After an inspection, we rate the quality of care overall and for our five key questions: are they safe, effective, caring, responsive and well-led?
We award ratings on a four-point scale: outstanding, good, requires improvement, or inadequate.
It is a legal requirement for all providers to display CQC ratings.
We decide all ratings using a combination of aggregating the service level ratings and the professional judgement of inspection teams. We provide ratings at different levels and we use a set of ratings principles to help us to determine the final ratings.
Where there is a change of ownership or address at an existing location, CQC’s website and internal systems will display the provider’s ‘regulatory history’ (rating and inspection report under a previous provider). See Continuation of regulatory history for more information.
Each rating is based on our assessment of the evidence we gather against the key lines of enquiry in the assessment framework for healthcare services. Inspectors refer to the corresponding ratings characteristics for the key lines of enquiry and use their professional judgement to decide on the rating.
When deciding on a rating for services, the inspection team asks:
- Does the evidence demonstrate a potential rating of good?
- If yes, does it exceed the standard of good and could it be outstanding?
- If no, does it reflect the characteristics of requires improvement or inadequate?
A service or location does not have to demonstrate every characteristic of a rating for us to give that rating. For example, if a location demonstrates just one of the characteristics of inadequate but it has significant impact on the quality of care or on people's experience, this could lead to a rating of inadequate. On the other hand, even locations rated as outstanding are likely to have areas where they could improve. In the same way, locations do not need to demonstrate every one of the characteristics of good in order to be rated as good.
Inspection teams use the ratings characteristics as a guide, not as a checklist or an exhaustive list. They take into account best practice and recognised guidelines, and assure consistency through CQC's quality control process.