Law

Health and Social Care Act 2008

United Kingdom · statute

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In force since 2023-04-01, as the publisher states.

Copy read on 2026-11-08. The page it was read from

Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.

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Contents: 186 provisions
  1. Title and introductory text
  2. 1 The Care Quality Commission
  3. 2 The Commission's functions
  4. 3 The Commission's objectives
  5. 4 Matters to which the Commission must have regard
  6. 5 Statement on user involvement
  7. 6 Transfers of property, rights and liabilities
  8. 7 Meaning of “health and social care services” in Chapter 1
  9. 8 “Regulated activity”
  10. 9 “Health or social care”
  11. 10 Requirement to register as a service provider
  12. 11 Applications for registration as a service provider
  13. 12 Grant or refusal of registration as a service provider
  14. 13 Condition requiring registered manager
  15. 14 Applications for registration as a manager
  16. 15 Grant or refusal of registration as a manager
  17. 16 Regulations about registration
  18. 17 Cancellation of registration
  19. 18 Suspension of registration
  20. 19 Applications by registered persons
  21. 20 Regulation of regulated activities
  22. 20A Functions relating to processing of information by registered persons
  23. 21 Code of practice relating to health care associated infections
  24. 21A Learning disability and autism training: code of practice
  25. 22 Codes of practice: consultation and Parliamentary scrutiny
  26. 23 Guidance as to compliance with requirements
  27. 24 Consultation in relation to guidance under s. 23
  28. 25 Effect of code under s. 21 or 21A and guidance under s. 23
  29. 26 Notice of proposals
  30. 27 Right to make representations
  31. 28 Notice of decisions
  32. 29 Warning notice
  33. 29A Warning notice: quality of health care
  34. 30 Urgent procedure for cancellation
  35. 31 Urgent procedure for suspension, variation etc.
  36. 32 Appeals to the Tribunal
  37. 33 Failure to comply with conditions
  38. 34 Offences relating to suspension or cancellation of registration
  39. 35 Contravention of regulations
  40. 36 False description of concerns, premises etc.
  41. 37 False statements in applications
  42. 38 Provision of copies of registers
  43. 39 Bodies required to be notified of certain matters
  44. 40 Periodic returns
  45. 41 Liquidators etc.
  46. 42 Death of registered person
  47. 43 Power to modify Chapter in relation to newly regulated activities
  48. 44 Interpretation of Chapter 2
  49. 45 Standards set by Secretary of State
  50. 45A Functions to be exercised by Healthwatch England
  51. 45B Conflicts of interest
  52. 45C Reports
  53. 45D Granting licence to use trade mark
  54. 46 Reviews and performance assessments : registered service providers
  55. 46A Reviews and performance assessments: local authorities
  56. 46B Reviews and performance assessments: integrated care system
  57. 47 Frequency and period of review
  58. 48 Special reviews and investigations
  59. 49 Power to extend periodic review function
  60. 50 Failings by English local authorities
  61. 51 Failings by Welsh NHS bodies
  62. 52 Transfer and amendment of functions under Mental Health Act 1983
  63. 53 Information and advice
  64. 54 Studies as to economy, efficiency etc.
  65. 55 Publication of results of studies under s. 54
  66. 56 Role of Audit Commission
  67. 57 Reviews of data, studies and research
  68. 58 Publication of information
  69. 59 Additional functions
  70. 60 Inspections
  71. 61 Inspections carried out for registration purposes
  72. 62 Entry and inspection
  73. 63 Entry and inspection: supplementary
  74. 64 Power to require documents and information etc.
  75. 65 Power to require explanation
  76. 66 Interaction with other authorities
  77. 67 Co-ordination of reviews or assessments
  78. 68 Avoidance of unreasonable burdens in exercise of regulatory powers
  79. 69 Co-operation between the Commission and Welsh Ministers
  80. 70 Co-operation between the Commission and NHS England
  81. 71 Provision of information by Auditor General for Wales
  82. 72 Provision of material to the Comptroller and Auditor General
  83. 73 Arrangements with Ministers
  84. 74 Arrangements with Northern Ireland Ministers
  85. 75 Inquiries
  86. 76 Disclosure of confidential personal information: offence
  87. 77 Defence
  88. 78 Use of information etc.
  89. 79 Permitted disclosures
  90. 80 Code of practice on confidential personal information
  91. 81 Publication of programme of reviews etc.
  92. 82 Failure by the Commission or Healthwatch England in discharge of functions
  93. 83 Reports for each financial year etc.
  94. 84 Reports and information
  95. 85 Fees
  96. 86 Penalty notices
  97. 87 Penalty notices: supplementary provision
  98. 88 Guidance by the Commission in relation to enforcement action
  99. 89 Publication of information relating to enforcement action etc.
  100. 90 Proceedings for offences
  101. 91 Offences by bodies corporate
  102. 92 Unincorporated associations
  103. 93 Service of documents
  104. 94 Electronic communications
  105. 95 Further amendments relating to Part 1
  106. 96 Application of Part 1 to Crown
  107. 97 General interpretation of Part 1
  108. 98. The Office of the Health Professions Adjudicator
  109. 107. Duty to inform the public
  110. 108. Duty to consult
  111. 109. OHPA rules: supplementary
  112. 110. Fees payable by General Medical Council and General Optical Council
  113. 111 Extension of powers under s. 60 of Health Act 1999
  114. 112 Standard of proof in fitness to practise proceedings
  115. 113 The Council for Healthcare Regulatory Excellence
  116. 114 Constitution etc. of Council
  117. 115 Powers and duties of Council
  118. 116 Powers of Secretary of State and devolved administrations
  119. 117 Duty to inform and consult the public
  120. 118 Reference of cases by Council to court
  121. 119 Responsible officers and their duties relating to medical profession
  122. 120 Additional responsibilities of responsible officers: England and Wales and Northern Ireland
  123. 121 Co-operation between prescribed bodies
  124. 122 Ss. 120 and 121: Crown application
  125. 123 Dissolution of Hearing Aid Council
  126. 124 Regulation of social care workers: Wales
  127. 126 Education and training of approved mental health professionals: Wales
  128. 127 Further amendments relating to Part 2
  129. 129 Public health protection
  130. 130 Further amendments relating to public health protection
  131. 131 Entitlement: Great Britain
  132. 132 Administration: Great Britain
  133. 133 Penalty: Great Britain
  134. 134 Entitlement: Northern Ireland
  135. 135 Administration: Northern Ireland
  136. 136 Penalty: Northern Ireland
  137. 137 Northern Ireland: health in pregnancy grant to be excepted matter
  138. 138 General and supplementary
  139. 139 Duty of Primary Care Trusts
  140. 140 Pharmaceutical services
  141. 141 Remuneration for persons providing pharmaceutical services
  142. 142 Indemnity schemes in connection with provision of health services
  143. 143 Weighing and measuring of children: England
  144. 144 Weighing and measuring of children: Wales
  145. 145 Human Rights Act 1998: provision of certain social care to be public function
  146. 146 Direct payments in lieu of provision of care services
  147. 147 Abolition of maintenance liability of relatives
  148. 148 Ordinary residence for certain purposes of National Assistance Act 1948 etc.
  149. 149 Power of Secretary of State to give financial assistance
  150. 150 Qualifying bodies
  151. 151 Forms of assistance under s. 149
  152. 152 Terms on which assistance under s. 149 is given
  153. 153 Directions to certain NHS bodies
  154. 154 Arrangements with other third parties
  155. 155 Power to form company
  156. 156 Interpretation of group of sections
  157. 157 National Information Governance Board for Health and Social Care
  158. 158 Duty to consult Board in relation to regulations about patient information
  159. 159 Functions of Health Protection Agency in relation to biological substances
  160. 160 Minor and consequential amendments relating to Part 5
  161. 161 Orders, regulations and directions: general provisions
  162. 162 Orders and regulations: Parliamentary control
  163. 163 Orders and regulations: control by National Assembly for Wales
  164. 164 Regulations: control by Northern Ireland Assembly
  165. 165 Directions
  166. 166 Repeals
  167. 167 Power to make transitional and consequential provision etc.
  168. 168 Financial provisions
  169. 169 Extent
  170. 170 Commencement
  171. 171 The appropriate authority by whom commencement order is made
  172. 172 Consultation in relation to commencement
  173. 173 Short title
  174. SCHEDULE 1 The Care Quality Commission
  175. SCHEDULE 2 Transfers of property and staff etc.
  176. SCHEDULE 3 Amendments of Mental Health Act 1983
  177. SCHEDULE 4 Interaction with other authorities
  178. SCHEDULE 5 Further amendments relating to Part 1
  179. SCHEDULE 6 The Office of the Health Professions Adjudicator
  180. SCHEDULE 8 Extension of powers under s. 60 of Health Act 1999
  181. SCHEDULE 10 Further amendments relating to Part 2
  182. SCHEDULE 11 Public health protection: further amendments
  183. SCHEDULE 12 Funding of expenditure in connection with provision of pharmaceutical services
  184. SCHEDULE 13 Transitional provisions relating to s. 147
  185. SCHEDULE 14 Further amendments relating to Part 5
  186. SCHEDULE 15 Repeals and revocations

