CQC scope of registration: which regulated activities you need

The rule: section 10 and regulation 3

CQC registration is a legal requirement, not a choice. Section 10(1) of the Health and Social Care Act 2008 says: “Any person who carries on a regulated activity without being registered under this Chapter in respect of the carrying on of that activity is guilty of an offence.” On summary conviction the penalty is a fine, imprisonment up to the general limit in a magistrates' court, or both; on conviction on indictment it is a fine, imprisonment “for a term not exceeding 12 months”, or both. Registration is “in respect of” each activity, so a provider registered for one activity and carrying on another is unregistered for the second.

Regulation 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 says which activities count. The activities in Schedule 1 “are prescribed as regulated activities”; “An activity which is ancillary to, or is carried on wholly or mainly in relation to, a regulated activity shall be treated as part of that activity”; “An activity is only a regulated activity if it is carried on in England”; and “The activities specified in Schedule 2 are not regulated activities.”

CQC's Scope of registration guidance (web page last updated 26 August 2026, with a full PDF, version 1.1) is the regulator's reading of those rules, and it says of itself: “This is a guide to the regulations but is not a substitute for them.” Its page Who has to register? sets out the two principles everything else follows from: “We register the regulated activity that will be carried on – not service types or professions”, and “It is the legal entity carrying on the regulated activity that must register – not the location or care setting where it is carried out.” The main guidance page also says: “You must apply to be registered even if you do not intend to provide those services on a regular or permanent basis.”

The 14 CQC regulated activities

Schedule 1 to the 2014 Regulations lists the 14 regulated activities in paragraphs 1 to 14. They are not the fourteen fundamental standards in Regulations 9 to 20A, a different list of the same length.

1. Personal care
2. Accommodation for persons who require nursing or personal care
3. Accommodation for persons who require treatment for substance misuse
4. Treatment of disease, disorder or injury
5. Assessment or medical treatment for persons detained under the Mental Health Act 1983
6. Surgical procedures
7. Diagnostic and screening procedures
8. Management of supply of blood and blood derived products etc
9. Transport services, triage and medical advice provided remotely
10. Maternity and midwifery services
11. Termination of pregnancies
12. Services in slimming clinics
13. Nursing care
14. Family planning services

Four of them decide most social care registrations.

Personal care (paragraph 1) is “the provision of personal care for persons who, by reason of old age, illness or disability are unable to provide it for themselves, and which is provided in a place where those persons are living at the time the care is provided”. It does not apply where the accommodation activity in paragraph 2 applies. Regulation 2 defines personal care as physical assistance with eating or drinking, toileting, washing or bathing, dressing, oral care, or the care of skin, hair and nails (except nail care by a chiropodist or podiatrist registered with the Health and Care Professions Council), or “the prompting, together with supervision, of a person” with any of those, “where that person is unable to make a decision for themselves in relation to performing such an activity without such prompting and supervision”. Prompting someone who can decide for themselves is not personal care.

Accommodation for persons who require nursing or personal care (paragraph 2) is “The provision of residential accommodation together with nursing or personal care”. It is the activity a care home registers for, with or without nursing. CQC's guidance treats the accommodation and the care as one thing where they come together: “A single package means the person using the service cannot choose to receive personal care from another provider while they are living in the accommodation.”

Nursing care (paragraph 13) covers nursing care, including in a person's own home, that is not “provided as part of any other regulated activity”. A care home with nursing does not need it separately; a home care agency sending nurses into people's homes may.

Treatment of disease, disorder or injury (paragraph 4) is the broad clinical activity. Whether a care home needs it depends on what its nurses do, as the next section explains.

How the activities fit together in care services

CQC's Scope of registration guidance (PDF, August 2026) is direct: “Each regulated activity requires a separate registration. There is no hierarchy of regulated activities – they are all equally important and you must apply for all that relate to your service.” Applied to social care services:

