Which regulated activity you're registering for
A care home registers for Accommodation for persons who require nursing or personal care.
CQC describes this as applying where residential accommodation is provided together with nursing or personal care as a single package — meaning the person can't choose to receive their personal care from another provider while living there, and to have the accommodation they must receive care from one specified provider.
That's the opposite of supported living, where care and accommodation must be separable. If people in your service could choose a different care provider and stay where they are, you may be running supported living and registering for the wrong activity. [Link: your supported living guide]
A point that saves confusion: you don't need to additionally register for Personal care or Nursing care if you're registered for Accommodation for persons who require nursing or personal care. It covers both.
If you're providing nursing, you likely also need Treatment of disease, disorder or injury. CQC says providers of care homes with nursing are likely to need this where they employ registered nurses or other listed professionals carrying on that activity.
What makes residential different
Registering a care home means registering a building. Alongside everything a home care agency must provide, you'll need a substantial body of premises evidence — and this is where applications slow down or stall.
Documents every provider must send
Statement of purpose
Complaints policy
Consent policy and procedure
Equality, diversity and human rights policy
Governance and quality assurance policies
Infection prevention and control policy
Medicines management and prescribing policy, including transportation of patient medication
Recruitment policy
Safeguarding policy and procedure
Public and employer liability insurance quote or certificate
Building control final certificate, where the location requires building regulations approval
Extra documents for care homes
Business continuity plan
Environment risk assessment
Evidence of legal occupancy
Fire risk assessment
Floor plan, sometimes called a layout
Gas and electrical safety certificates
Legionella risk assessment
Planning permissions
Service user guides
Staff training plan
Seven of those ten are about the building. None of them can be produced quickly if you haven't started early, and several depend on third parties — a fire risk assessor, a Legionella assessment, your local planning authority.
If you support autistic people or people with a learning disability
Positive behaviour support policy
Restraint policy
Plus the additional form for providers of services for autistic people and people with a learning disability. Right support, right care, right culture applies in full, and CQC runs a pre-application discussion service for these services which it recommends using before you make investment decisions. Read my supported living guide here.
Keep ready but don't send
Business plan and forecast
Duty of candour policy
Freedom to speak up / whistleblowing / confidential reporting policy
Initial assessment / admission policy
List of risk assessments
Person centred care planning policy
Reportable incidents policy
Risk management policy
Safety and security of premises policy
Sample care plan
Staffing structure and rotas
Worth noting: for care homes the business plan and forecast sits on the "keep ready" list, whereas home care and supported living services must submit theirs. Don't take that as permission to skip it — if CQC asks and you can't produce it, your application may be delayed.
The premises questions on the application form
CQC's application form asks you to confirm, for each location:
Planning consent — the local planning authority grants permission through a decision note. Not every condition must be discharged before you open, but you need documentary evidence the authority is satisfied the building can begin operating
Building regulations — approval is required to change the use of a property for institutional purposes. A completion certificate comes from Local Authority Building Control or an Approved Inspector
Food safety — if you provide food you must register with your local council's environmental health department
Safety of equipment, plant and utilities — whether you hold maintenance contracts, and if not, how you'll ensure timely servicing
Landlord or mortgage lender's permission — CQC must be confident the service can operate lawfully without disruption
Location readiness — the one that catches people out
CQC's guidance is blunt: "You should not submit applications until you are ready to provide your proposed service, or very nearly so."
It won't register where there are substantial outstanding building works, where essential equipment, staff or resources aren't yet available, or where the systems, procedures and policies aren't in place.
So the sequencing matters enormously. Apply too early and you're refused or delayed. Apply too late and you're paying for an empty building while you wait.
When to submit
This is the question I’m asked most about residential registration, and getting it wrong is expensive in both directions.
CQC won’t register where there are substantial outstanding building works, or where essential equipment, staff or systems aren’t yet in place. So you can’t apply at the start of a building project and expect the assessment to run alongside it. But the assessment itself takes months, and every one of those months with a finished, empty building is money going out with none coming in.
The way I’d think about it is to work backwards from the evidence CQC needs rather than from your opening date. The application can go in once you have:
the building control completion certificate, or clear evidence from the authority that the building can begin operating
your fire risk assessment, Legionella risk assessment, and gas and electrical safety certificates
a floor plan that matches what you’ve actually built and the bed numbers you’re registering for
your registered manager appointed, and ready to be interviewed
your policies, systems and staffing model in place, not just planned
What that means in practice is that the application follows completion of the works, but the preparation for it runs in parallel with them. The assessments you need can mostly be commissioned while the building is still being finished. The registered manager should be recruited well before you apply, because CQC will interview them and they need to know the service. The policies should be written around the actual building, not a generic one.
