Who Needs to Register With CQC? Regulated Activities and Exemptions Explained

Who Needs to Register With CQC? Regulated Activities and Exemptions Explained

Registration depends on what you do, not what you call yourself. Here is how CQC decides who must register, with the care-sector examples and exemptions.

You must register with CQC if you carry on a regulated activity in England, such as personal care or accommodation for people who need nursing or personal care. It is the legal entity carrying on the activity that registers, not the building. It is an offence to carry on a regulated activity without being registered. Providers can be individuals, partnerships or organisations. Some arrangements are exempt, such as a personal assistant directly employed and directed by the person they care for.

“Do I need to register with CQC?” is one of the most searched questions in social care, and the answer turns on definitions. CQC’s scope of registration guidance says you may need to register if you provide, or intend to provide, health or adult social care activities in England, even if you will not provide them regularly or permanently.

This guide explains the tests and the care-sector examples. It is general information. CQC advises you to read the scope guidance and the legislation, which this article does not replace. If you are unsure, ask CQC before you start. Once you know you must register, see how to register with CQC.

Who Has to Register?

“Service providers” must register. A service provider can be an individual, a partnership or an organisation such as a company, charity, NHS trust or local authority. CQC registers the regulated activity carried on, not service types or professions, and the legal entity responsible for directing and controlling it, not the location or care setting. Ask yourself:

1. Will I be carrying on a regulated activity, and which?
2. Who is responsible for directing and controlling it?
3. Do any exceptions apply?
4. Where will it be carried on (locations)?
5. Do I need a registered manager at each location?
6. If I serve children, do I need CQC, Ofsted or both?

The Regulated Activities Most Relevant to Adult Social Care

CQC lists further activities, such as surgical procedures, diagnostic and screening procedures and maternity services, in its scope guidance. Each regulated activity requires a separate registration and there is no hierarchy. Sometimes registration for one removes the need for another: you will not need to register for personal care where it is part of accommodation for people who require nursing or personal care, or for nursing care that is part of another activity. But where personal or nursing care is provided in its own right, you may need to register for it as well.

Example from CQC: a care home registered for accommodation with personal care that also provides personal care to people in their own homes needs to register separately for personal care.

What Counts as Personal Care?

CQC’s description: providing personal care for people who are unable to provide it for themselves because of old age, illness or disability, in the place where they live when the care is provided. It includes homecare, housing with care and supported living. For supported living and extra care to be correctly registered, there must be a real separation between the personal care and the accommodation agreements.

You do not need to register if you only provide:

• housing support or social support, such as help with shopping, with no tasks in the definition of personal care; or
• support to administer, prompt or supervise medicines, without any of the activities defined as personal care.

Common Exceptions and Exemptions

CQC’s personal care guidance lists specific exceptions, including:

• Directly employed carers or personal assistants employed by a person or related third party, without an employment agency or business, who work wholly under that person’s direction and control to meet their personal care needs.
• Employment or introductory agencies that supply care workers to another organisation that will then be responsible for providing care, or to a person who takes whole responsibility for arranging their own care under a personal budget or private arrangement. Merely introducing a care worker, with no ongoing role in the care, does not need registration.
• Prison managers providing personal care to detainees, though a homecare agency providing care in a prison must register.
• Fostering agencies inspected by Ofsted providing personal care to placed children.

CQC also notes general exceptions and exemptions in Schedule 2 of the 2014 Regulations. Even if an exception applies to one activity, check whether you need to register for any others. Arrangements for self-employed carers vary depending on who directs and controls the care, so ask CQC if you are unsure.

Do You Need a Registered Manager?

Most registered providers carrying on regulated activities in adult social care need a registered manager at each location, unless the provider is an individual or partnership in day-to-day charge. See CQC’s guidance on managers and how to hire a registered manager, fit and proper persons and interim registered managers.

What Happens If You Do Not Register?

CQC says it is an offence to carry on a regulated activity without being registered. Registration also requires you to show you can meet the regulations, which is why preparation matters. See fundamental standards. Changes to your service later may require changes to registration first. See how to change or cancel your CQC registration.

A Quick Self-Check

1. List every task you provide, and compare it to the definitions of personal care, nursing care and accommodation.
2. Identify who directs and controls the activity and which legal entity that is.
3. Check Schedule 2 exceptions, and the specific exceptions for each activity.
4. Identify the locations and whether a manager is required.
5. If you are still unsure, contact CQC or take specialist advice before you start.
6. To check whether another provider is registered, see how to check a provider’s registration.