Registering a Nursing Home with CQC: Clinical Requirements and What Makes It Different

What is a nursing home?

A nursing home — formally, a care home with nursing — is a residential care service that also provides nursing care. This means the service is registered for the regulated activity "Treatment of disease, disorder or injury" in addition to "Accommodation for persons who require nursing or personal care" and "Personal care." This additional regulated activity significantly raises the regulatory bar.

Nurse staffing requirements

Nursing homes must have a qualified registered nurse on duty at all times — not just available on call, but physically present. This is a fundamental requirement that differentiates nursing homes from residential care homes. CQC will scrutinise your staffing rota and your contingency arrangements for nurse sickness or absence very closely.

All registered nurses must have a valid NMC PIN, and you should retain evidence that you have verified each nurse's registration with the NMC before they begin work. The NMC Online Register allows free, real-time verification.

Clinical governance

Nursing homes are expected to have formal clinical governance arrangements. This includes clinical supervision for nursing staff, a process for monitoring and acting on clinical incidents, a relationship with the local GP practice and community health services, and systems for ensuring that clinical practice reflects current evidence and NICE guidance.

Medicines management at a nursing level

The medicines management requirements for nursing homes go beyond those for residential care. If the service will administer medicines by any route other than oral — including subcutaneous injections, IV medication, intramuscular injections, or enteral feeds — you must have policies, protocols, and staff competencies specific to each route. Syringe drivers, if used, require specific training and competency assessment for all staff who use them.

End of life care

CQC expects nursing homes to have robust end of life care arrangements. This means advance care planning, DNACPR processes, an approach to palliative symptom management, and access to specialist palliative care when needed. The Gold Standards Framework provides a structured approach that CQC recognises and values.