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Table of contents
When you deliver personal care in someone's home, the CQC fundamental standards are the legal bedrock of everything you do. They set out the minimum standard of care below which no regulated provider must fall - and are the starting point for every CQC inspection.
The fundamental standards come from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There are 13 in total, and they cover everything from how care plans reflect individual needs to how staff are recruited, how complaints are handled, and what happens when something goes wrong. They apply to every CQC-registered provider - and for domiciliary care agencies, they shape the daily detail of how all your care is planned, delivered and evidenced.
This guide explains each of the 13 standards in plain English, identifies which ones most often cause problems in home care, and sets out what good evidence looks like in a domiciliary context.
The 13 CQC fundamental standards
First let’s take a look at each standard, the area it covers, and what the required evidence looks like for a home care agency specifically.
Person-centred care (Regulation 9)
This regulation requires care to be tailored to the individual, based on their assessed needs and personal preferences. A generic care plan doesn't meet this standard.
In a home care agency, strong evidence includes care plans that describe the person beyond their clinical needs - their daily routines, personal preferences, communication style and what matters most to them. Evidence of regular reviews and updates when needs change is equally important. An inspector will look for plans that clearly belong to the individual, not a template.
Dignity and respect (Regulation 10)
People must be treated with dignity at all times. Their cultural, religious and personal beliefs must be respected and reflected in how care is delivered.
Strong evidence includes care plans that record personal preferences and any specific requirements around personal care, privacy or communication. Evidence that carers are briefed on individual preferences before their first visit - and that this briefing is documented - demonstrates that dignity is built into the system, not left to chance. Feedback from clients and families also carries weight under this standard.
Consent (Regulation 11)
Care must only be provided with the person's informed consent. Staff must understand the Mental Capacity Act and know how to apply it when someone's capacity to make a specific decision is in question.
Strong evidence includes signed consent records, mental capacity assessments where relevant, and best-interest decision records where a person lacks capacity. Evidence of staff training on the Mental Capacity Act - with completion dates and records of understanding - is essential, particularly for agencies supporting clients with dementia or acquired brain injuries.
Safe care and treatment (Regulation 12)
Risks must be identified, assessed, documented and actively managed. Medications must be handled correctly. Incidents and near-misses must be recorded, investigated and acted on.
Strong evidence includes current, signed risk assessments for every client - reviewed when needs change, not just at the annual review. Medication administration records completed at the time of each visit, without gaps. An incident and near-miss log with clear records of the investigation, outcome and learning from each event. This regulation is the source of the most common compliance failures in domiciliary care.
Safeguarding from abuse (Regulation 13)
The agency must have robust safeguarding policies in place. Every member of staff must be able to recognise signs of abuse or neglect and know how to raise a concern promptly.
Strong evidence includes a current safeguarding policy, evidence of staff training in safeguarding with completion dates recorded, and a log of concerns raised - including how each was escalated, to whom, and how it was resolved. Inspectors will speak to care workers directly about how they would handle a safeguarding concern. If staff can't answer that question clearly, this regulation will be flagged.
Food and drink (Regulation 14)
Where care includes support with nutrition or hydration, people's individual dietary needs, preferences and any clinical requirements must be met.
Strong evidence includes care plans that record dietary needs, allergies and preferences with enough detail to be actionable. Evidence of referrals to a dietitian, speech and language therapist or other specialist where clinically indicated. Fluid monitoring charts or nutrition records where these form part of the care package.
Premises and equipment (Regulation 15)
Equipment used during visits must be safe and properly maintained. This includes any aids or devices used in the client's home that the agency is responsible for.
Strong evidence includes equipment maintenance logs with service dates. Evidence of staff training on the safe use of specific equipment - hoists, slings, moving-and-handling aids - with training records linked to the equipment used by that individual carer. A clear process for reporting and removing from use any equipment that is defective or overdue for service.
Complaints (Regulation 16)
A clear, accessible complaints process must exist. Complaints must be acknowledged, investigated and responded to. The agency must demonstrate that it has learned from complaints and made changes where needed.
Strong evidence includes a written complaints policy, shared with clients and families at the start of the care package. A log of all complaints received, with acknowledgement dates, investigation records, outcomes communicated to the complainant, and any changes made to practice. An inspector will look for themes - if the same type of complaint appears repeatedly without evidence of systemic change, that is a governance concern as much as a complaints concern.
Good governance (Regulation 17)
The agency must have effective governance systems: quality monitoring, audits, risk management, and oversight of how the service performs as a whole.
Strong evidence includes regular audit records covering care planning, medication management, visit completion, and staff compliance - with documented outcomes and tracked actions. A quality improvement plan with evidence that actions have been completed and their impact reviewed. Board-level or ownership-level records of oversight where the agency is part of a larger organisation. This regulation is consistently one of the highest-risk areas in domiciliary care inspections.
Staffing (Regulation 18)
Enough suitably qualified and trained staff must be in post at all times to meet the needs of clients safely.
