At Stephensons, our specialist CQC lawyers regularly provide advice and representation to care providers and managers nationwide who are unsure of their CQC registration requirements, or who have received a proposal to refuse an application for registration, or an application to vary the conditions of their existing registration.
Our experienced CQC lawyers have successfully challenged numerous proposals and decisions from the CQC, which have resulted in a provider or manager being granted registration without the need for a further lengthy application. Our CQC lawyers also regularly advise both registered and unregistered providers regarding the scope of CQC registration and their specific regulated activities. You can view our CQC case studies for more details on some of our recent cases.
If you require specialist advice on the scope of your CQC registration, or you have received a Notice of Proposal to refuse your registration from the CQC and require assistance with compiling a robust and detailed response to the CQC to successfully challenge this decision, our specialist CQC lawyers can help you. For a confidential discussion with one of our specialist CQC lawyers, please contact us on 0161 696 6250 or complete our online enquiry form.
Requirement to register with the CQC
It is a legal requirement that any individual, partnership or organisation must be registered with the CQC if they provide a regulated activity in England. The various regulated activities and the definitions of those activities are contained in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
It is a criminal offence to carry out a regulated activity without registration with the CQC under Section 10(1) of the Health and Social Care Act 2008. This offence can be dealt with by the Magistrates or Crown Court and if found guilty, the Court can impose an unlimited fine and/or a sentence of up to 12 months imprisonment. You can visit our webpage on criminal investigations and prosecutions by the CQC for more information.
It is therefore vital that, if you are setting up a health and social care service, you obtain registration with the CQC before providing any regulated activity. However, many individuals and businesses are often unclear as to whether their activities fall within the definition of a regulated activity and the legislation and guidance in this area can often be confusing and complex. Specialist legal advice is therefore essential in order to protect your business and your reputation, and to avoid any criminal enforcement action by the CQC.
You can view some of our recent registration cases on our CQC case studies page.
Challenging a decision to refuse your registration
Notice of proposal to refuse registration
The CQC has the power to refuse an application for registration under Section 12 of the Health and Social Care Act 2008. Before refusing the application, the CQC must issue a Notice of Proposal, which details their reasons for the proposed refusal of registration. An applicant has 28 days to make written representations against this proposal.
This is an opportunity to respond to the CQC’s concerns; make any submissions in line with the CQC’s Enforcement Policy and relevant guidance; and provide any additional evidence in support of the application. It is important that a provider reviews each reason carefully and takes a robust but measured approach to any representations made. This is only a proposal at this stage and there is still time to persuade the CQC to grant the registration.
After assessing any representations and evidence submitted, the CQC will determine whether to proceed with their refusal. If the proposal is adopted, the CQC will issue a Notice of Decision and there will be a right of appeal against this decision to the First-tier Tribunal (Care Standards Chamber). This appeal has to be made in writing within 28 days. These appeals can take a number of months to conclude and in order to stand any prospect of success, providers need to ensure that they are able to support their challenge with clear, documentary evidence.
Our key CQC registration advice
The CQC’s registration process can be quite complex and time-consuming and over the past few years, the CQC have increasingly been issuing more proposals to refuse applications. In the CQC’s Annual Report for 2018/19, it confirmed that the CQC had issued 564 registration Notices of Proposal in 2018/2019, which was an increase of 119 (26.7%) from 2017/2018. However, the key to being successful with your challenge is to ensure that your representations are clear and supported by documentary evidence.
Where a provider disputes the reasons for a refusal, it is important that robust submissions are made to challenge the refusal with supporting documentation, and with reference to any applicable legislation; guidance; or case law.
If any of the reasons provided by the CQC are accepted, providers should consider how they can rectify or address those concerns as quickly as possible. Where the CQC’s concerns can be addressed before the deadline, it is important that providers supply documentary evidence to demonstrate this. If this is not possible, a detailed action plan outlining how the provider intends to address these issues with realistic timeframes may be helpful. It is important that you provide reasonable assurances to the CQC about your future compliance, particularly before any final decision on the registration is made.
You can view some of our recent registration cases on our case studies page here.
CQC registration FAQs
Can I obtain CQC registration with a conviction?
Having a conviction is not a bar to registration, provided you are open and honest. You can read our recent blog here.
If you are a manager trying to register, you may want to consider providing a reflective statement to the CQC at the time of applying. This should include the full details of the conviction, any relevant circumstances and mitigation. It should also demonstrate appropriate insight and reflection in respect of that conviction and why you think you are now a’ fit and proper person’.
If you are a provider looking at whether you can employ someone as a manager with a conviction, you need to ensure that you carry out a full investigation into the circumstances of the conviction; that you note the outcome of that investigation in writing with detailed reasons for your decision; and if you chose to employ that person, you need to consider whether it would be appropriate to carry out a risk assessment or any other action before that person is allowed to work.
How long does the CQC registration process take?
A brand new provider application usually takes up to 10 weeks provided there are no delays and your application is thoroughly prepared. However, applications are likely to take longer at present due to the covid-19 pandemic.
Do I require registration for the regulated activity of personal care?
‘Personal care’ is described in the CQC’s ‘the scope of registration’ document dated March 2015, as: “…the provision of personal care for people who are unable to provide it for themselves, because of old age, illness or disability, and which is provided to them in the place where those people are living at the time when the care is provided. As an example, this includes personal care provided by a domiciliary care agency.”
You will likely fall within the definition of carrying out ‘personal care’ where care is provided to an elderly, ill or disabled person in their own home; that care is not provided by you but another person on your behalf (such as an employee); and the payment for that care service is not received directly from the service user, but via another person or the local authority (so that the service user has no direct control over the payment). However, each case has to be considered on its own facts and it is therefore strongly recommended that you seek specialist legal advice to ensure that you are operating within the law.
You can view our blog on the requirement to register for personal care here.
What will happen if I don’t register with the CQC?
It is a criminal offence to carry out a regulated activity without being registered with the CQC under Section 10(1) of the Health and Social Care Act 2008. The CQC can issue you with a Fixed Penalty Notice or prosecute you. This offence can be dealt with by the Magistrates or Crown Court and if found guilty, the court can impose an unlimited fine and/or a sentence of up to 12 months imprisonment.
You can view our blog on the consequences of failing to register here.
Obtaining CQC registration
In this webinar, Laura Hannah and Helen Fuller, Managing Director of Care4Quality, discuss the Care Quality Commission’s registration process and explore the steps that can be taken to improve your prospects of obtaining registration as a service provider or manager, including when the CQC are proposing to refuse your registration - watch now:
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