Care Quality Commission
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What does Adult Social Care look like across CQC's new ratings?

The Care Quality Commission (CQC) has set out what Outstanding, Good, Requires Improvement and Inadequate Adult Social Care would look like across each of the key areas it will routinely inspect services against. 

From next month, CQC will roll out its new approach to regulating Adult Social Care in England. Specialist teams, including trained members of the public (Experts by Experience), will inspect services against what matters most to the people who use them – are they safe, caring, effective, responsive to their needs, and well-led.

CQC will then rate these services as Outstanding, Good, Requires Improvement and Inadequate so that the public has clear information to help them make choices about their care.

Following its public consultation and testing earlier this year, CQC has published the questions (called 'key lines of enquiry') that its inspection teams will use to guide them on their visits, as well as descriptions of what care would look like for each of these ratings.

The guidance will be used by CQC's inspection teams when they inspect care homes and community services to help them be consistent when making their judgements. For care providers, it can help them to understand the sorts of things that CQC’s inspection teams will be focusing on and help to know what CQC will be looking for when awarding its ratings.

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission said:

"The key lines of enquiry and ratings characteristics are an important part of our new approach to inspecting and rating Adult Social Care in England, which we will roll out formally from next month.

"They will allow our inspectors to really get under the skin of adult social care services across England so that providers know what we are expecting and families and how we will consistently rate their services.

"The key lines of enquiry and ratings characteristics have been developed after extensive engagement, testing and consultation with people who use services, carers, providers, commissioners and national partners. I am very grateful to everyone who has been involved in helping to shape and design the questions we will ask and the characteristics of the ratings. I am sure that this will mean people can be confident in the judgements our inspections will make."

CQC has published separate key lines of enquiry and ratings characteristics for residential (care homes, with and without nursing) and community services (when people receive care in their own homes, including Shared Lives and supported living services).


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Last updated:

26 September 2014

Notes to editors

For further information about the key lines of enquiry and ratings characteristics that CQC's inspection teams will begin to use on their inspections of Adult Social Care services in England from next month, please visit our Adult Social Care page for providers.

Examples care across the ratings and in relation to the five key 'domains' include:

1. Safe: A good service will protect people from bullying, harassment, avoidable harm and potential abuse and its staff will have a comprehensive awareness and understanding to recognise such cases consistently. An outstanding service will have additional characteristics that make it exceptional and distinctive, with people's feedback describing it in these terms. Also, the service will use imaginative and innovative ways to manage risk and keep people safe, while making sure they have full and meaningful lives.

2. Effective: A good service will make sure that the needs of people are met consistently by staff who have the right competencies, knowledge, qualifications, skills, experience, attitudes and behaviours, with the needs and preferences of people being identified and met. Also, people will always be asked to give their consent to their care, treatment and support. If the service requires improvement, it will monitor people’s needs but it will not consistently act on issues identified and Deprivation of Liberty Safeguards and the Mental Capacity Act 2005 may not be fully understood despite staff attending training.

3. Caring: In a good service, people will receive care and support from staff who know and understand their history, likes, preferences, needs, hopes and goals. Staff will know, understand and respond to each person’s diverse cultural, gender and spiritual needs in a caring and compassionate way. A service that is inadequate will have widespread and significant shortfalls in the caring attitude of its staff and some regulations will not be met. The service will not be listening to people or understanding how to support them to express their views.

4. Responsive: In a good service, people will receive consistent, personalised care, treatment and support and they will be involved in identifying their needs, choices, preferences and how they are met. Care planning will be focused on the person’s whole life, including their goals, skills, abilities and how they prefer to manage their health. In an outstanding service, people will report that staff have an excellent understanding of their social and cultural diversity, values and beliefs that may influence their decisions on how they want to receive care, and staff will be innovative in meeting them. Ongoing improvement will be seen as essential.

5. Well led: A good service will have a clear vision and set of values that includes honesty, involvement, compassion, dignity, independence, respect, equality and safety, which will be understood and consistently put into practice. Staff will have confidence to question practice and report concerns and when this happens, they will be supported and their concerns will be investigated. In an inadequate service, leadership will be weak or inconsistent, with support and resources not always made available. Staff will not be adequately supervised and staff turnover may be high.

CQC will begin its new way of inspecting adult social care from October. By March 2016, CQC expects to have rated every Adult Social Care service in England as Outstanding, Good, Requires Improvement or Inadequate.

For further information about CQC's public consultation earlier this year, please visit our consultation section. The consultation closed on 4 June 2014

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