How are care homes regulated in the UK? A family guide
By CareFinder Research Team · Published 2025-10-27 · Last reviewed 2026-09-18
Every care home in the UK must register with an independent regulator: the Care Quality Commission (CQC) in England, the Care Inspectorate in Scotland, Care Inspectorate Wales and the RQIA in Northern Ireland. In England, homes must meet legal fundamental standards covering safety, dignity, consent, staffing, complaints and visiting. The CQC inspects, publishes ratings and reports, and can take enforcement action, including prosecution, when care falls short.
Every care home in the UK has to be registered with an independent regulator, and it can be inspected, rated and, if necessary, shut down. In England that regulator is the Care Quality Commission (CQC), and homes must meet a set of legal "fundamental standards" below which care must never fall. Knowing what those standards say, and who to go to when they are not met, puts you in a much stronger position when choosing a home or raising a worry.
Regulation changes from time to time. For current news, check the CQC website (England) or the regulator for your nation, rather than relying on any article with a date in its title.
Who regulates care homes in each UK nation?
Social care is devolved, so each nation has its own regulator, standards and rating system.
| Nation | Regulator | Standards | How homes are rated |
|---|---|---|---|
| England | Care Quality Commission (CQC) | Fundamental standards in the 2014 Regulated Activities Regulations | Outstanding, good, requires improvement or inadequate |
| Scotland | Care Inspectorate | Health and Social Care Standards | Grades on a six-point scale, from unsatisfactory to excellent |
| Wales | Care Inspectorate Wales (CIW) | Welsh regulations and statutory guidance | Published ratings for each theme since April 2025 |
| Northern Ireland | Regulation and Quality Improvement Authority (RQIA) | Minimum standards set by the Department of Health | Inspection reports, with each home inspected at least twice a year |
In Scotland, the Care Inspectorate registers and inspects every care service and publishes a report for each one. In Wales, CIW ratings for care homes started in April 2025, and most homes must display them. In Northern Ireland, the RQIA inspects each registered home at least twice a year against minimum standards.
The rest of this guide focuses on England, with notes where the other nations differ.
What are the CQC fundamental standards?
The fundamental standards are set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The CQC describes them as the standards below which your care must never fall. In plain terms, a resident is entitled to:
- Person-centred care that is tailored to their needs and preferences.
- Dignity and respect, including privacy and support to stay independent.
- Consent: care or treatment only with their consent, or that of someone legally acting for them.
- Safety: no unsafe care, and no avoidable risk of harm.
- Safeguarding from abuse, neglect, degrading treatment and unnecessary or disproportionate restraint.
- Food and drink enough to stay in good health.
- Clean, suitable premises and equipment.
- A working complaints system that investigates and acts on problems.
- Good governance, enough suitably qualified staff, and "fit and proper" staff who have been properly checked.
- Duty of candour: honesty when something goes wrong, including an explanation and an apology.
- Visible ratings: the home must display its CQC rating on site and on its website.
What are residents' rights to visitors?
Since 6 April 2024, visiting has been a fundamental standard in its own right in England. Regulation 9A says that, unless there are exceptional circumstances:
- people living in a care home must be helped to receive visits there;
- residents must not be discouraged from going out on visits away from the home;
- visits should be arranged in a way that suits the resident's needs and, as far as practical, their preferences.
No one has to accept a visit they do not want. If a resident lacks the mental capacity to decide, a visit is not required where it would not be in their best interests. Homes can take proportionate precautions, for example during an outbreak, but a blanket ban without good reason is unlikely to meet the standard.
How does the CQC inspect and rate care homes?
The CQC assesses every service against five key questions: is it safe, effective, caring, responsive and well-led? Each question gets a rating, and there is an overall rating: outstanding, good, requires improvement or inadequate.
The method behind those ratings is changing. In March 2026 the CQC said it was moving away from its single assessment framework towards separate frameworks for each sector, including adult social care. The five key questions and four rating levels stay. Check the CQC website for how far the new approach has been rolled out.
When you read a report, look at:
- the date of the last inspection, since an old rating may not reflect the home today;
- each key question, not just the overall rating (a home rated good overall can still require improvement on safety);
- what inspectors found, including any breaches of regulations and what the home was told to do.
What can the CQC do when a home falls short?
The CQC has a range of enforcement powers. It can:
- serve a warning notice when a provider fails to meet a legal requirement;
- impose conditions on a registration, such as stopping new admissions;
- suspend or cancel a registration, including urgent cancellation in serious cases;
- prosecute for certain offences.
Some breaches can be prosecuted directly. For others, including safe care and treatment (Regulation 12) and parts of safeguarding (Regulation 13), the CQC can prosecute only where the breach exposed people to avoidable harm or a significant risk of it, or to a loss of money or property. Enforcement action is published, so it is worth checking before you choose a home.
How do you raise a concern or complaint in England?
The route depends on what is wrong and who pays.
- Speak to the home first. Every provider must have a complaints process and must investigate and respond.
- If the council funds or arranged the care, you can also complain to the council.
- If you are still unhappy, the Local Government and Social Care Ombudsman can investigate complaints about all adult social care, whether the council or the resident pays.
- Tell the CQC. It cannot investigate or resolve individual complaints, but it uses what people report to decide when and where to inspect.
If you think someone is being abused or neglected, contact the council's adult safeguarding team straight away, or the police if a person is in immediate danger. In Scotland, Wales and Northern Ireland, the regulators and ombudsmen are different, so follow the complaints procedure for that nation.
How can you use regulation when choosing a home?
A short checklist:
- Read the latest inspection report, not just the headline rating.
- Ask the manager what the home changed after its last inspection.
- Ask to see the visiting policy and the complaints procedure.
- Check that the rating on display matches the one on the regulator's website.
- Ask how staff are trained and supervised, and how the home keeps enough staff on duty.
This is general information about how regulation works. If you are in a dispute with a home or a council, Age UK, Citizens Advice or a solicitor who specialises in community care can advise on your situation.
Frequently asked questions
Does the CQC regulate care homes in Scotland, Wales or Northern Ireland?
No. The CQC covers England only. Scotland has the Care Inspectorate, Wales has Care Inspectorate Wales and Northern Ireland has the RQIA, each with its own standards and way of reporting.
Can a care home stop my relative having visitors?
In England, only in exceptional circumstances. Regulation 9A requires homes to help residents receive visits and not to discourage visits out of the home. Precautions must be proportionate, and the resident's own wishes (or best interests, if they lack capacity) come first.
Will the CQC sort out my complaint about a care home?
Not on its own. The CQC does not investigate individual complaints, but it wants to hear about poor care. Complain to the home first, then the council if it arranged the care, and then the Local Government and Social Care Ombudsman.
How often are care homes inspected?
In England it varies with risk and past ratings, and the CQC can inspect at any time if concerns are raised. In Northern Ireland, the RQIA inspects each registered home at least twice a year.
What does "requires improvement" mean for my relative?
It means the CQC found the home was not performing as well as it should in one or more areas. It is not a closure notice. Read which key questions were affected, ask the manager what has changed since, and look out for a re-inspection.
Key takeaways
- Every UK care home must register with its nation's regulator; in England that is the CQC.
- The fundamental standards set a legal minimum for safety, dignity, consent, staffing, complaints and visiting.
- Since April 2024, visiting has been a fundamental standard in England.
- Read the full inspection report and its date, not just the overall rating.
- Complain to the home first; the Ombudsman can investigate if that fails, and the CQC wants to hear about poor care.