CQC ratings: is the CQC getting harder to please?

audit paperwork

Looking at the CQC ratings given by inspectors over the last three years, this year has seen a move towards focused inspections, increasingly downgrading homes. But what is the real picture behind the headline statistics? And what does this mean for your care home management as you prepare for your next inspection?

The coronavirus pandemic backdrop: dramatic fall in inspections

Of course, any analysis of figures relating to CQC inspections this year needs to remember that the pandemic caused a significant drop in the overall number of inspections conducted by the CQC.

We analysed CQC rating data for reports for residential social care organisations published between 1 July to 30 September 2018, 2019 and 2020. The number of reports issued during this period in  each year was:

2018       1,924 reports

2019       1,957 reports

2020       244 reports

Coronavirus: CQC focused inspections  

Moreover, the CQC prioritised homes with ‘Requires Improvement’ or ‘Inadequate Ratings’, and very few new services were inspected. As such, the figures are best understood by looking at the proportion of services whose ratings changed, excluding new services and accounting for the over-representation of homes with lower ratings.

Of the 244 reports published, most were focused inspections – Well-led was reported in all audits and Safe in 241 reports. Caring was the least inspected area with only 49 reports having a rating in this inspection area.

2020: Increase in ‘Inadequate’ and ‘Requires improvement’ CQC ratings

Analysing the overall CQC ratings of the reports, we found that the proportion of reports with an overall rating ‘Inadequate’ jumped from 6% to 24%, whilst reports with an overall rating of ‘Requires Improvement’ increased from around 32% to 50%, while the proportion of reports with overall ratings of ‘Outstanding ’ or ‘Good’ both fell. [Table 1]

Therefore, nearly three quarters of the reports published during the period 1 July to 30 September 2020 were less than “Good” – a significant increase compared to around 40% in the same period in the years 2019 and 2018.

2020: More care homes rated ‘Inadequate’ for leadership, safety and effectiveness

Inadequate CQC ratings in the ‘Safe’ inspection area have increased from 6% in 2019 to 24% in 2020, while over the same time period, Inadequate rating in the ‘Effective’ area have risen from 2% to 12%, with ‘Well-led’ seeing the biggest increase – from 8% to 28%. [Table 2]

Another important point for care home owners and providers to note is that the ‘Requires improvement’ rating for Caring has increased from 14% to 49%. [Table 2]

2020: Increase in CQC ratings downgrades

Our analysis also showed that in 2018, 16% of reports resulted in a ratings downgrade. This increased to 22% in 2020. [Table 3]

This is mainly due to rating downgrades in the Well-led, Safe and Effective inspection areas. [Table 4]

Anecdotally, we at Fulcrum Care have also witnessed CQC and Local Authorities cracking down on homes with ‘Inadequate’ and ‘Requires Improvement’ ratings, calling for quicker and more extensive actions to avoid the imposition of closures and conditions on registration.

Lessons for care home owners and providers

It is impossible to be sure what is driving this trend of fewer services retaining their previous rating while more are having their ratings downgraded, but the public scrutiny which the care sector has faced over the past few months is likely to play a part of this. The pressure this has put on care home staff, providers, local authorities and regulatory bodies seems to have resulted in increasingly harsh and pedantic inspections.

Instead of waiting for your next inspection, risking your rating in the current climate, get in touch with Fulcrum Care now for an accurate, impartial, assessment of CQC compliance. We can even create a tailored action plan to help you get your home on track for the rating you want and deserve.

Contact us on 020 3411 4014 or email info@fulcrum.care