• A care home that also provides home care. CQC's own example: a provider registered for accommodation “also provide[s] care to people in their home (called a domiciliary or homecare service). In this case, the provider must also register for the regulated activity of Personal care because the domiciliary or homecare service involves personal care that is separate to the care home service.”
• A care home with nursing. Such providers “are likely to need to also register for Treatment of disease, disorder or injury if they employ registered nurses or other listed professionals who carry on this regulated activity”. The exception CQC allows is narrow: “only when registered nursing staff are not employed in their professional capacity and do not actually carry out the treatment for a disease, disorder or injury.”
• A care home without nursing. CQC says: “Providers of care homes without nursing should not register for this regulated activity. This is because if you are carrying out these treatments in the care home, it will likely be by delegation from a healthcare professional working for another registered provider.”
• Supported living and extra care housing. These register for personal care, not accommodation, only where care and housing are genuinely separate: “For the care service to be correctly registered for the regulated activity of Personal care, there must be a real separation between the provision of personal care and the accommodation agreements.” If tenants cannot choose another care provider and stay in their homes, it is a single package and the accommodation activity applies.
• Shared Lives schemes. Schedule 1 excludes accommodation provided under a shared lives agreement from paragraph 2, so CQC says such schemes “should register only for the regulated activity of Personal care and not the regulated activity Accommodation for persons who require nursing or personal care”.
• Housing or social support, or medicines support alone. CQC says “you do not need to register if you only provide housing support or social support (such as help with shopping), but no tasks that are included in the definition of personal care”, and the same applies if you only “administer, prompt or supervise medicines”. That takes the service out of the personal care activity; check that no other activity applies.
• Children at home. Registration is not only for adult care: “Services that provide the regulated activity of Personal care to children outside of an establishment or agency that is registered by Ofsted need to register with CQC. For example, a domiciliary or homecare agency may provide personal care to a child in their own home.”

Exceptions, and who has to register

Some activities are taken out of scope altogether. Schedule 2 to the 2014 Regulations lists the general exceptions, including activity carried on “in the course of a family or personal relationship” and “for no commercial consideration”, first aid given by health care professionals in unexpected or potentially dangerous situations, by organisations established for first aid, or by trained non-professionals, and services in establishments and agencies registered by Ofsted.

Paragraph 1(3) of Schedule 1 adds four exceptions to personal care alone:

1. an employment agency or business supplying carers to a registered service provider (the provider that uses them is registered, not the agency);
2. “the introduction of carers to an individual (other than a service provider) by a person (including an employment agency or an employment business) having no ongoing role in the direction or control of the service provided to that individual”;
3. a carer employed directly by the individual or a “related third party” (such as an attorney), with no agency involved, “working wholly under the direction and control of that individual or related third party”;
4. personal care provided in a prison.

The edges of these exceptions move with the business model. CQC's guidance warns that if a directly employed carer “stops working for the person in a directly employed capacity and instead sets up a limited company for business arrangements, they then work for their own company. … In this case, the company may be in scope for registration”. CQC's guidance says an employment or introductory agency is exempt if it only helps people find carers and “they do not have any role in managing or directing the nursing or personal care” that a carer provides, so one that starts arranging cover or setting rotas risks losing the exception.

Registration attaches to the legal entity: the company, charity, partnership or individual that carries on the activity. Under regulation 5 of the Care Quality Commission (Registration) Regulations 2009, the registration of a service provider “in respect of a regulated activity must be subject to a registered manager condition” where the provider is “a body of persons corporate or unincorporate”, or an individual who is not fit to manage the activity or not in full-time day-to-day charge of it; health service bodies are excepted. A care home company adding personal care needs a registered manager for that activity too. Our registered manager responsibilities guide covers the role.

One 2026 change sits outside care. SI 2026/495, made on 29 April 2026, removes the exceptions for treatment at sports grounds, gyms and sporting or cultural events (transport within an event site stays excepted). It applies from 7 September 2026 only to registration and variation applications and appeals, and from 6 December 2027 for all other purposes, so carrying on that treatment unregistered is an offence only from 6 December 2027.

Adding a regulated activity: apply first

Registration is per activity, so a provider that wants to add one applies to CQC to be registered for it. CQC's form for changes to activities we regulate says: “Use this form if you want to provide a new activity we regulate. You will need to submit one copy for each activity being added. This form will also allow you to add new locations at the same time.” Until the application is granted, the provider is not registered for the new activity, and carrying it on is the section 10 offence.

Locations and other conditions are varied differently. CQC's page on making changes to your registration says “We list your locations as a condition of your registration”, and moving, adding or removing a location is an application to vary that condition under section 19 of the 2008 Act. CQC is plain about timing: “You must have your application granted before you start to implement any change you apply for.” Failing “without reasonable excuse, to comply with any condition” of registration is a separate offence under section 33, punishable by a fine.

CQC said that from 1 July 2025, under part 2 of its pilot for new homecare applications, it would “routinely return and reject applications that are not complete or accurate at the point of receipt”; a provider can correct and resubmit, but “this will count as a new application and will not keep its place in the queue”.

Adding an activity also means revising the statement of purpose; our CQC statement of purpose guide covers when to update and send it. Notifying CQC or revising the statement of purpose does not by itself register the provider for anything.

