Healthcare and social care regulation (CQC)

Healthcare and social care regulation is devolved in the UK, meaning each nation has its own regulator with different registration requirements, standards, and inspection frameworks. The information below covers England's Care Quality Commission (CQC) system.

Devolved nation regulators

If you operate in Scotland, Wales, or Northern Ireland, you must register with the appropriate devolved regulator. Requirements, fees, and inspection frameworks differ significantly from England's CQC system.

England-specific CQC requirements

The following information applies to England only and covers Care Quality Commission (CQC) registration and compliance.

CQC registration for specific service types

Registration requirements and fees vary depending on which regulated activities you provide:

Personal care services

Domiciliary care agencies and care homes without nursing:

Nursing home services

Care homes with registered nurses providing nursing care:

Treatment services

GP practices, clinics, and other treatment providers:

Diagnostic services

Imaging centres, pathology labs, and screening services:

Surgical services

All surgical procedures including minor and cosmetic surgery:

Maternity services

Birth centres, midwifery units, and maternity departments:

CQC fundamental standards

Once registered, you must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, known as the 'fundamental standards' (regulations 9 to 20A):

• Person-centred care - Treat people with dignity and respect their preferences
• Dignity and respect - Ensure privacy, dignity and respect
• Need for consent - Obtain valid consent before providing care
• Safe care and treatment - Assess and mitigate risks
• Safeguarding service users from abuse - Systems to prevent abuse and improper treatment
• Meeting nutritional and hydration needs - Adequate food and drink
• Premises and equipment - Suitable, safe premises and equipment
• Receiving and acting on complaints - Accessible complaints system
• Good governance - Systems to assess, monitor and improve quality
• Staffing - Sufficient qualified, competent staff
• Fit and proper persons employed - Recruitment checks (DBS, references, qualifications)
• Duty of candour - Openness and transparency when things go wrong
• Display of ratings - Display your CQC rating at your premises and on your website (regulation 20A)

Failure to meet fundamental standards can result in enforcement action, prosecution, and cancellation of registration.

CQC inspections and ratings

CQC inspects all registered services and publishes ratings:

• Outstanding
• Good
• Requires Improvement
• Inadequate

Ratings are published on CQC website and must be displayed at your premises and on your website.

CQC assesses services against 5 key questions:

• Safe - Are people protected from abuse and avoidable harm?
• Effective - Do people's care, treatment and support achieve good outcomes?
• Caring - Do staff involve and treat people with compassion, kindness, dignity and respect?
• Responsive - Are services organised so they meet people's needs?
• Well-led - Does leadership promote person-centred, high-quality care?

CQC is replacing the single assessment framework with sector-specific frameworks during 2026. The four ratings and five key questions are retained.

Notifying CQC of changes

You must notify CQC about certain events and changes, including:

• Death of service user (within specified timescales depending on circumstances)
• Serious injury requiring medical treatment
• Deprivation of Liberty Safeguards (DoLS) authorisations
• Safeguarding incidents (abuse or allegations of abuse)
• Incidents reported to or investigated by police
• Changes to registered manager
• Changes to premises (address, refurbishments)
• Changes to service delivery (new activities, closure of location)

Failure to notify CQC is a breach of regulations and can result in enforcement action.