Registered providers must notify CQC about certain events, incidents and changes. The duty comes from the Care Quality Commission (Registration) Regulations 2009, and failing to notify is a criminal offence — not an administrative slip.
The one that catches most services is Regulation 18, "notification of other incidents", which must be sent without delay. It covers serious injury, any abuse or allegation of abuse, police involvement, events that threaten your ability to operate safely, and DoLS outcomes.
Most guidance on this topic tells you to notify CQC about “serious incidents” and leaves you to work out what that means. The regulations are more precise than that, and the precision matters — because the thresholds are specific numbers, and knowing them is the difference between over-reporting everything and missing something notifiable.
This page sets out what the law actually says.
First, clear up the Regulation 15 confusion
If you have searched for “CQC Regulation 15” and come away confused, there is a good reason. There are two different Regulation 15s, in two different sets of regulations, and they mean entirely different things:
| Regulation | Which regulations | What it covers |
|---|---|---|
| Regulation 15 | CQC (Registration) Regulations 2009 | Notice of changes — telling CQC when your registered details change |
| Regulation 15 | Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 | Premises and equipment — one of the fundamental standards |
The notification duties live in the 2009 Registration Regulations. The fundamental standards — the ones you are assessed against — live in the 2014 Regulated Activities Regulations. When someone says “Reg 15” without saying which set, ask.
We have mapped the full collision between the two sets, and what each fundamental standard requires, in CQC fundamental standards and regulations.
The notification regulations are:
- Regulation 14 — notice of absence
- Regulation 15 — notice of changes
- Regulation 16 — notification of death of a service user
- Regulation 17 — notification of death or unauthorised absence of a service user detained or liable to be detained under the Mental Health Act 1983
- Regulation 18 — notification of other incidents
- Regulation 22A — the form notifications must take
Regulation 18 in detail — the thresholds that actually matter
Regulation 18(1) requires the registered person to notify CQC “without delay” of the incidents listed in 18(2), where they occur while services are being provided, or as a consequence of the regulated activity.
Serious injury — and what “serious” legally means
Notifiable under 18(2)(a) is any injury which, in the reasonable opinion of a health care professional, has resulted in:
- an impairment of sensory, motor or intellectual functions which is not likely to be temporary
- changes to the structure of the person’s body
- the person experiencing prolonged pain or prolonged psychological harm
- the shortening of the person’s life expectancy
Also notifiable under 18(2)(b): any injury which, in the reasonable opinion of a health care professional, requires treatment to prevent death, or to prevent one of the outcomes above.
Here is the part that is almost never quoted, and it is the most useful thing on this page. Regulation 18(5)(g) defines those terms numerically:
“‘prolonged pain’ and ‘prolonged psychological harm’ means pain or harm which a service user has experienced, or is likely to experience, for a continuous period of at least 28 days”, and “a sensory, motor or intellectual impairment is not temporary if such an impairment has lasted, or is likely to last, for a continuous period of at least 28 days.”
28 days is the line. Not a judgement call about severity — a defined period. That single definition resolves most of the “is this notifiable?” arguments that happen in practice.
Abuse — and what counts as abuse
18(2)(e) requires notification of any abuse or allegation of abuse in relation to a service user. Note “allegation” — you do not wait to establish whether it happened.
Regulation 18(5)(b) defines abuse as: sexual abuse; physical or psychological ill-treatment; theft, misuse or misappropriation of money or property; and neglect and acts of omission which cause harm or place at risk of harm.
That definition is broader than many services assume. Misappropriation of a resident’s money is abuse in the legal sense, and it is notifiable.
Police involvement
18(2)(f) requires notification of any incident which is reported to, or investigated by, the police. Under 18(3) this does not apply where the service provider is an English NHS body.
Events that threaten safe operation — with hard time limits
18(2)(g) covers any event which prevents, or appears likely to threaten to prevent, your ability to carry on the regulated activity safely or in accordance with your registration. The regulation gives four examples, and three carry explicit thresholds:
- insufficient numbers of suitably qualified, skilled and experienced staff
- an interruption to electricity, gas, water or sewerage lasting longer than a continuous period of 24 hours
- physical damage to premises which has, or is likely to have, a detrimental effect on treatment or care
- failure or malfunctioning of fire alarms or other safety devices lasting longer than a continuous period of 24 hours
The 24-hour clock is continuous. A fire panel fault fixed at hour 23 is not notifiable under this limb; the same fault still open at hour 25 is.
Children in adult psychiatric units
18(2)(h) requires notification where a person under eighteen is placed in a psychiatric unit intended for adults, and that placement lasts longer than a continuous period of 48 hours.
DoLS
Regulation 18(4A) requires notification of any request to a supervisory body for a standard authorisation under Schedule A1 of the Mental Capacity Act 2005, and any application to court to deprive someone of their liberty under section 16(2)(a).
Under 18(4B), you notify once the outcome is known — or at the point of withdrawal if the application is withdrawn — and the notification must state the date and nature of the application, whether it followed an urgent authorisation, the outcome or reason for withdrawal, and the date of that outcome.
