CQC Registration Requirements: A Complete Guide for Care Providers & Managers

The Care Quality Commission (CQC) is the independent regulator of health and social care services in England, dedicated to ensuring care providers meet essential standards of quality and safety. If you’re planning to offer such care services, registering with the CQC is a legal requirement. Your registration must be approved before you can legally begin, so it’s crucial to apply early. Read on to discover how to streamline the CQC registration process and maintain compliance at every stage.

CQC Registration Requirements: An Overview

CQC registration is the mandatory process by which care providers, including organisations, partnerships, and individual practitioners that provide health and adult social care services, gain approval to deliver regulated activities. Registration ensures that providers comply with the legal and regulatory standards of the Health and Social Care Act 2008 and related regulations. 

Who Needs to Register?

Any provider of care services must register with the CQC. They can be:

• An individual
• An organisation, including charities, companies, NHS trusts, and local authorities
• A partnership 

Understanding Locations

If you operate from multiple locations, you must register and include all sites in your application. A ‘location’ refers to a specific site associated with the management or delivery of regulated activities. This can vary based on the type of service:

• Fixed service sites: Such as care homes, GP surgeries, or dental clinics.
• Mobile or online services: The main office or operational base from which activities are directed.
• Domiciliary care services: Administrative bases from which staff are managed for home care delivery​.

Nominated Individuals

Organisations applying for registration are required to appoint a nominated individual. This person acts as the primary contact between the provider and CQC. Key points about nominated individuals include:

• Eligibility: Must be a director, manager, or secretary of the organisation and in a senior position to supervise the management of regulated activities.
• Responsibilities: Ensure compliance with regulations and act as a spokesperson on how regulated activities are carried out.
• Flexibility: One person can be nominated for all regulated activities, or different individuals can be assigned to specific activities.
• Exceptions: Small organisations may have the same person as the registered manager and nominated individual, though this is discouraged for reasons of accountability.

For individual or partnership registrations, there is no need to appoint a nominated individual​.

This backlog in registrations posed challenges, particularly for small providers aiming to establish new care homes, domiciliary care services, or healthcare services. These delays often resulted in financial losses, reduced investments, and further strained the overall capacity of the sector.

What are Regulated Activities?

Regulated activities, defined under Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, encompass specific care and treatment services that require registration with the CQC. These include the following services:

• Personal care
• Treatment of diseases
• Diagnostic services
• Surgical procedures

Care providers must ensure their service aligns with the regulated activities they register for. They may even have to register for multiple regulated activities, depending on the nature and breadth of their services.

Providers offering diverse services must register for all relevant activities unless specific exemptions apply. For instance, a care home registered for accommodation and personal care must also register for personal care if they operate a separate domiciliary care service.

What are the Conditions of CQC Registration?

The CQC may impose conditions to regulate providers and managers, aligning their practices with legal and safety requirements. These conditions fall into two main categories: routine and non-routine.

Routine Conditions

Routine conditions are mandatory for all providers and managers and often define fundamental operational requirements. Examples include:

• Providers must declare the locations where regulated activities are conducted.
• These may depend on the organisational structure, such as partnerships or corporate bodies.
• Limiting the number of residents a care home can accommodate.
• Restricting services for specific groups, such as autistic individuals or people with learning disabilities, unless the provider demonstrates compliance with CQC standards.
• Certain providers must appoint a registered manager for each regulated activity at every location. This is a statutory requirement under the CQC (Registration) Regulations 2009 and cannot be removed when legally mandated.
• If a provider does not meet the fitness criteria outlined in Regulation 4, a condition requiring a registered manager may be imposed. Providers can request the removal of this condition upon demonstrating compliance​.

Non-Routine Conditions

Non-routine conditions are specific to individual cases and imposed when necessary to address risks or promote improvement. These conditions might include:

• Restricting services to certain age groups when staff lack appropriate training, e.g., only serving individuals over 16 years of age.
• Prohibiting new admissions without prior CQC approval if there are concerns about the service quality.
• Using conditions to mitigate risks or drive improvements in service delivery​.

CQC Application: Scope & Supporting Documents for Registration 

You must apply for CQC registration if:

• You provide or intend to provide regulated activities, such as healthcare, personal care, or diagnostic services, either on a regular or temporary basis.
• You operate care homes, medical practices, or remote care services.
• You offer services to children (subject to dual registration with Ofsted in some cases).