Proposed changes to this act

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186 provisions

Title and introductory text

Health and Social Care Act 2008 2008 c. 14 An Act to establish and make provision in connection with a Care Quality Commission; to make provision about health care (including provision about the National Health Service) and about social care; to make provision about reviews and investigations under the Mental Health Act 1983; to establish and make provision in connection with an Office of the Health Professions Adjudicator and make other provision about the regulation of the health care professions; to confer power to modify the regulation of social care workers; to amend the Public Health (Control of Disease) Act 1984; to provide for the payment of a grant to women in connection with pregnancy; to amend the functions of the Health Protection Agency; and for connected purposes. [21st July 2008] Be it enacted by the Queen's most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—

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1 The Care Quality Commission

(1) There is to be a body corporate known as the Care Quality Commission (referred to in this Part as “the Commission”). (2) The Commission for Healthcare Audit and Inspection, the Commission for Social Care Inspection and the Mental Health Act Commission are dissolved. (3) Schedule 1 (which makes further provision about the Care Quality Commission) has effect.

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2 The Commission's functions

(1) The Commission has the functions conferred on it by or under any enactment. (2) Those functions include— (a) registration functions under Chapter 2, (b) review and investigation functions under Chapter 3, and (c) functions under the Mental Health Act 1983 (c. 20).

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3 The Commission's objectives

(1) The main objective of the Commission in performing its functions is to protect and promote the health, safety and welfare of people who use health and social care services. (2) The Commission is to perform its functions for the general purpose of encouraging— (a) the improvement of health and social care services, (b) the provision of health and social care services in a way that focuses on the needs and experiences of people who use those services, and (c) the efficient and effective use of resources in the provision of health and social care services. (3) In this Chapter “health and social care services” means the services to which the Commission's functions relate.

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4 Matters to which the Commission must have regard

(1) In performing its functions the Commission must have regard to— (a) views expressed by or on behalf of members of the public about health and social care services, (b) experiences of people who use health and social care services and their families and friends, (c) views expressed by Local Healthwatch organisations or Local Healthwatch contractors about the provision of health and social care services ..., (d) the need to protect and promote the rights of people who use health and social care services (including, in particular, the rights of children, of persons detained under the Mental Health Act 1983, of persons who are deprived of their liberty in accordance with the Mental Capacity Act 2005 (c. 9), and of other vulnerable adults), (e) the need to ensure that action by the Commission in relation to health and social care services is proportionate to the risks against which it would afford safeguards and is targeted only where it is needed, (f) any developments in approaches to regulatory action, and (g) best practice among persons performing functions comparable to those of the Commission (including the principles under which regulatory action should be transparent, accountable and consistent). (2) In performing its functions the Commission must also have regard to such aspects of government policy as the Secretary of State may direct. (3) In subsection (1)(c), “Local Healthwatch contractor” has the meaning given by section 223 of the Local Government and Public Involvement in Health Act 2007.

