CQC requires improvement? How to fix the common problems

April 14, 2022

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As of April 2024, the CQC launched the single assessment framework across all health and social care providers. This framework has included a number of changes to the way the CQC perform inspections and provide a rating. Therefore the information below may contain some outdated information. For the latest information on what has changed and what you need to know, please head here.

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Learn everything you need to know about CQC requires improvement.

We completely understand the disappointment in receiving a CQC rating of ‘requires improvement’.

If you didn’t quite meet the requirements for a good or outstanding rating, we know you’ll be looking to make improvements before your next inspection.

The good news is that the CQC framework outlines the exact expectations to meet to receive a higher rating, so you can identify and work on the areas in which you fell short.

In this article, we will break down the common areas that can bring down a rating and identify how you can make changes to improve.

A breach of regulations will always result in a CQC requires improvement rating

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Breach of CQC regulations is an instant barrier to achieving a good or outstanding rating, regardless of anything else, so check that you adhere to all the relevant regulations. For example, you’ll automatically get requires improvement if you don’t have a registered manager in post or statutory notifications haven’t been submitted.

What factors might result in a CQC requires improvement rating?

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Below are examples of comments from real CQC reports where a rating of requires improvements was awarded.

“It was not clear whether 1, 2 or 3 topical medicines had been applied”

“Regular checks of the environment and maintenance and safety of equipment had not been sufficiently undertaken to protect people from risk of harm”

“Management systems were not consistent in providing oversight and driving improvements at the service”

“Care plans and risk assessments were not in place for all people’s known risks”

The CQC inspection undertakes five Key Lines of Enquiry (KLOEs) to assess the standard of care your service delivers. The five KLOEs are Safe, Effective, Caring, Responsive, and Well-Led.

Of the five KLOEs, the three that most commonly result in a CQC requires improvement rating are Safe, Responsive, and Well-Led. In a lot of cases, two, or even all three of these areas are lacking.

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There are, however, common themes that arise across all the KLOEs. Let’s take a closer look at them and think about the actionable steps you can take to improve standards to achieve a good or outstanding rating.

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Table showing what can go wrong with medications management — Are you making any of these mistakes?

Table showing what can go wrong with record-keeping — Does your record-keeping need some work?

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Table showing what can go wrong with risk assessments — Incorrect, missing or risk assessments that don't include learnings or actions can bring down your rating

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Table showing what can go wrong with Quality Assurance — Quality assurance is high priority for the CQC. Is it for you?

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Top Tips to fix CQC requires improvement

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Make record-keeping a top priority. There’s a saying in health and social care: “If it’s not documented, it didn’t happen.” Documentation is your defence if anything should go wrong - it needs to be clear and accurate enough to stand in a court of law.

Refer to the Medicines in health and social care CQC report for additional guidance on good medicines management.

Use thorough recruitment practices when hiring. The CQC expects you to employ ‘fit and proper persons’. Always get two written references from past employers and check the candidate’s DBS status and right to work in the UK. Remember that your clients are vulnerable adults who must be protected from harm.

Make sure all staff are familiar with the Mental Capacity Act and issues around consent. The Mental Capacity Act is frequently changing, so plan for regular updates and training

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Tools to help you move out of a CQC requires improvement rating

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Birdie’s tools are closely aligned with the CQC framework and can help you provide evidence to support your goal of achieving a good or outstanding rating in your inspection. We’ve created products that enable you to access, store, and update client records digitally.

Records can be shared with staff in the office, carers on visits, clients themselves, and their families. You can record clients’ personal preferences, share medication schedules and review data to complete audits. Find out more here.

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