What Is The CQC - What Does CQC Mean And What Does It Do?

The Care Quality Commission (CQC) is the independent regulator for care within England. This includes the care provided by the local authorities, independent providers, the NHS and voluntary organisations in registered settings. The CQC register most but not all types of care. 

The CQC regulates:

• Providers of healthcare services to people of all ages, including hospitals, ambulance services, clinics, community services, mental health services and other registered locations, including dental and GP practices.
• Providers of social care services for adults in care homes (where nursing or personal care is provided), in the community and in people's own homes.
• Providers of services for people whose rights are restricted under the Mental Health Act.
• Providers of health and care services for children or young people

The CQC register health and adult social care services across England and focus on inspections, to check whether or not standards are being met. Their inspections take place regularly and can be unannounced or notified dependent on service. Changes to the CQC’s strategy from 2021 see them taking a more proactive approach, with a greater use of data and ongoing monitoring alongside periodic inspections.

Further change began in mid-late 2022, with the introduction of CQC New Inspection Framework which you should certainly familarise yourself with if you are, or aspire to be a provider of care services in England. 

What does CQC mean for the care profession?

1. Residential adult social care services

As mentioned, inspections will usually be unannounced. In a few instances, where there are very good reasons, they may let the provider know they are coming. For example, they may contact small homes to check that people are home before setting off to inspect.

2. Community adult social care services

CQC inspections of domiciliary care agencies and Shared Lives schemes will usually be announced 48 hours in advance. This is so they can be sure the manager or a senior person in charge is available on the day of the visit.

They may also give 48 hours’ notice to supported living schemes and extra care housing, but this will vary depending on the way the service is organised – in particular, in relation to the location of the registered manager and people using the service.

3. Hospice services

Hospice inspections for inpatient hospices will usually be unannounced. In a few instances, where there are very good reasons, they may let the provider know they’re coming. The CQC usually announce inspections of community-based hospice services and day hospices 48 hours in advance. This is so that they can be sure the manager or a senior person in charge is available on the day we plan to visit.

CQC Registration

Providers that want to provide care that is regulated under the Health and Social Care Act 2008 must apply to be registered with CQC. As part of the application process, they have to provide evidence that shows they will be able to provide care that meets the government standards. To find out more about CQC registration download this free guide to registering with the CQC.

CQC Inspecting and monitoring

As spoken about earlier, once the CQC have approved a provider’s registration application, they monitor the provider to check that the care they are providing at each of their locations meets government standards. By ‘government standards’ this mean the regulations made under the Health and Social Care Act 2008.

Enforcement

If the CQC find that a service isn’t meeting the standards required, they can take action. This is called ‘Enforcement’. There are a range of enforcement actions, that are exercised in proportionate ways, such as:

• Issuing a warning notice requiring improvements within a short period of time.
• Restricting the type of care that the service can offer.
• Stopping admissions into the care service.
• Issuing fixed penalty notices.
• Suspending or cancelling the service’s registration.
• Prosecution.

Publication

The CQC publish results publicly for their regulatory work, to help the public make informed decisions on what service provider to choose. They do this by:

• Publishing inspection reports on our website.
• Publishing summaries of our inspection findings on our website, through a care directory of every service we regulate.
• Issuing local media releases when we have taken enforcement action against a service because they are non-compliant with one or more of the regulations.

The regulations and this guidance are an essential component of CQC's approach, as set out in their strategy Raising Standards, putting people first. The diagram of their operating model summarises how they register, monitor, inspect and award ratings to providers, take enforcement action and provide an independent voice on the quality of care.

As well as their inspecting and rating of health and care services, CQC also publish research, advice and guidance and market reports.

The CQC was established in April 2009 as part of a major reform of health and social care regulation in England. It replaced three former bodies - the Healthcare Commission, the Commission for Social Care Inspection, and the Mental Health Act Commission - to create a single, unified regulator responsible for overseeing health and adult social care services. This consolidation strengthened regulatory consistency and improved the monitoring of standards across hospitals, care homes, GP practices, and community care services.

Understanding the CQC’s origins adds helpful context to its current role, highlighting how its formation was designed to streamline oversight and ensure safer, more effective care nationwide.

The CQC uses a four‑point rating scale to show how well a health or social care service is performing: Outstanding, Good, Requires Improvement, and Inadequate. These ratings are based on ongoing monitoring and formal inspections, where services are assessed for safety, effectiveness, care quality, responsiveness, and leadership.

