CQC Notifications for Serious Injury and Police Involvement: What Counts and Which Form
What counts as a serious injury, when police involvement triggers a notification and how to choose the right form when more than one could apply.
You must notify CQC without delay of a serious injury to a person using your service, and of any incident reported to or investigated by the police. A serious injury is one that a health care professional reasonably considers has caused lasting harm or needs treatment to prevent it. If the injury came from an assault, or the police matter involves a death, injury or abuse of a person using the service, use that specific form instead.
Two of the most common Regulation 18 notifications are also two of the most confusing. Managers ask what makes an injury “serious”, and which form to use when the police attend an incident that also involved an injury or an allegation.
This guide follows the regulation (CQC: Regulation 18) and CQC’s forms for serious injury and police involvement. For every other trigger, see our notifiable events list.
Key takeaways
- Serious injury is judged by the reasonable opinion of a health care professional, not by the manager alone.
- Lasting means at least 28 days continuous, or likely to last 28 days or more.
- Pressure sores of grade 3 or above that develop after the person started using the service are within scope.
- Police involvement covers any incident reported to or investigated by the police that may affect health, safety and welfare.
- Use the death, serious injury or abuse form instead of the police form where one of those applies.
In this guide
What Counts as a Serious Injury for CQC?
Regulation 18(2)(a) and (b) cover two groups of injury. In each case the test is the reasonable opinion of a health care professional:
Injuries that have caused lasting harm
An injury that has resulted in any of:
- an impairment of sensory, motor or intellectual functions that is not likely to be temporary;
- changes to the structure of the person’s body;
- prolonged pain or prolonged psychological harm; or
- shortening of life expectancy.
Injuries that need treatment to prevent those outcomes
An injury that requires treatment by a health care professional to prevent death, or to prevent an injury that, left untreated, would lead to one of the outcomes above.
How long is “prolonged” or “not temporary”?
The regulation defines both as lasting, or likely to last, a continuous period of at least 28 days.
CQC’s Examples of Injuries That Qualify
CQC’s guidance lists injuries that lead, or if untreated would be likely to lead, to permanent damage or damage lasting more than 28 days to:
- sight, hearing, touch, smell or taste;
- any major organ, including the brain and skin;
- bones, muscles, tendons, joints or vessels;
- intellectual functions such as thinking, remembering, making judgements and speech;
- a pressure sore of grade 3 or above that develops after the person has started to use the service; and
- any injury or event that causes pain lasting, or likely to last, more than 28 days.
Psychological harm includes post-traumatic stress disorder, other stress requiring clinical treatment or support, psychosis, clinical depression and clinical anxiety. CQC states these lists are not exhaustive.
Practical tip: ask the paramedic, GP, nurse or hospital clinician for their view and record it. If a resident has a fall and a fracture, the injury affects bones, so it is likely to qualify. A skin tear that heals in days is unlikely to. When you cannot tell, notify or ask CQC.
When Does Police Involvement Need Notifying?
Regulation 18(2)(f) requires notification of any incident which is reported to, or investigated by, the police. CQC’s page says to notify incidents that may affect someone’s health, safety and welfare when using, visiting or working at your service.
Examples might include a burglary or criminal damage at the service, a visitor threatening or assaulting staff, a missing person report, or a staff member reported for a criminal offence that does not involve a person using the service.
The exception that decides the form
CQC says do not use the police involvement form if you made a police report about an event affecting a person using your service that was a:
- death;
- serious injury; or
- abuse or allegation of abuse.
In those cases use the specific form. NHS trusts do not need to notify CQC about police attendance.
Which Form Should You Use? Worked Examples
| Scenario | Form to use | Why |
|---|---|---|
| Resident falls and fractures a hip; hospital treats | Serious injury | Bone injury likely to last 28 days or more, assessed by a health care professional |
| Resident develops a grade 3 pressure sore after admission | Serious injury | CQC lists it as an example |
| Resident is hit by another resident and injured; police called | Allegation of abuse | Injury from assault goes on the abuse form, and the police report is covered by it |
| Resident dies after a fall; police attend | Death | The specific death form applies |
| Intruder breaks into the home; no resident harmed; police attend | Police involvement | Incident investigated by the police affecting safety of the service |
| Visitor threatens a staff member; police called | Police involvement | Affects the safety of people working at the service |
| Staff member suspected of stealing a resident’s money | Allegation of abuse | Theft or misappropriation counts as abuse for notification purposes |
If you are unsure, notify under the most specific heading and mention the overlap in the description. See notifying CQC of an allegation of abuse and notifying CQC of a death.
How to Submit the Notification
- Use the relevant form in the CQC provider portal, or complete CQC’s Word form and email it to HSCA_notifications@cqc.org.uk.
- Notify without delay. CQC’s police page says as soon as possible.
- Use a unique identifier, not the person’s name or other identifying details.
- Keep the reference number CQC issues.
- If a medicines error was a known or possible cause, say so in the notification.
Other Duties That May Apply
- Duty of candour. A serious injury may also be a notifiable safety incident under Regulation 20. See duty of candour in a care home.
- RIDDOR. Some injuries and events must also be reported to HSE. See fire safety and RIDDOR reporting.
- Safeguarding. Unexplained injuries should prompt a safeguarding review. See safeguarding referrals.
- Learning. Review the incident, update risk assessments and share lessons. See incident management log.
Tracking Notifications and Follow-Up Actions
CQCLogic’s incident log carries flags for CQC notification and RIDDOR, and the CQC notification tracker records notifiable events and deadlines. The tracker logs notifications; it does not submit them to CQC. Record the clinician’s opinion, the form used, the reference number and the actions you took, so you can explain your decision later.
Log the decision, the form and the follow-up
CQCLogic keeps incident records, CQC notification references and follow-up tasks together. See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
What counts as a serious injury for a CQC notification?
An injury that a health care professional reasonably considers has caused a lasting impairment, change to body structure, prolonged pain or psychological harm, or shortened life expectancy, or that needs treatment to prevent those outcomes. Lasting means at least 28 days continuous, or likely to be.
Is a fall with a fracture a notifiable serious injury?
A fracture is an injury to bone. If a health care professional reasonably considers it will cause damage or pain lasting, or likely to last, 28 days or more, it falls within Regulation 18. Check with the treating clinician and record their view.
Do I notify CQC of a grade 3 pressure sore?
CQC’s guidance lists a pressure sore of grade 3 or above that develops after the person has started to use the service as an example of a qualifying injury.
Do I notify CQC every time the police attend?
You must notify incidents reported to or investigated by the police that may affect the health, safety and welfare of people using, visiting or working at the service. Use the death, serious injury or abuse form if the incident relates to one of those events for a person using the service.
Which form do I use if a resident is injured in an assault?
The allegation of abuse form. CQC says that where a serious injury is the result of an assault, you should use that form instead of the serious injury form.
How quickly do I have to notify CQC?
Without delay under Regulation 18. CQC’s police involvement page says as soon as possible.