What does CQC registration cover?

The CQC registers care homes to provide regulated activities, principally accommodation for people who need nursing or personal care. A home's registration records whether it provides nursing, the maximum it is set up for, and which groups it can care for, such as people living with dementia.

What is the difference between residential and nursing beds?

A residential bed provides personal care: help with washing, dressing, meals and medication. A nursing bed adds care from a registered nurse on site 24 hours a day, for residents with ongoing medical needs. Nursing beds cost more to run and command higher fees.

What does dementia registration mean?

It means the home is registered to care for people living with dementia, in either a residential or a nursing setting. It signals capability, often including adapted environments and trained staff, though not every bed in the home is necessarily a dementia place.

How does the registration mix reveal a gap?

If a catchment's beds are mostly residential while its population is ageing into higher-acuity need, nursing and dementia provision may be short even when total beds look adequate. Weak CQC ratings among the existing homes thin the effective supply further.

Nursing, residential and dementia registration explained

Threshold Guides · 8 min read · England & Wales

Two care homes on the same street can hold the same number of beds and yet address completely different needs, because what a home is registered to do, not just how big it is, determines who it can take. For a developer reading a catchment, the registration mix of the competing homes is one of the clearest signals of where real demand is going unmet. This guide explains residential, nursing and dementia registration, and how to read them as a gap.

What CQC registration actually is

In England every care home is registered with the Care Quality Commission (CQC) to carry out regulated activities, principally the accommodation for persons who require nursing or personal care. Registration is not a formality: it defines the regulated activities a location may provide, the maximum size it is set up for, and the groups of people it can care for. The public register, the CQC HSCA Active Locations list, records for every home its beds, whether it provides nursing, the groups it serves, and its latest inspection rating (Outstanding, Good, Requires improvement or Inadequate).

Residential registration: personal care

A home registered for personal care without nursing is what most people mean by a residential care home. It supports residents with the activities of daily living, washing, dressing, mobility, meals and medication, but does not provide on-site nursing as a condition of registration. Where a resident needs clinical care, it is brought in from the community, for example by a district nurse. Residential beds cost less to staff than nursing beds and carry a correspondingly lower fee.

Nursing registration: a registered nurse on site

A home registered for nursing care must have a registered nurse on site 24 hours a day. That single requirement changes both the economics and the resident profile: nursing homes take higher-acuity residents with ongoing medical needs, cost significantly more to run because of clinical staffing, and command higher weekly fees. A home can be registered for both, holding residential and nursing beds under one roof, which is why counting registered beds alone tells you less than counting them by registration type.

Dementia registration: a capability, not a building type

Dementia is recorded by the CQC as one of the groups a home is registered to support, and it can apply to either a residential or a nursing setting. A dementia-registered home is set up to care for people living with dementia, typically with adapted, secure environments and staff trained in dementia care. Two points matter for reading demand:

Registration signals capability, not a headcount. Not every bed in a dementia-registered home holds a resident with dementia, but the home is set up to take them.
Because dementia prevalence climbs steeply with age, dementia-registered provision tracks the oldest and fastest-growing part of the population, and is often the tightest part of local supply.

Why the distinctions matter operationally

Registration type is not paperwork; it drives the whole operating model:

Staffing: nursing registration requires round-the-clock registered nurses, the scarcest and most expensive staff in the sector.
Fees and funding: higher-acuity nursing and dementia beds carry higher fees, and a different funding mix, than basic residential.
Design: dementia and nursing care shape the building itself, from secure circulation and wayfinding to assisted bathing and clinical space.
Regulation: the wider the registration, the more the CQC expects of the home, which feeds its rating and, ultimately, its durability.

Reading a catchment's registration mix as a gap signal

This is where registration becomes a development tool. A raw bed count treats every bed as identical; the registration mix tells you which needs are actually covered. When you map the competing homes in a catchment, look for:

Thin nursing or dementia cover: a catchment whose beds are overwhelmingly residential, sitting under a population ageing into higher-acuity need, may be short of nursing and dementia places even if total beds look adequate.
Weak ratings concentrated in one type: if the nursing or dementia beds that do exist sit largely in homes rated Requires improvement or Inadequate, the effective quality supply is thinner than the count suggests, and some of it is at closure risk.
Old stock: long-established homes registered decades ago may not meet modern expectations, leaving a quality gap that a new, well-specified scheme can occupy.

Worked read. Suppose a catchment holds enough beds in total to look balanced on the headline 32.5-per-100 benchmark, but three-quarters of those beds are residential-only, and the handful of nursing beds sit in homes rated Requires improvement. The headline says balanced; the registration mix says the nursing and dementia segment is wide open. That is a scheme with a clear position, invisible to anyone counting beds alone.

Putting it to work

Registration turns a flat bed count into a map of covered and uncovered need. The national picture, roughly 14,700 registered care homes and 484,000 beds across England at about 32.5 beds per 100 people aged 85 and over, is only the starting frame; the opportunity lives in how those beds split by type and quality in your specific catchment. Threshold reads the CQC register for you: browse the beds, registration split and ratings for any area in the care data pages, see how the products differ in the guide to later living versus care and nursing homes, and turn a single site into a full appraisal with Threshold Care.

Frequently asked questions

What does CQC registration cover?: The CQC registers care homes to provide regulated activities, principally accommodation for people who need nursing or personal care. A home's registration records whether it provides nursing, the maximum it is set up for, and which groups it can care for, such as people living with dementia.
What is the difference between residential and nursing beds?: A residential bed provides personal care: help with washing, dressing, meals and medication. A nursing bed adds care from a registered nurse on site 24 hours a day, for residents with ongoing medical needs. Nursing beds cost more to run and command higher fees.
What does dementia registration mean?: It means the home is registered to care for people living with dementia, in either a residential or a nursing setting. It signals capability, often including adapted environments and trained staff, though not every bed in the home is necessarily a dementia place.
How does the registration mix reveal a gap?: If a catchment's beds are mostly residential while its population is ageing into higher-acuity need, nursing and dementia provision may be short even when total beds look adequate. Weak CQC ratings among the existing homes thin the effective supply further.

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Care figures are statistical estimates from official open data (CQC HSCA Active Locations, ONS population and 2022-based subnational projections) under the Open Government Licence. England coverage. Not investment or valuation advice.