It's Friday afternoon. A registered manager rings your agency needing a carer for a Monday morning shift. The candidate is keen, the money is real, and the whole thing comes down to one question: is the reference in place, and does it cover what CQC will want to see?
Under Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, a care provider in England must hold, for every person it employs, satisfactory evidence of that person's conduct in previous health or social care work, together with a full employment history and a written explanation of any gaps. That reference is one of the pieces of information a CQC inspector can ask to see, so it earns real scrutiny before a shift starts.
We ran an education recruitment agency for seven years. The regulator and the barred list are different in care, but the job of clearing a temp worker before a shift is the same problem we lived every day. Here's what Regulation 19 actually asks for, who the referee should be, and where care referencing parts company with education.
What Regulation 19 actually requires
Regulation 19 is titled "fit and proper persons employed." It says that anyone a provider employs must be of good character, must have the qualifications, competence, skills and experience the work needs, and must be able to do the job by reason of their health, after reasonable adjustments. The provider has to run recruitment procedures that check all of this, and it has to hold the information listed in Schedule 3 for every person.
Schedule 3 is where the reference requirement actually lives: Regulation 19 sets the duty, Schedule 3 spells out the paperwork.
The duty sits with the provider, the care home or the domiciliary care service. When a home uses agency staff, it doesn't lose that duty. It pushes the requirement down to you through the terms of the booking and its own audits. Your file becomes part of the evidence the home relies on at inspection, so a gap in your process becomes a gap in theirs.
What the reference has to cover
A letter saying "she was lovely, we'd have her back" doesn't meet Schedule 3 on its own.
Schedule 3 asks for satisfactory evidence of the person's conduct in previous employment concerned with health or social care, or with children or vulnerable adults. It also asks, where the person has worked with vulnerable adults before, for satisfactory verification of why that role ended, so far as is reasonably practicable. "Satisfactory" here means satisfactory in CQC's opinion, which is worth remembering when you are deciding whether a thin reference is good enough.
So a reference that holds up covers the dates of employment, the role held, the person's conduct in the job, and, where it applies, why they left. Skills for Care describes the mindset a provider should bring to this as a curious, safeguarding one: read the reference, risk-assess anything that gives you pause, and document the decision rather than filing it unread. The same discipline we set out in our guide to safer recruitment references applies just as well in care.
Who counts as a valid referee
The regulation points you at conduct in previous care work, so the referee has to be someone who can actually speak to that.
In practice that's a previous registered manager, a former supervisor from a care setting, or the previous care agency. It is rarely a friend, a landlord, or a character reference from outside the sector. Those have their place, but they don't answer the question Schedule 3 asks.
This is where agencies get caught out. Supply carers move between agencies the same way supply teachers do, so the person who can vouch for their last three months of shifts is often another agency's consultant, not a home's manager. That's normal, as long as the referee genuinely knows the work. The referee should be whoever saw the candidate on the floor.
What "full employment history" means
This is where care asks for more than education does. Schedule 3 wants a full employment history with a satisfactory written explanation of any gaps in employment. That means every employer, the whole run, with the gaps accounted for. A three-month gap that nobody explained is exactly the kind of thing an inspector notices, and "we didn't ask" is a poor answer to give a registered manager trying to protect their own rating.
Full history doesn't mean a reference from every job going back a decade. It means the timeline is complete on paper and the gaps are explained. Where a previous role involved vulnerable adults, you also want to know why it ended. Get that down at registration, while the candidate is keen and in front of you, rather than chasing it on a Friday with a shift riding on it.
