What regulated care means
Care services registered with the Care Quality Commission (CQC) must meet legal standards and are subject to inspection. CQC publishes its findings publicly. Regulated services include care homes, nursing homes, and domiciliary care agencies. Registration is not optional for these service types — it is a legal requirement.
What the CQC actually checks
CQC inspects against five key questions: Is the service safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led? Each question is rated Outstanding, Good, Requires Improvement, or Inadequate. The overall rating reflects all five. CQC publishes inspection reports in full.
What is not regulated
Direct hire of an independent carer — where a family employs someone privately — is not regulated by CQC. The carer is not registered, not inspected, and CQC has no visibility of the arrangement. This does not mean direct hire is wrong, but it means the protection mechanisms are different. Families using this route take on employment responsibilities and should carry out their own checks.
Introductory agencies — a middle ground
Some agencies introduce carers to families but do not employ them directly. The carer then works as a self-employed individual. The agency itself may be CQC-registered but the carer is not employed by them and is not subject to the same oversight as a carer employed by a managed agency. This distinction matters when something goes wrong.
What regulated status does not guarantee
A Good or Outstanding rating reflects the service at the time of inspection. Inspections do not happen continuously. Ratings can become outdated. A regulated service can deteriorate after a Good rating is awarded. CQC registration is a floor, not a ceiling.
How to use this when choosing care
Check the current CQC rating before visiting any service. Read the full inspection report, not just the headline rating. Look at the date of the last inspection. Pay particular attention to the Safe and Well-led sub-ratings — these are often more predictive of day-to-day experience than the overall rating.