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CQC regulates health and social care providers and some care agencies as providers of regulated activities. This guide explains what CQC standards apply to care agencies and how the CQC framework affects both agencies and the providers that use them.
The Care Quality Commission (CQC) is the independent regulator of health and social care in England. It registers and inspects care providers and takes action where standards are not met. The extent to which a care agency falls under direct CQC regulation depends on how it operates: agencies that supply workers to care providers regulated by CQC are not themselves subject to CQC inspection for that supply activity, but agencies that provide care directly to individuals may require CQC registration and inspection. Understanding the regulatory framework is important for both agencies and providers.
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A care agency that directly provides personal care to individuals in their own homes, or that provides nursing care, is providing a regulated activity and must register with CQC as a provider. An agency that introduces workers to care providers, where the provider then supervises and manages those workers, is operating as an employment business and does not require CQC registration for that introduction activity. The distinction depends on who directs and manages the worker’s activities during the placement.
All providers registered with CQC must meet the Fundamental Standards set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These include: person-centred care; dignity and respect; consent; safe care and treatment; safeguarding service users from abuse; meeting nutritional and hydration needs; premises and equipment; receiving and acting on complaints; good governance; staffing; fit and proper persons; duty of candour; and display of ratings. Failure to meet the Fundamental Standards can result in CQC enforcement action.
CQC assesses registered services against five domains: Safe (how systems, processes and practices keep people safe and protected from abuse); Effective (how people’s care, treatment and support achieves good outcomes); Caring (how staff involve and treat people with compassion, dignity and respect); Responsive (how services are organised to meet people’s needs); and Well-Led (how the leadership, management and governance assures the delivery of high-quality care). The overall rating given to a service reflects performance across all five domains.
CQC inspects registered services through a combination of announced and unannounced inspections, data monitoring between inspections and engagement with service users, families and staff. Inspectors review documentation, observe care delivery, speak with service users and staff and examine data including safeguarding referrals, incidents and complaints. Following an inspection, CQC publishes its findings and the service’s rating on its website, making inspection outcomes publicly available to commissioners, families and the public.
Registered care providers remain responsible for the quality and safety of care delivered in their service regardless of whether that care is delivered by directly employed staff or agency workers. Agency workers working under the provider’s direction are part of the provider’s workforce for CQC purposes. Inspectors will assess whether agency workers are appropriately inducted, supervised and integrated into the provider’s quality systems. Persistent use of unfamiliar agency workers without proper oversight is a risk factor in CQC inspection outcomes.
Providers using agencies that provide regulated activities should verify the agency’s CQC registration status before engaging with them. CQC registration can be verified through the CQC website, which lists all registered providers and their current ratings and inspection reports. Using an unregistered provider of regulated activities creates legal and regulatory risk for the commissioning provider. For agencies operating purely as employment businesses, CQC registration is not required, but providers should verify other compliance credentials.
For related information see our articles on Compliance in Health and Social Care and Verify a Care Agency Compliance.
A care agency that directly provides personal care to individuals requires CQC registration as a provider of regulated activities. An agency that introduces workers to care providers, where the provider then supervises and manages those workers, operates as an employment business and does not require CQC registration for that supply activity. Providers should verify the CQC registration status of any agency providing regulated activities directly.
CQC assesses registered services against five domains: Safe, Effective, Caring, Responsive and Well-Led. Each domain reflects a different aspect of care quality. The overall rating given to a service reflects performance across all five domains. Outstanding ratings require strong performance across all domains.
Yes. Registered care providers remain responsible for the quality and safety of care delivered in their service by all workers, including agency workers who work under their supervision. Agency workers must be inducted, supervised and monitored by the provider to the same standard as directly employed staff. CQC will assess the quality of agency worker management as part of their inspection.
Visit our Health and Social Care Agency Resource Hub for more guides on staffing, compliance, CQC standards, agency costs and how to choose the right care agency for your organisation.
The information in this article is provided for general guidance only and does not constitute legal, regulatory or professional advice. Regulations, rates and compliance requirements change: always verify current requirements with the relevant regulatory body. SENDhelp Education Limited accepts no responsibility or liability for any loss or damage arising from reliance on this content. Any links to third-party websites are provided for convenience only and do not constitute endorsement of their content.
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