All care homes would have a ‘good’ or ‘outstanding’ CQC rating in an ideal world, but the harsh reality is that many of the nation’s care providers are nowhere near up to par. Out of 121 care homes assessed in October 2024, only 2 received an outstanding rating while 69 were ranked as good, 40 required improvement, and 10 were ranked as inadequate, according to the latest data from the CQC.
Whilst these figures might leave some providers feeling concerned and apprehensive about an upcoming inspection, the good news is that there are plenty of practical ways to bring up your CQC rating and quickly resolve any issues or deficiencies that you may have or that are likely to be brought to light.
This guide highlights what to expect during your latest inspection, along with an action plan to help prepare providers - who have already had their assessment - improve their current rating.
What Is a CQC Inspection and What Does It Involve?
Based on your current CQC rating, an inspection may take place every one to five years. These inspections are designed to ensure that care home professionals and staff are delivering against the following quality statements, which are used to measure the quality of services and care standards provided.
The CQC quality statements that sit under each of the five key lines of enquiry (KLOES) are as follows:
Safe
- Learning culture
- Safe systems, pathways and transitions
- Safeguarding
- Safe environments
- Safe and effective staffing
- Infection prevention and control
Effective
- Assessing needs
- Delivering evidence-based care and treatment
- How staff, teams and services work together
- Supporting people to live healthier lives
- Monitoring and improving outcomes
- Consent to care and treatment
Caring
- Kindness, compassion and dignity
- Treating people as individuals
- Independence, choice and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
Responsive
- Person-centred care
- Care provision, integration and continuity
- Providing information
- Listening to and involving people
- Equity in access
- Equity in experience and outcomes
- Planning for the future
Well-Led
- Shared direction and culture
- Capable, compassionate and inclusive leaders
- Freedom to speak up
- Workforce equality, diversity and inclusion
- Governance, management and sustainability
- Partnerships and communities
- Learning, improvement and innovation
- Environmental sustainability -sustainable development
Each quality statement is designed to measure and gather evidence on a provider’s ability to fulfil their obligations and commitments to delivering the highest standard of care and services to residents and staff.
Note that these quality statements apply to all registered health and care providers as a whole, not an individual member of staff or entity.
CQC Ratings Explained
The CQC rating system is unchanged, however, ratings are now determined by a broader scope of information and a more timely and dynamic approach, transcending the previous method of one-time inspections. This ‘rolling’ approach enables ratings to be adjusted more easily as evidence is continuously gathered. As a result, ratings could be updated more frequently based on new evidence, making it crucial for care homes to maintain high standards consistently.
Providers are assessed on the answers given to the five key questions. Once the inspection has taken place and the score for each key question has been calculated, one of the following ratings will be awarded:
Outstanding - Your care home is demonstrating exceptional performance.
Good - Your care home is operating effectively and meeting the expectations set by the CQC.
Requires improvement - Your care home is not meeting the desired standards, and the inspector has provided guidance on necessary improvements.
Inadequate - Your care home is performing poorly, and the CQC has taken corrective measures against the individual or organisation responsible.
In collaboration with care consultancy Duffy & Shaw, we’ve recorded a comprehensive CQC webinar that covers the new rating system in detail and written a CQC Checklist to help you prepare for your next inspection.
Characteristics of High-Ranking Providers
CQC Outstanding
Rawlyn House care home was assessed in July this year, with the report published in October. Inspectors assessed the care home across 11 quality statements, covering crucial areas such as safeguarding, safe environments, staffing, infection control, and governance. Rawlyn House excelled in these areas, indicating a comprehensive approach to ensuring residents’ safety, wellbeing, and independence.
Some of the following details and comments were highlighted in the Rawlyn House inspection report carried out by the CQC:
· People were protected from risk of harm and abuse. Staff received safeguarding training and understood their duty to keep people safe. People and relatives were involved in understanding and formulating plans to reduce the risks associated with people’s care. Risks associated with people’s on going care needs were identified and acted on. There were sufficient staffing levels and oversight to ensure people’s needs were being met and people received their medicines as prescribed.
· We received positive comments from healthcare professionals and people’s relatives about their experiences at the service. Through our observation and speaking with staff we identified that people living at the service experienced positive outcomes which were driven by staff and the providers commitment to ensure people received person centred care that matched their individual needs and preferences.
CQC Good
Victoria House is another care home that exemplifies adherence to the quality statements set out by the CQC.
According to the inspection report published by the CQC, their findings evidence that the care home had 'good' safeguarding measures in place to protect people from harm and abuse, with the report praising the facility and staff on the following points:
· Risk assessments were in place and assisted staff readily identify how to mitigate risks. The management team consistently worked with staff to review people’s needs, identify any changes to their health and well-being and produce additional risk assessments when needed. The care and support risk assessments were very detailed, proportionate and effectively assisted staff to safely mitigate risks.
· People and relatives told us happy with the service. A relative said, "The standard of care my father-in-law receives is excellent." We observed staff worked with people in a sensitive, caring and considerate manner. They encouraged people to be as independent as possible and really encouraged them to reach their full potential. All interactions were conducted in a positive manner.
