The five questions the CQC asks, and the four ratings it gives
The Care Quality Commission (CQC) inspects every health and social care service in England against the same five questions, whatever the size or the specialty. It asks whether a service is safe, whether it is effective, whether it is caring, whether it is responsive to people's needs, and whether it is well-led. An inspection gathers evidence against each of the five before the CQC settles on a rating.
- Safe: whether people are protected from harm and avoidable risk.
- Effective: whether care and treatment achieve good outcomes.
- Caring: how staff treat the people using the service and their families.
- Responsive: how well the service meets people's individual needs.
- Well-led: how the service is run, from day-to-day management to overall leadership.
The four ratings
Once the CQC has weighed the evidence against all five questions, it gives the service one rating: Outstanding, Good, Requires Improvement, or Inadequate. The same four ratings apply whether the service is a hospital trust, a GP practice or a care home, so a rating for one kind of provider means the same thing as a rating for another.
The CQC publishes its ratings and its directory of registered providers under the Open Government Licence. Its API updates daily and its ratings file updates monthly, so the rating you find against a provider's name is drawn from a record the CQC keeps current on its own terms. Healthcare.uk acknowledges its use of CQC information. You can check the current version of a rating, and the terms it is published under, on Data and sources.
The four CQC ratings compared
The CQC gives every inspected provider one of these four ratings, based on the same five questions each time. This table sets out what each one tells you and where to look for more detail.
| Rating | What it means | What it doesn't tell you | What to check next |
|---|---|---|---|
| Outstanding | The CQC found this provider performing well beyond what's expected, across most or all of the five questions it asks. | Fewer providers hold this rating than the other three, so it can sit alongside an older inspection date. | Check the date on the inspection report against how long ago that visit took place. |
| Good | The provider meets what the CQC expects on safety, effectiveness, care, responsiveness and leadership. | It's the most common rating, so on its own it doesn't separate one provider from another. | Read the report for detail on whichever of the five questions matters most to you. |
| Requires improvement | The provider falls short of what the CQC expects on one or more of the five questions. | The rating alone doesn't say which question fell short. | Look for the CQC's follow-up action and whether a further inspection has taken place since. |
| Inadequate | The provider falls seriously short, which can bring the CQC's enforcement powers into play. | This is the least common rating; the report sets out what the CQC found and required. | Read what the CQC required the provider to do and whether that's been completed. |
This is a guide to reading a rating, not a substitute for the CQC's own report, which can change after a later inspection. A rating says nothing about how long you'd wait for treatment; for that, our which waiting-time standard applies to me? tool shows the published standard for your own referral pathway, with its source and read date.
Inspections, ratings and how they age
An inspection looks at how a service works. Inspectors check records, speak to staff and to people using the service, and look at how the provider manages risk, staffing and complaints, against the same five questions the rating is built on. The result is one rating for the service as a whole, and sometimes separate ratings for individual areas the provider runs, such as a specific ward or department.
How old a rating can be
A rating is dated to the inspection it came from. There is no fixed interval at which every provider is reinspected, so one provider's rating may be recent while another's is several years old. The date sits alongside the rating on the CQC's own record for that provider, and it is worth checking before you weigh the rating against anything else you know about the provider now.
Reading a rating beside a waiting-time figure
A CQC rating and a waiting-time figure measure different things. The rating covers how safe, effective, caring, responsive and well-led a service was found to be at inspection. A waiting-time figure covers how long patients referred to that provider have actually waited, for a given specialty and month. A provider can be rated well and still have a long wait in one specialty, or the reverse, because neither figure stands in for the other.
Reading them together is a matter of putting the rating's inspection date next to the waiting-time figure's publication month, and treating each as answering its own question. How NHS waiting times are measured sets out what the published waiting figures cover and how the clock starts. Before you compare a wait against the standard, it helps to know which standard covers your own referral in the first place: use which waiting-time standard applies to me? to check the published standard for your pathway, when its clock starts and what pauses it. If you are choosing between providers under your right to a named provider, Data and sources lists where both the ratings and the waiting-time figures are published, so you can check the current version of each before deciding.
This site describes what the CQC publishes; it is not a substitute for reading the CQC's own report for the service in question, and it does not assess your own clinical situation. For anything about your own care, speak to your GP, a pharmacist, NHS 111 or, in an emergency, 999.