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5 Statement on user involvement

(1) The Commission must publish a statement describing how it proposes to— (a) promote awareness among service users and carers of its functions, (b) promote and engage in discussion with service users and carers about the provision of health and social care services and about the way in which the Commission exercises its functions, (c) ensure that proper regard is had to the views expressed by service users and carers, and (d) arrange for any of its functions to be exercised by, or with the assistance of, service users and carers. (2) The Commission may from time to time revise the statement and must publish any revised statement. (3) Before publishing the statement (or revised statement) the Commission must consult such persons as it considers appropriate. (4) In this section— (a) “service users” means people who use health or social care services, and (b) “carers” means people who care for service users as relatives or friends.

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6 Transfers of property, rights and liabilities

Schedule 2 (which makes provision for the transfer of property, rights and liabilities) has effect.

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7 Meaning of “health and social care services” in Chapter 1

In this Chapter “health and social care services” has the meaning given by section 3(3).

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8 “Regulated activity”

(1) In this Part “regulated activity” means an activity of a prescribed kind. (2) An activity may be prescribed for the purposes of subsection (1) only if— (a) the activity involves, or is connected with, the provision of health or social care in, or in relation to, England, and (b) the activity does not involve the carrying on of any establishment or agency, within the meaning of the Care Standards Act 2000 (c. 14), for which Her Majesty's Chief Inspector of Education, Children's Services and Skills is the registration authority under that Act. (3) For the purposes of subsection (2), activities connected with the provision of health or social care include, in particular— (a) the supply of staff who are to provide such care; (b) the provision of transport or accommodation for those who require such care; (c) the provision of advice in respect of such care.

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9 “Health or social care”

(1) This section has effect for the interpretation of this Part. (2) “Health care” includes all forms of health care provided for individuals, whether relating to physical or mental health, and also includes procedures that are similar to forms of medical or surgical care but are not provided in connection with a medical condition. (3) “Social care” includes all forms of personal care and other practical assistance provided for individuals who by reason of age, illness, disability, pregnancy, childbirth, dependence on alcohol or drugs, or any other similar circumstances, are in need of such care or other assistance. (4) “Health or social care” means health care or social care.

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10 Requirement to register as a service provider

(1) Any person who carries on a regulated activity without being registered under this Chapter in respect of the carrying on of that activity is guilty of an offence. (2) The Secretary of State may by regulations make provision for the purposes of this Chapter for determining, in relation to a regulated activity carried on by two or more persons acting in different capacities, which of those persons is to be regarded as the person who carries on the activity. (3) In the following provisions of this Part, the registration of a person under this Chapter in respect of the carrying on of a regulated activity by that person is referred to as registration “as a service provider” in respect of that activity. (4) A person guilty of an offence under this section is liable— (a) on summary conviction, to a fine, or to imprisonment for a term not exceeding the general limit in a magistrates’ court, or to both; (b) on conviction on indictment, to a fine, or to imprisonment for a term not exceeding 12 months, or to both. (5) In relation to an offence committed before 2 May 2022, the reference in subsection (4)(a) to the general limit in a magistrates’ court is to be read as a reference to 6 months.

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11 Applications for registration as a service provider

(1) A person seeking to be registered under this Chapter as a service provider must make an application to the Commission. (2) The application must be made in such form, and contain or be accompanied by such information, as the Commission requires. (3) In such cases as the Commission may determine, a person seeking to be registered as a service provider in respect of two or more regulated activities may make a single application in respect of them.

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12 Grant or refusal of registration as a service provider

(1) Subsections (2) to (4) apply where an application under section 11 has been made in accordance with the provisions of this Chapter with respect to a regulated activity. (2) If the Commission is satisfied that— (a) the requirements of regulations under section 20, and (b) the requirements of any other enactment which appears to the Commission to be relevant, are being and will continue to be complied with (so far as applicable) in relation to the carrying on of the regulated activity, it must grant the application; otherwise it must refuse it. (3) The application may be granted either unconditionally or subject to such conditions as the Commission thinks fit. (4) On granting the application, the Commission must issue a certificate of registration to the applicant. (5) The Commission may at any time— (a) vary or remove any condition for the time being in force in relation to a person's registration as a service provider, or (b) impose any additional condition. (6) Subsections (3) and (5) have effect subject to section 13.

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13 Condition requiring registered manager

(1) The registration under this Chapter of a person (“S”) as a service provider in respect of a regulated activity must in prescribed cases be subject to a registered manager condition. (2) In deciding whether to impose a registered manager condition under section 12(3) or (5), in a case where subsection (1) does not require such a condition to be imposed, the Commission must have regard to prescribed matters. (3) For the purposes of this Chapter, a registered manager condition is a condition that the activity as carried on by S, or the activity as carried on by S at or from particular premises, must be managed by an individual who is registered under this Chapter as a manager in respect of the activity, or the activity as carried on at or from those premises.

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14 Applications for registration as a manager

(1) A person seeking to be registered under this Chapter as a manager in respect of a regulated activity in respect of which a registered manager condition has, or is to have, effect must make an application to the Commission. (2) The application must be made in such form, and contain or be accompanied by such information, as the Commission requires. (3) In such cases as the Commission may determine, a person seeking to be registered as a manager in respect of two or more regulated activities carried on by a person registered as a service provider may make a single application in respect of them.

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15 Grant or refusal of registration as a manager

(1) Subsections (2) to (4) apply where an application under section 14 has been made in accordance with the provisions of this Chapter with respect to a regulated activity in respect of which a person is registered under this Chapter as a service provider and in respect of which a registered manager condition has effect. (2) If the Commission is satisfied that— (a) the requirements of regulations under section 20, and (b) the requirements of any other enactment which appears to the Commission to be relevant, are being and will continue to be complied with (so far as applicable) in relation to the carrying on of the regulated activity, it must grant the application; otherwise it must refuse it. (3) The application may be granted either unconditionally or subject to such conditions as the Commission thinks fit. (4) On granting the application, the Commission must issue a certificate of registration to the applicant. (5) The Commission may at any time— (a) vary or remove any condition for the time being in force in relation to a person's registration as a manager, or (b) impose any additional condition.

