How Home Care Is Regulated, and What CQC Does Not Cover

The short answer

In England the CQC registers the service, not the carerA home care agency has to be registered before it takes on a single visit. Providing personal care without that registration is a criminal offence.
Two arrangements sit outside that system by designAn introductory service that finds you a carer, and a carer you engage directly, are written out of the regulations rather than overlooked by them.
A rating describes the organisation, not the person at the doorThe CQC rates how an agency is run: its recruitment, its training, its response when something goes wrong. It says nothing about the carer who arrives on Tuesday.
Where nobody inspects, the checking is yours to doYou cannot request a criminal record check for a carer you hire yourself. They request it, and you check the certificate.

England is covered in most detail, because that is where the Care Quality Commission has its remit. Every rule below was checked against the regulator or the legislation in September 2026.

Who regulates it

Who regulates care at home in each of the four nations

Care at home is regulated country by country rather than across the UK, so the body that registers a service in Cardiff is not the one that registers it in Carlisle. The regulator you want is the one where your relative lives.

	Who registers the service	Who registers the care workers	Where to look a service up
England	Care Quality Commission	No register for care workers. Nurses are registered separately with the Nursing and Midwifery Council.	cqc.org.uk
Scotland	Care Inspectorate	Care at home workers in a registered service must be on the Scottish Social Services Council register.	careinspectorate.scot
Wales	Care Inspectorate Wales	Domiciliary care workers have to register with Social Care Wales. It is a legal requirement.	careinspectorate.wales
Northern Ireland	Regulation and Quality Improvement Authority	Domiciliary care workers must register with the Northern Ireland Social Care Council.	rqia.org.uk

England

Who registers the service: Care Quality Commission
Who registers the care workers: No register for care workers. Nurses are registered separately with the Nursing and Midwifery Council.
Where to look a service up: cqc.org.uk

Scotland

Who registers the service: Care Inspectorate
Who registers the care workers: Care at home workers in a registered service must be on the Scottish Social Services Council register.
Where to look a service up: careinspectorate.scot

Wales

Who registers the service: Care Inspectorate Wales
Who registers the care workers: Domiciliary care workers have to register with Social Care Wales. It is a legal requirement.
Where to look a service up: careinspectorate.wales

Northern Ireland

Who registers the service: Regulation and Quality Improvement Authority
Who registers the care workers: Domiciliary care workers must register with the Northern Ireland Social Care Council.
Where to look a service up: rqia.org.uk

Sources: the Care Quality Commission, the Scottish Social Services Council, gov.uk for Wales, and the UK regulated professions register for Northern Ireland. Checked September 2026.

In all four nations it is the organisation providing the care that has to register. In England there is no second register for the care worker who comes to the house. In the other three nations that layer does exist, so the person doing the visits has to be registered in their own right as well as working for a registered service.

Providing personal care in England without being registered is a criminal offence. If somebody is visiting on behalf of an organisation you cannot find on the register, ask about that first. Home care covers what these services do, and the council's care needs assessment is the route in if you want the council involved.

Three arrangements

The three ways care at home is arranged, and who checks each one

Much of the confusion about whether home care is regulated comes from treating it as one thing. It is three different things, and the regulations treat each of them differently.

The same care at home, arranged three ways

A home care agency
Registered and inspected
How it works
The agency employs the care workers and sends whoever is on its rota that day. You are the agency’s customer rather than the carer’s.
The regulator
The agency has to be registered with the Care Quality Commission before it starts work, and the CQC inspects it and gives it a rating you can read.
Who does the checking
The agency recruits the staff, runs their criminal record checks, trains them and is answerable for how a visit goes.
In law: Personal care given where somebody lives is a regulated activity under paragraph 1(1) of schedule 1 to the 2014 regulations.
An introductory service, which is what PrimeCarers is
Outside CQC registration
How it works
The service introduces you to self-employed carers. You choose one, and you agree the visits and the rate with that carer directly.
The regulator
No CQC registration, because the service has no continuing part in directing or controlling the care once the introduction is made.
Who does the checking
The service checks the carers on it before you see them. Ask any service what those checks cover, and what they leave to you.
In law: Paragraph 1(3)(b) excludes the introduction of carers to an individual by a person "having no ongoing role in the direction or control of the service".
A carer you find and hire yourself
Outside CQC registration
How it works
You find the carer, agree what the work is, and pay them. They are self-employed and responsible for how they do the job.
The regulator
No CQC registration for the carer, so long as they work as an individual under your direction rather than through their own limited company.
Who does the checking
Every check is yours to make, and you cannot ask for a criminal record check on their behalf. They have to request it themselves.
In law: Paragraph 1(3)(c) excludes the services of a carer "employed by an individual or related third party, without the involvement of an undertaking acting as an employment agency or employment business", working wholly under that person’s direction and control.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, schedule 1, on legislation.gov.uk. Checked September 2026.

