How do we register a new care service with CQC?

Do we actually need to register with CQC?

If you will carry on a regulated activity in England, yes. CQC's guidance on what registration is says any person, partnership or organisation that provides regulated activity in England must be registered, otherwise they commit an offence. There are 14 regulated activities, and CQC is clear that it is your responsibility to register for each one you carry on. Some providers need more than one.

The first decision is who the provider actually is. CQC registers the legal entity that carries on the regulated activity, which might be you as an individual, a partnership, or an organisation such as a limited company or a charity. Getting this wrong at the start means applying in the wrong name, so settle it with your accountant or solicitor before you fill in a single form.

What does CQC say the process involves?

The guidance on registering as a provider is more direct than people expect. You must only apply when everything is in place to start providing your services, including the locations and the staff. CQC says it cannot hold applications that are not ready.

Before you apply, CQC expects four things to be done. Your main point of contact needs a DBS check. If you are an organisation or a partnership, your registered managers must already be chosen. Your supporting documents should be prepared, and your premises ready for a site visit if one is needed.

Once the application arrives, CQC's page on assessing your application describes two stages. Initial checks come first, confirming the forms and statement of purpose are complete and every supporting document has arrived. Then the documents themselves are reviewed for accuracy and relevance. Only after that does the assessment begin, which can include more questions, interviews with you and your registered manager, and for most new registrations a visit to your premises.

Stage	What CQC looks at	What stops it
Before you apply	DBS check, chosen registered manager, supporting documents, premises	Applying before these are in place
Initial checks	Complete forms, statement of purpose, every required document	Anything missing, so the application is rejected
Document review	Whether each document is complete, accurate and relevant to your service	Generic or out of date documents
Assessment	Further information, interviews and, for most new services, a site visit	Not agreeing dates for assessment activities
Decision	Whether you have shown fitness and compliance	Gaps CQC cannot be satisfied about

How long does CQC registration take?

Longer than most business plans allow for. CQC's guidance says the registration process can take a few months, and that you cannot manage regulated activities until CQC has confirmed you are registered. Its page on the assessment stage says it can take several months to complete.

Some of the waiting happens before you can even apply. CQC's DBS guidance says it can take up to 60 working days to receive your DBS certificate, and you cannot submit your application until you have it. The certificate must also be current. Applications with DBS checks over 12 months old are rejected without further review.

Once you are in the assessment stage, keep your diary open. If you cannot agree a date for an assessment activity within 28 days of being contacted, CQC says your application may be returned or it may propose to refuse your registration.

I would plan backwards from the date you want to open, and build in more time than feels comfortable. Rent, salaries and loan repayments do not pause while you wait for a decision.

Which policies and documents should be ready before we apply?

CQC publishes a list of the documents every provider applicant must send. It includes your statement of purpose, a complaints policy, a consent policy and procedure, an equality, diversity and human rights policy, governance and quality assurance policies, infection prevention and control, medicines management, a recruitment policy, a safeguarding policy and procedure, and proof of public and employer liability insurance. Depending on your service, there may be more.

CQC also sets out in detail what each document must include. Every document needs your business name, the person responsible for it, the date it was created and the date it will be reviewed. It must be consistent with your other policies and carry up to date references to legislation and guidance, with working links.

Templates get a warning of their own. If you use one, it must suit your service type. Its own example is that a template for residential care will not work for a home care applicant. I would read that sentence twice before buying a policy pack. If you want a way to test what you already have, my post on whether your care policies were written for someone else walks through it.

Who should be our registered manager and nominated individual?

If you register as an organisation or a partnership, you will need at least one registered manager, and CQC says the manager forms must go in with your provider application. Without them, your application cannot be processed.

CQC's guidance on registering as a new manager sets a real bar. Applicants must have proven management experience, and recent experience managing a relevant regulated service is highly desirable. They must give a full work history from age 16 onwards and explain any gaps over 4 weeks. For a home care service, CQC says a Level 5 Diploma in Leadership and Management or an equivalent would strengthen the application. And it warns that a person could be fined up to £2,500 for giving false or misleading information.

The registered manager shares legal responsibility with the provider for meeting the regulations. That is not a role to fill with whoever is available.

An organisation also names a nominated individual, the senior person who supervises how the regulated activity is managed. I have written about that role in more detail in what a nominated individual actually does.

Why do applications stall?

The first reason is applying too early. CQC's position is plain: it cannot process an application if the steps before applying have not been done, and it cannot register you if the application is incomplete or contains incorrect information. If information or documents are missing at the first check, it rejects the application and emails you to explain why.

The second is treating the documents as paperwork rather than as a description of how your service will run. CQC checks them against the service you are applying to provide. A policy that names a different kind of service, refers to guidance that has been replaced, or contradicts your statement of purpose tells CQC something about how ready you are.

The third is the premises. CQC says it might refuse an application if the premises are not suitable, and gives the example of being unable to keep people's records safe and secure.

Each of these costs you time you have already budgeted for something else. A rejected application usually means starting again with what you should have sent the first time.

When is this not the answer?

If you are not sure whether what you plan to do is a regulated activity at all, start with CQC's own scope of registration guidance before anything else. Some services fall outside it.

If you are buying an existing registered service rather than starting a new one, the route is different, and CQC has separate guidance on buying, selling or transferring a registered business.

If your questions are about company structure, leases, employment contracts or funding, you need a solicitor or an accountant, not a care consultant. I would always rather point you to the right person than guess at an answer outside my work.

And if your plans include services outside England, another regulator and another process apply. This post covers England only.

Where should we start?

Write down your planned opening date, then list everything CQC needs before you can apply: the DBS check, your registered manager, your supporting documents and your premises. Put a realistic date next to each one. If the dates do not add up, you have found your first problem early, which is the best time to find it.

If you would like help, my policy and procedure development work builds documents around your actual service, and nominated individual services support the people who will lead it. When you are ready, book some time with me and we can look at your plans together.