CQC notification of death

The duty: Regulations 16 and 17 of the 2009 Registration Regulations

Two regulations in the Care Quality Commission (Registration) Regulations 2009 deal with deaths. They sit among the statutory notifications every registered provider must make, which our guide to CQC notifications sets out in full; this page takes the two death notifications on their own.

Regulation 16, notification of death of service user. Regulation 16(1) says that "the registered person must notify the Commission without delay of the death of a service user" where the death occurred "whilst services were being provided in the carrying on of a regulated activity", or where it "has, or may have, resulted from the carrying on of a regulated activity". Regulation 16(3) adds that the notification "must include a description of the circumstances of the death". CQC's guidance gives the purpose in one line: "The intention of this regulation is to ensure that CQC is notified of the deaths of people who use services so that where needed, CQC can take follow-up action."

Regulation 17, death or unauthorised absence of a detained person. Where a service user is detained or liable to be detained under the Mental Health Act 1983, Regulation 17 applies instead, and Regulation 16(5) says so: "This regulation does not apply where regulation 17 applies." The registered person "must notify the Commission without delay of the death in any location or unauthorised absence from a relevant location" of that person, and the notification of a death must again include a description of the circumstances.

Both duties fall on the registered person: the provider and any registered manager. Filling in the form can be delegated; the accountability cannot. Both are enforceable in the strongest way CQC has. For each regulation CQC's guidance states that it "can prosecute for a breach of this regulation or a breach of part of the regulation", which "means that CQC can move directly to prosecution without first serving a warning notice", and that CQC "must refuse registration if providers cannot satisfy us that they can and will continue to comply with this regulation".

Which deaths must be notified

Regulation 16 has two limbs, and a death that meets either is notifiable; CQC's form page puts it as "You must tell us about the death of a person using your service if either of the following has happened". The first is about when the person died: while the regulated activity was being provided. The second is about why: the death has, or may have, resulted from the regulated activity or the way it was provided. In practice that means:

• In a care home, every death of a resident in the home, expected or not. A resident who dies peacefully at the end of a long illness, with palliative care in place and the family present, died while services were being provided, and the death is notifiable.
• In home care and supported living, a death during a visit or while support was being provided, and a death that has or may have resulted from the care, for example after a missed call, a medicines error or a fall during a transfer. A death between visits with nothing to connect it to the care is a harder judgement; record the reasons either way.
• A death away from the service can still be notifiable. CQC's form asks where the person died and offers the location itself, their own home, hospital, hospice and ambulance among the answers. A resident admitted to hospital after a fall at the home who dies there a week later may have died as a result of the regulated activity, and the second limb is the one to apply. Where in doubt, notify, and say in the description why.
• NHS bodies, local authorities exercising public health functions and providers of primary medical services have a narrower test in Regulation 16(2): the death must also be one that "cannot, in the reasonable opinion of the registered person, be attributed to the course which that service user's illness or medical condition would naturally have taken if that service user was receiving appropriate care and treatment". For primary medical services, the care must also have been provided within the two weeks before the death. These providers may report deaths through NHS England's Learn from Patient Safety Events service instead of to CQC directly.
• A person detained or liable to be detained under the Mental Health Act 1983, including a community patient recalled to hospital, falls under Regulation 17. CQC's guidance is emphatic that the death of any such patient must be notified, and that this "is not dependent on the security level of the inpatient unit which was the detaining authority for the patient, nor where nor how that death occurred".

Regulation 17 also covers unauthorised absence, but only narrowly. CQC's guidance says an absence without leave is notifiable only when the person is absent from an inpatient unit designated as low, medium or high security, and "the person is still absent after midnight on the day their absence began". The return must then be notified too, under Regulation 17(2A). A resident with dementia who leaves a care home unnoticed is not a Regulation 17 event; if the police are called to find them, it is a notification under Regulation 18 instead, which the notifications guide covers.

