CQC Regulation 19: Fit and Proper Persons Employed

Every care provider registered with the Care Quality Commission has to prove that the people it employs are safe to be around the people they support. That obligation sits in Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and it applies to everyone on the payroll or roster — care assistants, nurses, activities coordinators, kitchen and housekeeping staff, agency and bank workers, volunteers and contractors who work in the service. If a person works in the regulated activity, Regulation 19 applies to them.

This is a separate requirement from the test applied to directors and other people running the organisation, which sits under Regulation 5, the fit and proper persons test for directors. The two regulations share a name and a similar underlying idea — that unsuitable people should not be in a position to cause harm — but they are legally distinct, cover different people, and are inspected against different evidence. This article focuses squarely on Regulation 19: the checks a provider must carry out and keep up to date for every member of staff, not just those at board level.

What Regulation 19 actually requires

Regulation 19 says a provider must not employ someone in a regulated activity unless that person is of good character, has the necessary qualifications, competence, skills and experience for the role, and is physically and mentally fit to carry it out. The regulation is backed by Schedule 3 of the same regulations, which sets out the specific information a provider must hold for each employee before they start — and CQC inspectors will ask to see this information in personnel files during any inspection.

The Schedule 3 checklist: what must be on file before day one

Schedule 3 lists the information that must be obtained and verified for every relevant person. In practice, a compliant personnel file should contain:

• Proof of identity, including a recent photograph.
• A criminal record check appropriate to the role — usually an enhanced DBS check with barred list information for those working closely with people who use care services. If you want the mechanics of applying for and renewing these, our separate guide to DBS checks for care staff covers the process in detail; here, treat it as one line item among several, not the whole of Regulation 19.
• Satisfactory evidence of conduct in any previous role involving health or social care, or work with children or vulnerable adults.
• Where a previous role involved caring for children or vulnerable adults, the reason that employment ended, where this is available.
• Documentary evidence of relevant qualifications for the duties the person will carry out.
• A full employment history, with a satisfactory written explanation for any gaps.
• References covering that full employment history, not just the most recent employer.
• Information about the person's physical and mental fitness to carry out the role.

"Satisfactory" is defined in the regulations as satisfactory to the CQC — which means a provider cannot decide unilaterally that a partial file is good enough. If a piece of information cannot reasonably be obtained (a previous employer has gone out of business, for example), the file needs to show what was done to try to get it and why the gap is acceptable, not simply an absence of paperwork.

What "fit" actually means in this context

CQC guidance breaks fitness down into three connected strands, and providers are expected to evidence all three, not just the easiest one to tick off.

Good character means honesty, trustworthiness and reliability, judged through references, conduct checks and criminal record information. A caution or conviction does not automatically rule someone out; providers are expected to make a proportionate, documented judgement about relevance to the role.

Qualifications, competence, skills and experience means checking that any required qualification is genuine and current, and that the person is actually competent to do the job, not just theoretically eligible for it. For care workers without a professional qualification, providers are expected to reference the Care Certificate standards and to supervise staff until competence is demonstrated, rather than leaving new starters unsupervised from day one.

Physical and mental fitness means assessing whether the person can safely carry out the specific duties of their role, with reasonable adjustments considered under the Equality Act 2010 where needed. This is about fitness for the role's actual demands, not a blanket judgement about health conditions or disability.

The part providers most often miss: the ongoing duty

This is where Regulation 19 differs most sharply from a one-off recruitment tick-box exercise, and it is the section CQC guidance is most emphatic about. Fitness is not established once at the point of hire and then forgotten. Providers must keep reviewing the fitness of employees throughout their employment, respond without delay when a concern is raised, and put interim protective measures in place while any concern is investigated. Where a registered professional no longer meets their professional body's standards, the provider is expected to inform that regulator.

In practice, this ongoing duty is usually discharged through supervision, appraisal and disciplinary processes rather than a separate standalone system. A supervision record that never mentions conduct, health changes or capability is a gap an inspector will notice. So is a personnel file where a safeguarding concern was raised eighteen months ago with no note of what happened next. Ongoing fitness monitoring is, in effect, a governance function, and it sits closely alongside the broader expectations set out in our piece on good governance in health and social care.

What CQC inspectors look for as evidence

When inspectors assess Regulation 19, they are not just counting whether a DBS certificate exists on file. They typically sample a cross-section of personnel files — recent starters, agency staff, long-serving employees — and check for a complete audit trail: the recruitment decision, the Schedule 3 information, evidence that references were actually followed up rather than just requested, supervision and appraisal records that reference fitness where relevant, and a clear record of any concern raised and how it was resolved. Gaps in recruitment records are a recurring theme in enforcement action and poor ratings, and recruitment failings frequently sit alongside other governance weaknesses identified during inspection; our article on why providers fail CQC inspections looks at how these threads connect in practice.

Building a Regulation 19-ready process

A practical way to stay ahead of this is to treat Regulation 19 as a lifecycle, not a checklist you complete once:

• Build a standard pre-employment checklist mapped directly to the eight Schedule 3 categories, and do not let a new starter begin unsupervised work until every item is either complete or has a documented, justified gap.
• Set a supervision and appraisal schedule that explicitly asks about conduct, capability and health, so ongoing fitness is captured as a matter of routine rather than only when something goes wrong.
• Agree a clear escalation route for fitness concerns, including who decides on interim measures such as redeployment or suspension while an issue is investigated.
• Audit a sample of personnel files periodically, the way an inspector would, rather than waiting for an inspection to find the gaps first.
• Keep director-level and staff-level fit and proper persons processes separate but aligned, so nobody assumes Regulation 5 checks on the board cover the rest of the workforce.

Handled this way, Regulation 19 stops being a recruitment-day formality and becomes what CQC actually intends it to be: continuous assurance that everyone delivering care remains suitable to do so, for as long as they are employed.