Care home policies and procedures: the full list every home in England needs

A care home in England needs somewhere between forty and seventy policies and procedures, depending on whether it provides nursing, supports people with a learning disability or mental ill health, and how it organises its HR. CQC does not publish a fixed list, but the regulations it enforces make most of them unavoidable. This guide gives the full list, grouped by CQC key question, with review frequencies and the mistakes that get homes marked down.

It is written by someone who has built the policy folder from scratch for new registrations and rebuilt it after inheriting homes where the folder was full and nobody had read it. Both are common. The aim here is a set of policies that staff actually use, that match what the home does, and that an inspector can see in practice.

The short answer

You need a policy for every regulated area of practice: safeguarding, whistleblowing, medicines, infection prevention, health and safety, consent and the Mental Capacity Act, care planning, complaints, equality, confidentiality, recruitment, training, supervision, governance and data protection, plus the clinical and specialist policies your service type demands. Each should be dated, version-controlled, reviewed at least annually and whenever the law or your practice changes, and matched to a procedure that says who does what. Staff need to have read the ones that apply to their role, and you need to be able to prove it. Most importantly, what happens on shift must match what the policy says, because that is what the inspector checks.

What are policies and procedures in health and social care?

A policy states what the home does and why. A procedure states how, step by step, and who is responsible. The safeguarding policy says the home will recognise, respond to and report abuse and neglect in line with the Care Act 2014. The safeguarding procedure says that a worker who witnesses abuse makes the person safe, tells the senior, records what they saw within the shift, and that the manager refers to the local authority within a set time and notifies CQC.

Homes often merge the two into one document, which is fine as long as both parts exist. What does not work is a policy with no procedure, because staff are left knowing the principle and guessing the steps, or a procedure with no policy, because nobody knows why the steps exist and they get skipped when inconvenient.

Policies and procedures in health and social care are also the point where law, regulation and local practice meet. They translate the Care Act, the Mental Capacity Act 2005, the Equality Act 2010, the CQC regulations and the Health and Safety at Work Act into instructions a support worker can follow at 2am.

The importance of policies and procedures in health and social care

Policies matter for three reasons. First, Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires providers to have systems and processes to assess, monitor and improve quality and safety. Policies are the written form of those systems. A home without a medicines policy cannot show it has a system for medicines.

Second, they protect staff. A worker who follows the procedure and something still goes wrong has a defence. A worker in a home with no procedure is exposed. Third, they create consistency. Residents should receive the same standard of care whichever team is on. Without a written standard, care depends on who is in the building.

What policies do not do is guarantee good practice. A home can hold every policy on the list and still deliver poor care. Inspectors know this, which is why they read policies and then watch the floor to see whether practice matches. A policy that is contradicted by what staff do is worse than no policy, because it proves the home knew the standard and did not meet it.

At a glance: policies grouped by CQC key question

Does CQC require specific policies?

Not by name, with a few exceptions. The regulations require certain things to exist: a statement of purpose, a complaints system, a system for safeguarding, safe recruitment procedures, arrangements for the duty of candour. CQC's guidance on meeting the regulations describes what providers should have in place, and in practice that means a policy for each area.

Inspectors will ask to see policies under Well-led and will refer to them when checking other key questions. If a worker describes a whistleblowing route that differs from the policy, or a medicines practice that the policy does not allow, that gap becomes a finding. So the question is not whether CQC requires a policy on a topic; it is whether you can show a system for it. A written, reviewed, followed policy is the easiest way to show one.

Homes buying a policy package from a supplier should still check the list below against their own service. Generic packages often include policies for services the home does not provide and miss the specialist ones it does. Our guide to the CQC fundamental standards maps each regulation to the practice it expects.

Safe: the policies every home needs

• Safeguarding adults, including the local authority referral route and thresholds
• Whistleblowing and raising concerns, naming CQC as a prescribed body
• Medicines management, covering ordering, storage, administration, PRN, covert administration, controlled drugs, errors and disposal
• Infection prevention and control, including outbreak management
• Health and safety, including risk assessment, COSHH, RIDDOR and lone working
• Fire safety and evacuation, including personal emergency evacuation plans
• Moving and handling
• Incident and accident reporting, including near misses
• Risk assessment and positive risk taking
• Restrictive practice and physical intervention, including reduction plans
• Falls prevention and post-fall management
• Pressure area care
• Choking and dysphagia, including IDDSI levels
• Missing person
• Business continuity and emergency planning
• Security and visitors

The medicines policy is the one most often found wanting. It needs to match how the home actually administers medicines, including the electronic MAR if one is used, and it needs a procedure for errors that staff are not afraid to follow. Our guide to whistleblowing in care homes covers what the raising concerns policy must contain.

