Healthcare & Social Care Healthcare and social care UK-wide

Healthcare and social care regulation (CQC)

CQC registration requirements for health and social care providers in England, including detailed guidance on regulated activities, costs, and devolved nation alternatives.

Guide summary

You must register with the Care Quality Commission (CQC) before providing regulated health or social care services in England. The application process changed in 2024 – you now submit a downloadable form by email with supporting evidence. There is no application fee, but annual fees range from £313 to £15,710 per location. Registration can take several months.

  • Register with CQC before operating any regulated care service
  • Use downloadable form and submit by email (provider portal closed)
  • No application fee; annual fees from £313 to £15,710 per location
  • Appoint a fit and proper registered manager for each location
  • Prepare policies covering all fundamental standards
  • Await CQC assessment – can take several months
  • Display CQC rating certificate once registered
  • Submit statutory notifications for serious incidents on time
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Related guides in CQC Registration

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.

Healthcare & Social Care Requirement

CQC registration required for regulated activities (England only)

All providers of regulated activities in England must register with the Care Quality Commission (CQC). This applies regardless of business size - even sole practitioners and small care providers must register.

Regulated activities include:

  • Personal care (helping with washing, dressing, eating, medication)
  • Nursing care (administered by or under supervision of registered nurse)
  • Treatment of disease, disorder or injury (GP surgeries, clinics, hospitals)
  • Surgical procedures (including cosmetic surgery)
  • Diagnostic and screening procedures (MRI, X-ray, blood tests)
  • Maternity and midwifery services
  • Management of supply of blood and blood-derived products
  • Accommodation for persons who require nursing or personal care (care homes)
  • Accommodation for persons who require treatment for substance misuse

Geographic scope - CQC regulates England only. Other UK nations have separate regulators:

  • Scotland - Care Inspectorate (social care), Healthcare Improvement Scotland (healthcare)
  • Wales - Care Inspectorate Wales (CIW)
  • Northern Ireland - Regulation and Quality Improvement Authority (RQIA)
Who this applies to: Anyone providing regulated healthcare or social care activities in England, regardless of size. Solo practitioners, small clinics, large hospitals, domiciliary care agencies, care homes - all must register.
Enforcement:
CQC can issue warning notices, impose conditions, suspend registration, cancel registration, or prosecute for operating without registration. Penalties include an unlimited fine and/or up to 12 months' imprisonment for providing services without registration.
CQC registration guidance (opens in a new tab)

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.