CQC compliance for care homes

Registration and conditions

• Register the location, the regulated activities, and the maximum number of people — and never exceed the condition, even temporarily.
• Keep your statement of purpose aligned with who you actually admit. Admitting people with needs outside your stated scope is one of the fastest routes to a safe-domain finding.
• Notify CQC of changes to the manager, nominated individual, premises or bed numbers, and apply to vary conditions before, not after, the change.

Safe staffing, day and night

Use a documented dependency tool, re-run it when needs change, and keep the calculation with the rota so the link is visible. Assessors frequently look specifically at nights, weekends and mealtimes.

• Evidence induction, Care Certificate progress, mandatory training and refresher dates in a live matrix.
• Supervision at planned intervals, plus competency assessments for medicines, moving and handling and any clinical task.
• For nursing homes, show how registered nurse cover is maintained and what happens when a nurse shift is unfilled.
• Track agency use and how continuity and induction are maintained when agency staff are used.

Medicines

• Ordering, receipt, storage including controlled drugs and fridge temperatures, administration, and disposal — each with a record.
• Clear protocols for 'when required' medicines, time-critical medicines, and covert administration with a lawful best interests decision.
• Homely remedies, thickeners, topical creams and body maps, and PEG or enteral routes where relevant.
• Monthly medicines audit with actions closed, and error reporting that leads to competency review rather than blame.

Nutrition, hydration and health outcomes

• Nutritional screening and re-screening, weight monitoring, and referral to dietetics or SALT with the advice actually followed in the care plan.
• IDDSI-consistent modified diets and thickened fluids, with kitchen and care staff working from the same information.
• Mealtimes observed as social, unhurried and offering real choice.
• Skin integrity: pressure area risk, repositioning records, equipment settings, and wound care led by clinical advice.
• Falls: individual risk plans, post-fall protocol, and service-level pattern analysis by time, place and person.

Premises, equipment and infection control

• Fire risk assessment current, personal emergency evacuation plans for every person, and drills including night scenarios.
• Legionella, gas, electrical, hoist and bed rail checks in date, with a clear maintenance log.
• Environment that supports people living with dementia: signage, contrast, lighting, orientation and access to outside space.
• IPC lead, cleaning schedules, PPE availability, and outbreak plan with reporting routes.

Consent, restriction and dignity

• Decision-specific capacity assessments with recorded best interests decisions and least restrictive alternatives considered.
• DoLS applications tracked, expiry dates diarised, conditions met and evidenced, and authorisations notified to CQC.
• Any restraint or restrictive practice recorded, reviewed and reduced over time.
• Privacy in practice: knocking, personal care behind closed doors, personalised rooms, and choice over routines.

Governance that stands up to scrutiny

• An audit calendar covering care plans, medicines, infection control, health and safety, kitchen, records and complaints — with owners and closure dates.
• A provider-level quality visit or report, so oversight is visible above the registered manager.
• Resident and relative meetings and surveys, with a published 'you said, we did'.
• A self-assessment against every quality statement, honestly scored, with a live improvement plan.

Common questions

Official sources

• Regulated Activities Regulations 2014 — fundamental standards
• CQC — How we assess services
• NICE NG22 — Older people with social care needs and multiple long-term conditions
• Mental Capacity Act 2005 Deprivation of Liberty Safeguards

More guides

• CQC inspection and assessment questions
• The CQC standards and quality statements
• Becoming a CQC registered manager
• Complex care compliance