raising standards improving lives
Application to voluntarily cancel registration from a social
care provider or manager 1
You must complete and return this form to apply to cancel your registration as a provider or a manager.
There are two sections to this form. Part A is an application to cancel registration as a provider; part B is an application to cancel registration as a manager.
You must send the applicable part of the form to Ofsted at the address given below at least three months' before the date you want the cancellation to take effect. We may agree to a shorter period of notice in exceptional circumstances.2
If we have served you with a notice of proposal to cancel your registration as a provider or a manager,3 or a notice of decision,4 you cannot apply to voluntarily cancel your registration.5
We will not be able to process your application for cancellation unless all the required information is provided to us. We may contact you to ask for further information. If you do not provide the required information, this may cause delays in processing your application and may result in the need to revise your proposed cancellation date.
If this is an application to cancel a registered provider, then this form must be signed by someone who makes up the registered provider and any application without the appropriate signature(s) will need to be resubmitted.
If this is an application to cancel the registration of a manager, then this form must be signed by the manager who is applying to cancel their registration.
We cannot process forms that are not signed by the correct person(s) and any application without the appropriate signature(s) will need to be resubmitted
The provider must return the certificate of registration on the agreed cancellation date.
If you have questions on completing this form, please contact our contact centre on 0300 123 1231.
1 Section 15 (1)(6) of the Care Standards Act 2000 and regulation 13 of the Care Standards Act 2000 (Registration)(England) Regulations 2010. 2 Regulation 13(2)(6) of the Care Standards Act 2000 (Registration)(England) Regulations 2010. 3 Section 17( 4)(a) of the Care Standards Act 2000. 4 Section 19(3) of the Act. 5 Section 15(2) of the Act.
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Part A
Notice of application from a registered provider to voluntarily cancel their registration under
section lS{l){b) of the Care Standards Act 2000
Information about the establishment or agency
Section 1a
Name of registered provider
Name of establishment or
agency
Address
Postcode
Telephone number
Date of registration
Ofsted reference number
Proposed date of voluntary cancellation
Description of the establishment or agency
Section 2a
Please tick as appropriate
Children's home
Independent fostering agency
Voluntary adoption agency
Adoption support agency
Residential family centre
Residential holiday scheme for disabled children
I I I
I I I
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S e cti o n 3 a
W h at ar e y o ur r e a s o n s f or a p pl yi n g t o c a n c el y o ur r e gi str ati o n ?
S e cti o n 4 a
If y o ur pr o p o s e d d at e f or c a n c ell ati o n i s l e s s t h a n t hr e e m o nt h s fr o m t h e d at e of
t hi s a p pli c ati o n, w h at ar e t h e r e a s o n s f or t hi s ? Pl e a s e al s o pr o vi d e a r e p ort a b o ut
w h et h er y o ur e st a bli s h m e nt or a g e n c y h a s c e a s e d t o b e fi n a n ci al vi a bl e, or i s li k el y
t o c e a s e t o b e fi n a n ci all y vi a bl e, wit hi n t h e n e xt 1 2 m o nt h s .
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S e cti o n 5 a
W h at arr a n g e m e nt s h a v e y o u m a d e t o e n s ur e t h at c hil dr e n, y o u n g p e o pl e a n d
w h er e a p pr o pri at e, a d ult s er vi c e u s er s , will c o nti n u e t o b e pr o vi d e d wit h si mil ar
a c c o m m o d ati o n a n d s er vi c e s t o t h e t y p e t h at y o u c urr e ntl y pr o vi d e aft er t h e
p r o p o s e d c a n c ell ati o n d at e ? (Pl e a s e c o nti n u e o n a s e p ar at e s h e et if n e c e s s ar y)
S e cti o n 6 a
W h at arr a n g e m e nt s h a v e y o u m a d e f or t h e r et e nti o n a n d s e c ur e st or a g e of r e c or d s
aft er t h e pr o p o s e d c a n c ell ati o n d at e ?
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(ii) representatives of the people listed in (i), including placing authorities
Section 7a
What notice or information have you given to the following people about your
application to cancel your registration?
(i) the people who use your service, including children and young people, foster
carers, adoptive parents and families
(iii) the local authority in the area where the establishment or agency operates
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S e cti o n 8 a If y o u h a v e n ot gi v e n i nf or m ati o n t o a n y of t h e p e o pl e li st e d i n s e cti o n 7 a , w h at ar e t h e cir c u m st a n c e s t h at h a v e pr e v e nt e d y o u fr o m gi vi n g t h e m i nf or m ati o n a b o ut y o ur n oti c e t o c a n c el ?
