Registration process for designated centres Frequently Asked Questions 1. Why has the Authority changed its registration process? Responsible regulators are accountable to the public for the efficiency and effectiveness of their activities. In line with best practice, and in the interests of responsible regulation and continuous quality improvement, we have reviewed all aspects of our registration process in order to ensure that our regulatory practices continue to meet its intended objectives. We reviewed our experiences over the first 18 months of regulating the sector and made changes based on this knowledge and the feedback we have received from key stakeholders over that time. 2. What stakeholders provided the Authority with feedback? We received feedback from a number of sources, including: providers who have gone through the registration process provider panels our own inspectors our registration office the Department of Health and Children. 3. My centre has not yet been registered by the Authority. How does the new registration process affect my application? The key changes in our registration process relate to the registration conditions. The purpose of conditions is to govern each centre s operation during their three-year period of registration. Conditions of registration relate to the concept of dependent persons under Section 2(1)(a)(iii) and 2(1)(b) of the Act. Section 1 of the Health (Nursing Homes) Act, 1990, states: "dependent person" means a person who requires assistance with activities of daily living such as dressing, eating, walking, washing and bathing by reason of - (a) physical infirmity or physical injury, defect or disease, or (b) mental infirmity This means that conditions of registration will no longer be based on the age of the resident (with the exception of people under the age of 18 years) or on categories of care or categories of service (for example, people with dementia, people with intellectual disabilities, respite care, convalescent care). Instead, we will be registering centres under two categories of conditions: 1. General conditions 2. Specific conditions
4. What other changes are there? A number of other changes have come into effect as follows: Application documentation is now available on our website and we will now accept electronic applications. The applicant will however also be required to submit a signed hard copy of the application. We will notify each provider in writing when an application to register a centre should be made. The applicant has eight weeks from this date to submit all the application documentation. An application is only deemed made when all the required documentation is completed and forwarded to us and the relevant fees are paid. 5. What type of centres does the Authority register? The Authority registers designated centres. For the purposes of registration of applications under the Health Act 2007 the term designated centre refers specifically to residential care settings for dependent people. 6. How do I determine if my centre is a designated centre? In order to determine whether to apply for registration as a designated centre, it should firstly be established whether the facility meets the definition of a designated centre as defined by Section 2 (1) of the Health Act 2007. 7. Who is the registered provider? The provider of services, referred to in the Health Act 2007 as the registered provider, is the person with overall responsibility for the residential service. The registered provider is legally responsible for the designated centre and will be held accountable for any faults with the services. 8. Who is the person in charge? The person in charge is distinguished from the registered provider and is sometimes described as the manager. The person in charge of the residential service is the person with responsibility for the day-to-day running of the centre. The person needs to be an appropriately skilled member of staff suitable to the responsibilities of the role. The person in charge could be the same individual as the registered provider or another to whom functions have been assigned. The Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 (as amended) state that the person in charge is a registered nurse with a minimum of three years experience in the area of nursing of older people within the previous six years. 9. Which services must be registered? Under the Health Act 2007, all designated centres (residential care centre for older people) must be registered. There are three categories of residential services for older people, which will be required by law to register with the Social Services Inspectorate of the Health Information and Quality Authority:
residential services for older people that have been previously registered by the Health Service Executive (HSE) existing residential services for older people that have not been registered by the HSE new residential services for older people applying for first-time registration. 10. How do I know when I need to apply for registration? If your centre has already been registered, you must apply for registration renewal within 6 months of the expiry date of your centre s existing registration. We will notify each provider in writing when they should apply. A registration application should not be made until the provider has received this notification. Following this notification the provider has eight weeks to complete an application. A provider of a new centre should notify us of his/her intention to open the new centre at least six months before he/she is ready to operate. We can then advise the provider how they should proceed with the application. 11. If I operate the business of more than one centre do I have to complete an application for each centre? Yes. Under Section 48(5) of the Health Act 2007, providers who operate or intend to operate more than one designated centre must make a separate application for registration, or the renewal of the registration for each centre. 