Care Home Policies and Procedures

Running a care home in England requires a robust framework of policies and procedures that meets the standards set by the Care Quality Commission (CQC) and complies with a wide body of legislation, including the Health and Social Care Act 2008, the Care Act 2014, the Mental Capacity Act 2005, and the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

Well-written, up-to-date policies are not only a regulatory requirement, they are the foundation for delivering safe, effective, and person-centred care to every resident in your home.

The Regulatory Framework for Care Homes

Care homes in England must be registered with the CQC under the Health and Social Care Act 2008.

The Act established the CQC as the independent regulator of health and social care services and gave it powers to register, inspect, rate, and take enforcement action against care providers.

The associated regulations, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, set out the Fundamental Standards that all registered providers must meet.

The Care Act 2014 introduced a comprehensive framework for adult social care in England.

It placed safeguarding adults on a statutory footing for the first time, established the wellbeing principle (requiring local authorities to promote the wellbeing of individuals), and introduced new duties around market shaping, information and advice, and care and support planning.

For care home operators, the Care Act 2014 reinforced the requirement to have clear safeguarding policies, transparent complaints procedures, and person-centred care planning processes.

CQC Fundamental Standards: Regulations 9 to 20

The CQC Fundamental Standards, set out in Regulations 9 to 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, define the minimum quality and safety standards that care homes must meet.

Each regulation must be supported by written policies and procedures. The key regulations are:

• Regulation 9: Person-centred care, Care must be appropriate, meet the service user's needs, and reflect their preferences.
• Regulation 10: Dignity and respect, Service users must be treated with dignity and respect at all times, including privacy and autonomy.
• Regulation 11: Need for consent, Care must only be provided with the consent of the service user (or in accordance with the Mental Capacity Act 2005 where consent cannot be given).
• Regulation 12: Safe care and treatment, Care must be provided safely, risks must be assessed and mitigated, and medicines must be managed safely.
• Regulation 13: Safeguarding service users from abuse and improper treatment, Systems and processes must be in place to prevent abuse, neglect, and improper treatment, including restraint.
• Regulation 14: Meeting nutritional and hydration needs, Adequate food and hydration must be provided to meet service users' needs.
• Regulation 15: Premises and equipment, Premises must be suitable, properly maintained, and fit for purpose.
• Regulation 16: Receiving and acting on complaints, An accessible complaints procedure must be in place, and complaints must be investigated and responded to.
• Regulation 17: Good governance, Effective systems must be in place to assess, monitor, and improve the quality and safety of services.
• Regulation 18: Staffing, Sufficient numbers of suitably qualified, competent, skilled, and experienced staff must be deployed.
• Regulation 19: Fit and proper persons employed, Recruitment procedures must ensure staff are of good character and have the necessary qualifications and skills (including DBS checks).
• Regulation 20: Duty of candour, Providers must be open and transparent with service users when things go wrong, including notifying them of safety incidents.

Mandatory Care Home Policies

While the CQC does not publish an exhaustive checklist of required policies, inspectors will expect to see comprehensive documentation covering the following areas as a minimum.

Each policy should be tailored to your specific service, regularly reviewed, and accessible to all staff:

• Safeguarding Adults Policy
• Safeguarding Children Policy (where applicable)
• Medication Management Policy
• Health and Safety Policy
• Fire Safety Policy and Emergency Evacuation Procedures
• Infection Prevention and Control Policy
• Moving and Handling Policy
• Risk Assessment Policy
• RIDDOR Reporting Policy
• COSHH Policy
• First Aid Policy
• Mental Capacity and Deprivation of Liberty Safeguards (DoLS) Policy
• Consent to Care and Treatment Policy
• Person-Centred Care Planning Policy
• End of Life Care Policy
• Nutrition and Hydration Policy
• Complaints and Compliments Policy
• Whistleblowing (Raising Concerns) Policy
• Equality, Diversity and Inclusion Policy
• Data Protection and GDPR Policy
• Confidentiality Policy
• CCTV Policy
• Recruitment and Selection Policy (including DBS checks)
• Staff Induction and Training Policy
• Supervision and Appraisal Policy
• Disciplinary and Grievance Procedures
• Lone Working Policy
• Business Continuity and Emergency Planning Policy
• Duty of Candour Policy
• Use of Restraint Policy
• Falls Prevention Policy
• Pressure Ulcer Prevention and Management Policy
• Missing Persons/Absent Without Leave Policy