The mistake I see most often is treating registration as the last item on the project plan. By the time someone realises the assessment will take months, the building is finished, the staff are hired and the costs have started. The providers who do this well start preparing for registration at the same time as they start the building work.
Bed numbers become a condition of registration
The maximum number of people you can accommodate is set as a condition on your registration certificate, and it drives your annual fee. Get it wrong and you'll need to vary your registration later.
What it costs
CQC's annual fee
Care homes are charged by the maximum number of service users, not by a formula:
Maximum service users Annual fee
Less than 4 £3134–10£816
11–15 £1,643
16–20 £2,388
21–25 £3,268
26–30 £4,270
31–35 £5,023
36–40 £5,779
41–45 £6,533
46–50 £7,289
51–55 £8,037
56–60 £8,792
61–65 £10,048
66–70 £11,050
71–75 £12,058
76–80 £13,062
81–90 £14,069
More than 90 £15,710
There's no application fee. CQC sends an invoice with your exact fee before it's due.
The published table is labelled 2024/25 and CQC's fees page states the 2019/20 scheme "remains valid until further notice".
Note the jumps. Registering for 21 beds rather than 20 costs an extra £880 a year, every year. Worth thinking about when you set your maximum.
The costs people forget
The CQC fee is the predictable part. Residential registration’s real cost sits in the building and in the months before your first admission.
The premises assessments - Fire risk assessment, Legionella risk assessment, gas and electrical safety certificates, an environment risk assessment and a floor plan are all required with your application. Each is a separate commission with a separate lead time, and the cost rises with the size and complexity of the building. Budget for them, and book them early — the delay costs more than the fee.
Works arising from those assessments - This is the one that breaks budgets. A fire risk assessment doesn’t just produce a document; it produces a list of works. Doors, compartmentation, alarms and emergency lighting can all turn up at a late stage with a price attached, and the assessment can’t be signed off until they’re done.
Planning and building regulations - Changing a building’s use for institutional purposes needs building regulations approval, and most conversions need planning consent. Both carry fees, professional costs, and — more significantly — time.
Adaptations - Whatever the building was before, it now has to work as a care home: bathrooms, hoisting, call systems, flooring, kitchen and laundry facilities to commercial standards.
Staff before income - Your registered manager must be appointed and ready for interview before CQC assesses the application, which means paying a senior salary for months with no residents. Care staff need to be recruited, DBS-checked and trained before your first admission, not after. DBS checks are £20 for a basic or standard check and £41 for an enhanced check with barred lists, plus an umbrella body’s administration fee, for every member of staff.
Insurance, food safety and equipment contracts - Public and employer liability from the point of application. Registration with environmental health if you provide food. Maintenance contracts for equipment, plant and utilities, or a credible plan for servicing them.
The empty building - The largest cost of all, and the one nobody budgets for. From the day your works finish to the day CQC registers you, you are paying a mortgage or rent, utilities, insurance and a registered manager’s salary on a building with no residents in it. If that period runs to several months — and CQC says most applications take a few months, sometimes more — it will dwarf everything else on this list.
That’s the real reason to get the application right first time - It isn’t the hassle of resubmitting. It’s another two or three months of carrying an empty home.
Read more about financial forecasting for CQC registration
How long it takes
CQC doesn't publish a timescale. Its guidance says it takes "a few months to process most applications, sometimes more", and that applications are assessed in the order received.
For residential there's an additional factor: CQC may visit the premises as part of its assessment.
CQC doesn’t publish a timescale. Its guidance says it takes “a few months to process most applications, sometimes more”, and that applications are assessed in the order received.
Residential adds a variable the other service types don’t have: CQC may visit the premises as part of its assessment, which has to be scheduled, and the building has to be ready when they come.
In my experience the range is wide enough that I’d plan for the longer end rather than the shorter, and make sure your financial forecast can absorb it. The single biggest factor is whether the application was complete when it arrived.
CQC introduced a two-stage process — initial checks, then assessment — in July 2025, and its published guidance on that process refers specifically to homecare applications. Nothing has been published extending it to residential. That said, the underlying principle is clear across all service types: an incomplete application is returned, and a returned application starts again.
Why care home applications fail
The patterns from my [domiciliary care guide] apply here too — documents that contradict each other, template policies, an unprepared registered manager. But residential applications also fail for reasons specific to registering a building.
1. Applying before the building is ready
CQC is explicit that it won’t register where there are substantial outstanding building works, or where essential equipment, staff or resources aren’t available, or where systems, procedures and policies aren’t in place. Its guidance says not to apply until you’re ready to provide the service, or very nearly so.
Applications still go in too early, usually because someone is trying to run registration in parallel with the build to save time. It doesn’t save time. It costs an application.