The forms, the timing, and what CQC asks

Both regulations say "without delay", and CQC's guidance on Regulation 16 repeats that "Notifications about deaths must be sent to CQC without delay". Its form page puts it as "You must notify us as soon as possible". Neither sets a number of hours, and nothing in the regulations or CQC's guidance lets a death overnight or at a weekend wait for the next working morning, so the on-call arrangements should say who makes the notification when the registered manager is not there. CQC's Regulation 17 guidance mentions its own hours only alongside the duty: "Regulations require notifications to be made ‘without delay’. Services may note that CQC operates office hours in respect of such notifications." Nothing allows the notification to wait for a post-mortem, a coroner's decision or a death certificate: the form asks whether the medical cause of death is known yet, and "no" is an acceptable answer. CQC's notifications guidance is blunt about the alternative: "It is an offence not to notify us when a relevant change, event or incident has happened."

There are two forms. For a death under Regulation 16, use CQC's death of a person using the service notification form, either online through the CQC provider portal or as the Word form emailed to CQC. For the death of a detained patient, use the death of a detained mental health patient notification form, which goes to CQC's Mental Health Act team; unauthorised absences have their own absent without leave form. CQC is clear that "You must use this up-to-date form and provide all the information we ask for. If your form is incomplete we will return it to you."

The Regulation 16 form does not use the person's name. It asks for a unique identifier, and for month and year of birth rather than a date. CQC's notifications guidance makes the Mental Health Act death the exception: there "you must identify the person using their name and date of birth. This is so the coroner can give us information about the cause of death." Keep the key to any identifier you use in your own records, so the notification can be matched to the person later.

What the Regulation 16 form asks is a useful checklist for what your own record needs to hold before you sit down to complete it:

• The person's identifier, when they began to use the service, and whether they were receiving end of life or palliative care
• Whether the cause of death is known, the date, time and place of death, and whether the person died within 30 days of surgery or of the use of restraint
• Whether the death was the expected outcome of an illness, when the last medical consultation was, and whether the person was receiving appropriate care and treatment
• Whether the death is subject to a formal investigation by the police, the coroner, the Health and Safety Executive or environmental health
• For an unexpected death, the last person involved in providing care, and any concerns about medicines or medical devices
• The circumstances: what led up to the death, who was present, when the person was last seen by staff, recent risk assessments, and any notifications about them in the last three months
• Whether the death is a notifiable safety incident under the duty of candour and, if so, whether the relevant person has been told

The detained-patient form goes further, asking about the section of the Act, medicines, restraint, seclusion and rapid tranquilisation in the days before the death, leave, and whether the coroner has been told. Where the death is related to a patient safety incident, CQC asks you to quote the local risk management system reference so it can match the reports. Keep the acknowledgement CQC sends, whether it carries an ENQ number, a notification ID or a case ID; it is the proof the notification was made.

The death of a registered provider is a separate notification, under Regulation 21. Where an individual provider dies, the personal representative must notify CQC in writing "without delay of the death" and, "within 28 days of the date of death", of their intentions for the future of the service. Where a partner dies, the surviving partner notifies CQC without delay. CQC's forms page warns that a service carried on by an unregistered person "would be an offence".

Deaths under a DoLS authorisation, and the other people to tell

A resident who dies while subject to a Deprivation of Liberty Safeguards authorisation under the Mental Capacity Act 2005 is notified to CQC under Regulation 16, like any other resident. Regulation 17 applies only to people detained under the Mental Health Act 1983, and a DoLS authorisation is not detention under that Act. The separate Regulation 18 notification about DoLS concerns the outcome of an application, not the death of the person it was for.

The coroner question changed in 2017. Section 178 of the Policing and Crime Act 2017 inserted a new subsection into section 48 of the Coroners and Justice Act 2009, so that "a person is not in state detention at any time when he or she is deprived of liberty under section 4A(3) or (5) or 4B of the Mental Capacity Act 2005". The Chief Coroner's Guidance No 16A explains the effect for deaths on or after 3 April 2017: the death "should be treated as with any other death outside the context of state detention: it need only be reported to the coroner where one or more of the other requisite conditions are met". Those conditions, for the doctor, are the ones in the Notification of Deaths Regulations 2019: a death suspected to be due to poisoning, medication, violence, trauma or injury, self-harm or neglect, an unnatural death, an unknown cause, or no attending practitioner available, among others. The guidance also notes that the exemption covers a deprivation of liberty that was authorised; a person held under restrictions amounting to detention without an authorisation may still be treated as having died in state detention. Check the DoLS paperwork is current, and record that you checked.