Strong evidence includes rota records and shift coverage data reviewed regularly. Staff-to-client ratios examined and evidenced. Clear records of how staffing gaps are identified and managed - not just that they occur, but what the agency does when they do. Evidence that staffing decisions are driven by client need, not operational convenience.
Fit and proper staff (Regulation 19)
All staff must be appropriately recruited before starting work. DBS checks, employment references and relevant qualifications must be confirmed and recorded.
Strong evidence includes a complete recruitment file for every member of staff: application, references, DBS certificate, identity checks and right-to-work documentation. A live register of DBS status showing check dates, levels and renewal schedules. Evidence that overseas qualifications have been verified through a recognised process where applicable. Gaps in recruitment files are among the most frequently cited findings in domiciliary care inspections.
Duty of candour (Regulation 20)
When something goes wrong and causes harm, the agency must be open and honest with the person and their family. This includes offering an apology, providing an explanation, and keeping a record of both.
Strong evidence includes a duty of candour policy that staff have been trained on, with training records. A log of instances where the duty was triggered - including dates, who was notified, what was communicated, and what changed as a result. Evidence that the person or family received a written account of what happened. Many agencies have this policy in a folder but cannot show that it is operational. That gap will be visible to an inspector.
Display of ratings (Regulation 20A)
The CQC rating must be displayed clearly at the agency office, on the website, and in written materials sent to people using the service.
Strong evidence is straightforward: an up-to-date rating certificate displayed at the office entrance, the current rating on the website homepage or a clearly linked page, and the rating included in any introductory pack sent to new clients. Displaying an expired or incorrect rating is itself a breach of this regulation - not just an oversight.
Which standards are most commonly failed in domiciliary care
Across the domiciliary care agency inspections published on the CQC website, some of the fundamental standards appear more frequently in the Requires Improvement rated businesses.
Good governance (Reg 17) tops the list. An agency might be delivering perfectly safe, compassionate care - but if the registered manager can't demonstrate real oversight of quality and risk, inspectors can't be confident the service is consistently well-run. The absence of regular audits, an untested risk register, or a quality monitoring process that exists on paper but not in practice will each be picked up.
Staffing and fit and proper staff (Regs 18 and 19) are consistently flagged, particularly in agencies that have grown quickly or experienced high staff turnover. Gaps in DBS records, missing references, incomplete induction records, or staff delivering care tasks they have not been trained for all fall under these regulations.
Safe care and treatment (Reg 12) failures in home care most often involve medication management. Incomplete MARs, carers administering medications without documented competency checks, and missed medication reviews with no recorded rationale are among the most common inspection findings in the domiciliary sector. For more on how to evidence medication management well, see our guide to what digital evidence CQC expects.
Duty of candour (Reg 20) is under-reported and under-evidenced in many agencies. Staff may not know the policy exists, or the agency may not have a clear process for when the duty is triggered and how it is recorded.
What good evidence looks like
For the standards that carry the highest risk, here's what inspectors actually want to see in a domiciliary care agency.
Safe care and treatment:
A full, unbroken set of medication administration records, completed at the time of the visit. Risk assessments updated when the person's condition changes, not just at annual review. A log of incidents and near-misses with documented investigation, outcome and learning.
Good governance:
Evidence that audits happen regularly - not just on paper but with results, identified issues and tracked actions. A quality monitoring system that lets the manager see patterns across the whole service, not just individual cases. Board-level or ownership-level evidence of oversight where the agency is part of a larger organisation.
Staffing:
A training matrix showing every member of staff against the mandatory and role-specific training they need, with current status and next-due dates. Supervision records that show regular one-to-one meetings, with notes and any agreed actions. Appraisal records with evidence of goal-setting and review.
Duty of candour:
A documented policy that staff have been trained on. A log of instances where the duty was triggered, including dates, who was notified, what was said, and what changed as a result. Evidence that the person or family received a written account of what happened.
How to self-audit against the fundamental standards
A practical self-audit before an inspection does not need to be complicated. The goal is to identify gaps while there is still time to address them.
Start with the standards most likely to fail: governance, staffing and safe care. For each one, ask: can you pull relevant records quickly? Do they show consistency? If something went wrong, is there evidence that it was identified, investigated and resolved?
Work through each standard and ask the same question an inspector would: what would you show me to demonstrate this is met? If the answer is "we have a policy" without supporting evidence that the policy is being followed and reviewed, that's a gap.
Check records for completeness and currency. Risk assessments that have not been reviewed in over a year, training records with expired dates, or supervision logs with significant gaps will all draw scrutiny. Spot-check a sample of care records from different carers and clients to understand whether standards are consistent across the service.
For a much broader view of how to prepare your agency for inspection, check out our complete guide to CQC compliance for home care agencies.
Birdie's Q-Score helps agencies monitor their performance against CQC's quality categories in real time, so compliance gaps show up on a dashboard - not in an inspection report. If you want to see how Birdie supports self-audit and evidence management, the resources hub includes CQC toolkits and practical guides built for domiciliary care managers.
Published date:
April 20, 2026
Author:
Lucy Ogilvie
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