· Processes were in place to take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Staff were extremely positive about the management team and how well supported they felt. They described how their work was routinely praised and recognised by the new management team. All felt confident they could deliver the service in line with expected best practices and their ideas were valued.
Examples of Inadequate and Poor Ratings
In contrast to the strong and positive feedback the CQC issued to the above care homes, multiple others were urged to enhance their standards of care and practices after receiving poor or inadequate ratings.
The CQC states that “a decision to rate a practice inadequate overall would take careful consideration of the quality of care across each of the five key questions we ask when we inspect.”
Some examples of inadequate or poor practices include, but are not limited to:
· No systematic screening of staff during the recruitment process
· Poorly managed disposal and storage of medicines
· Improper safeguarding measures for vulnerable people
· Poor managerial response to incidences
· Improper hygiene practices
· Lack of training and support for staff
· No personal emergency evacuation plan
· Putting people at risk of illegal deprivation of liberty
· Not completing required risk assessments
· Ineffective use of quality assurance systems
· Insufficient systems for undertaking mental capacity assessments
Consequences of Receiving a Poor or Inadequate Rating
If an inspection results in an inadequate CQC rating or your care home requires improvement, the CQC will implement special measures. In severe cases, if the situation is particularly serious, the inspector may enforce immediate measures.
If you receive a ‘poor’ CQC rating, you’ll be given six months to rectify any problems, followed by another visit from the inspector to see what steps you have taken to improve and resolve issues.
If your care unit is still deemed insufficient after the initial six-month period, you may be granted an additional six months to improve your services. However, the CQC will likely implement measures that bring your operations to a halt in the meantime. For instance, they may impose an embargo, preventing the acceptance of new service users or residents.
If Standards Do Not Improve
If there are no improvements to standards in the second 6-month block, the CQC has the authority to close down a care home. Therefore, it is crucial to diligently adhere to all the instructions and feedback provided by the inspector.
It’s also important to remember that the CQC is focused on the wellbeing of the people both receiving care and providing it. Although their intention is not to shut down care facilities, they may take action if they have concerns regarding the health or safety of residents.
Steps You Can Take To Pass a CQC Inspection
Failing a CQC inspection can feel extremely disheartening for all parties involved. If your care home has been awarded a poor or inadequate rating, these suggestions can assist you in transforming your service and improving your rating.
- Adhere to regulations - the care facility must comply with all applicable regulations and standards governing care homes, including those concerning staffing, safety and hygiene.
- Provide exceptional person-centred care - ensure that residents receive care of the highest quality, characterised by safety, effectiveness, and a person-centred approach that caters for their unique needs.
- Create a strong leadership team - assemble a robust leadership team that is dedicated to delivering outstanding care and cultivating a positive environment for everyone there.
- Employ well-trained staff - employ staff members who are well-trained, motivated, and dedicated to providing exceptional levels of ongoing care to residents.
- Involve residents and families in decision-making - care home residents and their families should be kept updated with changes and incidents. Providers should also actively seek their input when making decisions about the care and services available to them.
- Promote continuous improvement - foster a culture that values continuous improvement, actively identifying and addressing the areas that need it.
- Implement quality assurance systems - ensure there are effective systems in place to monitor and measure the quality of care provided and that the users of these systems are properly trained. This information can then be used to continuously improve services.
The Importance of Using a Reliable EPR
As part of the NHS’s long-term plan, Integrated Care Systems (ICS) organisations must reach a minimum level of digital maturity in line with the "What Good Looks Like" by March 2025. One such objective of this is for 80% of CQC-registered adult social care providers to be using digital care records. Only 45% of social care providers are using any form of digital care record at current, and studies indicate that those who have adopted a digitally mature approach to care have improved the efficiency of their operations by approximately 10% compared to non-digital providers.
An Electronic Patient Record (EPR system) is crucial for care homes aiming to meet this milestone as well as the CQC’s stringent standards, especially with the shift to continuous monitoring. Access Rio, our advanced EPR healthcare solution, brings all essential patient information into a single, accessible platform, ensuring that care staff have real-time access to accurate, comprehensive records. This integration allows for seamless communication and coordination across the care team, improving care quality and helping staff deliver safe, effective, and person-centred care.
Under the CQC’s updated framework, Access Rio supports CQC compliance with quality statements such as safe staffing, safeguarding, and infection control by providing a detailed, up-to-date record of each resident’s health and social care needs. Access Rio’s intuitive interface enables care teams to identify and address risks proactively, document key interactions and outcomes, and demonstrate adherence to CQC standards through easily accessible evidence.
Other Ways Access Can Help
Improving your CQC rating ultimately comes down to utilising tools that effectively increase quality, compliance, and safety within your care home.
The Access Group offers a comprehensive range of solutions designed to help you enhance care quality, optimise operations and manage your services with tools that can substantially improve your CQC rating and assist you in meeting CQC outstanding practices.
From conducting audits to improving overall care quality, our Care Compliance software and Care Policies Procedures software has been built to aid providers in meeting and complying with the regulations specifically related to adult social care homes and those working within domiciliary care.
For more information about our CQC management software solutions and other information regarding the CQC, visit our CQC Information Hub or Contact Us today.