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16 Regulations about registration

Regulations may make provision for the purposes of this Chapter about— (a) the keeping by the Commission of registers, (b) the making of applications for registration as a service provider or manager, (c) the registration of persons as service providers or managers, and (d) the notification by registered persons to the Commission of an address for service of documents.

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17 Cancellation of registration

(1) The Commission may at any time cancel the registration of a person (“R”) under this Chapter as a service provider or manager in respect of a regulated activity— (a) on the ground that R has been convicted of, or admitted, a relevant offence; (b) on the ground that any other person has been convicted of any relevant offence in relation to the regulated activity; (c) on the ground that the regulated activity is being, or has at any time been, carried on otherwise than in accordance with the relevant requirements; (d) on the ground that R has failed to comply with a requirement imposed by or under Chapter 6; (e) on any ground specified by regulations. (2) The Commission must cancel the registration of a person under this Chapter as a manager in respect of a regulated activity if— (a) no-one is registered under this Chapter as a service provider in respect of the activity, or (b) the registration of a person under this Chapter as a service provider in respect of the activity ceases to be subject to a registered manager condition. (3) For the purposes of this section, the following are relevant offences— (a) a Part 1 offence, (b) an offence under the Registered Homes Act 1984 (c. 23) or regulations made under it, (c) an offence under Part 2 of the Care Standards Act 2000 (c. 14) or regulations made under it, ... (ca) an offence under Part 1 of the Regulation and Inspection of Social Care (Wales) Act 2016 (anaw 2) or specified in regulations made under section 45 or 46 of that Act, and (d) any other offence which appears to the Commission to be relevant. (4) In this section “relevant requirements” means— (a) any requirements or conditions imposed by or under this Chapter, and (b) the requirements of any other enactment which appears to the Commission to be relevant.

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18 Suspension of registration

(1) The Commission may at any time suspend a person's registration under this Chapter as a service provider or manager for a specified period. (2) Except where the Commission gives notice under section 31, the power conferred by subsection (1) is exercisable only on the ground that— (a) the regulated activity is being, or has at any time been, carried on otherwise than in accordance with the relevant requirements, or (b) the person has failed to comply with a requirement imposed by or under Chapter 6. (3) The suspension of a person's registration does not affect the continuation of the registration (but see sections 34 and 36 as to offences). (4) A period of suspension may be extended under subsection (1) on one or more occasions. (5) In this section “relevant requirements” has the same meaning as in section 17.

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19 Applications by registered persons

(1) Except in case A or B and subject to subsections (3A) to (3F, a person registered under this Chapter as a service provider or manager (“R”) may apply to the Commission— (a) for the variation or removal of any condition for the time being in force in relation to the registration, other than a registered manager condition required by section 13(1), (b) for the cancellation of the registration, or (c) for the cancellation of, or the variation of the period of, any suspension of the registration. (2) Case A is where— (a) the Commission has given R notice under section 26(4)(a) of a proposal to cancel the registration, and (b) the Commission has not decided not to take that step. (3) Case B is where— (a) the Commission has given R notice under section 28(3) of its decision to cancel the registration, and (b) either the time within which an appeal may be brought has not expired or, if an appeal has been brought, it has not yet been determined. (3A) R may not apply under subsection (1)(a) for the variation of a condition where either subsection (3B) or (3C) applies. (3B) This subsection applies where— (a) the Commission has given R notice under section 26(4)(c) of a proposal to make that variation (or a variation which would have substantially the same effect as that variation), and (b) the Commission has not decided not to take that step. (3C) This subsection applies where— (a) the Commission has given R notice under section 28(3) of its decision to make that variation (or a variation which would have substantially the same effect as that variation), and (b) either the time within which an appeal may be brought has not expired or, if an appeal has been brought, it has not yet been determined. (3D) R may not apply under subsection (1)(a) for the removal of a condition where either subsection (3E) or (3F) applies. (3E) This subsection applies where— (a) the Commission has given R notice under section 26(4)(c) of a proposal to remove that condition, and (b) the Commission has not decided not to take that step. (3F) This subsection applies where— (a) the Commission has given R notice under section 28(3) of its decision to remove that condition, and (b) either the time within which an appeal may be brought has not expired or, if an appeal has been brought, it has not yet been determined. (4) An application under subsection (1) must be made in such form, and contain or be accompanied by such information, as the Commission requires. (5) If the Commission decides to grant an application under subsection (1)(a), it must serve notice in writing of its decision on the applicant (stating, where applicable, the condition as varied) and issue a new certificate of registration. (6) If the Commission decides to grant an application under subsection (1)(c), it must serve notice in writing of its decision on the applicant (stating, where applicable, the period as varied).

