CQC compliance for supported living

Separating care from housing

• The person holds a tenancy or licence for their home, with the rights that go with it. Support is a separate arrangement they can, in principle, change.
• Avoid arrangements where the same organisation controls both so tightly that leaving the support means losing the home — CQC and commissioners treat this as a serious concern.
• Keep housing management tasks and regulated personal care distinct in your records and your contracts.
• Be clear in the statement of purpose that you provide personal care, and where.

Right Support, Right Care, Right Culture in practice

• Small-scale, ordinary housing in ordinary streets rather than campus or congregate settings.
• Support plans built around the person's own goals — work, education, relationships, community — not only personal care tasks.
• Staff matched to the person, with the person involved in choosing who supports them wherever possible.
• Outcomes recorded in the person's terms, and progress reviewed with them.

Consent, capacity and restrictive practice

• Decision-specific capacity assessments; where a person lacks capacity, best interests decisions recorded with the least restrictive option chosen.
• Restrictions in a person's own home may amount to a deprivation of liberty requiring Court of Protection authorisation, not DoLS. Identify these honestly and seek authorisation.
• No blanket rules — locked kitchens, fixed bedtimes, restricted access to food, phones or money must be individually justified, authorised, recorded and reduced over time.
• Positive behaviour support plans authored with clinical input, with proactive strategies dominant and any physical intervention as a last resort, recorded and reviewed after every use.
• Report every restrictive intervention, monitor trends, and demonstrate a reduction programme.

Staffing and skills

• Training matched to the people supported: autism and learning disability, communication including AAC and Makaton where relevant, positive behaviour support, epilepsy and rescue medication, mental health, and the Oliver McGowan mandatory training.
• Consistent teams, low turnover and minimal agency use — continuity is a core quality indicator in these services.
• Supervision, competency checks and reflective practice after incidents.
• Staffing levels that support community access, not just presence in the house.

Medicines and health

• Support levels defined per person, with MAR records completed in the moment.
• Active involvement in STOMP and STAMP: challenge and review psychotropic medication, with evidence of GP or psychiatry reviews.
• Annual health checks, health action plans, hospital passports and reasonable adjustments in place.
• Epilepsy protocols and rescue medication competency where relevant.

Governance and culture evidence

• House-level and service-level audits: support plans, restrictions register, medicines, incidents, finances handled on a person's behalf.
• Speaking up arrangements staff can name, and evidence of what happened last time someone raised a concern.
• Involvement of families and advocates, with clear boundaries about the person's own wishes.
• A self-assessment against the quality statements and Right Support Right Care Right Culture, honestly scored, with an improvement plan.

Common questions

Official sources

• CQC — Right support, right care, right culture
• Mental Capacity Act 2005
• NICE NG11 — Challenging behaviour and learning disabilities
• NICE NG96 — Care and support of people growing older with learning disabilities

More guides

• How to register with CQC
• The CQC standards and quality statements
• Complex care compliance
• Home care and domiciliary compliance