CQC Regulation 9A: Visiting and Accompanying in Care Homes

Since 6 April 2024, care homes, hospitals and hospices in England have been operating under a new fundamental standard: Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, covering visiting and accompanying. It was introduced after years of campaigning over the isolation caused by pandemic-era visiting bans, and it now sits alongside the other fundamental standards CQC assesses at every inspection. For registered managers, it changes the default position from "visits happen unless we decide otherwise" to "visits happen unless there is a documented, justified reason why not" — a distinction that matters enormously when you are trying to avoid the common reasons providers fail CQC inspections.

What Regulation 9A Actually Requires

Regulation 9A applies to care homes, hospitals and hospices (it does not extend to domiciliary care or substance misuse treatment services, which are regulated differently). In practice, it requires registered providers to:

• Enable people using the service to receive visits from those they want to see — family, friends, or anyone else they choose.
• Enable people to be accompanied by a family member, friend, or other support person when they leave the premises, including for hospital or other health appointments.
• Avoid discouraging visiting or accompaniment through unreasonable restrictions or burdensome administrative processes, such as requiring advance booking for every visit or limiting visit length without justification.
• Treat visiting and accompaniment as the default position, not something a resident or their family has to request or justify.

The regulation is not a criminal offence in the way that some other fundamental standards are, but CQC inspectors actively assess it under the Caring and Safe key questions, and it feeds directly into your overall rating.

Where It Came From: Gloria's Law and the Pandemic Visiting Bans

Regulation 9A did not appear out of nowhere. Blanket visiting bans during the Covid-19 pandemic left many care home residents isolated for months, with well documented consequences for their physical and mental health. The campaign that followed, widely known as "Gloria's Law", was founded in 2020 by families who had experienced this first-hand, and later gained a high-profile ambassador in actress Ruthie Henshall, whose mother Gloria had been isolated in a care home during the pandemic. The campaign called for a legally enforceable right to an in-person "care supporter" for anyone in a care setting.

The government's response was to lift the pandemic-era restrictions and introduce Regulation 9A as a regulatory fundamental standard rather than a standalone piece of legislation. Campaigners have been clear that they see this as a partial win — a regulatory duty on providers, enforced through CQC, rather than a personal legal right that an individual could enforce directly. That distinction is still live in policy debate, and it is worth registered managers understanding, because it explains why CQC's expectations under Regulation 9A go further than a simple "allow visitors" policy.

What Counts as an "Exceptional Circumstance"

Regulation 9A does allow restrictions, but only where they are genuinely justified. CQC's guidance is explicit that blanket or long-term bans are not acceptable, even during outbreaks of infection. Any restriction has to be:

Infection control outbreaks and specific, evidenced safeguarding concerns remain the two most common legitimate grounds for a temporary restriction, but even then CQC expects providers to have considered alternatives — such as visiting in a different area of the building, screening, PPE, or supporting contact by video call — before removing in-person contact altogether.

What CQC Expects You to Evidence

When CQC looks at Regulation 9A during an inspection, inspectors are not just asking whether visiting happens. They are looking for a paper trail that shows how decisions get made. In practice that means having, and being able to produce:

• A written visiting and accompanying policy that starts from the presumption that visits will happen, not one written primarily around restriction.
• Individual risk assessments for anyone whose visiting or accompaniment is currently restricted in any way, rather than a single home-wide rule.
• Care plans that record each person's visiting preferences, who they want to see, and how they wish to be supported to leave the premises when needed.
• Evidence that the person themselves, their family, friends or an advocate were involved in any decision to restrict visiting.
• A clear review date and record of subsequent review for every restriction in place.
• Records showing alternatives to restriction were actively considered, not just that a restriction was applied.

Gaps here are a common finding during inspections, and they tend to compound other issues, since the same governance systems that produce robust minutes, audits and reviews elsewhere in your service are what will keep your visiting records defensible too.

Accompaniment Beyond the Building: Hospital and Other Appointments

The "accompanying" half of Regulation 9A is sometimes overlooked because it is less visible than visiting policy, but it carries equal weight. Residents have the right to be accompanied by a family member, friend or other support person when they attend hospital appointments, outpatient visits, or other trips outside the home. Providers should not be the ones deciding, by default, that a resident attends alone because it is simpler to arrange transport for one person, or because a family member was not available at short notice. Where a resident lacks capacity to make this decision themselves, accompaniment decisions need to be considered alongside best-interests processes — which is where Regulation 9A intersects directly with your obligations under the Mental Capacity Act and DoLS. Staff who are not confident distinguishing a capacity issue from a simple preference will struggle to apply Regulation 9A consistently, so this is a training gap worth closing early.

The March 2026 Review: What Changed and What's Coming Next

The Department of Health and Social Care opened a six-week call for evidence on how Regulation 9A was working in practice on 28 May 2025, closing on 9 July 2025, roughly a year after the regulation came into force. The outcome was published on 18 March 2026, and it is worth knowing what it found, because it signals where scrutiny is heading next rather than treating this as settled, historic policy.

The government's response was not to weaken or remove Regulation 9A but to strengthen it: DHSC confirmed it is exploring legislative proposals to reinforce visiting rights further, alongside nearer-term steps including better data collection through the Capacity Tracker, targeted communications and awareness resources for providers and families, and a working group involving people with lived experience to help develop practical guidance. For registered managers, the practical takeaway is that this is an area CQC and DHSC are actively watching, not a box that was ticked in 2024 and can now be left alone.

Where Visiting Decisions Intersect With Safeguarding

Safeguarding concerns are one of the few legitimate grounds for restricting a visit, but they are also one of the areas most likely to be challenged if the reasoning is not properly documented. A restriction justified by "safeguarding" without a specific, recorded concern, a named risk, and a review date will not withstand scrutiny — either from CQC or from a family member exercising their right to query the decision. If you are reviewing how safeguarding decisions are recorded and evidenced across your service, our guide to Regulation 13 and safeguarding from abuse and improper treatment covers the documentation standard CQC expects, and the same discipline applies directly to any visiting restriction you justify on safeguarding grounds.

A Practical Checklist for Registered Managers

• Review your visiting policy against the presumption that visits and accompaniment happen by default, not by exception.
• Check that every current visiting restriction on file has an individual risk assessment, a named justification, evidence of consultation with the person and their family, and a review date.
• Confirm care plans capture visiting preferences and accompaniment needs for every resident, not just those currently subject to a restriction.
• Brief staff — particularly those on reception and shift leads — on what they can and cannot restrict without escalation, and on the difference between a preference and a capacity-based decision.
• Audit whether alternatives to restriction (screened visiting, PPE, video calls) are genuinely offered and recorded before in-person contact is limited.
• Keep evidence ready for inspection: a policy alone will not satisfy inspectors without individual records behind it.

Building This Into Your Wider Compliance Culture

Regulation 9A is a good example of a fundamental standard that looks simple on the surface — "let people have visitors" — but that CQC actually assesses through the quality of your documentation, decision-making and review processes underneath it. Treating it as a standalone policy exercise, rather than embedding it into your existing risk assessment, care planning and safeguarding systems, is where most providers come unstuck. If your team needs a structured way to build this kind of regulatory literacy across compliance leads and registered managers, Learnsignal's CPD course library covers CQC fundamental standards, safeguarding and governance in more depth, and can help you turn guidance like this into a consistent, evidenced practice across your service.