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20 Regulation of regulated activities

(1) The Secretary of State must by regulations impose requirements that the Secretary of State considers necessary to secure that services provided in the carrying on of regulated activities cause no avoidable harm to the persons for whom the services are provided. (2) The Secretary of State may by regulations impose any other requirements in relation to regulated activities that the Secretary of State thinks fit for the purposes of this Chapter, including in particular provision with a view to— (a) securing that any service provided in the carrying on of a regulated activity is of appropriate quality, and (b) securing the health, safety and welfare of persons for whom any such service is provided. (3) Regulations under this section may in particular— (a) make provision as to the persons who are fit to carry on or manage a regulated activity; (b) make provision as to the manner in which a regulated activity is carried on; (c) make provision as to the persons who are fit to work for the purpose of the carrying on of a regulated activity; (d) make provision as to the management and training of persons who work for the purpose of the carrying on of a regulated activity; (da) impose requirements in connection with food or drink provided or made available to any person on hospital premises in England that are used in connection with the carrying on of a regulated activity; (e) make provision as to the fitness of premises; (f) impose requirements as to the keeping of records and accounts; (g) impose requirements as to the provision of information; (h) impose requirements as to the financial position of a person registered as a service provider; (i) impose requirements as to the making available to the public of information as to any charges made for the provision of any services provided in the carrying on of a regulated activity; (j) impose requirements as to the review of the quality of any services provided in the carrying on of a regulated activity, as to the preparation of reports of such reviews, and as to the making available to the public of such reports; (k) make provision as to the handling of complaints and disputes and the application of lessons learnt from them. (4) Regulations made under this section by virtue of subsection (3)(b) may in particular include provision as to the control and restraint, in appropriate cases, of persons receiving health or social care or other services in connection with the carrying on of a regulated activity. (4A) Regulations made under this section by virtue of subsection (3)(d) may in particular include provision for a specified person to set the standards which persons undergoing the training in question must attain. (4B) Regulations made under this section by virtue of subsection (3)(da) may in particular— (a) specify nutritional standards, or other nutritional requirements, which are to be complied with; (b) require that specified descriptions of food or drink are not to be provided or made available. (5) Regulations made under this section may make provision for the prevention and control of health care associated infections and may include such provision as the Secretary of State considers appropriate for the purpose of safeguarding individuals (whether receiving health or social care or otherwise) from the risk, or any increased risk, of being exposed to health care associated infections or of being made susceptible, or more susceptible, to them. (5ZA) Regulations under this section must require service providers to ensure that each person working for the purpose of the regulated activities carried on by them receives training on learning disability and autism which is appropriate to the person’s role. (5A) Regulations under this section must make provision as to the provision of information in a case where an incident of a specified description affecting a person's safety occurs in the course of the person being provided with a service. (5B) In subsection (1)— (a) “cause” means cause or contribute to, whether directly or indirectly; and (b) harm is avoidable, in relation to a service, unless the person providing the service cannot reasonably avoid it (whether because it is an inherent part or risk of a regulated activity or for another reason). (5C) In subsection (3)(da) “hospital” has the meaning given by section 275 of the National Health Service Act 2006. (5D) In subsection (5ZA)— “learning disability” has the meaning given by section 1(4) of the Mental Health Act 1983; “service provider” means a person registered under this Chapter as a service provider in respect of a regulated activity. (6) In this Chapter “health care associated infection” means any infection to which an individual may be exposed or made susceptible (or more susceptible) in circumstances where— (a) health or social care is being, or has been, provided to that or any other individual, and (b) the risk of exposure to the infection, or of susceptibility (or increased susceptibility) to it, is directly or indirectly attributable to the provision of that care. (7) But “health care associated infection” does not include an infection to which the individual is deliberately exposed as part of any health care. (8) Before making regulations under this section, except regulations which amend other regulations under this section and do not, in the opinion of the Secretary of State, effect any substantial change in the provision made by those regulations, the Secretary of State must consult such persons as the Secretary of State considers appropriate. (9) Consultation undertaken by the Secretary of State before the commencement of this section is as effective for the purposes of this section as consultation undertaken after that time.

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20A Functions relating to processing of information by registered persons

(1) The Commission has the following functions in relation to the processing of relevant information— (a) to monitor the practice followed by registered persons in relation to such processing, and (b) to keep NHS England ... informed about the practice being followed by registered persons in relation to such processing. (2) The Commission must, in exercising those functions, seek to improve the practice followed by registered persons in relation to the processing of relevant information. (3) In this section “relevant information” means— (a) patient information, (b) any other information obtained or generated in the course of the provision of the health service continued under section 1 of the National Health Service Act 2006, (c) any other information obtained or generated in the course of the exercise by an English local authority of its adult social services functions, and (d) any other information obtained or generated in the course of the carrying on by an English local authority of adult placement schemes in connection with which arrangements are made for the provision of personal care. (4) In subsection (3) “patient information” means— (a) information (however recorded) which relates to the physical or mental health or condition of an individual (“P”), to the diagnosis of P's condition or to P's care or treatment, and (b) information (however recorded) which is to any extent derived, directly or indirectly, from that information, whether or not the identity of the individual in question is ascertainable from the information. (5) In this section— “adult placement scheme” and “personal care” each have such meaning as they have from time to time in regulations under section 20; “processing”, in relation to information, has the same meaning as in Parts 5 to 7 of the Data Protection Act 2018 (see section 3(4) and (14) of that Act); “registered person” means a person registered under this Chapter as a manager or service provider in respect of a regulated activity.

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21 Code of practice relating to health care associated infections

(1) The Secretary of State may issue a code of practice about compliance with any requirements of regulations under section 20 which relate to the prevention or control of health care associated infections. (2) The code may— (a) operate by reference to provisions of other documents specified in it (whether published by the Secretary of State or otherwise); (b) provide for any reference in it to such a document to take effect as a reference to that document as revised from time to time; (c) make different provision for different cases or circumstances. (3) The Secretary of State must keep the code under review and may from time to time— (a) revise the whole or any part of the code, and (b) issue a revised code.

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21A Learning disability and autism training: code of practice

(1) The Secretary of State must issue a code of practice about compliance with requirements imposed by virtue of section 20(5ZA) (requirements relating to training on learning disability and autism). (2) The code must make provision about— (a) the content of training; (b) training appropriate to different roles; (c) circumstances in which it is appropriate for training to be delivered in person; (d) the involvement of people with learning disability, autistic people, or their carers, in the provision of training; (e) accreditation of training; (f) procurement of training; (g) monitoring and evaluation of the impact of training; (3) The code may make different provision for different cases or circumstances. (4) The Secretary of State must, at least once every five years— (a) review the code, and (b) lay before Parliament a report setting out the findings of the review.

