety aspects and patient facing aspects of your delivery.

It is true to say that QOF clinical governance and performance is one aspect of quality that a CQC inspector may look at, but it is only a part of the overall examination.

What if I am not compliant?

This is not a black and white issue of being compliant or not compliant.

The CQC will take a very reasonable approach based on the degree of seriousness of your failure and potential harm to the public. In most cases, they will also give you an opportunity to fix things but unlike the old relatively relaxed days under PCTs, they will give you a time frame within which you have to fix this, and visit your practice to check up on all this.

After registration, if you persistently fail in the standards, they can impose fines from £300 to £50,000; suspend trading until you fix things; close you down, and in serious cases prosecute you as well.

What if I don't register?

Not Registering

This is now a regulated business, which means that to trade as a practice you have to abide by the new regulations. As a first step, anyone wishing to practice must now register with the CQC and confirm that they are compliant with all the requirements and will continue to be so from here on.

Trading without registration is an offence. In plain English, this means you will be committing a criminal offence and liable to hefty fines of up to £50,000 and prosecution and possibly a stretch at Her Majesty's pleasure. Don't even think about it!

Section 10(1) of the Act dictates a fine of £4,000 for "Carrying on a regulated activity without being registered"

CQC prosecutes cosmetic surgery company for failure to register 4 May 2012

A company providing cosmetic surgery treatment at independent clinics in Wakefield and London without being properly registered has been ordered to pay a fine of £40,000 by magistrates in Wakefield.

The Care Quality Commission brought the prosecution against The Northern Clinic.com Limited who had been carrying out a surgical liposuction procedure known as "Body Tite" fat removal treatment, at clinics at Homestead Drive, Alverthorpe Road, Wakefield and at Hannah House, 11-16 Manchester Street, London.

On Tuesday 2 May at Wakefield Magistrates' Court, the company pleaded guilty to two offences of carrying on a regulated activity without being registered to do so.

Inspectors visited the clinic at Wakefield unannounced in February 2011 after receiving information from a member of the public. Further inspections of both the Wakefield and London clinics confirmed that at both locations the company was carrying out liposuction procedures even though the company was not registered with CQC, as required by law.

Can they shut me down?

Several enquirers have commented that they could not see how the CQC could possibly close down a practice. "How can they stop me trading? Are you telling me that they will physically board up my front door?" The CQC's job is to protect the public and they would only use sanctions where they feel it necessary.

If they suspended your trading licence or asked you to close down, they will have good reasons for this, most likely because they believe that you are in effect a danger to the public. Make no mistake, they have the powers of enforcement.

If you continue to trade in defiance then although the inspectors might not actually come to nail boards to your door, putting offenders behind bars is equally effective.

Do I need to hire a consultant to take me through the registration process?

The simple answer is No but maybe.

The actual CQC registration process is relatively straight forward, and you can get though it without any outside help. However the CQC expect you to have a full Quality Management System in place before you even start, and drafting this can be very time consuming and daunting for anyone new to the process.

Documents you have to produce:-

How will you comply with the 5 Key Domains
A Governance Document
A Quality Management Statement
A Safeguarding Policy Statement

Drafting these will take several days, and if you don't already have a system in mind, you will likely start by purchasing policies from a supplier and reading through them to produce the above documents. Once you start trading, you will be expected to explain all of the above to your staff as part of their training

Can I say I am compliant and catch up with it later

It is more common than most would like to admit that practice managers often declare that they are complaint when in fact they are not, but hope to catch up afterwards when they have the time. A classic example is the end of the year QOF compliance and issues such as IG Toolkit and staff appraisals. Labelled as "just a little white lie" this used to have little or no consequences, mostly because no one really came to check.

Not anymore!

In most cases, it is most likely that the practice manager will have done the preparation but it will be the GP partner who will have to sign the declaration to the CQC. This is where you have to exercise care:-

Will the GP check everything for full compliance before signing the declaration?
Will most GPs who have not taken an interest in the managers work in the past, know what they are looking for?
What if shortcuts have been taken and the GP is unaware of these?
What if the GP signs the declaration and finds out later that the practice is not compliant and all facts were not disclosed at the time of registration?

The Registration document is a formal declaration of compliance.

A false declaration is a serious criminal offence and not a minor white lie ..... this is the official CQC position.

Who should be the registered manager?

For CQC, a Registered Manager is the person registered with the CQC to be in day-to-day management of one or more regulated activities. The registered manager takes on special responsibilities and has a legal role in enabling and monitoring compliance with essential standards across your regulated activities.

If you are a practice manager who agrees to be the registered manager as well, your role will change from just administrative to that of being legally responsible for compliance. What this means is that if there are serious failures, you can be held responsible, fined and even prosecuted.

