CQC registration lawyers

Requirement to register with the CQC

It is a legal requirement that any individual, partnership or organisation must be registered with the CQC if they provide a regulated activity in England. The various regulated activities and the definitions of those activities are contained in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

It is a criminal offence to carry out a regulated activity without registration with the CQC under Section 10(1) of the Health and Social Care Act 2008. This offence can be dealt with by the Magistrates or Crown Court and if found guilty, the Court can impose an unlimited fine and/or a sentence of up to 12 months imprisonment. You can visit our webpage on criminal investigations and prosecutions by the CQC for more information.

It is therefore vital that, if you are setting up a health and social care service, you obtain registration with the CQC before providing any regulated activity. However, many individuals and businesses are often unclear as to whether their activities fall within the definition of a regulated activity and the legislation and guidance in this area can often be confusing and complex. Specialist legal advice is therefore essential in order to protect your business and your reputation, and to avoid any criminal enforcement action by the CQC.

You can view some of our recent registration cases on our CQC case studies page.

Challenging a decision to refuse your registration

Notice of proposal to refuse registration

The CQC has the power to refuse an application for registration under Section 12 of the Health and Social Care Act 2008. Before refusing the application, the CQC must issue a Notice of Proposal, which details their reasons for the proposed refusal of registration. An applicant has 28 days to make written representations against this proposal.

This is an opportunity to respond to the CQC’s concerns; make any submissions in line with the CQC’s Enforcement Policy and relevant guidance; and provide any additional evidence in support of the application. It is important that a provider reviews each reason carefully and takes a robust but measured approach to any representations made. This is only a proposal at this stage and there is still time to persuade the CQC to grant the registration.

After assessing any representations and evidence submitted, the CQC will determine whether to proceed with their refusal. If the proposal is adopted, the CQC will issue a Notice of Decision and there will be a right of appeal against this decision to the First-tier Tribunal (Care Standards Chamber). This appeal has to be made in writing within 28 days. These appeals can take a number of months to conclude and in order to stand any prospect of success, providers need to ensure that they are able to support their challenge with clear, documentary evidence.

Our key CQC registration advice

The CQC’s registration process can be quite complex and time-consuming and over the past few years, the CQC have increasingly been issuing more proposals to refuse applications. In the CQC’s Annual Report for 2018/19, it confirmed that the CQC had issued 564 registration Notices of Proposal in 2018/2019, which was an increase of 119 (26.7%) from 2017/2018. However, the key to being successful with your challenge is to ensure that your representations are clear and supported by documentary evidence.

Where a provider disputes the reasons for a refusal, it is important that robust submissions are made to challenge the refusal with supporting documentation, and with reference to any applicable legislation; guidance; or case law.

If any of the reasons provided by the CQC are accepted, providers should consider how they can rectify or address those concerns as quickly as possible. Where the CQC’s concerns can be addressed before the deadline, it is important that providers supply documentary evidence to demonstrate this. If this is not possible, a detailed action plan outlining how the provider intends to address these issues with realistic timeframes may be helpful. It is important that you provide reasonable assurances to the CQC about your future compliance, particularly before any final decision on the registration is made.

You can view some of our recent registration cases on our case studies page here.

CQC registration FAQs

Do I require registration with the CQC?

It is ultimately a provider’s responsibility to establish whether they need to be registered with the CQC and failing to make sufficient and appropriate enquiries to determine the correct registration position is not a suitable defence. You should consult the CQC’s ‘The scope of registration’ guidance (updated and re-published May 2022) and if you are unsure whether your proposed activities fall within the scope of CQC registration, it is important that you seek specialist legal advice as soon as possible to protect your position.

Can I obtain CQC registration with a conviction?

Having a conviction is not a bar to registration, provided you are open and honest. You can read our blog on this issue here.

If you are a manager trying to register, you may want to consider providing a reflective statement to the CQC at the time of applying. This should include the full details of the conviction, any relevant circumstances and mitigation. It should also demonstrate appropriate insight and reflection in respect of that conviction and why you think you are now a 'fit and proper person’.

If you are a provider looking at whether you can employ someone as a manager with a conviction, you need to ensure that you carry out a full investigation into the circumstances of the conviction; that you note the outcome of that investigation in writing with detailed reasons for your decision; and if you choose to employ that person, you need to consider whether it would be appropriate to carry out a risk assessment or any other action before that person is allowed to work. As a provider, it is your responsibility to satisfy yourself that a manager is a ‘fit and proper person’.

How long does the CQC registration process take?

Preparing a brand new application to register with the CQC can take several weeks, as this includes applying for a CQC-countersigned DBS number; drafting a statement of purpose; compiling your supporting documentation; preparing the relevant application forms; and ensuring that your location is ready for a registration visit. Once a new provider registration application it submitted to the CQC, it will usually take up to a minimum of ten weeks to complete, provided there are no delays and your application is thoroughly prepared. However, applications often take much longer if there is a backlog of applications being considered by the CQC; your application is returned due to an error; or the CQC require further information not already submitted.

Do I require registration for the regulated activity of personal care?

‘Personal care’ is defined in the CQC’s ‘the scope of registration’ document (updated and re-published May 2022), as follows:

“The regulated activity of personal care involves providing personal care for people who are unable to provide it for themselves because of old age, illness or disability. The personal care must be provided in the place where those people who need it are living at the time when the care is provided. … For example, this includes personal care provided through domiciliary or homecare services, and housing with care or supported living services.”

Page 24 of the document sets out a decision tree to assist in establishing whether the regulated activity of personal care is being carried out. Each case has to be considered on its own facts and it is therefore strongly recommended that you seek specialist legal advice to ensure that you are operating within the law.

You can view our blog on the requirement to register for personal care here.

What will happen if I don’t register with the CQC?

It is a criminal offence to carry out a regulated activity without being registered with the CQC under Section 10(1) of the Health and Social Care Act 2008. The CQC can issue you with a Fixed Penalty Notice or prosecute you. This offence is usualyy dealt with by the Magistrates Court and if found guilty, the court can impose an unlimited fine and/or a sentence of up to 12 months imprisonment.

You can view our blog on the consequences of failing to register here.

Obtaining CQC registration 

In this webinar, Laura Hannah, Partner at Stephensons and Helen Fuller, Managing Director of Care4Quality Ltd, discuss the Care Quality Commission’s registration process and explore the steps that can be taken to improve your prospects of obtaining registration as a service provider or manager, including when the CQC are proposing to refuse your registration - watch now: