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CQC ratings – How to be outstanding

CQC ratings – How to be outstanding

What’s the secret to achieving a good, or even outstanding, CQC (Care Quality Commission) rating of your care establishment? Care providers who have achieved this accolade often point to resolute and inspiring leadership along with compassionate and unwavering care for each individual service user. But beyond this general good practice, there are also many smaller, practical steps you can take to help pave the way for a good CQC rating. In fact, a step-by-step approach can begin as soon as the previous inspection finishes, to help ensure you are ready for when they next inspector calls…..

Plan and prepare

It may sound obvious, but it’s essential that you know and understand exactly what you are being assessed on! The answer to that usually can be found in the CQC’s Key Lines of Enquiry (KLOEs) document. The KLOEs cover the five areas that the inspector will focus on when visiting your establishment, and these questions should form a regular part of your businessmonitoring – regardless of whether or not an inspection is imminent:

  1. Are service users safe from abuse and harm?
  2. Is the care delivered effective? Does it lead to good outcomes?
  3. Are staff caring and compassionate towards those in their care?
  4. Are services responsive to the needs of service users?
  5. Is the organisation well-led? Are there effective governance arrangements in place?


Whether you are writing a care plan for an individual user, collecting together compliance documentation, training your staff or creating a patient survey, the CQC’s KLOEs should help shape your every decision.

CQC reports are publicly accessible online and can be a good place to study the difference between a ‘good’ and ‘outstanding’ rating. By reading the detail and comparing a very good service to the one you provide, you should get a clearer idea of what the inspector is looking for, and may perhaps be able to identify where you fall short or could improve.

Collate your compliance

Documented evidence is crucial when it comes to inspection day. Not only will you need to collect proof that you are compliant and meeting your legal obligations, but you’ll also want to collate examples of where your service has gone above and beyond meeting the needs of your residents or patients.

As a basic requirement, you’ll need documentation showing your compliance with safeguarding and risk management. You’ll need valid records of your policies and procedures, copies of your health and safety and fire risk assessments, proof of staff training and qualifications, DBS records for relevant staff, equipment maintenance records and legionella test results, just to name a few. This evidence will be used as proof that you are compliant with the standards set by the CQC.

However, not only is it vital that these policies, procedures and records are in-date and fit for purpose, but they should also be regularly updated. It’s not enough to just gather the documents together at the start of the year and then wait for an inspector. To really impress it’s advisable to be proactive! Review your accident and incident records, for example, to look for patterns so you can put preventative measures in place. Check your safeguarding investigations and use them as a chance to see how you could improve and use this a positive rather than a negative on inspection day.

Don’t forget to collate the good stories too, the compliments from your service users and their families, examples of good practice to prove what makes your service outstanding, and records of special projects or days out with your residents, along with photos, for example.

This can be a lot to manage and it can help to use the services of an external compliance service provider. Specialist software can simplify the storage and maintenance of multiple compliance documentation, making it easier to find and keep on top of annual renewals and regular updates.


Inspectors are looking for leadership, management and governance that results in the provision of high-quality care for its users, and they’ll be talking to you, your staff and patients to find out how your establishment achieves this.

When it comes to your staff, the CQC will want to know if you’ve set clear objectives for your organisation as a whole? Does each team member understand their individual responsibilities? Are your staff members satisfied with their roles? What kind of culture or practice ethos do you encourage? One way to explore this issue is to hold mock interviews with your employees before inspection day as this can be a good way to find out how much your staff really understand, and how happy they are. It can often be useful to get an external professional to carry out these interviews on your behalf, as the result can be more insightful than a solely internal perspective.

Staff training and ethos of care

Properly trained staff members are, of course, vital in all areas of health and social care provision. Make sure you keep training certificates up-to-date and store them away safely ready for inspection. Ensure your staff understand the procedures and policies that are in place, that they have access to them, and that their knowledge is refreshed regularly. Again, access to a personalised compliance management portal where access is enabled for all relevant staff can be helpful here.

But just as important, although harder to practically achieve, is the general culture of your establishment and staff. The behaviour of staff and the general atmosphere that they create, along with the effect that this has on all those in your care, cannot be underestimated. The heart of the CQC’s strategy is to focus on the experience received by those in care, and that of their families. Empathy, dignity, compassion, care and commitment are words that are easy to write but not always easy to deliver, especially when overrun by the demands of modern-day care homes or GP practices, for example.

Wanting to make the outcome better for your residents or patients should be a driving passion of your work and CQC inspectors will be looking for that extra effort required to make every day a little bit happier or more comfortable for all those who use your services.

Innovate and be proud

A good tip is to focus on your strengths and to encourage innovation. Shout out about improvements, successful policies and projects, and even individual cases where you can showcase what you and your team have made progress with. An innovative method of care or procedure or policy could help you improve from ‘good’ to ‘outstanding’. It can also increase efficiency.

Feedback is vital

Spend time talking to your patients or residents, and their families, to get feedback on where you are doing things right and where you can improve. Having this information before inspectors arrive can make all the difference. Patient surveys are also a good method of assessing how effective your service has been for your users and will be a good measure of how you and your staff are valued.

Designate an area in your reception area or hallway where people can comment, and yes, even complain! Don’t be tempted to hide negative feedback as taking such feedback onboard can actually be used to your advantage. Inspectors won’t be hoodwinked into believing a collection of purely 5* reviews! Negative comments add credibility to your collection of patient feedback and can be used to your advantage, particularly if you record your subsequent actions when families or users have flagged up concerns or how you have worked hard to meet the actual needs of a resident or patient.

Be safe

And perhaps the most obvious, but details are all-important when it comes to keeping your service users and staff safe. Minimise risk and keep up to date with all your health & safety assessments. The CQC inspector will expect you to know about all kinds of details, from fridge temperatures to the contents of the doctor’s bag. Fire equipment should be stored in the right place, tested as appropriate and a log-book kept up to date. Drugs need to be locked away, keys kept safe and a method of stock control put in place. Infection control, cleanliness and daily workplace routines are all crucial to keep on top of, and record.

A lot is common sense, and good general management practice, along with a whole lot of planning, organisation and record-keeping.


If that still sounds like too much of a pain, here at KCS Compliance Services our staff are experienced and specialists in supporting you through getting and keeping your compliance documentation in order before the next inspector comes knocking.

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