12. I want to open a new centre. Can I start operating the centre before applying to register? No. Section 46(1) of the Health Act 2007 prohibits any person from carrying on the business of a centre that is not registered - a person shall not carry on the business of a designated centre unless the centre is registered under this Act and the person is its registered provider. Section 46(2) prohibits any person from managing a centre that is not registered. You should contact us at least six months before you wish to begin operation. 13. Which application form do I complete? There are separate forms for new centres applying for first time registration and for existing designated centres. There are other forms that apply to both. Please see our checklist to find out which forms you should complete. 14. How do I know what organisation type I am? There are separate application forms for: Individuals/sole trader Partnership Company (limited company or company limited by guarantee) Unincorporated body A body established under the Health Acts 1947 to 2008 or a body established under the Health (Corporate Bodies) Act 1961
15. Who is responsible for making an application? In the case of an application by an individual/sole trader, the person responsible for making the application must be the provider. In the case of a partnership the person responsible for making the application should be a partner. For all other organisation types the person responsible for making the application must be nominated by the provider and must be a senior member of the organisation involved in supervision of the management of the designated centre, sufficiently senior to make decisions and implement recommendations arising from an inspection of the designated centre. 16. What happens if I cannot complete the application in time? If a provider cannot meet the application deadline he/she should contact us as early as possible to inform us of any difficulty submitting the required documentation. 17. What happens if I do not submit all of the documentation? Under Section 48(2) of the Health Act 2007, the application form must be completed correctly and all documentation should be enclosed as requested. There is a checklist at the back of the form to identify the required information and documentation. If any information is missing the Authority will consider the application incomplete. Incomplete applications will be returned to the provider for completion. Failure to submit a complete application will inform the inspector s judgment regarding the fitness of the provider and may result in the provider being subject to enforcement activity on the basis of his/her failure to comply with Section 48 of the Health Act 2007. 18. How do I submit an application? The application should be filled in electronically and both posted and emailed to the Authority. The signed hard copy of the application should be sent by post to: Registration Office Health Information and Quality Authority Social Services Inspectorate Unit 1301 City Gate Mahon Cork A copy should also be emailed to: registrationapplications@hiqa.ie 19. I don t have the facilities to access the application online. What can I do? If you cannot download the documentation from the Authority s website please contact the Authority s registration office on 021-2409340 who will send you the required documentation.
20. How much is the registration fee? The fee to be paid for registration is 500 and must be paid in full before the registration application can be processed 21. Can I pay by cheque or credit card? Fees are collected by electronic funds transfer only. The registration fee must be paid before an application is deemed complete. The bank details for the EFT payment are as follows: Account name: Health Information and Quality Authority Bank sort code: 98-54-90 Account number: 01002186 Bank name and address: Ulster Bank Ltd., Midleton-Cork Branch, 95 Main Street, Midleton, Co Cork 22. My statement of purpose has changed since I submitted my registration application registration. Do I need to submit an up-to-date Statement of Purpose? Yes. An application for registration is examined and assessed in respect of the services and facilities as set out in the Statement of purpose. It is imperative therefore that the Statement of purpose is up to date and accurately sets out the services and facilities provided and that the designated centre is operated strictly in accordance with the statement. 23. What is the Fit-person Entry Programme? The Fit-person Entry Programme is a tool for providers to assess their fitness to provide a service and must be completed by the provider as part of the registration process. It has defined learning outcomes and self-assessment activities and is designed to be used without the need for any specialist training or additional resources. 24. I ve lost the provider folder I was sent when the Authority commenced regulation of designated centres. How can I get a new copy of the Fitperson entry programme? The Fit-person Entry Programme can be found on the Authority s website - www.hiqa.ie 25. What is the Fit-person Entry Programme self-assessment? The Fit-person Entry Programme is a self-assessment tool, developed as part of the registration process to help the provider to assess the everyday activities, systems and processes within his/her centre. The self-assessment must be completed and returned to us as part of the application process. 26. What is a fit-person interview? Fit-person interviews take place separately with the provider, the person in charge, and where relevant, other senior managers. During the interview, the provider and person in charge will be assessed on their understanding of, and capacity to comply with the requirements of the regulations and the Standards. The fit-person interviews generally
