Sample policy · CQC Reg 12

CQC Statement of Purpose template

Statutory anchor: Regulation 12 (Statement of purpose) and Schedule 3, Care Quality Commission (Registration) Regulations 2009 (SI 2009/3112, as amended). · primary source

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The PDF version of this template is the same content, formatted for adaptation in your document control system. The disclaimer above is repeated on the PDF cover.

Verivius pack version v1, 2026-06-10

1. What the regulation says

The registered person must give the Commission a statement of purpose containing the information listed in Schedule 3. (Regulation 12(1))

The registered person must keep under review and, where appropriate, revise the statement of purpose. (Regulation 12(2))

The registered person must provide written details of any revision to the statement of purpose to the Commission within 28 days of any such revision. (Regulation 12(3))

The full text is at https://www.legislation.gov.uk/uksi/2009/3112/regulation/12 and Schedule 3 is at https://www.legislation.gov.uk/uksi/2009/3112/schedule/3. Where this policy and the regulation diverge, the regulation wins.

2. Plain-English summary

The registered person must give CQC a Statement of Purpose that contains the information listed in Schedule 3 of the Care Quality Commission (Registration) Regulations 2009. That information covers who the provider is, the aims and objectives of the service, the regulated activities and where they are carried on, the people the service is for, and the registered managers. The registered person must keep the Statement of Purpose under review, revise it where appropriate, and tell CQC in writing about any revision within 28 days of making it.

3. What this document is for

CQC asks all new provider applicants to send a Statement of Purpose. It tells CQC, inspectors and the public:

The provider keeps the live Statement of Purpose under review. When it is revised, the provider tells CQC in writing about the revision within 28 days.

4. Provider details

Complete this section with the provider's legal details.

Field Provider entry
Legal business name
Trading name, if different
Legal status <sole trader, partnership, limited company, charity, LLP or other>
Companies House or charity number, if applicable
Registered office or principal business address
Address for CQC notices and formal documents
Main telephone number
Main email address
Website, if applicable
Nominated Individual, if applicable <name, role, email, telephone>
Partners, if a partnership
Responsible person for this Statement of Purpose

Before submission, check that these details match the CQC application form and any Companies House, charity or partnership records.

5. Aims and objectives

Describe the aims and objectives of the regulated activities the provider will carry on. Keep this specific to the service. Avoid generic statements such as "we provide high-quality care" unless the rest of the paragraph explains what that means in practice.

5.1 Our aims

The provider's aims are:

  1. <aim 1, linked to the regulated activities>
  2. <aim 2, linked to the people the service is for>
  3. <aim 3, linked to safety, governance and continuity>

5.2 Our objectives

The provider will meet those aims by:

  1. <objective 1, for example assessment before accepting a referral or booking>
  2. <objective 2, for example staffing and competency controls>
  3. <objective 3, for example governance, audit and learning systems>
  4. <objective 4, for example accessibility and communication support>
  5. <objective 5, for example escalation when needs move outside the service's scope>

6. Locations and regulated activities

Complete one location table for each CQC location. A location is not just a mailing address. It must be the place where the regulated activity is carried on or managed from.

Location 1:

Field Provider entry
Location name
Full location address
Location telephone
Location email
Type of location <clinic, dental practice, GP practice, care home, domiciliary-care office, diagnostic centre, patient transport base, ambulance base, independent hospital, other>
Description of premises <brief description, including any other uses for the property>
Other property uses <none, or describe other uses such as domestic dwelling, shared professional premises, office suite or leased clinical rooms>
Regulated activities carried on or managed from this location <activity 1; activity 2; activity 3>
Service type at or from this location
Registered manager for this location

Location 2: <location name, if applicable>

Repeat the table above for every location.

7. People the service is for

List the service-user bands or population groups the provider is asking CQC to register at each location. Do not select a group unless the provider can evidence that it can meet that group's needs.

Location Service-user bands or population groups Evidence that the service can meet those needs
<for example whole population, older people, dementia, learning disability or autism, physical disability, sensory impairment, mental health, children, adults over 65> <training, staffing, premises, equipment, communication support, policies and pathways>

7.1 Specialist service-user bands

If the provider intends to support autistic people, people with a learning disability, people living with dementia, people with sensory impairment or another specialist group, explain the specific steps taken to make the service safe and accessible.