The BMA guidelines suggest that:-
" ..... we believe that for most providers it will be appropriate for a partner to be the registered manager, although in some cases you may decide that it is more appropriate for a practice manager to take this role. The registered manager role should certainly not be viewed simply as an administrative management role, due to the legal responsibilities involved."

As a partner you need to have a better understanding of operational issues and how everything works, or at least have good systems that make you aware of alerts and what outcomes are being achieved.

Do all my staff need a DBS check?

The CQC do not require staff other than the Registered Manager to have a CQC countersigned DBS (formerly CRB) check for purposes of CQC registration.

But whilst it is not a CQC requirement, the NHS Employment Check Standards recommends that general practices ensure that they carry out appropriate DBS checks on all applicants for any position within their practice that qualifies for such a check. This should include health visitors, nursing staff and so on.

CLICK HERE to find out more

I am registered with the GMC. Do I require a standard DBS?

From 1 April 2013, all GP providers and registered managers that make an application to register with the CQC must have a CQC-countersigned DBS check. GMC numbers in lieu of a CQC-countersigned DBS check is no longer accepted.

Also note that Nominated individuals (usually a Practice Manager) do not need a CQC-countersigned DBS check. Providers must, however, carry out their own DBS checks on all their nominated individuals and may be asked to supply evidence of these

Can I contact the CQC for help and advice?

Yes you can contact the CQC directly for help and advice.

The National Customer Service Centre
(Opening hours are Monday to Friday, between 8.30am and 5:30pm)

Phone: 03000 616161
Fax: 03000 616171
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Address:
CQC National Customer Service Centre
Citygate
Gallowgate
Newcastle upon Tyne
NE1 4PA

What is the purpose of the fit person interview?

This is to assess the applicant's fitness to be registered – not their suitability for the particular job. These are not job interviews – they use them to assess fitness against the criteria in the regulations.

"We use this interview to verify the information we have and to gather new information to help us make a judgement about the fitness of the applicant"

It is not a test that the applicant passes or fails. Matters can be re-visited and assessed outside of the interview.

How long is the interview

CQC quote 30 minutes but it can be a couple of hours.

The interview is not a test of the CQC legislation, but whether you are fit to be a Registered Manager and understand your responsibilities and understand what CQC is about.

Location of interview

These can be held:

face-to-face
at a CQC regional office or
on-site or on the telephone.

The CQC will let you know in advance; you will have time to prepare.

Do I need to know about the legislation?

You do not need detailed knowledge of the legislation, but you should know:-

It is based on the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The basics of CQC guidance, and compliance requirements.
What KLOEs are (The 5 Key Domains)
How inspections are conducted

Detailed knowledge of CQC guidelines and requirements

Very few people have expert or detailed knowledge of the guidelines. How inspections are conducted and what they will ask has changed several times in the last few years, many have lost track

Make sure you know what is meant by the term 'KLOEs', you don't need to know the details.

It is ok to be able to say, "I know what they are about, I know where to find these detailed guidelines, and I intend to follow them."

It's about you

The interview is to determine whether you are a fit and proper person to take on the responsibility of a Registered Manager. Although this is not a recruitment interview, the principles are similar in that you should have a clean background and some history to demonstrate your ability to take this on this role.

Relevant experience

Just like a normal recruitment interview, relevant experience always helps. However, what the CQC are looking for is management and supervision skills, experience in similar trades, and ability to understand and comply with rules and regulations.

Why am I applying?

Applying for any position in Care assumes that you are interested in a profession where the welfare and wellbeing of those in your care is important to you. You need to show that you have the right attitude, motivation and respect for the profession.

Equality & Diversity

This is a hot topic so be prepared to be questioned on this and make sure you are clear in explaining that your values and beliefs align with the requirement to be fair and respectful to all.

Your Qualifications

You must have the necessary qualifications, skills and experience. Professional qualifications make the process easier

You can gain registration without some of the relevant qualifications if you can demonstrate sufficient skills and experience, which can be earned through being "qualified by experience" in that job. Some qualifications may be essential for the job.

What the CQC says: "For the purpose of registration, CQC does not currently require a manager to have a professional qualification in relation to any particular regulated activity within either health or adult social care sectors."

Documents needed with the application form

The application form will include all the information that needs to be submitted. If you are applying to be registered for more than one location, you will need to submit an additional section for each location.

The other documents listed on the application must be available to view when you are interviewed. These include:

Job description
Full CV
Certificates and qualifications evidence

What happens once CQC has accepted my application as complete?

Completed Applications

What the CQC says:

The application form is reviewed by our registration teams, in liaison with local inspectors and registration assessors.
We will assess your application and declaration of compliance alongside any other information that we have about you.
If we need any additional information, we will inform you.
If we need to clarify any issues, or request additional documentation in some circumstances, we are most likely to telephone you for this.
In most cases we expect to get all the information we need to make a judgement from the application form and at interview.

