Rebuilding CQC: Why stronger regulation still depends on strong governance
Our Fabio Cecchi, considers CQC’s recent update on its progress during 2025 and explains why improvements in regulation do not reduce the need for strong governance within services.
Over the past year, many providers have questioned whether the regulatory system was capable of keeping pace with the pressures facing health and social care. CQC’s latest update on its progress during 2025 is an attempt to answer that question, setting out where the regulator believes it has stabilised operations and rebuilt capacity.
The update presents clear evidence of progress, including reductions in assessment backlogs, increased inspection activity and changes to leadership, structures and registration processes. These developments matter, and they should be recognised.
At the same time, stronger regulation does not remove the responsibility on providers to maintain robust governance within their own organisations. Services still need to manage risk, assure quality and make decisions every day, often in the absence of timely external scrutiny and against a backdrop of continued pressure.
This is our view on what the CQC’s update means in practice and why good governance remains essential as regulation continues to evolve.
What CQC says it has achieved
CQC’s update focuses on progress across several key areas that affect how providers experience regulation:
- Clearing backlogs and increasing assessments
CQC reports that it has reduced the backlog of assessment reports from around 500 to just four. It has also set a target of publishing 9,000 assessments by September 2026 and states that more than 4,300 have already been published, with inspection activity running significantly higher than in 2024. This is an important step towards restoring credibility and predictability in inspection activity.
- Improving registration processes
CQC has increased the number of registration inspectors and piloted changes to simplify and speed up home care registrations. It has also begun testing a simpler registration form and improving online guidance, with plans to roll these changes out across other sectors. These changes should, over time, reduce delays and uncertainty for providers planning new services or changes in ownership.
- Rebuilding structures, frameworks and systems
The update also highlights wider structural changes, including the creation of sector-based inspectorates, new senior leadership appointments and work to redesign assessment frameworks, inspection methodologies and digital systems through the ‘Better regulation, better care’ programme. The intention is to move towards a more consistent, transparent and stable regulatory approach.
Fulcrum Care’s view
From working with providers across the UK, three points stand out.
- Progress is welcome, but its impact will be uneven
There is no doubt that CQC has made progress, and the figures published suggest real improvement. However, many providers will not yet feel a significant difference in their day-to-day experience of regulation.
Services may still be operating under historic ratings, inspections may remain infrequent in some areas, and digital systems are still bedding in. At the same time, pressures relating to workforce, finance and complexity of need continue to intensify. Providers should therefore avoid assuming that improved regulation automatically reduces operational or regulatory risk.
- Running reform and delivery in parallel increases transition risk
CQC is not only increasing activity; it is also redesigning how regulation works. New frameworks, revised methodologies and new digital systems inevitably introduce a period of transition.
For providers, this means operating on two tracks at once – delivering care under sustained pressure while preparing for a regulatory system that is still taking shape. Without strong governance, this creates a risk of confusion, inconsistent assurance and reactive decision-making.
- External oversight cannot replace internal assurance
Even in a fully functioning system, inspections are periodic and retrospective. They do not provide real-time assurance about quality and safety. Relying too heavily on inspection outcomes, particularly when they may be outdated, can create false reassurance or unnecessary anxiety.
Providers with strong governance build their own picture of quality using a range of information, including incidents, complaints, safeguarding concerns, workforce data and feedback from people who use services. This internal assurance is essential while inspection cycles and frameworks continue to change.
Four practical steps for providers
So, what should providers do now?
- Review whether governance arrangements still reflect current pressures
Governance frameworks that worked several years ago may no longer be sufficient. Providers should review whether reporting, escalation and oversight arrangements genuinely support effective decision-making under current conditions. The focus should be on clarity and grip, not volume of paperwork.
- Avoid relaxing scrutiny as inspection activity increases
As CQC increases assessments, there can be a temptation to rely on external oversight for reassurance. Providers should resist this. Strong organisations maintain robust internal scrutiny regardless of inspection timing or rating history.
- Be deliberate and selective in engaging with regulatory reform
CQC’s consultation and co-design activity presents an opportunity to influence future regulation. However, engagement should be targeted and proportionate, focusing on areas that directly affect services rather than attempting to respond to everything.
- Use data to inform judgment, not replace it
Improved data and digital systems are welcome, but they do not remove the need for professional judgement. Governance works best when data prompts questions and conversations, rather than acting as a substitute for understanding what is happening in services.
Progress worth recognising, but not a reason to ease off
CQC’s update shows meaningful progress in rebuilding regulation and restoring confidence. Over time, this should lead to a more consistent and credible system. However, it does not remove the need for providers to maintain strong governance now.
For the foreseeable future, providers will continue to operate in a system where regulation is improving, but pressures remain high. In this context, good governance remains the foundation for safe, sustainable care.
Fulcrum Care’s role is to help providers strengthen governance in a way that reflects these realities. We support organisations to move from reactive compliance to confident, evidence-based assurance.
If you would like to discuss what this update means for your organisation, or to review whether your governance arrangements remain fit for purpose, the Fulcrum Care team would be pleased to support you. To find out more about how Fulcrum Care supports providers with regulation and quality improvement, visit www.fulcrumcareconsulting.com