What is a CQC Notice of Proposal?
A Notice of Proposal (NOP) is a formal warning from the Care Quality Commission (CQC). A NOP signals that CQC is planning serious enforcement action, issued under the Health and Social Care Act 2008, because the regulator believes there are significant risks to people receiving care.
A CQC Notice of Proposal can feel overwhelming. Staff worry, families ask questions and you wonder: "Could my service close?"
You have 28 days to respond and this is your only chance to stop enforcement before it becomes final.
Understanding the Legal Notice
A Notice of Proposal is a formal legal document issued by the CQC when it intends to take enforcement action against a registered care provider. It sets out exactly what regulatory action they plan to impose and why.
The keyword is "proposal." CQC has not yet made a final decision. They're telling you what they're planning to do and giving you 28 days to respond. Your response is your opportunity to challenge their findings, correct errors or demonstrate that you've fixed the problems.
Think of it as the last chance to fix errors before serious consequences. Once those 28 days pass and the CQC issues a Notice of Decision, the enforcement action becomes real and much harder to stop.
The NOP will arrive by post or email to your registered manager and nominated individual. It includes:
The specific enforcement action being proposed.
Detailed reasons, referencing the regulations you've breached
The evidence from the inspection
Instructions on how to respond
The 28-day deadline
What Triggers an NOP?
CQC doesn't issue NOPs casually. They're reserved for situations where there's a serious risk to people's health, safety or welfare.
Inadequate Ratings
An Inadequate rating is the most common trigger, particularly in the categories of 'Safe' or 'Well-led'. These ratings indicate systemic issues that pose an immediate risk to people. However, ratings alone don't automatically trigger an NOP. CQC assesses the severity and immediacy of the risks.
Safeguarding Failures
If someone in your care experienced abuse, neglect, or avoidable harm and your systems failed to protect them, an NOP often follows quickly. This includes situations where staff didn't recognise or report concerns, managers were aware of risks but didn't act or basic procedures weren't followed.
Serious Incidents
Deaths or serious injuries that should have been prevented trigger immediate enforcement consideration. If someone dies because staff fail to follow basic procedures or risks are not properly assessed, the CQC will question whether your service is safe to continue operating.
Repeated Breaches
If the CQC has instructed you multiple times to rectify an issue and you haven't, that indicates either an inability or unwillingness to comply. Perhaps you were issued a Warning Notice, but the next inspection revealed that you had not made the required improvements. The CQC escalates to an NOP because ordinary enforcement tools aren't working.
The underlying principle is that the CQC believes there's a serious and ongoing risk to vulnerable people. NOPs are for situations where the fundamental standards protecting people's safety have broken down.
What Actions Can the CQC Propose?
The NOP specifies exactly what enforcement action the CQC intends to take. These are designed to either force immediate improvement or shut you down.
Conditions of Registration
Conditions are the most common enforcement action. These are legally binding restrictions on your registration that limit your ability to operate.
The most frequent condition is suspension of new admissions. You can continue caring for current residents, but you can't accept anyone new until the CQC lifts the condition. For most care services, this is financially devastating.
Other conditions include:
Notifying the CQC before making certain decisions
Limiting the number of people you can care for
Restricting the types of care you can provide
Requiring external oversight
Conditions remain until you apply to have them lifted and the CQC agrees. That usually takes several months, at the very least and sometimes years. The business impact is severe. New referrals cease, occupancy declines and revenue falls. However, you're still operational and have time to address the issues.
Suspension of Registration
Suspension means your registration is temporarily cancelled. You cannot operate at all.
This is rare but happens when the CQC believes the risk is so serious that the service must stop immediately. Everyone receiving care must be moved to alternative services within a very tight timeframe.
For the provider, suspension is devastating. You're paying fixed costs while generating zero revenue. Most services don't survive suspension.
Cancellation of Registration
Your registration has been permanently removed and the service will be closed permanently.
The CQC proposes cancellation when it believes the breaches are so serious that the service shouldn't continue, the provider can't maintain compliance or the risks are too high to allow even conditional operation.
Cancellation also creates barriers to re-entering the care sector. Obtaining approval as a registered manager or nominated individual elsewhere becomes significantly more challenging with a cancellation on your record.
Why This Matters
Impact on People Receiving Care
People in your care face enormous uncertainty. Many have dementia or conditions that make them vulnerable to stress and change. The prospect of moving causes real psychological harm.
Routines matter profoundly to people with cognitive impairments. They are familiar with their environment, recognise staff members and feel secure. An NOP threatens all of that. If the service closes, they face the trauma of relocation. Research shows forced moves in later life are associated with faster cognitive decline.
Families who trusted you are now questioning that decision and researching alternatives. Even if you successfully challenge the NOP, that trust may never fully return.
Impact on Staff
Your staff worry about their jobs. Many live paycheck to paycheck and uncertainty creates real financial anxiety. Some will start looking for work elsewhere immediately, which can worsen the staff shortages that may have contributed to the NOP.
Staff deal with anxious families and work under enormous stress. Good staff members are often the first to leave because they have the most options available to them.
Business Impact
New referrals stop almost instantly. Local authorities and CCGs are aware of NOP and will stop placing people with you. Private referrals dry up as words spread.
Occupancy drops as families move people out. But your costs don't drop. You still have rent, insurance, utilities and minimum staffing requirements to cover. The gap between income and costs widens.
If conditions prevent new admissions, you will face months or years of operating below capacity. Most care services operate on thin margins. Extended periods of low occupancy often result in closure, even if you successfully challenge the enforcement.
What Happens Next?
Understanding the timeline helps you prepare for what's coming.
The 28-Day Response Window
Once you receive the NOP, the clock starts. You have exactly 28 days to submit written representations challenging the proposed action.
This deadline is statutory. It can't be extended except in exceptional circumstances. If you miss the deadline, CQC will proceed to issue a Notice of Decision without considering your response.
Most providers require expert legal assistance during this period. The response must be comprehensive, evidence-based and strategically structured to persuade CQC.
CQC Review
After you submit your representations, a CQC decision-maker reviews everything: the original inspection evidence, the inspector's recommendations, your written response and all your supporting evidence.
This typically takes several weeks. You won't hear anything during this period and CQC doesn't provide updates. For many providers, this waiting period is agonising.
The Notice of Decision
Eventually, you'll receive one of two outcomes.
Best case: the NOP is withdrawn. The CQC has decided your evidence is compelling enough that enforcement isn't needed. The proposed action is cancelled. You've avoided conditions, suspension or cancellation.
If the NOP is upheld, you'll receive a Notice of Decision (NOD). This confirms the enforcement action will proceed as proposed. The conditions, suspension, or cancellation become effective on a specified date.
Right to Appeal
A Notice of Decision can be appealed to the First-tier Tribunal (Care Standards Chamber). This is a formal legal process where an independent judge reviews the CQC's decision.
Key points about appeals:
You have 28 days from receiving the NOD to lodge your appeal.
The enforcement action is typically paused while your appeal is pending.
You can usually continue operating while the appeal is pending.
The tribunal hearing is a formal courtroom setting requiring experienced legal representation.
Appeals are expensive and time-consuming. Legal fees run into thousands of pounds and hearings take months to schedule. That's why the NOP stage is so critical. It's your best opportunity to stop enforcement before entering the tribunal process.
A Notice of Proposal is CQC’s formal warning that serious enforcement action is coming. It follows inspections where significantly high-risk breaches were identified and it signals the regulator believes there's a serious risk to vulnerable people.
If you've received a Notice of Proposal, contact our team immediately. We specialise in CQC enforcement responses and can help you protect your service. Time is not on your side; reach out to our experts today.