The second and third arrangements are not gaps that nobody has closed. Schedule 1 of the regulations that define what the CQC must regulate lists the exclusions one after another, and two describe these situations. The reasoning is the same in both: the CQC regulates an organisation that directs and controls care, and where a family deals with the carer directly there is no such organisation to register.

Scotland reaches the same place in nearly the same words. The Public Services Reform (Scotland) Act 2010 defines the support services the Care Inspectorate registers, then excludes any provider who is an individual personally and solely giving the care in question.

One thing changes the answer. If a carer stops working for the family directly and trades through a limited company instead, the company becomes responsible for the care, and the CQC says it may then need to register. Whether a self-employed carer needs CQC registration goes through that in detail.

Reading a CQC rating

What a CQC rating tells you, and what it does not

Every agency the CQC rates is given one of four words. Newer reports carry a percentage score alongside it, so you can see whether a service sits at the top of a band or has only just reached it.

	What the CQC means by it	Score in newer reports
Outstanding	The service is performing exceptionally well.	88 to 100%
Good	The service is performing well and meeting the CQC’s expectations.	63 to 87%
Requires improvement	The service is not performing as well as it should, and the CQC has told it how it must improve.	39 to 62%
Inadequate	The service is performing badly and the CQC has taken action against the organisation running it.	38% or lower

Outstanding

What the CQC means by it: The service is performing exceptionally well.
Score in newer reports: 88 to 100%

Good

What the CQC means by it: The service is performing well and meeting the CQC’s expectations.
Score in newer reports: 63 to 87%

Requires improvement

What the CQC means by it: The service is not performing as well as it should, and the CQC has told it how it must improve.
Score in newer reports: 39 to 62%

Inadequate

What the CQC means by it: The service is performing badly and the CQC has taken action against the organisation running it.
Score in newer reports: 38% or lower

The Care Quality Commission, our ratings and scores, page last updated 8 January 2026. Checked September 2026.

Behind the overall word sit five key questions the CQC asks of every service: whether it is safe, effective, caring, responsive and well-led. Each gets its own rating, and the overall one is built from them. A service rated good overall can still be requires improvement on one of the five, so read those as well.

The regulations also say where a rating has to appear. An agency must show it on its own website, say where on the CQC's site the assessment can be read, and display a sign at the premises it works from. If it is not there, look the agency up on the register yourself.

There is a limit to what this can tell you. The rating describes how the organisation is run: its recruitment, its training, its response when things go wrong. It says nothing about whether the person who arrives on Tuesday is somebody your mother will get on with, because the agency decides who that is. Private carers and agency carers compared sets out what each route gives you.

The standards

What a registered agency has to do, and who it answers to

Registration is more than a licence to trade. It commits the agency to standards written into the regulations, and four matter most to a family receiving care at home.

Care built around the person

Care must be tailored to the person and meet their needs and preferences, and the person, or somebody legally acting for them, must consent to it.

Person-centred care and consent

Safe care, and protection from abuse

Nobody may be given unsafe care or put at avoidable risk. Neglect, ill-treatment and degrading care are prohibited, and restraint is allowed only where it is proportionate to a risk of harm.

Safety and safeguarding

Staff who have been checked and supported

The provider may only employ people who can do the job, must recruit properly, and must carry out the relevant checks, including criminal record and work history checks.

Fit and proper staff, and staffing

A complaints system, and an apology when one is owed

There has to be a system for handling complaints that investigates thoroughly. Where something goes wrong, the provider must be open about what happened and apologise.

