The Care Quality Commission checks whether hospitals, care homes and care services are meeting government standards. Visit our website at www.cqc.org.uk.
What is registration?
Below we have answered the most common questions about registration and explained some of the key terms we use both on the registration form and in our guidance documents.
You must register with us if you carry on one of the 15 activities we regulate (see below for a definition of these 'regulated activities').
You can find definitions of each of these activities and more information to help you decide if you are required to register in our scope document.
One of the words you will read a lot in our information about registration is 'provider'. We use this to mean the legal entity responsible for carrying on the health or adult social care services we regulate.
Types of providers
The legal entity can be one of three types of provider: individuals, partnerships or organisations.
When you come to register, it is important you apply as the correct entity and type of provider. It is an offence to carry on any of the health and social care services we regulate (known as 'regulated activities') without being registered.
You should register as an individual if you are a sole trader. Individuals register in their own name and are directly responsible for carrying on regulated activities.
If you carry on any regulated activities as a partnership, it is the partnership (including all the partners) that must register. The partnership as a whole, as well as each individual partner, is responsible for ensuring that the regulated activities provided meet the essential standards.
Therefore, you should only register as a partnership if you have made arrangements for all partners to accept joint and several liabilities for the way the activity is carried on, and each individual partner has agreed to this. This will normally be documented through a written agreement, but this is not a requirement; for example, partnerships-at-will can register as a partnership as long as appropriate arrangements are in place.
A partnership that doesn’t have these arrangements in place, such as one that is limited only to arrangements for expense sharing, should not register as a partnership. In this case, if each person is carrying on regulated activities as an individual without shared liability, they will need to register separately.
For legal reasons, a limited liability partnership (LLP) should register as an organisation, not as a partnership.
You should register as an organisation if you are a registered company or charity, a limited liability partnership (LLP) or other corporate body. In this case it will be the organisation itself that registers, not the people who control it.
When you are applying for registration with us, you will need to determine which health and adult social care services we regulate you carry on. These are known as 'regulated activities'.
It is your responsibility to ensure you register for each regulated activity that you carry on or manage. It is common to register for more than one.
In all, there are 15 regulated activities. For a more detailed explanation of who is covered by the registration system and a description of each regulated activity, you should refer to the Scope of Registration document (below).
Quick reference guide to regulated activities by type of service
Our new ‘quick reference guide’ helps providers to understand how regulated activities and services types could map to each other.
This will allow you to select the type of service provider you are and find out which regulated activities you are most likely to carry on.
It should be used in conjunction with our scope of registration document, which will allow you to evaluate in more detail if these regulated activities apply to you.
To be registered with us, a provider must meet essential standards of quality and safety in all of its regulated activities at each location.
These essential standards come from 28 regulations that you are legally required to comply with, which are set out in the legislation governing our work. You can find out more about what you need to do to comply with these regulations in the document below.
You can also read all our guidance about compliance that applies on the website below.
Guidance about compliance (opens in new window)
The guidance is focused on outcomes that people who use a service should expect when a provider is meeting the essential standards. It also includes prompts for each outcome to give guidance about how you can achieve the outcome. The essential standards are grouped under six main headings:
- Involvement and information
- Personalised care, treatment and support
- Safeguarding and safety
- Suitability of staffing
- Quality and management
- Suitability of management
Our guidance about compliance has a legal status and is also admissible as evidence in criminal or civil proceedings.
Registered providers are required to "have regard to" the guidance in relation to the requirements of the regulations, but you are not legally bound to use the outcomes and prompts in relation to each regulation. It is meant as guidance, not a checklist, and you are free to make alternative arrangements if you wish. If you do this however, you will need to be able to demonstrate that you have taken our guidance into account when judging compliance in day-to-day activities.
Providers and registered managers are responsible for ensuring compliance with the regulations. You need to:
- Understand the essential standards and make sure you continue to meet them.
- Be able to demonstrate compliance if asked to do so.
- Meet requirements to notify us of certain incidents and events.
It is important to remember that the standards are about essential levels of quality and safety. We expect most good quality services to be meeting the standards. Most primary medical care providers already have good monitoring and governance systems in place, which means you are likely to have plenty information to demonstrate compliance.
We would not expect you to make many changes to your existing monitoring systems. There is not a checklist of required evidence as it up to you how you meet the outcomes. We also recognise that the evidence you have will vary according to your size, governance and services.
When considering your compliance you should focus on the outcomes, views and experiences of people who use your services. Useful evidence will include how you:
- Meet people’s needs and make sure people are involved in decisions about their care.
- Protect people from risks to their health, welfare and safety.
- Listen to and act on feedback.
- Make improvements and changes in practice.
A location is a place in which, or from which, regulated activities are provided or managed. Once you are registered you may only provide services from the locations specified in the conditions of your registration.
In our definition of a location, we count each place where people may be admitted (for example, as an inpatient or as a resident) or treated (for example, a walk-in centre or a primary dental practice) as a location if the regulated activities provided in these places are managed independently.
Where regulated activities are provided and managed as one service but are carried out in a number of different premises, however, the place from which the regulated activities are 'carried on' or managed is counted as the only location.
For other services, such as mobile or visiting services, we need the location as either:
- The head offce.
- A regional office or area base from which day-to-day management of the regulated activities is directed.
If you provide regulated activities in or from more than one location, you will need to include details of all of these in your registration application. This includes which activities are provided at or from each location.
It is important to be clear about your locations because in your registration application, you will need to make a declaration about your compliance with the essential standards of quality and safety for each regulated activity at each location.
Once you are registered, as far as possible, we will aim to monitor your compliance with the essential standards at each location.
A registered manager is the person who is in day-to-day charge of one or more regulated activities. In most cases, a provider will need to have one or more registered managers.
As a registered person, they have legal responsibilities in relation to that position. A registered manager shares the legal responsibility for compliance with the regulations with the provider.
The regulations require that a provider must have one or more registered managers for its regulated activities if it is:
- A partnership.
- An organisation.
- An individual who is not personally in day-to-day charge of carrying on the regulated activities or is not fit to do so.
The person who you appoint as registered manager should be in day-to-day charge of carrying on the regulated activity or activities they apply to be registered for.
After registration, a registered manager has a role in enabling and monitoring compliance with essential standards across your regulated activities. This link to the regulated activities means that the registered manager should not be viewed simply as an administrative management role.
There are no restrictions on the number of regulated activities a manager can be registered for or the number of locations which they cover. You can appoint more than one registered manager at the same location if different regulated activities are managed by different individuals or if job share arrangements are in place. The registered manager can be the same person as the nominated individual.
In all cases, the registered manager must be able to demonstrate how they will manage the day-to-day running of the regulated activities at each of their locations.
If you are applying for registration as an organisation, the regulations require you to nominate an individual to act as the main point of contact with CQC.
A nominated individual should be someone who has responsibility for supervising the management of the regulated activity. They should be an employed director, manager or secretary of the organisation. It is up to you who to nominate, as long as they meet these criteria.
Your nominated individual can cover all or several of the regulated activities you provide. If you wish you can have a different individual for each regulated activity. The application form will ask you to state which regulated activities each nominated individual will be responsible for.
The nominated individual and registered manager can be the same person.
If you register as an individual or partnership you do not need a nominated individual.