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22 Codes of practice: consultation and Parliamentary scrutiny

(1) Where the Secretary of State proposes to issue a code of practice under section 21 or 21A, the Secretary of State must— (a) prepare a draft of the code, and (b) consult such persons as the Secretary of State considers appropriate about the draft. (2) Where the Secretary of State proposes to issue under section 21 or 21A a revised code which in the opinion of the Secretary of State would result in a substantial change in the code, the Secretary of State must— (a) prepare a draft of the revised code, and (b) consult such persons as the Secretary of State considers appropriate about the change. (3) Where, following consultation under subsection (1) or (2) in relation to a draft of a code or revised code under section 21, the Secretary of State issues the code or revised code (whether in the form of the draft or with such modifications as the Secretary of State thinks fit), it comes into force at the time when it is issued by the Secretary of State. (4) Where— (a) any document by reference to whose provisions the code operates as mentioned in section 21(2)(a) and (b) is a document published by the Secretary of State in connection with the Secretary of State's functions relating to health or social care, (b) the Secretary of State proposes to revise the document, and (c) in the opinion of the Secretary of State, the revision would result in a substantial change in the code, the Secretary of State must, before revising the document, consult such persons as the Secretary of State considers appropriate about the change. (5) Where— (a) any document by reference to whose provisions the code operates as mentioned in section 21(2)(a) and (b) is not one to which subsection (4)(a) of this section applies, (b) the document is revised, and (c) in the opinion of the Secretary of State, the revision results in a substantial change in the code, the Secretary of State must consult such persons as the Secretary of State considers appropriate about whether the code should be revised in connection with the change. (5A) Where, following consultation under subsection (1) or (2) in relation to a draft of a code or revised code under section 21A, the Secretary of State decides to proceed with the draft (in its original form or with modifications), the Secretary of State must lay a copy of the draft before Parliament. (5B) The Secretary of State may not issue the code or revised code if, within the 40-day period, either House of Parliament resolves not to approve it. (5C) In this section “40-day period” means— (a) the period of 40 days beginning with the day on which the draft is laid before Parliament, or (b) if the draft is not laid before each House on the same day, the period of 40 days beginning with the later of the days on which it is laid before Parliament. (5D) For the purposes of subsection (5C), no account is to be taken of any whole days that fall within a period during which— (a) Parliament is dissolved or prorogued, or (b) either House of Parliament is adjourned for more than four days. (6) Consultation undertaken by the Secretary of State before the commencement of this section is as effective for the purposes of this section as consultation undertaken after that time.

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23 Guidance as to compliance with requirements

(1) The Commission must issue guidance about compliance with the requirements of regulations under section 20, other than requirements which relate to— (a) the prevention or control of health care associated infections, or (b) training on learning disability or autism. (2) The guidance may, if the Commission thinks fit, also relate to compliance for the purposes of this Chapter with the requirements of any other enactments. (3) The guidance may— (a) operate by reference to provisions of other documents specified in it (whether published by the Commission or otherwise); (b) provide for any reference in it to such a document to take effect as a reference to that document as revised from time to time; (c) make different provision for different cases or circumstances. (4) The Commission may from time to time revise guidance issued by it under this section and issue the revised guidance.

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24 Consultation in relation to guidance under s. 23

(1) Where the Commission proposes to issue guidance under section 23, it must— (a) prepare a draft of the guidance, and (b) consult such persons as the Commission considers appropriate about the draft. (2) Where the Commission proposes to issue under section 23 revised guidance which in its opinion would result in a substantial change in the guidance, the Commission must— (a) prepare a draft of the revised guidance, and (b) consult such persons as the Commission considers appropriate about the change. (3) Where, following consultation under subsection (1) or (2), the Commission issues the guidance or revised guidance (whether in the form of the draft or with such modifications as the Commission thinks fit), it comes into force at the time when it is issued by the Commission. (4) Where— (a) any document by reference to whose provisions the guidance operates as mentioned in section 23(3)(a) and (b) is a document published by the Commission, (b) the Commission proposes to revise the document, and (c) in the opinion of the Commission, the revision would result in a substantial change in the guidance, the Commission must, before revising the document, consult such persons as the Commission considers appropriate about the change. (5) Where— (a) any document by reference to whose provisions the guidance operates as mentioned in section 23(3)(a) and (b) is not one to which subsection (4)(a) of this section applies, (b) the document is revised, and (c) in the opinion of the Commission, the revision results in a substantial change in the guidance, the Commission must consult such persons as the Commission considers appropriate about whether the guidance should be revised in connection with the change. (6) Consultation undertaken by the Commission before the commencement of this section is as effective for the purposes of this section as consultation undertaken after that time.

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25 Effect of code under s. 21 or 21A and guidance under s. 23

(1) Codes of practice under sections 21 and 21A and guidance under section 23 are to be taken into account— (a) in the making of any decision by the Commission under this Chapter; (b) in any proceedings for the making of an order under section 30; (c) in any proceedings on an appeal against such a decision or order; (d) in any proceedings for an offence under section 33 or under regulations under section 20. (2) Codes of practice under sections 21 and 21A and guidance under section 23 are also admissible in evidence in other criminal or civil proceedings. (3) A failure to observe any provision of a code of practice under section 21 or 21A or guidance under section 23 does not of itself make a person liable to any criminal or civil proceedings.

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26 Notice of proposals

(1) Subsections (2) and (3) apply where a person applies for registration as a service provider or manager in respect of a regulated activity. (2) If the Commission proposes to grant the application subject to any condition which has not been agreed in writing between it and the applicant, other than a registered manager condition required by section 13(1), it must give the applicant notice in writing of its proposal and of the conditions subject to which it proposes to grant the application. (3) The Commission must give the applicant notice in writing of a proposal to refuse the application. (4) Except where it makes an application under section 30 or gives notice under section 31, the Commission must give any person registered as a service provider or manager in respect of a regulated activity notice in writing of a proposal— (a) to cancel the registration (otherwise than by virtue of section 17(2) or in accordance with an application under section 19(1)(b)), (b) to suspend the registration or extend a period of suspension, (c) to vary or remove (otherwise than in accordance with an application under section 19(1)(a)) any condition for the time being in force in relation to the registration, or (d) to impose in relation to the registration any additional condition. (4A) Where a proposal under subsection (4) names an individual and specifies action that the Commission would require the registered person to take in relation to that individual, the Commission must give that individual notice in writing of the proposal. (5) The Commission must give the applicant notice in writing of a proposal to refuse an application under section 19(1)(a), (b) or (c). (6) A notice under this section must give the Commission's reasons for its proposal.