Complaints and duty of candour

These are the fundamental standards, which the CQC describes as the level below which care must never fall. They are a floor rather than a promise. An agency that meets them all can still be one your relative does not want in the house, and a rating of requires improvement does not mean the carers are unkind.

Two of the four are worth holding on to even where no agency is involved: care shaped around the person, and a clear account when a visit goes wrong. What carers are not allowed to do covers the boundaries any carer works within, and whether a private carer can give medication answers the question families ask most often.

Checking a carer yourself

How to check a carer you are hiring directly

Hiring a carer yourself takes the inspector out of the arrangement and puts you in that place. The first thing to know is which checks you can make, and which one you cannot.

What to see before a carer starts

0 of 8 ticked

Who they are

Photo identification, checked against the person in front of youA passport or driving licence, with an address matching something else they can show you.
Their right to work in the UKA legal check rather than a safeguarding one, and one a carer can evidence for you.

The criminal record check

An enhanced DBS check with the adults' barred listEnhanced adds information the local police consider relevant to the role, and the barred list shows whether the person is barred from this work.
You cannot request that check for themWhere you hire a self-employed person to deliver services to you or your family, gov.uk says plainly that you cannot request a DBS check for them. They request it, and you check the certificate.
Ask whether the certificate is on the Update ServiceA DBS check has no official expiry date, and what it shows was accurate on the day it was carried out. The Update Service keeps a certificate current, but a status check is only open to people entitled to request one, so ask the carer to show you theirs.

What no check will tell you

Their training and qualificationsNo register in England records these for a care worker. Ask what training they have done, and ask to see it.
What they are like with your relativeReferences on a profile and a conversation on the telephone do more here than any document.
Who covers a visit they cannot makeA registered agency arranges cover for its own staff. A carer you engage directly does not, so agree beforehand what happens then.

Most of that list is what an introductory service does before you ever see a profile. Every carer on PrimeCarers has had an identity check, a right to work check and an enhanced DBS check on the Update Service, and an online interview with us, before their profile appears. We do not check qualifications, training or references: references sit on the profile, and skills and training are for you to ask about. Carers are insured while they work. When you are ready, you can search for carers near you and compare their rates, reviews and availability, and how carers are checked sets out each check in full. Background checks on a private carer covers hiring off the platform.

What the two routes cost, and what you are agreeing to

Carers on PrimeCarers charge £18 to £25 an hour with our fee included. A CQC-registered agency charges £28 to £35 an hour for a comparable visit, and part of that difference pays for the registration, the rota and the cover. Hourly care costs sets the two side by side, and what care costs where you live puts a figure on a week in your relative's area.

Booking through PrimeCarers puts you in a written contract with the carer, which we provide but whose commercial terms we do not set. Notice is 48 hours for hourly care, and 7 days for live-in care once 168 hours have been worked. A visit the client cancels is payable in full, apart from unplanned hospitalisation, illness, or a reason the carer agrees to. Bank holidays are charged at one and a half times the carer's rate and Christmas Day at twice. Travel and mileage are chargeable only where agreed in advance in writing.

If something goes wrong

Where to take a complaint or a worry about safety

The order matters, because the ombudsman will not look at a complaint the organisation has not had a chance to answer. If somebody is in danger, ring the police first.

1
Put it to the service in writing
First, and required
Every registered provider must have a system for handling complaints and must investigate them thoroughly. Write it down, date it, say what you want put right, and keep a copy. Where the carer is self-employed there is no procedure to follow, so say it plainly and confirm it by message.
2
Ring the council if it is about somebody's safety
Straight away if it is urgent
Where an adult with care and support needs is at risk of abuse or neglect and cannot protect themselves because of those needs, the council must make whatever enquiries it thinks necessary. That duty applies whether or not the council is meeting those needs, so it covers privately paid care. The gov.uk postcode lookup finds the council.
3
The Ombudsman, once the provider has answered
Within 12 months, and free
The Local Government and Social Care Ombudsman looks at adult social care complaints, including care funded privately with no council involved, and it is free to use. It expects you to have been through the organisation's complaints process, or waited up to sixteen weeks for a reply, and it normally cannot look at a problem you have known about for more than twelve months.
4
Tell the CQC what happened as well
Alongside the rest
The CQC says it is not able to take complaints forward on your behalf. What it does with your account is decide when, where and what to inspect, so it is worth sending even so.
5
Outside England, go to the regulator directly
Scotland, Wales and Northern Ireland
The Care Inspectorate takes complaints about a registered care service in Scotland itself, by online form, email or telephone, unlike the CQC. Care Inspectorate Wales and the RQIA are the bodies to approach in Wales and Northern Ireland.