What to do instead: work backwards from the evidence rather than forwards from your opening date. If you can’t yet produce a building control completion certificate, a current fire risk assessment and a floor plan matching what you’ve built, you’re not ready to apply.
2. Premises evidence that doesn’t hold together
Certificates that have expired, assessments carried out before the layout changed, or a floor plan showing a different configuration from the one described in the application. CQC reads these documents against each other, just as it does the written ones.
What to do instead: before you submit, check every premises document describes the building as it now is. If anything changed during the works — a room repurposed, a bathroom moved, a bed added — make sure the assessments and the plan were done after that change, not before.
3. The wrong regulated activities
Accommodation for persons who require nursing or personal care covers personal care and nursing care, so you don’t need those separately. But a home with nursing is likely to also need Treatment of disease, disorder or injury where it employs registered nurses carrying on that activity — and this is missed often enough to be worth checking twice.
What to do instead: list what will actually happen in the building and who will do it, then match that to the regulated activities. If registered nurses will be employed in their professional capacity and carrying out treatment, assume you need the additional activity unless you’ve established otherwise.
4. Bed numbers that don’t add up
Your maximum number of service users becomes a condition of registration and sets your fee. Applications come unstuck when that number doesn’t match the floor plan, or when the staffing model clearly can’t support it.
What to do instead: make the number consistent everywhere — application form, floor plan, statement of purpose, staffing model and financial forecast. And set it deliberately rather than optimistically, remembering the fee bands jump sharply and that varying it later takes time.
5. For LD and autism services: a scheme that reads as congregate
Right support, right care, right culture applies to residential services too, and CQC states it won’t register services developed as new campus or congregate settings, and is unlikely to register services not provided in a way similar to ordinary residential accommodation.
What to do instead: describe the service as someone living there would experience it. What’s theirs? What do they choose? If the answer is “a bedroom in a building run to a routine”, the model needs rethinking before the application does. CQC’s pre-application discussion exists precisely for this, and it’s free.
The pattern? Home care applications fail on paperwork. Supported living applications fail on the model. Care home applications most often fail on readiness — applying before the building, the staff or the systems can actually evidence what the application claims.
Frequently asked questions
Do I need to register for Personal care as well? No. Accommodation for persons who require nursing or personal care covers both. You don't need to additionally register for Personal care or Nursing care.
Do I need Treatment of disease, disorder or injury? If you're a care home with nursing, probably yes. CQC says providers employing registered nurses or other listed professionals who carry on that activity are likely to need it. There are exceptions where nursing staff aren't employed in their professional capacity and don't carry out that treatment.
When should I apply — before or after the building work is finished? CQC says not to apply until you're ready to provide the service, or very nearly so, and won't register where there are substantial outstanding building works or where staff, equipment or systems aren't in place.
Does CQC limit the size of residential services for autistic people or people with a learning disability? CQC states it has never applied a six-bed limit. It refers to NICE guidance describing small services as usually no more than six people, but says this isn't an absolute upper limit. Larger services must demonstrate more clearly how they deliver person-centred care, and CQC won't register new campus or congregate settings.
Can I change my bed numbers later? Yes, by applying to vary your registration — but it takes time and affects your fee, so it's better to get the number right at the outset.
Do I need a consultant? Not always — and as with any service type, if you’ve registered a home before, you have the time to do it properly and your building work is well managed, you can do this yourself.
What’s different about residential is the cost of getting it wrong. With a home care application, a mistake costs you time and a place in the queue. With a care home, a mistake costs you months of mortgage or rent, utilities, insurance and a registered manager’s salary on a building with nobody living in it. The application fee is nothing next to the carrying cost of an empty home.
The two risks worth paying to avoid are timing and premises evidence. Applying before the building is ready gets you refused. Applying with assessments that don’t match the finished layout gets you delayed. Both are entirely avoidable, and both are easier to spot from outside the project than from inside it, when you’ve been living with the building for months.
Support tends to pay for itself when: it’s your first care home; you’re converting an existing building rather than taking over a going concern; you’re registering for nursing and need to be sure you have the right combination of regulated activities; your scheme is for autistic people or people with a learning disability, where the model is assessed as well as the paperwork; or your finance depends on opening by a particular date.
If you’d rather do the work yourself, a review before you submit is the sensible middle ground — and on a residential application, where a month’s delay can cost more than the review, it’s the easiest decision on this list.
Registering a care home is mostly a matter of sequencing: having the building, the evidence, the staff and the systems ready at the same moment, and applying only once they are. Get that right and the process is straightforward. Get it wrong and you’re carrying an empty home for months longer than you planned.
If you’d like your application reviewed before it goes in, or support through the whole process, my CQC Registration Support page explains how I work and what it costs. If you’re earlier than that — still planning the build, or not sure when to apply — book a free readiness call and we’ll work out the timing together.