Keep the record of scope like any other governance record:

• the certificate of registration, which CQC “must issue” on granting an application under section 12, and the new certificate it must issue when it grants a variation under section 19, listing activities, locations and conditions;
• each application and decision letter, with the date it was granted;
• a dated scope note for each service: what it does, which activities that involves, why any exception applies, and who decided;
• the board or owner's minute approving a new service, with the registration step and its date as a condition of starting.

Where a scope decision is first made

Providers rarely step outside their registration on purpose; they drift there one conversation at a time. The owner of a care home messages the registered manager: two families in the village have asked whether the home's carers could help their parents get up in the morning, and could we start next week? The deputy at a supported living scheme agrees in the staff group chat that the team will “help with showers” for a tenant whose needs have changed. A commissioner messages the manager to ask whether the home can take a resident who needs nursing, just for a fortnight.

Each of those is a scope decision that could put the provider outside its registration, and each is the evidence CQC or an insurer would want later: who knew what the service was taking on, when, and who decided it was covered. Made in personal messages, it sits on someone's own phone and may leave with them.

ComplyChat gives those work conversations a channel the provider holds. A mobile number verified by SMS is the identity, so managers, owners, bank staff and agency workers can take part without a work account; everyone added to a channel is told it is on the record; and messages are recorded on the server as they are sent. On paid plans the lasting record files into the provider's own Microsoft 365 once its tenant is connected, under its own retention rules. It does not decide scope, check a registration or submit applications to CQC; that stays with the nominated individual and the registered manager.

A question for the next leadership or board meeting: when did this service last change what it does, and can we show who decided the change was within our registration, and when?

Questions people ask

What are the 14 CQC regulated activities?

The 14 CQC regulated activities are listed in Schedule 1 to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: personal care; accommodation for persons who require nursing or personal care; accommodation for persons who require treatment for substance misuse; treatment of disease, disorder or injury; assessment or medical treatment for persons detained under the Mental Health Act 1983; surgical procedures; diagnostic and screening procedures; management of supply of blood and blood derived products etc; transport services, triage and medical advice provided remotely; maternity and midwifery services; termination of pregnancies; services in slimming clinics; nursing care; and family planning services.

Do I need to register with CQC?

You must register with CQC if you carry on any of the regulated activities in Schedule 1 to the 2014 Regulations in England, unless an exception applies; section 10 of the Health and Social Care Act 2008 makes carrying on a regulated activity without registration an offence. CQC registers “the legal entity carrying on the regulated activity”, not the location, the service type or the profession.

Does a care home need to register for treatment of disease, disorder or injury?

A care home registers for “accommodation for persons who require nursing or personal care”, which covers the personal and nursing care it provides. CQC's guidance says care homes with nursing “are likely to need to also register for Treatment of disease, disorder or injury if they employ registered nurses or other listed professionals who carry on this regulated activity”, while “Providers of care homes without nursing should not register for this regulated activity”, because treatment there is usually delegated by a professional working for another registered provider.

Does a care home that also provides home care need to register for personal care?

Yes: a care home provider that also provides care to people in their own homes “must also register for the regulated activity of Personal care”, because CQC's guidance says each regulated activity requires a separate registration and the home care is separate from the care home service.

How do I add a regulated activity to my CQC registration?

A registered provider adds a regulated activity by applying to CQC to be registered for it, using CQC's form to start providing an activity (“one copy for each activity being added”), and must not start the new activity until the application is granted, because carrying on a regulated activity without registration for it is an offence under section 10 of the Health and Social Care Act 2008. Changing a location or another condition is an application to vary conditions under section 19.

What is not a regulated activity?

Schedule 2 to the 2014 Regulations lists general exceptions, including care given “in the course of a family or personal relationship” for “no commercial consideration”, first aid, and services in establishments Ofsted registers. Schedule 1 also excludes some arrangements from personal care, such as a carer employed directly by the person, and CQC's guidance says housing or social support with no personal care tasks does not need registration.

Official guidance and your next step

The law is in Schedule 1 and Schedule 2 to the 2014 Regulations and section 10 of the Health and Social Care Act 2008. CQC's reading of it is its Scope of registration guidance, with the full PDF (version 1.1, August 2026, although its cover still reads May 2022), and its page on making changes to your registration. Quotations are from those pages as published on 8 October 2026.

This guide is a summary for providers in England, where regulated activities are regulated only if carried on in England; it is not legal advice about a particular service. As CQC puts it, “There are separate arrangements for regulating health and social care in other UK countries”: Care Inspectorate Wales and Healthcare Inspectorate Wales, the Care Inspectorate and Healthcare Improvement Scotland, and the RQIA in Northern Ireland.

Then do one thing: list every service your organisation runs and, against each, the regulated activities it involves. Compare the list with your certificate of registration. Any activity on your list that is not on the certificate needs an application before anything else.