What is registration?

You must register with us if you carry on one of the activities we regulate (see below for a definition of these 'regulated activities').

You can find definitions of each of these activities and more information to help you decide if you are required to register in our scope document.

The Scope of registration

Children’s homes and health care: Ofsted and CQC joint registration guidance

One of the words you will read a lot in our information about registration is 'provider'. We use this to mean the legal entity responsible for carrying on the regulated activity.

Types of providers

A provider can be one of three types of legal entity:

• individual
• partnership
• organisation.

When you apply for registration, it is important to understand which type of legal entity you are to ensure the application is made by the correct legal entity (i.e. the legal entity that will be carrying on the regulated activity).

Individuals

You should register as an individual if you will be carrying on the regulated activity yourself (sometimes referred to as a ‘sole trader’). Individuals register in their own name and are directly responsible for carrying on regulated activities.

Partnerships

A partnership exists where two or more individuals carry on a regulated activity together. If you carry on any regulated activities as a partnership, it is the partnership (including all the partners) that must register. The partnership as a whole, as well as each individual partner, is responsible for ensuring that the regulated activities provided meet the requirements of the relevant regulations and enactments

To be registered, a partnership cannot include other partnerships of organisations (i.e. it must be a partnership of individuals) and all of the partners must have agreed and have joint and several liabilities. Other arrangements in which one individual provider shares expenses only with another individual provider should not register as a partnership.

In this case, if each person is carrying on regulated activities as an individual without shared liability, they will need to register separately.

A limited liability partnership (LLP) should register as an organisation, because the legislation explicitly excludes an LLP from being a partnership.

Organisations

You should register as an organisation if you are a:

• local authority
• NHS trust
• registered company or charity
• limited liability partnership (LLP)
• other corporate body.

In this case, it will be the organisation itself that registers, not the people who control it (although, from April 1 2015, organisations will be subject to a fit and proper person requirement in relation to their directors and those in equivalent positions).

Company structures and brand names

We register the legal entity directly responsible for carrying on the regulated activity. We do not register:

• persons (including parent companies) that are not providing a regulated activity
• 'brands' that may identify groups of providers.

This is why we do not show information on company structures. We do show if a service is 'also known as' and give a brand or commonly-used name. This is not the specific name of a parent company with companies house.

In our next phase of regulation we are looking to register all parts of an organisation that direct or control systems of care.

When you are applying for registration with us, you will need to determine which health and adult social care services we regulate you carry on. These are known as 'regulated activities'.

When you are applying for registration with us, you will need to determine the regulated activities you will carry on.

It is your responsibility to ensure you register for each regulated activity that you carry on. It is common to register for more than one.

In all, there are 14 regulated activities. For a more detailed explanation of who is covered by the registration system and a description of each regulated activity, you should refer to the Scope of Registration document.

Read the Scope of registration

Quick reference guide to regulated activities by type of service

Our 'quick reference guide' is in 2 formats. It helps providers to understand how regulated activities and services types are likely to apply to particular types of service and provider.

This will help you to find out which regulated activities you are most likely to carry on.

Use it in conjunction with 'Scope of registration'. This will allow you to evaluate in more detail if any of these regulated activities apply to you.

Quick guide to regulated activities by type of service: online text version

Quick guide to regulated activities by type of service: chart

Locations may be where a regulated activity is being:

• delivered to people and may represent a ‘service’ (for example, a care home or dentist surgery)
• organised or managed from but the regulated activity is carried out elsewhere (for example, a domiciliary care (home care) agency or community nursing service)

For other services, such as mobile or online services, the location may be either:

• the head office
• a regional office or area base from which day-to-day management of the regulated activities is directed.

Our guidance on What is a Location? describes what we mean by a location and includes ‘rules’ to help you identify your locations. It is important that you read this guidance.

If you provide regulated activities in or from more than one location, you will need to include details of all of these in your registration application. You must tell us about all the activities to be provided at or from each location.

It is important to be clear about your locations because in your registration application you will need to make a declaration about your compliance with regulations for each regulated activity at each location.

Once you are registered, we will monitor your compliance with the regulations at each location.

Under the HSCA 2008 we can grant registration with or without conditions. Conditions of registration usually restrict what a provider or registered manager can do. They make your registration conditional on meeting a specific requirement. We link conditions to a regulated activity, location, service type or specific activity.

Routine conditions

We will always impose some ‘routine’ conditions to providers and managers at registration. For example, the location where you intend to carry on a regulated activity will be a condition of your registration.

