5 July 2026 · 12 min read · By CQC Queen Academy
Supported living is one of the fastest-growing sectors in adult social care. Across London and the South East, commissioning activity is increasing, but demand alone does not win placements. Commissioners want evidence. Regulators want compliance. And if your service provides personal care, you need to make sure your CQC registration reflects what you are actually doing.
This guide covers everything a new or growing supported living provider needs to know: what CQC expects, what the REACH standards require, how the REAL Tenancy Test applies, and the checklist you should work through before submitting your registration or responding to a tender.
What commissioners want from supported living providers
Before we get into regulation, it is worth understanding why commissioning is competitive. Local authorities and ICBs are placing people with complex needs (autism, learning disabilities, acquired brain injuries, mental health conditions) into supported living because it offers an alternative to inpatient settings and residential care. They are looking for providers who can demonstrate:
- Safe, consistent, person-centred support
- Robust governance and quality assurance processes
- Well-trained, well-supervised staff
- Clear, co-produced care and support plans
- A thorough understanding of CQC requirements and the regulatory framework
- Evidence of good practice aligned with national guidance
A strong CQC registration is the baseline. A tender-ready provider has everything above it.
Does your supported living service need a CQC registration?
Yes, if your supported living service provides personal care to people in their own homes or supported living accommodation, it is a regulated activity under the Health and Social Care Act 2008. You must be registered with the CQC to operate legally.
Important: Do not assume your domiciliary care registration automatically covers supported living. Many providers make this mistake. If you are expanding from domiciliary care into supported living, or moving from residential into supported living, you will need to review your registration conditions and may need to apply for a new or varied registration.
The CQC’s guidance on when personal care is regulated is set out in the Scope of Registration Guidance.
Right Support, Right Care, Right Culture: what it means for you
The key policy document for supported living providers working with autistic people and people with learning disabilities is Right Support, Right Care, Right Culture (CQC, updated 2022). This guidance shapes how the CQC assesses new registrations and inspections for these services.
Right Support, Right Care, Right Culture applies to you if you are:
- Seeking to register a new supported living service that will carry out regulated activity
- Applying to change registration conditions, for example adding new service types or locations
- Already running a service and reviewing whether your provision meets current expectations
The guidance is not optional. CQC inspectors use it as a framework and will look for evidence that your service has understood and is applying its principles.
The REACH Standards: person-centred living in practice
Right Support, Right Care, Right Culture asks providers to demonstrate that they have studied, understood and will apply the REACH Standards (Paradigm, 2014). These nine standards, rooted in human rights, are the benchmark for person-centred practice in supported living.
The nine REACH standards
- I choose who I live with
- I choose where I live
- I have my own home (with a tenancy or ownership)
- I choose who supports me and how I am supported
- I choose my friends and my relationships
- I get help to make changes in my life
- I choose how to be healthy and safe
- I choose how I am part of my community
- I have the same rights and responsibilities as other citizens
These standards connect directly to the Fundamental Standards, particularly Regulation 9 (Person-Centred Care), Regulation 10 (Dignity and Respect), Regulation 11 (Need for Consent), Regulation 12 (Safe Care and Treatment), Regulation 13 (Safeguarding) and Regulation 14 (Nutrition and Hydration).
Reference: Warren S. and Giles J. REACH: Support for Living. A Practical Guide to the REACH Standards. Paradigm (2015).
The REAL Tenancy Test: is your tenancy arrangement genuine?
Right Support, Right Care, Right Culture also asks supported living providers to apply the REAL Tenancy Test (National Development Team for Inclusion, 2015). The CQC does not register the housing component of supported living, only the regulated activity of personal care, but a genuine tenancy arrangement is considered essential.
The five REAL Tenancy standards are:
- A tenancy agreement is in place
- The tenant has control over where they live
- The tenant has control over who they live with
- The tenant has control over who supports them and how they are supported
- The tenant has control over what happens in their home
In addition, providers should reflect on practice questions, for example: has a tenant been moved from their home because of a decision by the support provider? Do staff have free access and hold keys to the tenant’s home? Is support provided at times set by the provider rather than the tenant? If the answer to any of these is yes, this is a concern that needs to be addressed.
Best practice guidance: what you need to have read
Right Support, Right Care, Right Culture specifically asks providers to study the following guidance. You should be able to demonstrate knowledge of these documents during registration and inspection:
- NICE Guideline CG142, Autism Spectrum Disorder in Adults: Diagnosis and Management
- NICE Guideline NG93, Learning Disabilities and Behaviour that Challenges
- NHS England/LGA/ADASS: Service model for commissioners, behaviour that challenges (October 2015)
How to start a supported living company in the UK: your checklist
Whether you are starting from scratch or expanding an existing care business into supported living, there is a clear set of foundations you need to have in place before you can register with the CQC, respond to a tender, or accept your first referral.
Stage 1
Business foundations
- Choose legal structure (Ltd, CIC, CIO)
- Register with Companies House
- Business plan with financial projections
- Insurance (liability, employers)
- Bank account and bookkeeping
Stage 2
CQC registration
- Confirm regulated activity scope
- Appoint Registered Manager
- Identify Nominated Individual
- Draft Statement of Purpose
- Study Right Support, Right Care, Right Culture
- Evidence REACH standards alignment
- Apply REAL Tenancy Test to your model
Stage 3
Policies and documents
- Safeguarding policy
- Medication management policy
- Mental Capacity Act / DoLS policy
- Positive behaviour support approach
- Lone working and risk policy
- Complaints and whistleblowing
- Infection control and H&S
Stage 4
Staffing and training
- Safer recruitment process
- DBS checks (enhanced) for all staff
- Mandatory induction training
- Autism and learning disability training
- Positive behaviour support training
- Supervision and appraisal schedule
Stage 5
Care planning
- Person-centred support plan template
- Risk assessment framework
- Communication profiles
- Health action plans
- Mental capacity assessments
- Positive behaviour support plans
Stage 6
Governance and quality
- Quality assurance framework
- Audit and monitoring schedule
- Incident reporting and learning
- CQC notifications process
- Service user feedback mechanisms
Stage 7
Tenancy and housing
- Tenancy agreement reviewed
- REAL Tenancy Test self-assessment
- Separation of housing and support clear
- Tenants’ rights and choice documented
Stage 8
Tender readiness
- CQC registration confirmed
- Registered on relevant frameworks
- Social value statement prepared
- Commercial pricing model prepared
- Mobilisation plan in place
Need help getting your supported living service CQC-ready and tender-ready?
Starting and registering a supported living service is one of the most involved registration processes CQC oversees. The bar is higher than domiciliary care, the documentation is more detailed, and commissioners expect you to be able to talk fluently about REACH, Right Support Right Care Right Culture, tenancy rights, and person-centred practice before they will place anyone with you.
Starter guide
£59
Guided checklist and roadmap for providers at the beginning of their journey.
Get the guideDetailed guide
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In-depth walkthrough of CQC registration, REACH, tenancy, policies and tender preparation.
Get the guideCQC Queen Academy is independent and is not affiliated with or endorsed by the Care Quality Commission. Nothing in this article constitutes legal or regulatory advice.
Further reading and official resources
- Right Support, Right Care, Right Culture (CQC, 2022)
- REACH Standards (Paradigm, 2014)
- REAL Tenancy Test (NDTi, 2015)
- NICE CG142, Autism Spectrum Disorder in Adults
- NICE NG93, Learning Disabilities and Behaviour that Challenges
- NHS England service model for commissioners
- CQC scope of registration guidance
- CQC Fundamental Standards