Safeguarding Adults in Care Homes

Safeguarding is central to the CQC's inspection framework and is underpinned by both the Care Act 2014 and Regulation 13 of the Fundamental Standards. A safeguarding adults policy must set out how the care home will:

• Prevent abuse, neglect, and improper treatment
• Recognise the signs and indicators of abuse (physical, emotional, sexual, financial, neglect, discriminatory, organisational, self-neglect, and modern slavery)
• Respond to safeguarding concerns, including the process for raising an alert with the local authority safeguarding team
• Support and protect the adult at risk throughout the safeguarding process
• Work in partnership with the local Safeguarding Adults Board (SAB), the police, and other agencies
• Conduct internal investigations and implement lessons learned
• Ensure that all staff receive regular safeguarding training appropriate to their role

The six safeguarding principles established by the Care Act 2014, empowerment, prevention, proportionality, protection, partnership, and accountability, should be embedded throughout the policy and reflected in day-to-day practice.

Medication Management

Safe medication management is a critical area of care home practice and is assessed under Regulation 12 (Safe care and treatment). A medication management policy should cover:

• Ordering, receipt, storage, and disposal of medicines
• Administration of medicines, including the use of Medication Administration Records (MARs)
• Controlled drugs management, including register-keeping and witness requirements
• Covert medication and the legal framework under the Mental Capacity Act 2005
• Self-administration of medicines by residents (where assessed as appropriate)
• PRN (as required) medication protocols, including clear guidance on when and how PRN medication should be given
• Medication errors and near-miss reporting procedures
• Staff competency assessments for medication administration
• Liaison with pharmacists, GPs, and other prescribers

The CQC frequently identifies medication management as an area for improvement in care home inspections. Common findings include gaps in MAR charts, lack of PRN protocols, failure to record refusals, and inadequate storage of controlled drugs.

Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS)

The Mental Capacity Act 2005 (MCA) provides the legal framework for making decisions on behalf of people who lack the mental capacity to make specific decisions for themselves. Care homes must operate within the five statutory principles of the MCA:

• A person must be assumed to have capacity unless it is established that they lack capacity
• A person is not to be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success
• A person is not to be treated as unable to make a decision merely because they make an unwise decision
• Decisions made on behalf of a person who lacks capacity must be made in their best interests
• Any act done or decision made must be the least restrictive option

Deprivation of Liberty Safeguards (DoLS) are an extension of the MCA and apply where a care home needs to restrict a resident's liberty in their best interests.

Under DoLS, the managing authority (the care home) must apply to the supervisory body (the local authority) for authorisation before depriving a resident of their liberty.

The care home must have clear policies and procedures covering capacity assessments, best interests decisions, DoLS applications, and the appointment of Relevant Person's Representatives (RPRs).

The 2026 Supreme Court Ruling on Deprivation of Liberty

On 2 June 2026 the Supreme Court overruled the 2014 Cheshire West judgment in [2026] UKSC 16. The single "acid test" of continuous supervision and control and not being free to leave no longer decides whether a resident is deprived of their liberty.

In its place is a multifactorial assessment in which no single factor is decisive. A resident who lacks capacity can still give valid consent to their care arrangements, and their expressed wishes, or their lack of objection, now carry real weight.

The DoLS process itself has not changed. The government's guidance on the ruling confirms that DoLS still applies in care homes, and that the ruling does not remove the need to comply with Article 5 of the European Convention on Human Rights where it is engaged.

For care homes, the guidance points to a short list of actions:

• Brief managers and staff on the new test, and update your MCA and DoLS policy and training materials.
• Review existing authorisations as soon as practicable. An authorisation left in place in the meantime does not make the arrangement unlawful.
• Record each resident's expressed wishes and any objection, including physical resistance or attempts to leave, in capacity and best interests records.
• Refer to the local authority where there is doubt, rather than assuming consent.

