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How the guidance fits with CQC's operating model

  • Organisations we regulate

The regulations and this guidance are an essential component of CQC's new approach, as set out in our strategy Raising standards, putting people first. The diagram of our operating model summarises how we register, monitor, inspect and award ratings to providers, take enforcement action and provide an independent voice on the quality of care.

The law says that we must take into account our guidance on meeting the regulations:

  • When we make regulatory decisions about a registered provider or manager's registration. That is, granting a registration, refusing an application for registration, cancelling or suspending a registration, or varying, removing or imposing conditions on a registration.
  • In our regulatory decisions when a registered provider or manager may have breached regulations, conditions of registration and in decisions relating to criminal offences.
  • In any proceedings for the urgent cancellation of a registration, or for appeals relating to an urgent cancellation.
  • In any proceedings for a failure to comply with conditions of registration or for breaches of regulations.

Our guidance on meeting the regulations is therefore central to:

1. Registration

We have strengthened CQC's registration process – particularly for how we assess applications for registration. To be registered with CQC, applicants must demonstrate that they will be able to meet the requirements set out in the regulations. When considering new applications for registration, and variation or cancellation of existing registrations, we now also take account of the duty of candour and the fit and proper person requirement for directors. To help us do this, we draw on the detail included in this guidance.

2. Inspection and ratings

To get to the heart of people's experiences of care and support, the focus of our inspections is on the quality and safety of services, based on the things that matter to people. We therefore ask five key questions about the service, are they:

  • Safe?
  • Effective?
  • Caring?
  • Responsive to people's needs?
  • Well-led?

To help our inspection teams direct the focus of their inspections, they use a standard set of 'key lines of enquiry' (KLOEs) and prompts. KLOEs help them to form a judgement about the quality of the service, determine a rating for each of the five key questions, and where relevant, produce an overall rating for the service. Ratings are an important part of our inspection process and use a four-point scale: outstanding, good, requires improvement, or inadequate.

Our provider handbooks describe how we carry out inspections, make judgements and, where appropriate, award ratings to providers. They list the KLOEs, which also provide additional information that may help providers to meet the requirements of these regulations. The KLOEs and prompts are specific to each sector and focus on the detail relevant to the sector.

For each of the five key questions we have developed characteristics to describe what care for each of those four rating levels looks like. These characteristics provide a framework, which, together with professional judgement, guide our inspection teams when they make a judgement about a rating.

Our use of ratings and the focus on looking for 'good' are an important part of our model for assessing the overall quality of the care people received. The characteristics of good and outstanding care that we look for in our inspections, as set out in our handbooks, go beyond the fundamental standards as set out in the regulations.

However, our inspections also assess whether the requirements set out in the regulations are met.

3. Enforcement

The regulations set in law a clear minimum standard that registered providers and managers must meet. CQC will be able to take enforcement action against registered providers and managers that do not meet them (the law calls this a breach of regulation(s)).

Last updated:
29 May 2017