None of that stops you changing the arrangement while it is going on. Notice on an agency contract is whatever its own terms say. With a carer booked through PrimeCarers it is 48 hours for hourly care, and 7 days for live-in once 168 hours have been worked. Notice periods covers ending an arrangement properly, and when your agency cancels on you covers the opposite problem.

Questions

Questions families ask about home care regulation

Partly, and it depends on how the care is arranged. In England an organisation that provides personal care in somebody's home has to be registered with the Care Quality Commission, which inspects and rates it, and providing that care unregistered is a criminal offence. A self-employed carer a family engages directly is excluded by the regulations themselves, as is an introductory service that finds a carer and then steps back. Scotland, Wales and Northern Ireland have their own regulators, and each registers care workers as well as services.

No, not where a family engages them directly with no agency involved. Paragraph 1(3)(c) of schedule 1 to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 excludes a carer employed by an individual or a related third party, without an employment agency or employment business being involved, who works wholly under that person's direction and control. The CQC says the answer changes if the carer sets up a limited company, because the company then becomes responsible for the care. Self-employed carers and the CQC has the detail.

No. PrimeCarers is an introductory service, not a care agency or a care provider, and it holds no CQC registration. The regulations exclude the introduction of carers to an individual by somebody having no ongoing role in the direction or control of the service. Every carer has had an identity check, a right to work check and an enhanced DBS check on the Update Service, and an online interview with us. How carers are checked sets out each one.

Outstanding means the service is performing exceptionally well. Good means it is performing well and meeting the CQC's expectations. Requires improvement means it is not performing as well as it should and the CQC has told it how to improve. Inadequate means it is performing badly and the CQC has taken action against the organisation running it. Newer reports also carry a percentage score, from 88 to 100 per cent for outstanding down to 38 per cent or lower for inadequate.

Search the CQC register by name or postcode and filter to homecare agencies. An agency also has to show its rating on its own website, say where on the CQC site the assessment can be read, and display a sign at the premises it works from, so a missing rating is worth asking about.

The Care Inspectorate registers and inspects care at home services in Scotland, and care at home workers in a registered service have to be on the Scottish Social Services Council register. Care Inspectorate Wales registers domiciliary support services, and domiciliary care workers in Wales are legally required to register with Social Care Wales. In Northern Ireland the Regulation and Quality Improvement Authority registers domiciliary care agencies, and domiciliary care workers must register with the Northern Ireland Social Care Council.

The agency first, in writing, because every registered provider must have a complaints system and must investigate thoroughly. If that does not settle it, the Local Government and Social Care Ombudsman looks at adult social care complaints, including privately funded care, normally within twelve months of you knowing about the problem. Where safety is at stake, ring the council's adult social care team, because it has a duty to make enquiries. Tell the CQC too: it cannot take your complaint forward, but your account helps it decide what to inspect.

How home care is regulated

Who regulates care at home in each of the four nations

The three ways care at home is arranged, and who checks each one

A home care agency

An introductory service, which is what PrimeCarers is

A carer you find and hire yourself

What a CQC rating tells you, and what it does not

What a registered agency has to do, and who it answers to

Care built around the person

Safe care, and protection from abuse

Staff who have been checked and supported

A complaints system, and an apology when one is owed

How to check a carer you are hiring directly

Where to take a complaint or a worry about safety

Put it to the service in writing

Ring the council if it is about somebody's safety

The Ombudsman, once the provider has answered

Tell the CQC what happened as well

Outside England, go to the regulator directly

Questions families ask about home care regulation

Start with our guide to home care

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