Effective: the policies every home needs

• Consent, mental capacity and best interests, including Deprivation of Liberty Safeguards
• Care planning and review
• Nutrition and hydration
• Induction, including the Care Certificate
• Training and development, including the mandatory list for your service
• Supervision and appraisal
• Working with other agencies and professionals
• End of life and palliative care, including advance care planning
• Oral health
• Access to healthcare, including GP, dentist, optician and annual health checks
• Transitions, including hospital admission and discharge

The consent and mental capacity policy should reflect the Mental Capacity Act 2005 as it stands. Liberty Protection Safeguards were legislated for in 2019 but had not replaced DoLS in practice, so the policy should describe the DoLS process the home actually uses and be ready to change. The training policy should list what is mandatory for each role; our guide to mandatory training for care home staff gives a working list.

Caring: the policies every home needs

• Dignity, respect and privacy
• Equality, diversity and inclusion, covering the nine protected characteristics
• Confidentiality and information sharing
• Advocacy and independent advocacy referral
• Visiting and family involvement
• Relationships, sexuality and intimacy
• Spiritual and cultural needs
• Personal possessions and residents' money

These are the policies inspectors test by observation rather than by reading. A dignity policy is evidenced by staff knocking and waiting, not by the document. The relationships policy is often missing from residential homes and is important in learning disability and mental health services, where staff need clear guidance on supporting adults to have relationships while safeguarding those who may be at risk of exploitation.

Responsive: the policies every home needs

• Person-centred care and involvement
• Complaints, compliments and concerns
• Pre-admission assessment and admission
• Activities and meaningful occupation
• Accessible information, meeting the Accessible Information Standard
• Discharge, transfer and moving on
• Behaviour that challenges and positive behaviour support

The care home complaints procedure deserves particular attention. It must be available to residents and families in a form they can understand, name a timescale for acknowledgement and response, explain the escalation route to the Local Government and Social Care Ombudsman, and be matched by a complaints log that shows every complaint, the investigation, the outcome and the learning. Inspectors read the log before the policy.

Well-led: the policies every home needs

• Statement of purpose, kept current and sent to CQC when it changes
• Governance and quality assurance, including the audit cycle
• Duty of candour
• Notifications to CQC
• Data protection and UK GDPR, including a privacy notice and records of processing
• Records management and retention
• Information security, including passwords, devices and remote access
• Safe recruitment, DBS and references
• Registered manager absence and cover
• Service user involvement and feedback
• Social media and use of personal devices
• Gifts, wills and financial abuse

Governance is the policy that describes how all the others are monitored. It should name the audits the home does, how often, who reviews them and how actions are tracked. A compliance system that holds the audit schedule, the findings and the actions gives this policy a home rather than a filing cabinet.

HR policies and procedures

The HR suite is often held separately, sometimes with an outsourced HR provider, but it is part of the policy set and inspectors under Well-led will ask about it.

• Recruitment and selection, including right to work checks
• Probation
• Disciplinary and grievance
• Capability
• Sickness absence
• Bullying and harassment
• Equal opportunities in employment
• Flexible working and family leave
• Working time and rest breaks
• Staff code of conduct and professional boundaries
• Alcohol and drugs
• Agency and bank staff
• Exit and references

The staff code of conduct is worth writing yourself rather than buying, because it is where the home's values meet its rules. It should reference the Skills for Care code of conduct for adult social care workers and be signed at induction. Personnel files, training records and supervision notes that sit in one HR system make the evidence for these policies easy to find.

What nursing homes need in addition

A nursing home needs the residential list plus a clinical set that reflects the registered nursing on site.

• Wound care and tissue viability
• Catheter care
• Enteral feeding, including PEG
• Diabetes management, including insulin and hypoglycaemia
• Controlled drugs, including the register and witnessing
• Oxygen storage and administration
• Verification of expected death
• Do not attempt CPR decisions and ReSPECT
• Syringe drivers and anticipatory medicines
• Nursing delegation to care staff
• Nurse revalidation support

Delegation is the policy that most often needs work. It should set out which clinical tasks a nurse may delegate to a care worker, what training and competency sign-off is required, and how the nurse retains accountability. Without it, homes drift into care staff doing tasks that neither they nor the nurse can defend.

What learning disability and mental health services need in addition

Services for people with a learning disability, autism or mental ill health carry their own regulatory expectations, including the CQC's Right support, right care, right culture guidance.

• Positive behaviour support, including functional assessment and PBS plans
• Restrictive practice reduction, including reporting of every use of restraint and seclusion
• Physical intervention, naming the accredited training used
• Mental Health Act, including section 17 leave, section 117 aftercare and community treatment orders
• Hospital passports and reasonable adjustments
• Easy read and accessible communication
• Relationships and sexuality
• Tenancy and housing, for supported living
• Self-harm and suicide prevention
• Substance use
• Transitions from children's services

Restrictive practice is the policy inspectors read most closely in these services. It should define restraint broadly, including chemical, mechanical and environmental restraint, require every use to be recorded and reviewed, and set out how the home reduces it over time. A policy that permits restraint without a reduction plan is a red flag.