(i) t h e p e o pl e w h o u s e y o ur s er vi c e, i n cl u di n g c hil dr e n a n d y o u n g p e o pl e, f o st er
c ar er s, a d o pti v e p ar e nt s a n d f a mili e s
(ii) r e pr e s e nt ati v e s of t h e p e o pl e li st e d i n (i ), i n cl u di n g pl a ci n g a ut h oriti e s
(iii) t h e l o c al a ut h orit y i n t h e ar e a w h er e t h e e st a bli s hm e nt or a g e n c y o p er at e s
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S e cti o n 9 a
If y o u h a v e n ot alr e a d y gi v e n n oti c e or i nf or m ati o n a b o ut y o ur a p pli c ati o n t o c a n c el
y o ur r e gi str ati o n t o t h e p e o pl e i n S e cti o n 7a , t h e l a w r e q uir e s t h at y o u d o s o wit hi n
s e v e n d a y s of m a ki n g t h i s a p pli c ati o n t o c a n c el. Will y o u pr o vi d e t h e s e
n otifi c ati o n s ? Pl e a s e writ e eit h er y e s or n o n e xt t o e a c h gr o u p b el o w.
S p e cifi e d P e r s o n s Y e s / N o
E a c h p er s o n w h o u s e s y o ur s er vi c e (i n cl u di n g c hil dr e n a n d y o u n gp e o pl e, f o st er c ar er s, a d o pti v e p ar e nt s a n d f a mili e s)
T h eir r e pr e s e nt ati v e , i n cl u di n g pl a ci n g a ut h oriti e s (thi s i n cl u d e sa n y o n e w h o h a s p ar e nt al r e s p o n si bilit y f or a c hil d/ y o u n g p er s o n)
T h e l o c al a ut h orit y i n t h e ar e a w h er e t h e e st a bli s h m e nt ora g e n c y o p er at e s
S e cti o n 1 0 a
If y o u h a v e r e s p o n d e d ‘n o ’ t o a n y a n s w er i n S e cti o n 9 a , w h at ar e t h e r e a s o n s t h atwill pr e v e nt y o u fr o m d oi n g t hi s ?
Section 11a
What notice or information have you given to staff of your service (including paid and volunteer staff) about your application to cancel registration?
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Declaration by the registered provider ( organisation and individual)
I declare that, to the best of my knowledge, the information given in support of this application to cancel my registration as detailed above is accurate.
Name:
Signed: .............................................................. .
Details of your role within the registered provider:
Date:
Declaration by the registered provider (partnership)
If partnership, all partners to sign.
We declare that, to the best of our knowledge, the information given in support of this application to cancel our registration as detailed above is accurate.
Signature Print name Date
Please continue on a separate sheet if necessary.
Please send your completed voluntary cancellation application form to:
Ofsted Piccadilly Gate Store Street Manchester M12WD
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N o ti c e of a p pli c a ti o n f r o m a r e gi s t e r e d m a n a g e r t o v ol u n t a ril y c a n c el t h e i r r e gi s t r a ti o n u n d e r
s e c ti o n 1 5 ( 1 ) ( b ) of t h e C a r e S t a n d a r d s A c t 2 0 0 0
1 0
P a r t B
I nf o r m a ti o n a b o u t t h e e s t a bli s h m e n t o r a g e n c y
S e cti o n 1 b
N a m e of r e gi st er e d m a n a g er
N a m e of r e gi st er e d pr o vi d er
N a m e of e st a bli s h m e nt or
a g e n c y
A d dr e s s
P o st c o d e
T el e p h o n e n u m b er
E m ail
Of st e d r ef er e n c e n u m b er
Pr o p o s e d d at e of v ol u nt ar y c a n c ell ati o n
D e s c ri p ti o n of t h e e s t a bli s h m e n t o r a g e n c y
S e cti o n 2 b
Pl e a s e ti c k a s a p p r o p ri a t e
C hil dr e n’ s h o m e
I n d e p e n d e nt f o st eri n g a g e n c y
V ol u nt ar y a d o pti o n a g e n c y
A d o pti o n s u p p ort a g e n c y
R e si d e nti al f a mil y c e ntr e
R e si d e nti al h oli d a y s c h e m e f or di s a bl e d c hil dr e n
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✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
1 1
S e cti o n 3 b
W h at ar e y o ur r e a s o n s f or a p pl yi n g t o c a n c el y o ur r e gi str ati o n ?