take place during the registration inspection visit, although the provider and/or person in charge may be asked to attend our offices in Dublin or Cork, for the interviews. 27. I ve already undergone a fit-person interview in relation to an application for a different centre? Do I need to be interviewed again? Providers of more than one centre who have completed the Fit-person interview within 6 months of the next registration inspection may not be required to formally undertake another interview. However, we will still need to meet with and speak with the provider, to clarify issues relevant to the purpose and function of the specific centre being registered. 28. Will you tell me the date of my registration inspection? All registration inspections are announced in advance. Once the fully completed application and the registration fee have been received, an inspection of your centre will be arranged through the our regional inspection office and you will be notified of the inspection date. 29. How long will the registration inspection take? It generally takes place over two days. However this can vary depending on the Statement of purpose, the number of residents and the size of the centre. 28. Who decides if I should be granted registration or not? In forming a judgment in relation to registration, our inspectors take into account many elements: the information provided in the application to register, the Fit Person selfassessment, the Fit Person interviews, findings from the registration inspection and the provider s capacity to implement any actions as a result of inspection. The inspector will also take into account the size of the service provided, the statement of purpose and function and the number and needs of the people who use the service. Following assessment of these elements the inspector will make a recommendation to grant or refuse registration. Applications involving a recommendation by the inspector to grant registration without any specific or limiting conditions are then examined and approved by a Regional Operations Manager. Applications involving a recommendation by the inspector to refuse registration, or to grant registration with limiting or prohibiting conditions are examined and approved by two members of a registration panel. The proposal to grant or refuse registration along with operating conditions attached to the application are then submitted for the consideration and approval of the Chief Inspector. 30. How will I be informed of the decision? Under Section 53 of the Health Act 2007 the Chief Inspector s proposal on registration will be sent to the provider through a written Notice of Proposal. The Notice of Proposal will:
grant an application for registration or registration renewal setting out the operating conditions refuse an application for registration or registration renewal. 31. I am not satisfied with the Notice of Proposal. What can I do? Under Section 54(1) of the Health Act 2007 the provider has 28 days to make written representations to the chief inspector concerning the matter which is the subject matter of the proposal. Therefore the proposal is not decided until the provider has: made written representations to the Chief Inspector concerning the proposal, or notified the Chief Inspector in writing that he/she does not intend to make representations, or the time limit of 28 days has elapsed. 32. When does the proposal come into effect? The provider is informed of the Chief Inspector s decision in writing in the form of a Notice of Decision. Under Section 55(3) of the Health Act 2007, as amended by the Health (Miscellaneous Provisions) Act 2010, the decision will not take effect until: if no appeal is brought, 28 days has elapsed since the provider has received the Notice of Decision, or a longer period determined by the Chief Inspector if the provider confirms in writing that he/she accepts the decision and requests that the decision takes effect at an earlier date, on a date prior to the expiration of 28 days after receipt of the Notice of Decision if an appeal to the District Court is brought, a determination is made, or the appeal is withdrawn. 33. I wish to appeal the Notice of Decision. What do I do? Under Section 57 of the Health Act 2007 the provider has the right of appeal against the decision to the District Court. The appeal must be made within 28 days after service of the Notice of Decision and the provider must notify the Chief Inspector of the appeal at the same time as it is made to the District Court. If an appeal to the decision is brought, the provider may continue to operate the designated centre until a determination is made, the appeal is withdrawn or a further appeal to the Circuit Court is lodged. Pursuant to Section 57(4) of the Health Act 2007 the District Court may: confirm the decision of the Chief Inspector or direct the Chief Inspector to: (a) register or renew the registration of the designated centre (b) restore the registration of the designated centre (c) vary or remove a condition of the registration, or (d) attach an additional condition to the registration.
34. I am closing my centre and wish to cancel my registration. Do I need to inform HIQA? Under Section 66 of the Health Act 2007, registered providers must give written notice of their intention to close to the Chief Inspector. The period of notice required is six months and the date of closure must be specified in the notice. This can be done by completing an NF35 form which can be found on our website at http://www.hiqa.ie/resource-centre/care-providers/forms-guidance 36. Where can I get more information about the registration process? Comprehensive guidance in respect of the registration of designated centres can be found on our website Registration of Designated Centres for Dependent People Guidance for Providers