Supported Living vs. Care Home: What's the Difference for CQC Registration?

Why the distinction matters

The difference between supported living and a care home is one of the most important and frequently misunderstood distinctions in the social care sector. Getting it wrong — either by operating a de facto care home under the guise of supported living, or by applying for the wrong type of CQC registration — can have serious regulatory and financial consequences.

What is a care home?

A care home is a service where the accommodation and the care are provided by the same organisation, under a single package. The provider owns or controls the building, and residents receive care as a condition of living there. A residential care home must be registered with CQC under the regulated activity "Accommodation for persons who require nursing or personal care." The building must be specifically registered with CQC, and it must meet all the relevant premises requirements.

What is supported living?

In supported living, the accommodation and the care are completely separate. The person being supported has their own tenancy agreement for their home — they are a tenant, not a resident of a care home. The care and support is provided separately by a care provider, which may or may not be the same organisation that manages the housing. The person being supported has the right to remain in their home even if they choose a different care provider.

A supported living service is registered with CQC under the regulated activity "Personal care." Unlike a care home, the individual properties where people live do not need to be registered — only the care-providing organisation needs registration.

The key legal test

The key test is whether the person has a genuine, independent tenancy. If a person could choose to use a different care provider and remain in their home, it is likely to be supported living. If leaving the care provider means leaving the home, it is likely to be a care home arrangement and should be registered as such.

CQC and local authorities have challenged arrangements that describe themselves as supported living but operate in practice as unregistered care homes. The consequences can include enforcement action, requirements to register retrospectively, and significant disruption to the people being supported.