How CQC care home inspections work and what the ratings mean
Residential homes are inspected by the Care Quality Commission, established in 2009 to regulate health and social care services in England.
The CQC is the regulator private and local authority-run homes, along with GP surgeries and hospitals. It has a team of inspectors who carry out announced and surprise visits.
Care providers need to be registered with the CQC to operate and are required to meet a set of safety and quality standards to do so.
There are four ratings issued by the CQC to regulate. These are outstanding, good, requires improvement and inadequate. Care homes are given an overall rating, and one for each of the inspection areas of being safe, effective, caring, responsive and well-led.
During an inspection, the CQC often speak to staff and residents at a home about the inspection areas to help get a rounded picture of the home.
By law, the care providers have to display their CQC ratings to be seen by the public.
Care providers must act on areas of concern and they will face follow-up visits to make sure the improvements have been made.
Homes that are rated as inadequate may be placed in special measures. This is where the CQC closely supervises people’s care and helps the home improve within a set timescale. Failure to improve on an inadequate rating can lead the CQC to make the decision to close a home down.
Warning notices can also be issued under the Health and Social Care Act 2008 if regulations have been breached.
Providers can be fined and prosecuted by the CQC in serious cases where people have been harmed or put in danger.
The CQC made its inspection regime stronger to better respond to whistleblowers and protect vulnerable people after a TV documentary exposed mistreatment of residents at Winterbourne View Hospital near Bristol in 2011.
Before Winterbourne View, the CQC was receiving around 50 whistleblowing contacts a month. The amount rose to more than 500 after the scandal emerged.
Local authority safeguarding teams also work with the CQC and respond to concerns raised over the welfare of care home residents.