How care referencing differs from education
If you've come from education recruitment, most of the muscle memory transfers. A few things change.
| Area | Education | Care |
|---|---|---|
| Regulator | Ofsted, ISI | Care Quality Commission |
| Rulebook | Keeping Children Safe in Education | Regulation 19 + Schedule 3 |
| Barred list | Children's Barred List | Adults' Barred List |
| Reference focus | Most recent employer, suitability to work with children | Conduct in previous care work, plus full employment history and reasons roles ended |
| DBS | Enhanced with Children's Barred List | Enhanced with Adults' Barred List for personal care |
On DBS: care workers who provide personal care for adults are in regulated activity, which means an Enhanced DBS check with the Adults' Barred List. Where staffing pressure genuinely risks safe delivery, a DBS Adult First check can let someone start under supervision before the full certificate returns. The rest of your safer recruitment still has to be done, and the home is expected to document the extra safeguards, such as direct supervision, until the full DBS is back.
The engine is the same shape as education. The rules, the lists, and the heavier employment-history requirement are what change.
Where the process breaks down
Back to that Friday afternoon. In seven years running an agency, these were the patterns that cost us shifts.
The reference comes in and gets filed without anyone reading it, so a soft or evasive answer goes unnoticed until it matters. The referee goes quiet, and non-response is the single most common reason a reference is late. A late reference on a Friday is a shift that goes to another agency. We wrote separately about what to do when a referee isn't responding.
Then there's the employment-history gap nobody chased, now a question mark on a file the home is auditing. And the placement that starts before the paperwork is complete. Sometimes the Adult First route makes that defensible, but only if the extra safeguards are real and written down. As a shortcut with no record behind it, it's where the risk lives.
The agencies that stay on top of this have a process that runs the same way on a frantic Friday as on a quiet Tuesday: a structured form built around Schedule 3, a named person who reads what comes back before a shift is confirmed, the employment history taken at registration, and an audit trail at every stage. That trail is what you hand a registered manager, an insurer, or a CQC inspector when they ask you to walk them through it.
Where PassQ fits
This is the problem we built PassQ for. We clear the full record on one worker, references, DBS, right to work, and qualifications, chased and verified, delivered as an audit-ready file the home can rely on.
The part that earns its keep in care is the voice agent. It picks up the phone and chases referees on a real call, switching into any language and accent to get an answer. In a care workforce where a former manager or a fellow carer answers more readily in Tagalog, Romanian, or Portuguese, that can be the difference between a reference back by Monday and a shift that goes elsewhere. It's live today, and you can listen to it work.
Our founding-partner pricing is on the pricing page. If you'd like to see what a faster, better-documented reference process looks like for a care desk, get in touch.
The short version
Regulation 19 and Schedule 3 require a care provider to hold, for every worker, satisfactory evidence of their conduct in previous care work, a full employment history with gaps explained, and where it applies, the reason a previous care role ended. The duty sits with the provider and flows down to the agency. The referee has to be someone who can speak to real care work, often a previous manager or another agency, and the whole thing has to be documented well enough to show an inspector. Most agencies are doing broadly the right things. The gaps that create risk are in how consistently the process runs and how well it's recorded, and both are fixable.
Frequently asked questions
Does Regulation 19 require references for care workers? Yes. Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, with Schedule 3, requires a provider to hold, for every person it employs, satisfactory evidence of their conduct in previous health or social care work, plus a full employment history with a written explanation of any gaps.
Who can give a reference for a care worker? Someone who can speak to the person's conduct in previous care work: a previous registered manager, a former supervisor, or the previous care agency. Supply carers move between agencies, so the referee is often another agency rather than a home.
How many references does CQC require for a care worker? The regulations don't set a number. Schedule 3 asks for satisfactory evidence of conduct in previous care employment. The test is whether the evidence is satisfactory in CQC's view, not how many letters you collect.
Can a care worker start a shift before references are back? References are part of the information a provider must hold under Regulation 19. In urgent cases a DBS Adult First check can let someone start under supervision before the full Enhanced DBS returns, but references and the rest of safer recruitment still apply, and the home is expected to document the extra safeguards until the full certificate arrives.
How is care referencing different from education? Education referencing centres on the most recent employer and suitability to work with children, under KCSiE and Ofsted. Care goes wider: Schedule 3 asks for a full employment history, the reasons previous care roles ended, and evidence of conduct in previous care work, under CQC Regulation 19. Different regulator, and the Adults' Barred List rather than the Children's.