S e cti o n 4 b
If y o ur pr o p o s e d d at e f or c a n c ell ati o n i s l e s s t h a n t hr e e m o nt h s fr o m t h e d at e oft hi s a p pli c ati o n, w h at ar e t h e r e a s o n s f or t hi s?
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S e cti o n 5 b
W h at n oti c e or i nf or m ati o n h a v e y o u gi v e n t o t h e f oll o wi n g p e o pl e a b o ut y o ur
a p pli c ati o n t o c a n c el y o ur r e gi str ati o n ?
(i) t h e p e o pl e w h o u s e y o ur s er vi c e, i n cl u di n g c hil dr e n a n d y o u n g p e o pl e, f o st er
c ar er s, a d o pti v e p ar e nt s a n d f a mili e s
(ii) r e pr e s e nt ati v e s of t h e p e o pl e li st e d i n (i ), i n cl u di n g pl a ci n g a ut h oriti e s
(iii) t h e l o c al a ut h orit y i n t h e ar e a w h ere t h e e st a bli s h m e nt or a g e n c y o p er at e s
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S e cti o n 6 b
If y o u h a v e n ot gi v e n i nf or m ati o n t o a n y o f t h e p e o pl e li st e d i n s e cti o n 5 b, w h at ar e t h e cir c u m st a n c e s t h at h a v e pr e v e nt e d y o u fr o m gi vi n g t h e m i nf or m ati o n a b o ut y o ur n oti c e t o c a n c el ?
(i) t h e p e o pl e w h o u s e y o ur s er vi c e, i n cl u di n g c hil dr e n a n d y o u n g p e o pl e, f o st er
c ar er s, a d o pti v e p ar e nt s a n d f a mili e s
(ii) r e pr e s e nt ati v e s of t h e p e o pl e li st e d i n (i ), i n cl u di n g pl a ci n g a ut h oriti e s
(iii) t h e l o c al a ut h orit y i n t h e ar e a w h er e t h e e st a bli s h m e nt or a g e n c y o p er at e s
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S e cti o n 7 b
If y o u h a v e n ot alr e a d y gi v e n n oti c e or i nf or m ati o n a b o ut y o ur a p pli c ati o n t o c a n c el
y o ur r e gi str ati o n t o t h e p e o pl e i n S e cti o n 5 b, t h e l aw r e q uir e s t h at y o u d o s o wit hi n
s e v e n d a y s of m a ki n g t hi s a p pli c ati o n t o c a n c el. Will y o u pr o vi d e t h e s e
n otifi c ati o n s ? Pl e a s e writ e eit h er y e s or n o n e xt t o e a c h gr o u p b el o w.
S p e cifi e d P e r s o n s Y e s / N o
E a c h p er s o n w h o u s e s y o ur s er vi c e (i n cl u di n g c hil dr e n a n d y o u n gp e o pl e, f o st er c ar er s, a d o pti v e p ar e nt s a n d f a mili e s)
T h eir r e pr e s e nt ati v e , i n cl u di n g pl a ci n g a ut h oriti e s (thi s i n cl u d e sa n y o n e w h o h a s p ar e nt al r e s p o n si bilit y f or a c hil d/ y o u n g p er s o n)
T h e l o c al a ut h o rit y i n t h e ar e a w h er e t h e e st a bli s h m e nt ora g e n c y o p er at e s
S e cti o n 8 b
If y o u h a v e r e s p o n d e d ‘ n o’ t o a n y a n s w er i n S e cti o n 7 b , w h at ar e t h e r e a s o n s t h atwill pr e v e nt y o u fr o m d oi n g t hi s ?
Section 9b
What notice or information have you given to staff of your service (including paid and volunteer staff) about your application to cancel registration?
Declaration by the registered manager
I declare that, to the best of my knowledge, the information given in support of this application to cancel my registration as manager as detailed above is accurate.
Name:
Signed: .............................................................. .
Date:
Please continue on a separate sheet if necessary.
Please send your completed voluntary cancellation application form to:
Ofsted Piccadilly Gate Store Street Manchester Ml 2WD
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