One quirk worth knowing
If you read Regulation 18(2) on legislation.gov.uk you will see the lettering jumps: (a), (b), then (e). Sub-paragraphs (c) and (d) were omitted in 2012. Nothing is missing from your copy — they were removed and the remaining letters were never renumbered.
The full list of notifiable events
CQC publishes notification forms for each. Under events and incidents:
- Absence of a registered individual for 28 days or more
- Allegations of abuse (safeguarding)
- Children and young people in adult psychiatric units
- Death of a detained mental health patient
- Death of a person using the service
- Death of a registered provider, and plans for the service
- Events that stop a service running safely and properly
- Liquidator or trustee’s plans for a service
- Outcome of an application to deprive a person of their liberty (DoLS)
- Police involvement in an incident
- Return of a registered individual after an absence of 28 days or more
- Serious injury to a person using the service
- Unauthorised absence
And under changes to your registered details:
- Change of contact details
- Change of an individual’s name
- Changes to your statement of purpose
- Insolvency
- Nominated individuals, officers and directors
- Provider stopping regulated activities
- Provider’s name and address
- Registered manager for an activity
If you are an NHS body, some of this is different
Regulation 18(4) disapplies the general notification duty for health service bodies to the extent that the incident has been reported to NHS England. And as noted, the police-involvement limb does not apply to English NHS bodies at all.
This is a genuine trap for independent providers delivering NHS-funded care: reporting into an NHS system does not automatically discharge your duty to CQC unless the exemption applies to you.
What happens if you do not notify
Failing to comply with the notification regulations is a criminal offence under Regulation 25, and CQC can issue a penalty notice under Regulation 26 as an alternative to prosecution.
In practice, the bigger risk is what a pattern of missed notifications says about your governance. A single late notification is a mistake. A service that did not notify because nobody knew it was notifiable, or because the incident was never escalated, is describing a well-led problem — and that is what an inspector will pursue.
The practical problem, and how to solve it
Almost nobody fails to notify because they decided not to. They fail because the incident was recorded in one place, the notification duty sat in someone’s head, and the two never met.
What works:
- Decide notifiability at the point of recording, not at the weekly review. The clock is “without delay”.
- Encode the thresholds — 28 days, 24 hours continuous, 48 hours — into whatever you use to triage incidents, so the judgement is prompted rather than remembered.
- Keep the trail. Record what you notified, when, and the CQC reference. If a notification is ever questioned, the record is the answer.
- Track the decision not to notify too. A documented, reasoned decision that something fell below the threshold is a defensible position. Silence is not.
Where CompliantCare fits
This is exactly what CompliantCare is built for. Incidents are recorded, triaged against notification criteria, and the ones that meet a threshold are flagged at the point of entry rather than a fortnight later. What was notified, when, and by whom stays on the record.
The decisions not to notify are recorded too, with the reasoning — which is the part most services cannot produce when asked.
See how incident management works →
Common questions
What notifications need to be sent to CQC? Deaths, serious injuries, abuse and allegations of abuse, incidents involving police, DoLS application outcomes, events that stop the service running safely, under-18s placed in adult psychiatric units for over 48 hours, and unauthorised absences. Separately, changes to your registered details — statement of purpose, registered manager, contact details, insolvency and others.
What are Regulation 18 notifications? Regulation 18 of the CQC (Registration) Regulations 2009 is “notification of other incidents”. It covers serious injury, abuse and allegations of abuse, police-involved incidents, events threatening safe operation, under-18s in adult psychiatric units, and DoLS outcomes. It must be sent without delay.
What is the CQC Regulation 15 notification? In the Registration Regulations 2009, Regulation 15 is “notice of changes” — notifying CQC when your registered details change. Note that Regulation 15 of the 2014 Regulated Activities Regulations is a completely different thing: premises and equipment.
How quickly must I notify CQC? Regulation 18 says “without delay”. It is not defined as a number of days, which in practice means as soon as you know — not at the next governance meeting.
Is an allegation of abuse notifiable even if it turns out to be unfounded? Yes. Regulation 18(2)(e) covers “any abuse or allegation of abuse”. You notify on the allegation.
Does reporting to the local authority or NHS England cover it? Not usually. Regulation 18(4) exempts health service bodies to the extent an incident has been reported to NHS England. If you are an independent provider, reporting to a safeguarding team or a commissioner does not discharge your duty to CQC.
What happens if I do not notify CQC? It is a criminal offence under Regulation 25, and CQC may issue a penalty notice under Regulation 26 instead of prosecuting.
Related: what the CQC is and how it regulates · CQC KLOEs and the 2026 reform · CQC’s new assessment frameworks · the CQC inspection checklist
Sources: The Care Quality Commission (Registration) Regulations 2009 (SI 2009/3112) · Regulation 18 — Notification of other incidents · CQC — Notifications · CQC — Notifications: guidance for providers
This page explains the regulations as published. It is not legal advice — if you are unsure whether a specific incident is notifiable, notify, and take advice.
Last reviewed: 30 July 2026. We review our CQC pages monthly against CQC's published guidance.