CQC Regulation 9 Explained: Person-Centred Care

CQC Regulation 9 is the legal requirement that every care and treatment decision must be built around the individual, not the other way round. It sits within the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as one of the Fundamental Standards, and it's the regulation CQC inspectors return to again and again when checking whether a service truly knows the people it supports. For UK care home managers, getting Regulation 9 right is not a paperwork exercise — it's the foundation most of a good inspection outcome is built on.

What Regulation 9 legally requires

Under Regulation 9, a provider must ensure that the care and treatment of service users is "appropriate, meets their needs, and reflects their preferences." In practice, CQC's own guidance breaks this down into several linked duties:

• Assessing needs properly. Carry out collaborative assessments covering health, personal care, emotional, social, cultural, religious and spiritual needs — not just clinical needs in isolation.
• Care planning with clear goals. Build care plans around agreed goals, with a strategy for maintaining and, where possible, building the person's independence.
• Reviewing and updating. Review assessments and care plans regularly and whenever circumstances change, such as a hospital discharge or a change in health.
• Involving the person, family and advocates. Enable people to "make, or participate in making, decisions relating to their care or treatment to the maximum extent possible."
• Giving understandable information. Provide information about a person's condition, options, and the risks and benefits of each, in a format they can actually understand.
• Respecting preference and choice. Where a preference genuinely cannot be met, explain why and look at alternatives — for example, offering food and drink choices that meet someone's needs "as far as is reasonably practical."

These duties sit alongside the Mental Capacity Act 2005 and the Mental Health Act 1983, since decisions must always be made by, or on behalf of, someone with the legal authority to do so. Where a person lacks capacity for a specific decision, mental capacity and supported decision-making practice becomes central to evidencing Regulation 9, alongside the closely related duties under Regulation 11 on consent.

Regulation 9 vs Regulation 9A: don't mix them up

It's easy to confuse Regulation 9 with Regulation 9A, but they cover different ground. Regulation 9 is the broad, holistic duty to deliver person-centred care — assessing needs, planning care, and involving people in decisions about their treatment and support. Regulation 9A, introduced later, is much narrower: it specifically protects a person's right to receive visitors in a care home, hospital or hospice, and to be accompanied by a family member, friend or supporter when attending appointments. Under Regulation 9A, CQC expects providers to treat visiting and accompaniment as the default, only restricting it for a genuine, individually risk-assessed reason, with any restriction proportionate, time-limited and regularly reviewed. If your service has already reviewed its visiting policy against Regulation 9A, that work does not automatically cover Regulation 9 — the two need separate evidence.

How CQC assesses person-centred care in practice

Under CQC's Single Assessment Framework, Regulation 9 is mainly evidenced through quality statements sitting under the "Responsive" and "Caring" key questions.

The Responsive key question includes the "Person-centred care" quality statement, where CQC's stated expectation is: "We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs." Inspectors look at whether care plans address physical, mental, emotional and social needs and take account of protected characteristics; whether people and those close to them are genuinely involved in shared decision-making; whether people understand their condition and options; and whether reasonable adjustments keep care individualised rather than one-size-fits-all.

Under the Caring key question, the closely related "Treating people as individuals" quality statement asks whether staff recognise each person's personal, cultural, social and religious needs, involve trusted family and friends where wanted, and respect cultural identity rather than applying a generic routine. Together, these two quality statements are where most of the practical evidence for Regulation 9 gets tested — through conversations with residents and families, observation of daily practice, and a read-through of care plans and review records.

Common breaches and enforcement risk

Breaches of Regulation 9 typically show up as gaps between what's written down and what's actually happening. Common patterns inspectors flag include care plans that are generic, out of date, or clearly not reviewed after a change in the person's needs; plans that were never actually discussed with the resident or their family; a lack of evidence that preferences — dietary, cultural, religious, routine — were identified or acted on; and decisions being made "for" people rather than "with" them, particularly around daily routines and activities. Where CQC finds that a lack of person-centred care is contributing to poor outcomes or a consistent pattern of disregard for individual preference, this can lead to a requirement notice or further enforcement action. The safest position is treating person-centred care as an ongoing process checked and evidenced continuously, not a document produced once at admission and left untouched.

Practical steps to evidence compliance

• Build genuinely individual care plans. Move beyond template language — plans should reflect the specific person's routines, preferences, culture, beliefs and goals, in their own words where possible.
• Involve the person and their family or advocate at every review. Document who was involved, what they said, and what changed as a result — not just that a review "took place."
• Review triggers, not just review dates. Reassess promptly after any significant change: a hospital admission, a new diagnosis, a change in mobility, or a shift in mood or behaviour.
• Train staff to recognise and act on preference. Person-centred care depends on frontline staff, so induction and refresher training matter — the Care Certificate's 16 standards are a strong foundation for this.
• Audit the gap between plan and practice. Spot-check whether what's written in the care plan actually matches what staff do on shift.

What's the difference between Regulation 9 and Regulation 9A?

Regulation 9 is the broad duty to deliver care that meets a person's assessed needs and preferences. Regulation 9A is a narrower, separate duty specifically about visiting rights and being accompanied to appointments. A service can be strong on one and weak on the other — both need their own evidence.

Which CQC key questions cover Regulation 9?

Regulation 9 is primarily evidenced under the "Responsive" key question (the Person-centred care quality statement) and the "Caring" key question (Treating people as individuals), though good practice shows up across other quality statements too.

Who is responsible for Regulation 9 compliance in a care home?

Ultimate responsibility sits with the registered provider and registered manager, but compliance is built day to day by care staff who carry out assessments, write and follow care plans, and involve people in decisions about their own support.

Getting Regulation 9 right comes down to habit as much as policy — consistently asking people what they want, writing it down accurately, and checking that practice matches the plan. If you're building out CQC-aligned training for your team, Learnsignal's CPD and compliance training courses can help embed person-centred care standards across your service.