The Department of Health and Social Care has said it will publish interim guidance with case studies. The Liberty Protection Safeguards in the Mental Capacity (Amendment) Act 2019 have still not been brought into force, so care homes should keep a working DoLS policy rather than adopt LPS-only documentation.

Staff Training and Competency

Under Regulation 18 (Staffing) and Regulation 19 (Fit and proper persons employed), care homes must ensure that staff are recruited safely and trained to a level appropriate to their role. Mandatory training for care home staff typically includes:

• Safeguarding adults (and children, where applicable)
• Health and safety, including fire safety
• Moving and handling
• Infection prevention and control
• First aid
• Food hygiene and allergen awareness
• Mental Capacity Act and DoLS
• Medication administration (for relevant staff)
• Equality, diversity, and human rights
• Data protection and confidentiality
• Communication and person-centred care

Care homes should also support staff to complete the Care Certificate (a nationally recognised set of 15 standards for health and social care workers), and encourage ongoing professional development through qualifications such as NVQ/QCF/RQF diplomas in health and social care.

The CQC Inspection Framework: Five Key Questions

The CQC assesses care homes against five key questions. Understanding these questions, and ensuring your policies directly address each one, is essential for achieving a positive inspection outcome.

• Safe: Are people protected from abuse and avoidable harm? This covers safeguarding, staffing levels, risk assessments, medication management, infection control, and incident reporting (including RIDDOR).
• Effective: Does care achieve good outcomes and promote a good quality of life? This covers care planning, nutrition and hydration, consent, staff training and supervision, and multi-agency working.
• Caring: Does staff treat people with compassion, kindness, dignity, and respect? This covers person-centred care, involvement of residents and families in care decisions, and respect for privacy.
• Responsive: Are services organised to meet people's needs? This covers personalised care, activities and social engagement, complaints handling, and end of life care.
• Well-led: Does the leadership, management, and governance of the organisation ensure high-quality care? This covers governance systems, quality assurance, duty of candour, and a culture of learning and improvement.

Each key question is rated as Outstanding, Good, Requires Improvement, or Inadequate. An overall rating is also given.

Providers rated as Inadequate may be placed in special measures, and the CQC has powers to issue warning notices, impose conditions on registration, suspend registration, cancel registration, or prosecute.

Since November 2023 CQC has assessed services under its Single Assessment Framework. The five key questions stayed the same, but evidence is mapped to 34 quality statements and assessment is ongoing and risk-based rather than run on fixed inspection cycles.

That framework is being replaced. In March 2026 CQC published draft assessment frameworks for each sector, including adult social care, with quality statements replaced by key lines of enquiry. CQC has said it will test and pilot the drafts before publishing final versions, so the Single Assessment Framework still applies for now.

The care home policies in this guide stay valid under either framework. What changes is how CQC collects and weighs evidence, not what good practice looks like.

RIDDOR Reporting in Care Homes

Care homes must comply with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

This means that certain incidents must be reported to the HSE, including deaths, specified injuries (such as fractures and amputations), over-seven-day incapacitation of workers, cases of occupational disease, and dangerous occurrences.

Falls resulting in fractures are one of the most common RIDDOR-reportable incidents in care homes. Having a clear RIDDOR policy and training staff on when and how to report is essential.

How Policy Pros Can Help

Policy Pros specialises in writing and reviewing policies and procedures for care homes, residential homes, and nursing homes across England. We understand the CQC Fundamental Standards, the legislative framework, and the practical challenges of running a care setting.

Whether you need a complete suite of care home policies from scratch, or you want your existing policies reviewed and updated to reflect the latest regulatory requirements, our team can help.

We offer dedicated safeguarding policy writing services for care providers, covering adults and children, and our healthcare policies and procedures service is tailored to the specific needs of the health and social care sector.

Every policy we produce is written in plain English, referenced to the relevant legislation and regulations, and designed to be a practical working document for your managers and staff.

Contact Policy Pros today to discuss your care home's policy requirements and find out how we can help you prepare for your next CQC inspection with confidence.