Why Are Some Care Providers Waiting Years for a New CQC Rating?

For many health and social care providers, their latest Care Quality Commission (CQC) rating no longer reflects the service they are delivering today. While some organisations have been inspected recently, others continue to display ratings that are several years old, raising questions from providers, commissioners and families about how current those assessments really are.

Unlike some regulators, the CQC does not inspect services on a fixed timetable. Instead, it uses a risk-based approach, prioritising inspections where there are concerns about quality or safety, alongside other intelligence such as safeguarding information, notifications and complaints. This means there is no guaranteed interval between inspections for services rated Good or Outstanding.

However, inspection activity slowed significantly following the introduction of the CQC’s Single Assessment Framework and supporting technology in 2023. An independent review led by Dr Penny Dash, published in October 2024, concluded that the regulator’s transformation programme had resulted in fewer assessments being completed, delays in publishing reports and inconsistent regulatory decisions. The review found that these issues had undermined confidence in the regulator and recommended a rapid programme of improvement.

The review also highlighted the importance of CQC ratings, noting that they influence public confidence, commissioning decisions, staff recruitment and the reputation of providers. When ratings are based on assessments carried out several years earlier, they may not accurately reflect the quality of care being delivered today.

The CQC has acknowledged these challenges and says it has been working to rebuild the organisation. In its latest progress update, the regulator said that around 500 assessment reports were waiting to be processed at the start of 2025, but that this backlog had been reduced to just four by the end of the year. It also reported that it is increasing inspection activity, with a target of publishing 9,000 assessments by September 2026. According to the regulator, more than 4,300 assessments had already been published by the end of 2025, putting it ahead of schedule.

For providers, the impact of inspection delays can be significant. Services that have invested in new leadership, improved staffing, strengthened governance or addressed previous concerns may continue to display an older rating until a new assessment takes place. Equally, a positive historical rating may not always reflect a service’s current performance if standards have declined since its last inspection.

The CQC has said that increasing assessment activity, improving its digital systems and introducing sector-specific assessment frameworks are all part of its wider programme to deliver more timely and consistent regulation. While progress is being made, the regulator accepts there is still work to do to restore confidence and ensure ratings provide an accurate picture of the care people receive today.

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