The scope of CQC registration can help determine whether you need to register:

• Identify if you’re ‘carrying on’ regulated activities and the scope of those activities.
• Determining the locations where activities will be carried out (e.g., clinics, care homes, or remotely).
• Confirm who will direct and control these activities.
• Check if any exceptions apply.
• Determine if a registered manager is required for your service type and location​.

Here are some exemptions and exceptions under the CQC registration regulations:

• Individuals hiring care workers or nurses directly without using an agency.
• Introductory or employment agencies that solely facilitate connections without managing care.
• Third-party trusts organising health or care services without direct service provision responsibilities.

Supporting Documents

Your CQC application must include supporting documents tailored to your service type, including the following. 

• Statement of purpose
• Policies and procedures
• Financial viability evidence
• Insurance documents
• Staffing structure

CQC Registration Requirements for a Provider 

A provider refers to any organisation or individual that delivers health or social care services in England. 

Let’s explore the three main types of service providers or legal entities and their requirements for CQC registration.

Individuals	If you’re operating the regulated activity alone, you need to register as an individual. As a sole proprietor, you’ll register in your name and remain directly responsible for the regulated activities.
Organisations	Organisations such as local authorities, NHS trusts, registered companies, charities, limited liability partnerships (LLPs), or other corporate bodies must register as entities. The organisation, not the individuals within it, is registered.
Partnerships	Partnerships must register as a single entity. Each partner is not registered individually. If any changes are made to the partnership (e.g., adding or removing partners), a variation application is required to update the registration.

In addition to the ones above, there are some other types of service providers, including:

• Corporate groups
• Franchises
• Joint ventures
• Primary care at scale
• Services registered with Ofsted
• Subcontracted services

How to Register as a Provider 

Here are the steps to register as a provider with the CQC. 

• Before starting the application, review the CQC’s scope of registration to ensure you are required to register.
• You should submit your CQC application only when all services, premises, and staff are in place to start providing care legally.
• Obtain Disclosure and Barring Service (DBS) checks for key personnel. This typically takes 14 days but may take longer.
• Decide who your registered managers will be if you’re registering as an organisation, partnership, or individual who isn’t directly responsible for daily operations.
• Gather all required supporting documents, including financial viability statements and proof of compliance with CQC standards.
• Ensure your premises are ready for a site visit, if necessary.
• Submit your CQC application via forms and email, as the CQC has moved away from online submission methods.

The CQC will review your application, request additional information if needed, and may schedule a site visit. It may even conduct interviews with your nominated manager or the individual responsible.

Your CQC application will be reviewed in the order of being received and it can take a few months to complete. Until your registration is confirmed, you cannot manage regulated activities.

The CQC registration process can take several months, depending on the complexity of your application and the completeness of submitted documents.

How the CQC Registration Fees is Calculated

Every registered provider must pay annual fees to the CQC. These fees enable the CQC to perform its statutory functions, ensuring health and social care services provide safe, effective, compassionate, and high-quality care while promoting improvements.

The fees contribute to covering all costs associated with:

• Initial registration
• Changes to your registration
• Monitoring, inspection, and rating activities
• Enforcement actions when necessary (civil or criminal)

Your annual fees are determined by:

• Type of Service: Each category of care service, such as dental practices, care homes, or community social care, has its own fee structure.
• Scale of Services: Factors such as the number of service users, locations, or size of operation influence the fee.

Charitable organizations pay the same fees as equivalent non-charitable providers.

Here are some points you should remember about CQC registration fees.

• Fees cover all registered locations on your anniversary date, and the fee amount and anniversary date will appear on your invoice.
• Payment methods include direct debit in 10 monthly installments or a single payment within 30 days of the invoice date.
• Payments must be made electronically. Cheques, postal orders, or cash are no longer accepted.
• Invoices are typically issued on the 15th of each month. For new providers, invoices are sent in the month registration takes effect, while invoices are issued in the anniversary month of the last annual invoice for existing providers. However, there will be a delay in issuing the invoice if additional information is needed to calculate your fee.
• It’s important to ensure your invoice address matches your registered address. 

GoAudits helped Careville streamline its auditing process by reducing the time required to generate reports from several hours to just 10 minutes. By consolidating audit data into a centralized platform, Careville eliminated the need to navigate through multiple spreadsheets and documents. This enabled their teams to conduct audits more frequently and efficiently, ensuring compliance with CQC standards and other internal procedures. 