How often to review policies

Every policy should carry a version number, the date it was approved, who approved it and the next review date. The default review interval is twelve months. Some policies need a shorter cycle or a trigger-based review.

• Annually, all policies, as a scheduled task spread across the year rather than done in one week
• Immediately, when the law or statutory guidance changes, for example a change to DoLS or to CQC's assessment framework
• After any serious incident, safeguarding enquiry or complaint that revealed a gap
• When the service changes, for example adding nursing, changing the resident group or moving to electronic records
• When an audit or inspection finding relates to the policy

Reviewing a policy means reading it against current practice and current law, not changing the date on the front. A review record should say what was checked, what changed and why. If nothing changed, say that and why.

How to write a policy staff will actually read

Keep it short

A policy that runs to twenty pages will not be read by a support worker on a break. Two to four pages for the policy, with the procedure as a numbered list, is a realistic target. Put the legal references at the end, not the beginning.

Write for the reader

The reader is a care worker, often with English as a second language, reading on a phone. Short sentences. Active voice. Say who does what: the senior on duty calls the GP, not the GP should be contacted.

Match it to your home

Name your own systems, forms and roles. If the home uses an electronic MAR, the medicines policy should say so and describe how it is used. If the registered manager is also the nominated individual, say so. A policy that describes a different home is not your policy.

Test it

Give the draft to two members of staff and ask them to follow it for an imaginary scenario. Where they hesitate, the policy is unclear. Fix that before approval.

Buying policies versus writing your own

Most homes buy a policy package and adapt it. That is sensible for the legal and HR policies, where the law is the same everywhere and a good supplier keeps the wording current. It is less sensible for the policies that describe how your home works: care planning, medicines, governance, restrictive practice, complaints. Those need to be written or heavily adapted by the manager, because they must match your systems and your residents.

Whichever route you take, the manager must read every policy before it goes in the folder. A purchased policy that names a supplier's generic form, or refers to a role the home does not have, tells an inspector that nobody has read it. Adaptation is not optional; it is the work.

Budget matters too. A subscription policy service costs money every year, and so does the manager's time to adapt it. Homes that hold policies inside their care and HR system, with version control and read receipts, often find that the ongoing cost is lower than a separate subscription plus a paper folder; Kiwi, for example, is a flat monthly fee per home with the HR and policy records included. What matters is that the policies are current, matched to practice and evidenced as read.

How to roll out a new or updated policy

1. Draft the policy and procedure, or adapt the purchased version, in plain English matched to your home.
2. Check it against the current law, the CQC guidance for the relevant regulation and your other policies for contradictions.
3. Test it with two members of staff using a scenario, and revise.
4. Approve it, with the version number, date, approver and next review date on the document.
5. Brief the team: at a team meeting, in handover over a week, or both. Explain what changed and why.
6. Require each affected worker to read it and confirm they have, with a date. Record the confirmation.
7. Add the policy to the induction list for new starters if it applies to their role.
8. Schedule the audit or spot check that will show the policy being followed, and put the review date in the governance calendar.

Steps six and eight are the ones homes skip. Without them the policy exists but there is no evidence anyone knows about it or that it changed anything.

Proving staff have read and follow the policies

Inspectors will ask staff about policies and will ask the manager for evidence that staff have read them. This checklist covers what should exist.

• A policy index showing every policy, its version, approval date and next review date
• A read-and-understood record per worker, listing the policies that apply to their role with the date they confirmed each one
• Induction records showing the core policies covered in the first week
• Team meeting minutes showing policy changes briefed
• Supervision notes that reference policies when discussing practice
• Audit results that test practice against the policy, with actions where they differ
• Incident and complaint reviews that ask whether the policy was followed and whether it needs to change

A digital HR system that holds the policies and records each worker's confirmation, with the date, gives the manager one report to show. It also flags who has not read the new version, which a paper signature sheet never does.

Linking policies to practice through audit

A policy only has value if practice matches it, and the way to know is to audit. Each major policy should have an audit that tests it: a medicines audit against the medicines policy, a care plan audit against the care planning policy, an infection control audit, a personnel file audit against safe recruitment.

The audit schedule belongs in the governance policy. Each audit should record the sample, the findings, the actions, the owner and the date closed. When an audit shows practice diverging from policy, there are two honest responses: change the practice or change the policy. Ignoring the gap is the dishonest third option and it is the one inspectors find.

Where records are electronic, some audits become continuous. An electronic MAR shows missed doses and late administrations in real time. A care records system shows overdue reviews. That does not remove the need for a human audit, but it means the audit starts from data rather than from a pile of paper.