Will CQC make a visit or any interviews as part of this process?

If you are not currently registered they will arrange a meeting or interview to assess your fitness and to look at the documents listed in the checklist on your Registered Manager application form. This interview may be face-to-face or conducted over the telephone, or on-site or at one of CQC's regional office.

When the application is a combination of a new Provider and a Registered Manager, that interview may include a review of the Provider's Governance, Processes and Policies.

The inspectors try to be reasonable "We understand that interviews can sometimes be stressful for some people, so we will make every effort to allow the interviewee to be at ease and demonstrate their abilities and experience."

When will my registration be complete?

The CQC will make a decision on your fitness once they have completed their assessment and have made a recommendation to the regional Registration Manager.

They will notify you of the outcome in writing by issuing a written Notice of Proposal and/or Notice of Decision.

Final decision

The steps:

Notice of Decision: Application accepted
Notice of Proposal: Application refused (This is a proposal that they will refuse unless you convince them otherwise)
Representation: You have 28 days to make representation to convince the CQC to change their mind
Final decision: If still refused, you have the right to appeal to the first-tier tribunal.

Will I get a certificate?

CQC says "Yes, we will issue a certificate to each manager in an electronic format, sent by email. Each registered manager has a unique number assigned to their registration"

In this section, you will learn that the critical part of CQC Registration is ensuring you have a robust system in place when you make the application, else convincing the CQC of your credentials can drag on for a very long time. The application is the relatively easy part, the hard part is ongoing compliance, which can be very time-consuming.

This is an overview of the process you have to go through to register. The time scales are entirely dependent on the industry you are in and the complexity of the services you expect to deliver. For most small providers, the entire process can be completed in as little as 10 weeks.

project plan overview

project plan stage1

project plan stage2

project plan stage3

Monitoring your own account

You can monitor and manage your registration and changes online, such as:

add regulated activities to your registration.
change your contact details.
apply to be a registered manager.
notify the CQC of events and incidents at your practice e.g. Death of a person using the service or abuse or allegations of abuse.

To access your CQC account CLICK HERE

Save

DBS-CRB

On 1 December 2012, the functions of the CRB (Criminal Records Bureau) and the ISA (Independent Safeguarding Authority) merged and are now carried out by the DBS (Disclosure and Barring Service).

As part of your initial applications made to the CQC, you would have undergone a CRB Check (criminal records bureau check). Any change in registered manager will also require the person to now undergo a DBS check.

Who needs to complete the CQC DBS check

The following people are usually required to complete the CQC DBS check process:

Individuals applying for registration to carry on or manage a care service
All Partners
Registered Managers

Note:From 1 April 2013, all GP providers and registered managers that make an application to register with the CQC must have a CQC-countersigned DBS check. GMC numbers in lieu of a CQC-countersigned DBS check is no longer accepted.

DBS checks when employing new staff

The CQC say Health or Adult Social care service providers are responsible for checking the suitability of their own staff.

Whilst it is not a CQC requirement, the NHS Employment Check Standards, recommends that everyone employed for the purpose of carrying on a regulated activity under the Health and Social Care, ensure that they carry out appropriate DBS checks on all applicants for any position within their practice that qualifies for such a check. This should include health visitors, nursing staff, contracted & temporary staff, practitioners working under practising privileges, volunteers, students and so on.

The requirement for a check and level of check is dependent on the roles and responsibilities of the job and the type of contact with vulnerable groups.

If the practice only treats adults, then staff who actually provide healthcare will require DBS checks - not the receptionists, etc.
If the practice treats children as well, any staff member who potentially comes into contact with the children may be eligible for the DBS check.

DBS checks for Staff who have been employed for some time

There is no legal requirement to carry out retrospective or periodic DBS checks. Employers can ask staff to apply for a DBS certificate retrospectively whenever they think it is necessary.

If a staff member has been employed with the provider for a long time (and therefore may not have a DBS check), the appropriateness of retrospective checks might be considered if there are other concerns about the provider's recruitment procedures or if concerns are raised with regards to specific members of staff.

What actions will the CQC take when they find a breach of this regulation

"The action we [the CQC] take will be proportionate to the impact that the breach has on the people who use the service and how serious it is".

The key thing is that the provider must be able to demonstrate they have effective and robust recruitment procedures in place for all new staff, which will include identifying if staff are eligible for DBS checks, as well as checking their references, employment history etc.

How long is a DBS check valid for?

There is no requirement for a service that directly employs its own staff to repeat disclosure and barring checks within a set period. Further checks on staff will depend on the registered person judging that this is necessary or advisable after a certain period.

When making their decision they should take into account the work they do, the potential scope for abuse, and the stability of the workforce.