Outstanding

An Outstanding rating means a service is performing exceptionally well, going above and beyond the fundamental standards of care expected by the CQC. For providers, it reflects strong leadership, consistently high‑quality care, and robust processes that exceed regulatory expectations. For service users, this rating offers reassurance that they can expect excellent, person‑centred care delivered safely and compassionately.

Good

A Good rating indicates that a service is performing well and meeting all key standards set by the CQC. Providers with this rating demonstrate reliable, safe, and well‑managed care. For service users, a Good rating means they can be confident the service is effective, well‑led, and responsive to their needs, with no significant concerns identified.

Requires Improvement

A Requires Improvement rating means a service is not performing as well as it should, and the CQC has identified specific areas where changes are needed. Providers must act on these recommendations and show evidence of improvement. For service users, this rating signals that while care may be safe, some aspects fall short of expected standards, and users may want to review inspection reports for more detail.

Inadequate

An Inadequate rating means the service is performing poorly, with serious failings in care quality, safety, or leadership. In these cases, the CQC may take enforcement action, which can include special measures or restrictions on how the service operates. For service users, this rating is a clear warning that the service is not meeting fundamental standards and may pose risks to their wellbeing.
These ratings help people make informed decisions about their care and encourage providers to maintain high standards through transparency and accountability.

When a care provider fails a CQC inspection, the Commission follows a formal enforcement and improvement pathway designed to protect service users and ensure that poor‑quality care is addressed quickly and effectively. This process can involve special measures, strict improvement deadlines, and ultimately the risk of registration cancellation if a provider does not make sufficient progress.

Entering Special Measures

If a service is rated Inadequate, the CQC may place it into special measures, a formal process used when there are serious failings in care quality or safety. Under special measures, the provider is given clear actions that they must take to improve, and the CQC increases its level of monitoring and oversight. 

The 6‑Month Improvement Window

Once in special measures, providers typically have up to six months to make significant improvements. During this time, the CQC carries out follow‑up inspections to check progress and assess whether the required standards of care are being met. Services rated Inadequate are normally re‑inspected within 12 months, but those under special measures often see more frequent reviews to monitor their progress against improvement plans.

Escalation Pathway

If a provider does not demonstrate sufficient improvement during the special measures period, the CQC can escalate its enforcement actions. This escalation may include:

• Issuing warning notices requiring rapid corrective action.
• Imposing conditions on a provider’s registration, limiting what services may be delivered.
• Restricting new admissions to protect service users while improvement work is ongoing.
• Direct prosecution for breaches of regulations, enabled by CQC’s enhanced enforcement powers.
• Placing the provider into special measures (if not already) or maintaining that status until improvement is demonstrated.

Risk of Registration Cancellation

If, after the improvement window and enforcement actions, the provider still fails to meet the fundamental standards of care, the CQC can move to cancel the provider’s registration, effectively preventing them from operating. This is the most serious outcome and is reserved for cases where care remains unsafe, ineffective, or poorly led, despite opportunities to improve.

Care regulation across the UK is devolved, meaning each nation has its own independent bodies responsible for inspecting and overseeing health and social care services.

In Scotland, care services are regulated by the Care Inspectorate, which inspects and monitors standards across a wide range of social care services; hospitals and hospices are separately regulated by Healthcare Improvement Scotland.

In Wales, health services are regulated by Healthcare Inspectorate Wales (HIW), while social care and childcare services fall under Care Inspectorate Wales (CIW). These bodies ensure services meet national standards and carry out inspections, registration, and enforcement where required.

In Northern Ireland, the Regulation and Quality Improvement Authority (RQIA) is responsible for inspecting and monitoring both health and social care services, providing an oversight role similar in scope to other UK regulators.

If you are looking to start a new care service and are trying to understand how to register, read this 'how to' article on CQC registration.

As the CQC is currently undergoing fundamental changes to how it inspects and regulates care services, you should also read this article to get the fundamentals on the new CQC Single Assessment Framework and for a deeper dive, download the free guide via the link below. 

We understand that inspections can be stressful, time-consuming, and costly. Fortunately, there are software solutions available to help you navigate the inspection process while demonstrating compliance to the CQC fundamental standards.  

At Access we have been supplying software solutions to the care industry for more than 30 years. We currently support over 11,000 registered care locations across the UK.  

Our Access Care Compliance platform helps your audits become more systematic and effective while managing, tracking and improving quality to make your services more compliant.  

Access Evo, our AI in Care tool, leverages the power of AI to help you carry out mock inspections in accordance with the CQC’s new inspection framework. The integrated AI allows you to flag any areas of concern and can create a roadmap for improving your CQC rating.   

To find out more about the care compliance software we offer at Access, contact us here to discuss your needs or book a demo.