The flexibility of the system is endless! Not only can I update audit checklists, but with the feature ‘Build your own template’, I was able to build documents that are not directly related to auditing, such as a Confidentiality form to be signed by new joiners. I keep thinking of new ways to use GoAudits to run our processes even more efficiently! – Ibilola Akinola, Registered Manager at Careville Ltd.

Prepare for a CQC Visit with Free Audit Checklists for Care Providers

As part of the CQC registration process, CQC may visit your site to assess it. GoAudits offers a wide range of checklists you can use to prepare for an inspection. 

• CQC Inspection Audit
• CQC Dental Inspection Checklist
• CQC Registered Manager Checklist
• MAR/EMAR Audit Checklist
• Care Home Audit Checklist
• Care Home General Observation
• Daily Care Home Audit
• Daily Care Home Cleaning Check
• Care Home Internal Audit Checklist
• Dignity in Care Audit
• Patient Care Checklist

CQC Registration Process for a New Manager

In most cases, providers must have a registered manager appointed, especially for organisations, partnerships, and individuals not directly involved in the daily management of these activities​.

You need to register as a manager if you are in charge of managing regulated activities for:

• A partnership or organisation
• An individual provider who is not responsible for the day-to-day operations of the regulated activities

How to Register as a Manager 

• You should apply as soon as you assume responsibility for managing regulated activities at a service.
• Gather all necessary documentation, including your qualifications, DBS certificate, and employment history.
• You can apply online via the CQC provider portal, or by completing the appropriate application form (depending on your provider’s situation, e.g., new or existing provider).
• The CQC reviews applications in the order they are received. The process may take several weeks or months, depending on the complexity of your application and the workload. 
• You cannot manage regulated activities until you are registered

What is the Responsibility of a CQC Registered Manager?

A registered manager ensures compliance with CQC regulations. They are responsible for the day-to-day operations of regulated activities at a service, working alongside the provider to uphold the required standards. 

The registered manager shares legal responsibility with the provider to uphold the standards of care and is often the primary point of contact between the service and the CQC​.

What is a Statement of Purpose?

Your Statement of Purpose (SoP) outlines what your business does, where it operates, and who it serves. All registered providers are required to maintain an up-to-date SoP as a legal obligation under Regulation 12: Statement of Purpose of the Health and Social Care Act 2008. Failing to provide or maintain an accurate and up-to-date SoP could result in delays or issues during inspections or registration renewals.

Here’s what your Statement of Purpose must include:

• Name of the business, legal status (e.g., sole trader, partnership, organisation), business address, telephone number, email address, and names of any partners or key personnel involved in the business.
• Clear goals and objectives for the regulated activities you provide at your service locations and a detailed description of your service offering and the needs you aim to meet.
• List all locations where services are provided, including addresses, a description of each location, the type of service delivered, and the unique needs of the service users. Mention the registered manager overseeing activities at each location.
• Include full names and contact details of registered managers, addresses for serving notices and other documents, the locations they manage and the percentage of their time spent at each.

DBS Checks for CQC Registration

A Disclosure and Barring Service (DBS) check is a key part of the CQC registration process. It helps assess an individual’s suitability to work in environments that involve care for vulnerable individuals. The DBS check evaluates criminal records or other relevant disclosures, which could impact your suitability for providing care services.

DBS checks are essential for anyone applying to become a registered individual provider, registered partner, or registered manager.

DBS checks must be no older than 12 months when submitting your CQC application.

If you fail to provide a valid DBS certificate, your CQC application will be rejected.

If there are any previous or outstanding issues in your DBS, these could affect the outcome of your CQC registration process.

How Does CQC Registration Impact Healthcare Providers?

CQC registration has a significant impact on healthcare providers in several key areas. 

Firstly, legal compliance and accountability are crucial. Healthcare providers must meet CQC standards to maintain their registration, ensuring they operate within the law and adhere to established care standards. It extends to various sectors, including hospitals, GP practices, and care homes, which must demonstrate their ability to meet safety, effectiveness, and quality standards.

Secondly, CQC registration sets high operational standards by establishing clear expectations for quality care. Providers are evaluated against key questions such as safety, effectiveness, and leadership, which influence their ratings and public perception. They compel providers to continuously improve their services.

Patient safety and trust are directly impacted. Inspections and compliance with CQC requirements ensure that patients receive care that is safe and of high quality. It helps build patient confidence, as individuals can make more informed choices about the providers they engage with.

Lastly, CQC registration emphasises the importance of staff training. Providers are required to ensure that their staff are adequately trained and equipped to meet regulatory standards. This contributes to improved service delivery and operational efficiency.