Policies under the single assessment framework

The CQC single assessment framework, in full use by 2026, assesses services against quality statements and gathers evidence in categories that include processes. Policies are process evidence. Inspectors may request specific policies before or during an assessment and will look for the policy behind any practice they observe.

The framework also places weight on feedback from staff and people using the service. A policy staff have never seen, or that residents cannot understand, scores poorly however well it is written. Under Well-led, the quality statement on governance, management and sustainability expects clear responsibilities, effective systems and a culture of learning. The policy set, its review cycle and the audits that test it are the core of that evidence.

Common mistakes

• Holding a policy folder that was bought once, never adapted and never read by the manager.
• Policies that describe systems the home does not use, such as paper MAR when the home is electronic.
• Review dates changed without the policy being read against current law and practice.
• No read-and-understood record, or a paper signature sheet with no dates and missing staff.
• A complaints policy with no complaints log, or a log with no outcomes and learning.
• Restrictive practice policies that permit restraint without recording, review or reduction.
• No delegation policy in nursing homes, so care staff do clinical tasks nobody can defend.
• Policies contradicting each other, most often between the HR suite and the care policies on conduct and confidentiality.

What good looks like on inspection day

When the inspector asks for the policy index, the manager produces it in a minute, with versions and review dates, and none are overdue. When the inspector asks a support worker what they would do if they suspected abuse, the answer matches the safeguarding procedure and names the manager, the local authority and CQC. When the inspector reads the medicines policy and then watches the round, the practice matches. When the inspector picks a policy updated in the last six months and asks how staff were told, the manager shows the team meeting minutes and the read confirmations.

Good also looks like evidence of use. Audit records show the policy being tested. Incident reviews reference whether it was followed. Supervision notes show it being discussed. The complaints log shows the procedure working, including a complaint that was upheld and what changed. The statement of purpose is current and matches the service delivered.

None of this requires a large home or a large budget. It requires a manager who reads the policies, a review cycle that actually happens, and a system that records who has read what. Homes that hold policies, read confirmations, audits and actions in one place tend to find inspection day far calmer than those with a folder in the office and hope.

Final conclusion

Care home policies and procedures are not a box to fill for CQC. They are the written form of how the home keeps people safe and well, and they protect staff as much as residents. Build the list from the regulations and your service type, write or adapt each one so it describes your home, review them on a real cycle, prove staff have read them and audit whether practice matches. Do that and the policy folder becomes something inspectors can trust and staff can use, which is the only reason to have one.

Frequently asked

What policies and procedures does a care home need?

A care home in England needs policies covering safeguarding, whistleblowing, medicines, infection prevention, health and safety, consent and mental capacity, care planning, complaints, equality and diversity, confidentiality, recruitment, training, supervision, governance and data protection, plus an HR suite. Nursing homes and learning disability or mental health services need additional clinical and specialist policies.

Does CQC require a specific list of policies?

No. CQC does not publish a fixed list, but the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 require systems for safeguarding, complaints, safe recruitment, good governance and duty of candour among others. In practice the way to evidence each system is a written, reviewed and followed policy.

How often should care home policies be reviewed?

At least annually, and immediately when the law, statutory guidance or CQC framework changes, after a serious incident or complaint that reveals a gap, or when the service changes. A review means reading the policy against current law and practice, not just updating the date.

What is the difference between a policy and a procedure in health and social care?

A policy states what the home does and why, for example that it will recognise and report abuse under the Care Act 2014. A procedure sets out how, step by step, and who is responsible. Most homes hold both in one document, and both parts are needed.

How do I prove staff have read the policies?

Keep a read-and-understood record per worker listing each applicable policy and the date they confirmed it, include core policies in induction records, minute policy briefings at team meetings, and reference policies in supervision. A digital HR system that records confirmations and flags who has not read a new version makes this a single report.

Should I buy care home policies or write my own?

Buying is sensible for legal and HR policies that are the same everywhere, provided you adapt them to your home. Policies that describe how your service works, such as care planning, medicines, governance and restrictive practice, need to be written or heavily adapted by the manager. Every policy must be read and matched to practice before it goes in the folder.

What should a care home complaints procedure include?

How to complain, in a form residents and families can understand; timescales for acknowledgement and response; who investigates; how the outcome is communicated; and the route to the Local Government and Social Care Ombudsman. It must be matched by a complaints log recording each complaint, the investigation, the outcome and the learning.

Sources

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
• CQC: Regulation 17 Good governance
• CQC: Guidance for providers on meeting the regulations
• CQC: Right support, right care, right culture
• Care Act 2014
• Mental Capacity Act 2005
• Public Interest Disclosure Act 1998
• Health and Safety at Work etc. Act 1974