What does a CQC rating actually mean? How to read an inspection report
The four CQC ratings explained, what inspectors look at, and how to read a report like an insider.
Every home care provider in England must be registered with the Care Quality Commission, and most have been inspected and given a rating. Families are told to “check the CQC rating”, which is good advice, but the rating on its own tells you less than people think. Here is what the ratings mean, what inspectors actually look at, and how to read a report so that you learn something useful.
The four ratings
Outstanding means the service is performing exceptionally well. Relatively few home care providers hold it. Good means the service is performing well and meeting expectations, and it is the rating most well run providers hold. Requires improvement means the service is not performing as well as it should and the inspector has told it what to change. Inadequate means serious problems and CQC has taken action.
Apex holds a Good rating. We are proud of it and we also know exactly what it does and does not tell you, which is why we wrote this article.
What inspectors look at
CQC asks five questions of every service. Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well led? Under the current framework these are broken down into quality statements, which are written from the point of view of the person receiving care: “I am supported to make decisions about my care”, for example. Inspectors gather evidence by talking to people who use the service and their families, talking to staff, looking at care records and policies, and checking things like training, recruitment and how complaints and incidents were handled.
How to read a report
Look at the date. A Good rating from six years ago tells you what the service was like six years ago. Ask the provider when they were last inspected and what has changed since.
Read the “well led” section first. Safe and caring depend on the people at the top. If leadership is weak, everything else is fragile.
Look for what people said. Reports quote clients and relatives directly. Those quotes are the closest you will get to an honest review.
Read the negatives properly. Even a Good report will note things to improve. What matters is whether they are administrative, such as a form not being completed, or about care, such as missed visits or medication errors.
Check for breaches. If the report says the provider was in breach of a regulation, find out which one and what was done about it.
What a rating cannot tell you
Whether the carer who comes to your mother will be kind. Whether the office rings back. Whether the provider has capacity in your area at the times you need. Whether the culture that was inspected has survived a change of manager. For those things you need to meet the provider, ask the direct questions in our article on choosing a provider, and read independent reviews on homecare.co.uk.
Frequently asked questions
Is a provider without a rating a bad sign?
Not necessarily. New providers are registered before they are inspected, so they will show as “not yet rated” for their first year or two. Ask when their first inspection is expected and how they are preparing.
Should I avoid anyone rated Requires improvement?
Read the report before deciding. Some providers with that rating are on a clear path to Good and will talk openly about what they changed. Others are not. The report and the conversation will tell you which.
Can I complain to CQC about a provider?
You can tell CQC about your experience at any time and they use that information when deciding what to inspect. For a specific complaint you want resolved, go to the provider first, then to the Local Government and Social Care Ombudsman if you are not satisfied.
Where do I find a report?
Search the provider’s name on the CQC website. Every registered service has a page with its rating, its latest report and its history.
Want to talk to a provider who will show you their report and explain it? Ring us on 0118 391 3542 or arrange a free initial meeting.
Questions about care?
Our team can talk you through costs, funding and what might be available for your family. Call 0118 391 3542, it's free, and there's no pressure.