DoLS is the scheme in force in England at the time of writing. If the Liberty Protection Safeguards are brought in to replace it, read how the new scheme treats deaths before relying on this section.

A death usually involves several other people, each with a separate duty, and none of them is CQC:

• The family or representative, told promptly and kindly, and where the death is a notifiable safety incident, told in line with the duty of candour under Regulation 20 of the 2014 Regulations, which the CQC form asks about directly.
• The GP or attending practitioner, whose view on the cause of death decides whether the death is referred to the coroner. Since September 2024, deaths not investigated by a coroner are reviewed by a medical examiner before the death is registered.
• The local authority, as a safeguarding referral where abuse or neglect is suspected. The Safeguarding Adults Board may later hold a safeguarding adults review under section 44 of the Care Act 2014.
• LeDeR, where the person had a learning disability or was autistic. NHS England's page is plain: "Anyone can notify a death to the online LeDeR system."
• Commissioners, under the terms of your contract, and the Health and Safety Executive where a death arises from a work activity; our incident reporting guide covers RIDDOR.

What to record: the file behind the notification

Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires an accurate, complete and contemporaneous record for each person, and our record-keeping guide covers it. After a death, three things about that record matter more than usual.

The last entries are evidence. The daily notes, observations, fluid charts and medicines records for the final days are what a coroner, a safeguarding enquiry or a family will read. Finish them at the time. If something has to be added afterwards, add it as a dated late entry by the person who knows it, and never tidy or rewrite what was there.

The decisions need names and times. Who found the person, who confirmed the death, who was called and when, who decided whether the coroner needed to be told, who decided the CQC notification and the duty of candour question, and on what basis. The CQC form asks when the person was last seen and in what circumstances; your record should already say.

The notification should be traceable. Keep the CQC reference with the person's record, and a log of every death notification with its date, so that the pattern across a year can be reviewed: how many deaths, how many expected, how many involved restraint or followed a fall, how many were referred to the coroner. That review is part of Regulation 17's governance duty, not an extra.

The night a resident dies, in messages

Most of what the record needs about a death is first said in a message. The night carer texts the nurse in charge from the corridor. The nurse messages the on-call manager to ask whether to ring the family now or at seven. The son replies to a text from the home with a question about the last visit. The manager asks the deputy, in a direct message the next morning, "has anyone done the CQC one?", and the answer is "thought you had". If the death is later questioned, those are the messages that show who knew what and when.

They are records in the sense that matters here. They carry the times the form asks for, the decisions the coroner, a safeguarding enquiry or the family will ask about, and the conversation with the relevant person that the duty of candour requires to be recorded. Held on personal phones, they belong to the people who sent them, and a service asked about them a year later is relying on staff who may since have left.

ComplyChat provides a channel for those work conversations, with everyone in it told it is on the record, and a mobile number verified by SMS as the identity, so night staff, bank nurses and agency carers without a work account can be in it. Messages are recorded on the server as they are sent, and on paid plans the lasting record files into the provider's own Microsoft 365 once the tenant is connected, under the provider's retention rules. It is not a care record system, it does not submit notifications, and it does not decide whether a death is notifiable; the registered manager does.

A question for the next managers' meeting: for the last death in the service, could you show from records the service holds when the person was last seen, who decided the CQC notification and when it was sent, or would part of that answer come from someone's phone?

Official guidance and your next step

The primary sources are the Care Quality Commission (Registration) Regulations 2009, Regulations 16 and 17; CQC's notifications guidance for providers; its guidance on Regulation 17; the two death notification forms linked above; and, for deaths under a DoLS authorisation, the Chief Coroner's Guidance No 16A and section 48 of the Coroners and Justice Act 2009. Quotations are from those pages as published on 25 September 2026; CQC changes its forms often, so take the current one from its website.

This guide is a practical starting point for registered providers and managers in England, not legal advice about a particular death, inquest or prosecution. Where a death is contentious, take advice early.

Then do one thing: take the deaths in your service over the last twelve months and, for each, find the CQC reference and the date it was sent. Any death without a reference, or with a gap between the death and the notification that the record does not explain, is worth understanding before an inspector asks.