The service has considered:

The Statement of Purpose must match the Service User Guide, training plan, safeguarding policy, consent policy and any specialist policy the provider submits.

8. What the service does and does not provide

This section protects the provider and the public by making the service boundary explicit.

8.1 Regulated activities provided

The provider will carry on the following regulated activities:

Regulated activity Location How the activity is delivered

8.2 Services not provided

The provider does not provide:

Where a person's needs move outside the provider's scope, the service follows its escalation, referral and transfer arrangements.

9. Registered managers

Complete one registered-manager table for each registered manager. If the same manager covers more than one location, show the time split clearly.

Registered Manager 1:

Field Provider entry
Full name
Job title
Work telephone
Work email
Address for CQC notices and formal documents
Regulated activities managed <activity 1; activity 2>
Locations managed <location 1; location 2>
Percentage of working time at each location <location 1: percentage; location 2: percentage>
Job-share arrangements, if any
Interim-cover arrangement during absence

Registered Manager 2: <full name, if applicable>

Repeat the table above for every registered manager.

10. Review and CQC notification procedure

The provider keeps this Statement of Purpose under review so it remains accurate.

10.1 Routine review

The responsible person reviews this document:

10.2 Change control

When the Statement of Purpose needs to change:

  1. The responsible person records the proposed change and the reason for it.
  2. The provider checks the change against the application form, service-user guide, training plan, business plan, floor plan and relevant policies.
  3. The provider updates the Statement of Purpose.
  4. The provider notifies CQC in writing about the revision within 28 days.
  5. Where the change also requires a registration variation, the provider sends the proposed Statement of Purpose with the variation application.
  6. The provider keeps the superseded version in its governance records.

Operational controls to adapt

Purpose and scope

This template is for drafting, checking and maintaining the provider's Statement of Purpose. It applies to:

It does not replace CQC's application forms or any CQC-issued template the provider is required to use.

Roles and responsibilities

Records and evidence fields

The Statement of Purpose record should include:

Audit cadence

The provider checks this document at least annually and whenever the service changes. The audit should test:

Findings are recorded in the governance meeting or improvement-action register until complete.

Local adaptation prompts

Before adoption, replace every placeholder with local detail and answer these prompts:

11. Consistency checks before submission

Before submitting this Statement of Purpose, check it against the rest of the registration pack.

Check Confirmed by Date
Legal business name matches all documents
Locations match the CQC application and evidence of legal occupancy
Regulated activities match the application form
Service-user bands match the service-user guide
Specialist service-user bands are supported by training, premises, communication and policy evidence
Registered-manager names, activities, locations and time splits match RM application forms
Business plan and financial forecast match the declared service model
Floor plan and environment documents match the declared locations and service-user needs
Staff training plan matches the declared regulated activities and service-user bands
Complaints, safeguarding, consent, governance, IPC, medicines and other policies match the declared service model
Document has business name, responsible person, creation date and review date

12. Related policies in this pack

13. Sources and further reading

This template is based on CQC's guidance for providers and managers, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and other topic-specific legislation and guidance listed below. It is a starting point for adaptation, not a substitute for legal, clinical, HR, safeguarding or specialist professional advice.

Related reading

14. Document control

Version Date Author Changes
v1.0 2026-05-19 Verivius (sample) Initial Regulation 12 shell template.
v1.1 2026-06-07 Verivius (sample) Reworked into a CQC-registration-ready drafting template covering provider details, aims and objectives, locations, regulated activities, service-user bands, registered-manager details, review controls, 28-day CQC notification, and registration-pack consistency checks.
v1.2 2026-06-10 Verivius (sample) Conformed to the Verivius policy standard: added the verbatim "What the regulation says" block from the Care Quality Commission (Registration) Regulations 2009 Regulation 12, a plain-English summary, the standard sources block and document control. All original sections preserved and renumbered from 3.
v1.3 2026-07-14 Verivius (sample) Added purpose and scope controls, owner roles, governance-file records, audit cadence, local adaptation prompts and related reading.

This sample policy template was issued by Verivius as an example for guidance. It is a template, not a substitute for legal advice or the tenant's own registration-review process, and it is not a substitute for CQC's own templates. The provider is responsible for ensuring any Statement of Purpose it submits is accurate, current and specific to the service. Where this template and live law or regulator guidance diverge, the live source wins.

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Last reviewed 10 June 2026