Some providers may have other routine conditions imposed on their registration. For example, because of:

• the type of legal entity - for example, the members of a partnership
• the type of service - for example, to:
  • restrict the number of people a care home may accommodate
  • stop some providers from providing services to autistic people or people with a learning disability unless they have been assessed as meeting our standards for these services

Under regulation 5 of the Care Quality Commission (Registration) Regulations 2009, CQC must impose a condition on certain types of provider requiring them to have a registered manager for each regulated activity at each location. We are not able to remove this condition where this is legally required.

CQC may also impose this condition where an individual provider does not meet the fitness requirements under regulation 4. The provider can apply to remove the condition if they believe that the reason for the condition no longer stands.

Non-routine conditions

We may occasionally set ‘non-routine conditions’ to restrict what a provider or manager can do. For example, we do not routinely impose conditions restricting the age range of people using a service. But if staff do not have the knowledge and skills to work with children under the age of 16, we may impose a condition to restrict an activity to people over the age of 16.

We may also use non-routine conditions to drive improvement or mitigate risks to people using services. For example, we may impose a condition that a provider cannot provide regulated activity to any person new to their service without our prior written agreement.

Making changes to conditions

As a registered provider or registered manager, you can apply to have a condition varied or removed. This includes adding or removing a location from your location condition of registration. For partnerships, this includes adding or removing partners.

You may also have conditions that were applied because you were non-compliant with the regulations. When you become compliant, you can apply to have the condition removed. See guidance on Making changes to your registration.

In your application it is your responsibility to:

• specify the exact variation you are requesting
• provide clear evidence to support your application

You will need to confirm that:

• your services can meet the needs of the people using them
• you will be compliant with relevant regulations, and
• you will be able to effectively manage the regulated activities if the condition is removed or varied.

When assessing variation applications, we review why the condition was first imposed. We will assess the impact that removing or varying a condition would have on your service.

You cannot add or remove regulated activities by applying to vary your registration. This is because the law requires you to register each regulated activity separately. You will need to apply to make changes to your registration.

CQC can also vary, remove or add conditions to your registration.

Some providers must have a manager who is registered with us as a condition of the provider’s registration. The Care Quality Commission (Registration) Regulations 2009 set out the circumstances in which you must have a registered manager. For your manager to be registered with us they must meet specific requirements relating to registered managers.

In most cases, a provider will need to have one or more registered managers.

As a registered person, the registered manager has legal responsibilities in relation to that position. A registered manager shares the legal responsibility for meeting the requirements of the relevant regulations and enactments with the provider.

The regulations require us to impose a registered manager condition on the following types of providers requiring them to have one or more registered managers for the regulated activities they carry on:

• a partnership
• an organisation
• an individual who is not personally in day-to-day charge of carrying on the regulated activities or is not fit to do so.

The person who you appoint to become your registered manager should be in day-to-day charge of carrying on the regulated activity or activities they apply to be registered for.

Although the regulations do not prevent a person from being registered to manage several regulated activities, or from managing regulated activity at more than one location, the manager must be able to satisfy us that they have the capacity and capability to do so, as well as the necessary skills, qualifications, competence and experience. The purpose of the registered manager requirement, is to regulate the person managing the regulated activity on a day to day basis at the location where the regulated activity is provided, rather than a more senior manager who is not in day to day charge at the location.

You can appoint more than one person to manage a regulated activity at the same location (for example, where there is a job share arrangement).

Any provider who has a registered manager attached to their registration is in breach of that condition if they don’t have a registered manager. This is an offence under s33 (b) HSCA, unless the provider has a 'reasonable excuse'.

If you are applying for registration as an organisation, the regulations require you to nominate an individual to act as the main point of contact with us.

The nominated individual must be employed as a director, manager or secretary of the organisation (i.e. they should be a senior person, with authority to speak on behalf of the organisation). They must also be in a position which carries responsibility for supervising the management of the carrying on of the regulated activity (i.e. they must be in a position to speak, authoritatively, on behalf of the organisation, about the way that the regulated activity is provided).

It is up to you who to nominate, as long as they meet these criteria.

You can nominate the same person for all or some of the regulated activities you provide. Or if you wish you can have a different individual for each regulated activity. But you can only nominate one person for each of the regulated activities you provide. The application form will ask you for the details of your nominated individual/s and the regulated activities for which you are nominating them.

In very small organisations, it may be necessary for the same person to be both the registered manager and the nominated individual, but this should be avoided where possible. Where there are concerns about the way a regulated activity is being managed, there will be times when we need to speak to a more senior person within the organisation. This is more difficult where the registered manager and the person nominated by the organisation to represent them are one and the same.

If you register as an individual or partnership you do not need a nominated individual.

A statement of purpose for a business describes what you do, where you do it and who you do it for.

You must maintain an accurate statement of purpose throughout your registration. It must include:

• your aims and objectives
• the services you provide
• the different needs of people who use your service
• your contact details
• your service's legal entity
• the places where services are provided

More information about the statement of purpose.