Quick summary
The Care Quality Commission rates services Outstanding, Good, Requires Improvement or Inadequate, against five questions: is the service safe, effective, caring, responsive and well led. The headline word matters less than the detail underneath it. A service can be rated Good overall and Requires Improvement on the one thing that matters most to you.
Who the CQC is and what it does
The Care Quality Commission is the independent regulator of health and adult social care in England. Any organisation providing personal care in someone’s home has to register with it, and registration is a legal requirement.
Registration and rating are two different things, which is the first thing families tend to conflate. Every provider must be registered. Not every registered provider has a published rating.
The five key questions
Every service is assessed against the same five questions, and each one gets its own rating as well as feeding into the overall one (CQC, assessment framework).
Key question | What it means | What to look for as a family |
|---|---|---|
Safe | Are people protected from abuse and avoidable harm | Medication handling, safeguarding, staff recruitment checks, missed visits |
Effective | Does the care achieve good outcomes | Staff training, working with GPs and district nurses, consent and capacity |
Caring | Do staff treat people with compassion, dignity and respect | What people using the service actually said to inspectors |
Responsive | Is care organised around the person’s needs | Visit timings, continuity of carer, how complaints are handled |
Well led | Is the leadership and culture good | Management stability, staff turnover, how the service learns from mistakes |
“Responsive” and “well led” are the two most families skip and the two that predict day-to-day experience best. A service with high staff turnover and poor rota management can still be rated Good on caring, because the individual carers are kind, while the thing that frustrates you is that nobody arrives when they said they would.
The four ratings
- Outstanding. Performing exceptionally well. Rare, and worth understanding why it was awarded rather than treating it as a guarantee.
- Good. Performing well and meeting expectations. This is the standard most services are aiming at and the most common rating.
- Requires Improvement. Not performing as well as it should, and CQC has told it to improve. Not the same as unsafe, and worth reading the detail.
- Inadequate. Performing badly, with action taken. This is the one to treat as a stop sign.
One important piece of maths: the overall rating is not a simple average. Under the current approach, a single serious shortfall in one area can cap the rating for that whole key question, which is why a service with several strong areas can still come out at Requires Improvement.
What “not yet inspected” means
It means no assessment has been published yet, and nothing more than that.
Newly registered services have not had time to build up the evidence CQC assesses, and there is a queue. A service without a rating is not a service that has failed one. It does mean you have less published information, so the questions you ask directly carry more weight, which is what our guide to care plans and the questions in the next article are for.
The system is changing during 2026
CQC introduced a Single Assessment Framework in 2023, built on the same five key questions but using 34 quality statements and a numerical scoring system. Its own review, published after widespread criticism, concluded that the framework was not simpler than what it replaced and did not accurately reflect the quality of care in some services (CQC).
In March 2026 CQC published draft sector-specific frameworks, including one for adult social care, which replace the quality statements with key lines of enquiry, remove the numerical scoring, and reintroduce written descriptions of what each rating looks like in practice. The five key questions and the four ratings are staying.
Two practical consequences. Older reports were written under an older method, so a rating from several years ago is not directly comparable with a recent one. And assessments no longer always involve a site visit, with ratings able to change as new evidence comes in rather than only after an inspection.
How to read a report properly
- Check the date. A Good rating from four years ago describes a service that may have changed hands, changed manager and changed staff.
- Look at the five ratings separately, not just the overall word.
- Read what people said. Inspectors quote service users and relatives directly, and those quotes are usually the most revealing part of the document.
- Look for the specifics behind any criticism. “Records were not always completed” is a different problem from “people did not receive their medicines safely”.
- Check whether it is the right service. Large providers have many registered locations, and a rating for a branch in another county tells you nothing about the one coming to your mum’s house.
- Look for what changed. A service that was rated Requires Improvement and has since been reassessed may be better run than one coasting on an old Good.
What a rating cannot tell you
Being honest about the limits, since this is what families most often get wrong.
- Whether your carer will be any good. Ratings describe organisations, and your experience will be shaped by two or three individuals.
- What it costs, or whether visits are fifteen minutes or an hour.
- Whether staff are paid for travel time, which predicts continuity more than most published measures.
- What happens today. Assessment is a snapshot plus ongoing evidence, not live monitoring.
Use the rating as one input among several. The others are what you see in the assessment visit, what the provider says about visit length and continuity, and how they answer awkward questions.
If something goes wrong
CQC does not investigate individual complaints. It collects experiences and uses them in its monitoring, which is worth doing, and it will not get your specific problem resolved.
For that, use the provider’s own complaints procedure first, which every registered provider must have. If it is not resolved, the Local Government and Social Care Ombudsman can investigate privately arranged care as well as council-funded care. There is more detail in our guide to what to do when a carer doesn’t turn up.
Frequently asked questions
What are the CQC ratings?
Outstanding, Good, Requires Improvement and Inadequate, awarded overall and against each of the five key questions: safe, effective, caring, responsive and well led.
What does “not yet inspected” mean?
No assessment has been published for that service yet. It is common for newer registrations and says nothing about quality either way.
Is Requires Improvement a reason to walk away?
Not automatically. Read what specifically was criticised and when. Administrative failings and unsafe medicines handling are very different things.
How often are services reassessed?
There is no fixed cycle now. CQC uses ongoing evidence and can update a rating when new information arrives, which is why the date on a report matters.
Can I see the full report?
Yes. Reports are published free on the CQC website, and providers are required to display their rating.
Does a rating cover the whole company?
No. It covers a registered location. Check you are reading the one that would actually deliver your care.
About Visiting Angels Cheshire East
Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns. You can see the full list of areas we cover.
- You choose your caregiver. You meet them before care starts, and if it is not right you say so and we send someone else.
- No visit is ever shorter than an hour. There is no such thing as a fifteen minute call here.
- You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
- Carers trained in dementia, Parkinson’s, stroke recovery and complex care.
- Live-in care available, up to full time.
Sharon’s mother had been having visits for a fortnight when she wrote this:
“It is not something we ever thought we would need but Visiting Angels have been wonderful. They came to see us to find out exactly what we needed, even though we weren’t completely sure ourselves, but through our conversation we were able to put a package of support in place. They offered advice on other things that were available to us as well particularly financially. They put our minds at ease during what was quite a stressful time in our lives.”
Sharon Thornton, Google review
Not sure what you need yet? Start with a free assessment
Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:
- Work out what is actually difficult, and which times of day, which is usually what a visit should be built around.
- Talk through a realistic package, and what it would cost.
- Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to.
- Answer the awkward questions, including the ones about visit length, travel time and turnover that no rating will tell you.
If you are comparing providers and want straight answers, call us on 01625 720157. You can also send an enquiry, and you can read more about how we work.
Authored by Dr Haroon Ahmad, Managing Director, Visiting Angels Cheshire East.
Published 27 September 2026. Last updated 27 September 2026.
This article explains the regulatory system in general terms and is not legal advice. The Care Quality Commission’s frameworks and guidance change, and the position described was correct at the date of publication; check the CQC website for the current position. Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss arising from reliance on this article.
