CQC Regulation 18 Staffing: Staffing Levels, Training and Supervision Explained
Regulation 18 asks two questions: do you have enough competent staff, and are they supported to do the job? Here is how to evidence both.
CQC Regulation 18 requires you to deploy sufficient numbers of suitably qualified, competent, skilled and experienced staff at all times, and to give them the support, training, professional development, supervision and appraisal they need to do their jobs. Evidence it with a systematic staffing method, reviewed rotas, induction and training records, supervision and appraisal logs and checks on professional registration. CQC cannot prosecute for a breach of Regulation 18, but can take regulatory action.
Staffing is behind many “Requires Improvement” reports, and it is the regulation inspectors can feel on the floor: call bells, agency reliance, rushed care. CQC’s guidance (CQC: Regulation 18) spells out what it expects.
This article pairs with our guides on safe staffing levels, mandatory training, supervision and competency assessment, and supports your wider CQC compliance work.
Key takeaways
- You need enough suitably qualified, competent, skilled and experienced staff to meet people’s needs and the other regulations, at all times.
- Use a systematic approach to decide numbers and skill mix, and review it continuously.
- Staff need induction, training, development, supervision and appraisal appropriate to their role.
- All staff must receive training on interacting appropriately with people with a learning disability and autistic people, at a level suited to their role.
- CQC cannot prosecute for a breach of Regulation 18, but it can take regulatory action.
In this guide
- Regulation 18(1): Enough Staff With the Right Skills
- Regulation 18(2)(a): Support, Training, Supervision and Appraisal
- Regulation 18(2)(b) and (c): Qualifications and Professional Registration
- The Evidence Pack Inspectors Ask For
- Common Staffing Gaps to Fix
- Tracking Staffing Compliance
- Frequently asked questions
Regulation 18(1): Enough Staff With the Right Skills
CQC says providers should have a systematic approach to determine the number of staff and the range of skills needed to meet people’s needs and keep them safe at all times. It should reflect current legislation and guidance and consider:
- the different levels of skill and competence needed;
- the mix of registered professionals and support workers;
- supervision needs; and
- leadership requirements.
Staffing levels and skill mix must be reviewed continuously and adapted as people’s needs change. You also need emergency procedures that ensure enough suitable people are deployed to cover both the emergency and routine work.
How to evidence it
- A written staffing method, such as a dependency assessment linked to each person’s needs.
- Rotas against that method, showing planned and actual cover, skill mix and agency use.
- Evidence you adapt: changes after admissions, falls, deterioration or incidents.
- Feedback from staff and residents about whether there are enough people.
Try our free staffing calculator for a starting point, then see safe staffing levels in care homes. Remember that a shortage which threatens safe running may be a notifiable event; see CQC notifiable events.
Regulation 18(2)(a): Support, Training, Supervision and Appraisal
CQC’s guidance expects providers to have:
- an induction programme that prepares staff for their role;
- an assessment of training and development needs at the start of employment, reviewed at appropriate intervals;
- supervision of new staff until they can show they are competent to work unsupervised;
- ongoing or periodic supervision to maintain competence;
- access to statutory and mandatory training, plus any additional training needed for the role, including first aid training for adult social care staff;
- monitoring of training, with quick action when requirements are not met; and
- regular appraisal by an appropriately skilled and experienced person, identifying and planning development needs.
Health, social and other care professionals must have access to clinical or professional supervision as required by their regulator.
Learning disability and autism training
CQC says providers must ensure all staff receive training in how to interact appropriately with people with a learning disability and autistic people, at a level appropriate to their role, and supervision that helps them keep their competence. See the Oliver McGowan mandatory training.
Regulation 18(2)(b) and (c): Qualifications and Professional Registration
You must enable staff, where appropriate, to obtain further qualifications relevant to their work. Where staff are health care professionals, social workers or other registered professionals, you must enable them to provide evidence to their regulator that they continue to meet professional standards, for example revalidation. Keep a register of registrations, renewal dates and checks.
The Evidence Pack Inspectors Ask For
| Area | What to have ready |
|---|---|
| Numbers | Staffing method, dependency tool, rotas (planned and actual), agency use |
| Induction | Induction checklists signed off, Care Certificate progress |
| Training | Training matrix, renewal dates, plan for overdue items. See training matrix |
| Supervision | Supervision log with dates and actions. See supervision log |
| Appraisal | Annual appraisal records and development plans |
| Competence | Observed practice and competency sign-offs. See competency assessment |
| Recruitment | Files that meet Regulation 19. See recruitment file checklist |
Common Staffing Gaps to Fix
- Rotas that look fine but do not reflect sickness, agency or skill mix on the day.
- New starters working unsupervised before competence is signed off.
- Training records that show “complete” without checking refresher dates.
- Supervision completed late or not at all for night and part-time staff.
- No process for reviewing staffing when needs change.
Tracking Staffing Compliance
CQCLogic’s staff training tracker covers 15 mandatory courses with renewal tracking, and its supervision log records dual sign-off and flags overdue sessions. Task tracking holds actions with owners and deadlines. Our free staffing and staff turnover calculators help you model numbers and costs. Rotas themselves stay in your rota system.
Track training and supervision in one place
CQCLogic flags overdue supervision and training so staffing gaps do not surface for the first time on inspection day. See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
What does CQC Regulation 18 require?
Sufficient numbers of suitably qualified, competent, skilled and experienced staff at all times, and appropriate support, training, professional development, supervision and appraisal for those staff.
Does CQC set a minimum staff-to-resident ratio?
CQC’s Regulation 18 guidance does not set a fixed ratio. It says providers should use a systematic approach to determine the staff numbers and skill mix needed to meet people’s needs, and review it continuously.
Can CQC prosecute for a breach of Regulation 18?
CQC’s guidance says it cannot prosecute for a breach of Regulation 18 or any of its parts, but it can take regulatory action and must refuse registration if you cannot show compliance.
What training must all staff receive under Regulation 18?
Induction and role-appropriate training, plus training on interacting appropriately with people with a learning disability and autistic people, at a level suited to their role. Other statutory and mandatory training depends on the role and provider.
How often is supervision required?
CQC says staff should receive ongoing or periodic supervision to keep competence, and be supervised until competent when new. It does not specify a frequency. See our supervision guide for practical intervals.
Do agency staff count towards Regulation 18?
They must be suitably qualified, competent, skilled and experienced for the role and receive an appropriate induction. Heavy reliance on unfamiliar agency staff is a risk inspectors often examine.