The future regulation of health and adult social care in England - further consultation (2008)

In March 2008, the Department of Health published a further consultation on the detail of the new Care Quality Commission’s (CQC) registration requirements.

Registration for independent sector and social care providers had been established under the Care Standards Act 2000. In the future, it would be illegal for health and adult social care organisations to provide services without registering with the CQC. The registration requirements would cover essential levels of safety and quality. The new registration requirements were due to be implemented from 2010.

The consultation proposed that the CQC would use its registration functions to assess if an applicant would be able to meet the required levels of safety and quality; assess whether a registered provider was delivering those essential levels of safety and quality; and enforce those essential levels. The CQC would be able to apply sanctions including warning notices and fines and would have powers to de-register providers, place condition on registration, or prosecute.

Monitor’s powers to authorise foundation trusts would be distinct from CQC’s powers to register providers.

The consultation document proposed that registration should cover the following 18 domains:

  • whether care and treatment was safe and effective
  • whether vulnerable people were being safeguarded
  • cleanliness, hygiene and infection control
  • medicines management
  • whether people had access to safe and sufficient nourishment
  • whether people had care and treatment in safe, suitable places which supported independence, privacy and personal dignity
  • the use of safe and suitable equipment
  • informed decision making and involvement
  • whether appropriate consent mechanisms were in place;
  • responses to complaints
  • supporting independence
  • whether people, families and their carers were treated with respect
  • risk management, quality governance and clinical governance arrangements;
  • record keeping
  • whether the workforce was safe and competent
  • whether the provider was resourced appropriately
  • whether the workforce was appropriately supported to provide safe and effective care
  • cross-sector working.


The document suggested a wide range of services that might fall under the registration requirements which included personal care, palliative care and diagnostic services and listed elements of the services that might not require registration such as befriending and mentoring services.