1.3 Summarise the different types of service provision that are subject to registration and inspection

This guide will help you answer 1.3 Summarise the different types of service provision that are subject to registration and inspection.

A wide range of adult care services must register with the Care Quality Commission (CQC) and undergo inspection. These requirements are set out in the Health and Social Care Act 2008 and related regulations. If a service provides regulated activities, it cannot legally operate without registration. CQC then inspects these services to check standards and safety.

In this guide, we cover the main types of service provision subject to registration and inspection in England.

Care Homes

Care homes provide accommodation alongside personal care. Some care homes offer nursing care, while others do not.

Types include:

• Residential care homes (support with daily living tasks and personal care)
• Nursing homes (with nursing care by registered nurses)
• Homes for people with learning disabilities
• Homes for people with mental health needs
• Respite and short break accommodation

Care homes must register, meet the Fundamental Standards, and are subject to regular CQC inspections.

Homecare Agencies (Domiciliary Care)

Homecare agencies provide care and support to people in their own homes. This can include help with washing, dressing, medication, and household tasks.

Examples:

• General domiciliary care services
• Specialist homecare, such as dementia support or palliative care
• Supported living services (if personal care is delivered)

Homecare agencies must register with the CQC and are inspected the same way as care homes.

Supported Living Services

Supported living usually helps people with learning disabilities, mental ill health, or physical disabilities live independently. The support can include help with personal care, budgeting, and developing skills.

Registration is required if staff deliver personal care, not just housing support. CQC inspects the way care is planned, delivered, and reviewed.

Extra Care Housing (Assisted Living)

Extra care housing combines independent living with access to care and support onsite. Residents usually have their own flats and access additional services such as help with meals, daily living, or emergencies.

If personal care is provided, the care component must be registered and inspected.

Hospices

Hospices provide specialist end-of-life care, usually for people with complex needs or terminal illness. They may offer care in a hospice building, at home, in the community, or a mix of all.

Hospices caring for adults must register and face regular inspection to check the quality of palliative care.

Shared Lives Schemes

Shared Lives involves approved carers sharing their homes with adults who need support. The arrangement may be long-term, short breaks, or day support. Personal care services provided as part of Shared Lives schemes must be registered and inspected.

Local councils or voluntary agencies often run these schemes.

Specialist Clinics and Community Services

Community-based health and care services often require registration and inspection if they provide regulated activities to adults.

Examples:

• Community mental health teams (if carrying out personal care or treatment)
• Substance misuse treatment services
• Sexual health or contraception clinics
• Rehabilitation services
• Day centres that provide personal care activities

Not all community support needs registration—only those delivering regulated activities, such as personal care, treatment of disease, or nursing care.

Independent Hospitals

Some independent (private or voluntary) hospitals provide services for adults requiring medical or nursing care. Examples include rehabilitation, psychiatric treatment, or specialist surgery.

These hospitals must register and are regularly inspected, focusing on safety and effectiveness.

Services for People with Disabilities

Services that provide care and support to adults with learning disabilities, sensory impairment, or long-term conditions are often subject to registration. This includes supported living, care homes, and some activity-based services if personal care is delivered.

Ambulance Services

Independent ambulance providers delivering patient transport, emergency response, or treatment to adults usually need CQC registration and get inspected for safety and quality.

Substance Misuse Services

Providers offering treatment for drug or alcohol dependence, detox services, or supported withdrawal often perform regulated activities. Services offering personal care or treatment for adults must be registered and regularly inspected.

Excluded Services

Some services do not require registration if they do not provide regulated activities. Examples are ordinary housing provision, befriending, or social clubs with no personal care.

Registered and Inspected Service Types

Final Thoughts

You need to consider the following:

• Know if your service provides a regulated activity
• Make sure your registration is up to date and covers all service locations
• Prepare for regular CQC inspections and maintain compliance
• Keep accurate records of care, staffing, and compliance
• Communicate requirements and inspection outcomes clearly with your staff

By understanding which services are subject to registration and inspection, you protect both the people using services and your organisation’s legal standing.