CQC Regulation 9A: Visiting and Accompanying in Care Homes Explained

CQC Regulation 9A: Visiting and Accompanying in Care Homes Explained

Regulation 9A makes visiting a fundamental standard. Here is what care homes must do, when a restriction is allowed and how to keep your policy inspection-ready.

CQC Regulation 9A requires care homes, hospitals and hospices to support people to receive visits from the people they want to see, to not discourage visits out of the care home, and to let people be accompanied to appointments, unless there are exceptional circumstances. Visiting must be assumed to be possible. Any precaution must be necessary, proportionate and the least restrictive option, decided with the person and reviewed regularly. CQC cannot prosecute for a breach, but it can take regulatory action.

Regulation 9A was added to the fundamental standards to protect people’s right to family life and social contact in care. CQC’s guidance (CQC: Regulation 9A) is direct: everyone should work on the assumption that in-person visiting and accompaniment are possible.

This guide explains what the regulation requires of a care home, how to write and review a visiting policy, and what to do in the rare cases where a restriction may be needed. A government review of Regulation 9A has been published, so check CQC’s current guidance for any updates. See also CQC fundamental standards explained.

What Does Regulation 9A Say?

Unless there are exceptional circumstances:

• people whose care involves an overnight stay or accommodation in a care home, hospital or hospice must be facilitated to receive visits at those premises;
• people provided with accommodation in a care home must not be discouraged from taking visits out of the home; and
• people attending a hospital or hospice for care that does not involve an overnight stay must be enabled to be accompanied by a family member, friend or person providing support.

“Visit” means seeing someone in person. CQC says staff should do all they can to make visits possible and easy to arrange, and that this may look different for different people and settings, which is why individual risk assessments matter.

Visits Out of the Care Home

CQC says this part of the regulation supports social contact, community connections and different experiences. Providers must not:

• discourage visits out;
• impose unreasonable rules on return, such as unreasonably long periods of isolation that could discourage a resident from going out; or
• make the process difficult, for example by requiring lengthy administrative processes before and after visits out.

Decisions about visits out should be supported by individual risk assessments and good care planning. The regulation is not about the provider resourcing visits out, but about ensuring discussions and decisions do not inhibit them. Existing contractual arrangements for additional staff to support outings do not change.

When Can You Restrict Visiting?

Very occasionally, there may be exceptional circumstances where, despite precautions, a visit still poses a significant risk to the health, safety or welfare of a person or of others on the premises. If there is no alternative but to restrict visiting at that time:

1. consider all possible precautions first, choosing the least restrictive option;
2. decide with the person and, where appropriate, their family, friends or advocates, helping them understand their options and making reasonable adjustments;
3. explain the reasons clearly to the person and to those restricted from visiting, and say who they can contact with questions;
4. put review arrangements in place and review regularly; and
5. remove the restriction as soon as circumstances change.

CQC encourages a human rights-based approach, balancing the right to private and family life, independence, choice and control against risk and safety, and asking whether restrictions are lawful, legitimate and proportionate. See CQC’s human rights approach.

Capacity, Best Interests and Representatives

Decisions about visitors must be made by people with legal authority. Take mental capacity into account, involve the person or someone lawfully acting for them in planning and reviewing care, and follow the Mental Capacity Act 2005, which includes a duty to consult families, unpaid carers and advocates where practicable. You must also work within the Human Rights Act 1998 and the Equality Act 2010, including making reasonable adjustments. See MCA and DoLS in practice.

Writing a Visiting Policy That Passes Inspection

• State the default: visiting is welcome at any time that suits the resident, with no fixed visiting hours.
• Describe how individual preferences and risks are recorded in the care plan, including who the person wants to see.
• List sensible, proportionate arrangements, such as protected mealtimes only where residents want them, and not as a blanket rule.
• Set out how infection outbreaks or other risks are assessed individually, with least restrictive options.
• Explain the process and contacts if a restriction is needed, plus review dates.
• Cover visits out, including minimal paperwork and no unreasonable isolation on return.
• Review the policy regularly, with feedback from residents and families.

What Inspectors May Look For

• Evidence people can receive visitors at times that suit them, and that families feel welcome.
• Individual risk assessments and care planning around visiting.
• Any restrictions, why they were used, who agreed, how they were reviewed and when they ended.
• Feedback from residents and relatives.
• How you monitor and review your visiting arrangements.

Keeping It on Track

CQCLogic’s policy library holds your visiting policy with owner and review date, task tracking assigns policy and risk assessment reviews, and the complaints log records concerns raised by families. Individual visiting preferences belong in each person’s care plan.