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27 Right to make representations

(1) A notice under section 26 must state that within 28 days of service of the notice any person on whom it was served may make written representations to the Commission concerning any matter which that person wishes to dispute. (2) Where a notice has been served under section 26, the Commission must not determine any matter to which the notice relates until either— (a) any person on whom the notice was served has made written representations to it concerning the matter, (b) any such person has notified the Commission in writing that the person does not intend to make such representations, or (c) the period during which any such person could have made representations has elapsed.

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28 Notice of decisions

(1) If the Commission decides to grant an application for registration as a service provider or manager in respect of a regulated activity— (a) unconditionally, or (b) subject only to conditions each of which is either required by section 13(1) or agreed in writing between the Commission and the applicant, it must give the applicant notice in writing of the decision. (2) A notice under subsection (1) must state the conditions subject to which registration is granted. (3) If the Commission decides to adopt a proposal of which it was required to give notice under section 26, it must give notice in writing of its decision to any person to whom it was required by section 26 to give notice of the proposal. (4) A notice under subsection (3) must— (a) explain the right of appeal conferred by section 32, (b) in the case of a decision to adopt a proposal under section 26(2), state the conditions subject to which the application is granted, (c) in the case of a decision to adopt a proposal under section 26(4)(b), state the period (or extended period) of suspension, and (d) in the case of a decision to adopt a proposal under section 26(4)(c) or (d), state the condition as varied, the condition which is removed or (as the case may be) the additional condition imposed. (5) Where a person (“M”) is registered as a manager in respect of a regulated activity, the Commission must— (a) give M a copy of any notice given under subsection (3) to the person (“S”) registered as a service provider in respect of the regulated activity, and (b) give S a copy of any such notice given under that subsection to M. (6) Subject to subsections (7) to (9), a decision of the Commission to adopt a proposal under section 26(2) or (4) takes effect— (a) at the end of the period of 28 days referred to in section 32(2), or (b) if an appeal is brought, on the determination or abandonment of the appeal. (7) Where the applicant notifies the Commission in writing before the end of the period mentioned in subsection (6)(a) that the applicant does not intend to appeal, the decision is to take effect when the Commission receives the applicant's notification. (8) But in a case where notice of the proposal has been given to an individual under section 26(4A) subsection (7) does not apply unless, by the time the Commission receives the applicant's notification, it has received notification from the individual that he or she does not intend to appeal. (9) And if the Commission receives notification from the individual after it receives the applicant's notification and before the end of the period mentioned in subsection (6)(a), the decision is to take effect when the Commission receives the individual's notification.

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29 Warning notice

(1) If it appears to the Commission that a person who is registered under this Chapter as a service provider or manager in respect of a regulated activity has failed to comply with the relevant requirements, the Commission may give the registered person a warning notice. (1A) But a warning notice under this section may not be given to an NHS trust established under section 25 of the National Health Service Act 2006 or an NHS foundation trust. (2) A warning notice under this section is a notice in writing— (a) specifying the conduct which appears to the Commission to constitute a failure to comply with the relevant requirements, (b) specifying the requirement concerned, and (c) where it appears to the Commission that the failure is continuing— (i) requiring the registered person to comply with the requirement concerned within a specified time, and (ii) stating that, if the registered person fails to do so within that time, the Commission may take action to secure compliance with the relevant requirements. (3) Subsections (4) and (5) apply where— (a) a warning notice under this section has been given to any person, and (b) where any failure to comply with a requirement is specified under subsection (2)(c), the requirement has been complied with within the specified time. (4) The failure to which the notice relates, so far as occurring before the relevant time, is not to constitute a ground for the cancellation or suspension of registration, the variation of the conditions of registration, the removal of a condition or the imposition of any additional condition. (5) No proceedings may be brought against any person registered in respect of the regulated activity for a Part 1 offence that arises out of the failure to which the notice relates, so far as occurring before the relevant time. (6) In subsections (4) and (5) “the relevant time” means— (a) where a time is specified under subsection (2)(c)(i), the time so specified, and (b) in any other case, the date on which the notice was given. (7) In this section “relevant requirements” means— (a) any requirements or conditions imposed by or under this Chapter or Chapter 6, and (b) the requirements of any other enactment which appears to the Commission to be relevant.

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29A Warning notice: quality of health care

(1) If it appears to the Commission that the quality of health care provided by an NHS trust established under section 25 of the National Health Service Act 2006 or by an NHS foundation trust requires significant improvement, the Commission may give the trust a warning notice. (2) A warning notice under this section is a notice in writing— (a) stating that the Commission has formed the view that the quality of health care provided by the trust requires significant improvement, (b) specifying the health care concerned, (c) giving the Commission's reasons for its view, and (d) requiring the trust to make a significant improvement to the quality of the health care concerned within a specified time. (3) Where a warning notice under this section imposes more than one requirement under subsection (2)(d), it may specify different times for different requirements. (4) The Commission must— (a) where the notice specifies only one time under subsection (2)(d), determine at the end of that time whether the requirement has been complied with; (b) where the notice specifies more than one time under subsection (2)(d), determine at the end of the latest of those times, whether the requirements have been complied with. (5) Where, having carried out the duty under subsection (4), the Commission is satisfied that a requirement to which the notice relates has not been complied with, it— (a) must decide what action to take in relation to the trust, and (b) must consider in particular whether to require NHS England to make an order under section 65B(1) or 65D(2) of the National Health Service Act 2006 (appointment of trust special administrator).

