Navigating the Care Quality Commission: New Registration Requirements and the Single Assessment Framework

The role of the CQC

The Care Quality Commission (CQC) is the regulator of health and social care in England. It inspects domiciliary care agencies and ensures they meet fundamental standards of safety, effectiveness, compassion and responsiveness. Providers must register with the CQC before they can legally deliver personal care. Ratings (Outstanding, Good, Requires Improvement or Inadequate) give families confidence when choosing services.

Two‑stage registration for new providers

In July 2025 the CQC introduced a two‑stage registration process for new domiciliary care providers. The goal is to ensure that services are safe from day one and to prevent companies without adequate governance from entering the market.

• Stage 1 – Service planning: Applicants must demonstrate robust governance, effective recruitment and safeguarding policies, and quality‑assurance systems. They undergo a structured interview with the CQC to assess their preparedness. At this stage, providers may not yet have clients or staff but must show that they understand regulatory requirements and have plans for training, supervision and risk management.
  
  

• Stage 2 – Service delivery: Once stage 1 is approved, providers can recruit and train staff but still cannot deliver care. They must then demonstrate that recruitment and training have been completed safely, digital systems for care planning and incident reporting are in place, and they are ready to start delivering services. Only after stage 2 approval can they commence care.

This dual approach aims to reduce the risk of poor quality or unsafe providers entering the market. However, it also means that starting a new home‑care agency takes longer and requires more up‑front investment. Prospective providers should plan for this extended timeline and ensure they can meet the detailed requirements. Clients should appreciate that newly registered providers will have undergone this rigorous process.

The Single Assessment Framework (SAF)

In addition to changes for new entrants, the CQC is rolling out a Single Assessment Framework (SAF) to replace multiple frameworks for different services. The SAF uses quality statements grouped under the five key questions (Safe, Effective, Caring, Responsive, Well‑led). While the intention is to make inspections more consistent, a Care Provider Alliance survey in February 2025 highlighted numerous concerns: providers said there were too many and overlapping quality statements, guidance was unclear, the sample‑based approach could miss important issues, and the process left staff distressed. Reports were often delayed or unclear, making it difficult for providers to learn from findings. Some managers even left the sector due to the stress of the new framework.

What this means for clients and providers

From a provider’s perspective, the CQC’s new registration process and SAF mean more preparation, documentation and engagement with inspectors. Agencies must invest in robust governance structures and digital systems from the outset. They should regularly review CQC guidance and consider using external consultants or joining industry associations for support.

For families researching care, understanding these changes can help interpret ratings and inspection reports. Ask agencies whether they have completed stage 1 or stage 2 registration (if new), how they ensure compliance with the SAF, and how they respond to inspection findings. Be aware that the SAF may result in more frequent but smaller sampling of evidence; some issues may not appear in reports. Ultimately, the changes aim to improve safety and accountability, but the transition may cause some delays and confusion in the short term.