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30 Urgent procedure for cancellation

(1) If— (a) the Commission applies to a justice of the peace for an order cancelling the registration of a person as a service provider or manager in respect of a regulated activity, and (b) it appears to the justice that, unless the order is made, there will be a serious risk to a person's life, health or well-being, the justice may make the order, and the cancellation has effect from the time when the order is made. (2) An application under subsection (1) may, if the justice thinks fit, be made without notice having been given to the registered person. (3) As soon as practicable after the making of an application under this section, the Commission must give notice of the application— (za) in any case where regulations so provide, to NHS England, (a) in any case where regulations so provide, to such integrated care board ... or English local authority as may be determined in accordance with regulations, (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (d) to such other persons as the Commission considers appropriate. (4) An order under subsection (1) must be in writing. (5) Where such an order is made, the Commission must, as soon as practicable after the making of the order, serve on the person registered as a service provider or manager in respect of the regulated activity— (a) a copy of the order, and (b) notice of the right of appeal conferred by section 32.

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31 Urgent procedure for suspension, variation etc.

(1) If the Commission has reasonable cause to believe that unless it acts under this section any person will or may be exposed to the risk of harm, the Commission may, by giving notice in writing under this section to a person registered as a service provider or manager in respect of a regulated activity, provide for any decision of the Commission that is mentioned in subsection (2) to take effect from the time when the notice is given. (2) Those decisions are— (a) a decision under section 12(5) or 15(5) to vary or remove a condition for the time being in force in relation to the registration or to impose an additional condition; (b) a decision under section 18 to suspend the registration or extend a period of suspension. (3) The notice must— (a) state that it is given under this section, (b) state the Commission's reasons for believing that the circumstances fall within subsection (1), (c) specify the condition as varied, removed or imposed or the period (or extended period) of suspension, and (d) explain the right of appeal conferred by section 32.

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32 Appeals to the Tribunal

(1) An appeal against— (a) any decision of the Commission under this Chapter, other than a decision to give a warning notice under section 29 or 29A, or (b) an order made by a justice of the peace under section 30, lies to the First-tier Tribunal. (2) No appeal against a decision or order may be brought by a person more than 28 days after service on the person of notice of the decision or order. (3) On an appeal against a decision of the Commission, other than a decision to which a notice under section 31 relates, the First-tier Tribunal may confirm the decision or direct that it is not to have effect. (4) On an appeal against an order made by a justice of the peace the First-tier Tribunal may confirm the order or direct that it is to cease to have effect. (5) On an appeal against a decision to which a notice under section 31 relates, the First-tier Tribunal may confirm the decision or direct that it is to cease to have effect. (6) On an appeal against a decision or order, the First-tier Tribunal also has power— (a) to vary any discretionary condition for the time being in force in respect of the regulated activity to which the appeal relates, (b) to direct that any such discretionary condition is to cease to have effect, (c) to direct that any such discretionary condition as the First-tier Tribunal thinks fit shall have effect in respect of the regulated activity, or (d) to vary the period of any suspension. (7) In this section— “discretionary condition”, in relation to registration under this Chapter, means any condition other than a registered manager condition required by section 13(1); ...

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33 Failure to comply with conditions

A person who— (a) is registered under this Chapter in respect of a regulated activity (whether as a service provider or manager), and (b) fails, without reasonable excuse, to comply with any condition for the time being in force by virtue of this Chapter in relation to the registration, is guilty of an offence and liable on summary conviction to a fine.

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34 Offences relating to suspension or cancellation of registration

(1) If a person (“S”) who is registered under this Chapter as a service provider in respect of a regulated activity carries on that activity while S's registration is suspended, S is guilty of an offence. (2) A person (“M”) whose registration under this Chapter as a manager in respect of a regulated activity is suspended is guilty of an offence if, during the period of suspension, M manages that activity at a time when no one else has been registered under this Chapter as a manager in respect of the activity since the suspension of M's registration. (3) A person (“M”) whose registration under this Chapter as a manager in respect of a regulated activity has been cancelled is guilty of an offence if M manages that activity at a time when— (a) a person (“S”) remains registered under this Chapter as a service provider in respect of the activity, (b) S's registration remains subject to a registered manager condition, and (c) no-one has been registered under this Chapter as a manager in respect of the activity since the cancellation of M's registration. (4) If a person (“M”) who is registered under this Chapter as a manager in respect of a regulated activity manages that activity while the registration of the person registered under this Chapter as a service provider in respect of the activity is suspended, M is guilty of an offence if M knows or could reasonably be expected to know of the suspension. (5) A person guilty of an offence under this section is liable on summary conviction to a fine.

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35 Contravention of regulations

Regulations under this Chapter may provide that a contravention of or failure to comply with any specified provision of the regulations is to be an offence, but may not provide for an offence to be triable on indictment or to be punishable with imprisonment or, except in the case of regulations under section 20, with a fine exceeding level 4 on the standard scale.

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36 False description of concerns, premises etc.

(1) Any person who, with intent to deceive any person— (a) applies any name to any concern carried on in England or to any premises in England, or (b) in any way describes such a concern or such premises or holds such a concern or such premises out, so as to indicate, or reasonably be understood to indicate, that the carrying on of the concern is a regulated activity or that the premises are used for the carrying on of a regulated activity is guilty of an offence unless the conditions in subsection (2) are met. (2) Those conditions are— (a) that a person is registered under this Chapter as a service provider in respect of the regulated activity in question, and (b) that the registration has not been suspended. (3) Any person who, with intent to deceive any person, in any way describes or holds out any person registered under this Chapter as a service provider in respect of a regulated activity as able to provide a service or do any thing the provision or doing of which would contravene a condition for the time being in force by virtue of this Chapter in relation to the regulated activity is guilty of an offence. (4) A person guilty of an offence under subsection (1) or (3) is liable on summary conviction to a fine not exceeding level 5 on the standard scale. (5) In this section “concern” includes any organisation.

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