How we aggregate ratings using the rating principles: adult social care services

Page last updated: 12 May 2022
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Organisations we regulate

Overall location ratings are produced on the basis of the following principles:

  1. In line with our enforcement policy, the overall rating for a service cannot be better than requires improvement if there is a breach of regulations.
  2. The five key questions are all equally important and are weighted equally when aggregating. Please note: for focused inspections, the new ratings for the key questions inspected will be aggregated with the existing ratings for the key questions not inspected.
  3. At least two of the five key questions would normally need to be rated as outstanding and three key questions rated as good before an aggregated rating of outstanding can be awarded.
  4. There are a number of ratings combinations that will lead to a rating of good. The overall rating will normally be good if there are no key question ratings of inadequate and no more than one key question rating of requires improvement.
  5. If two or more of the key questions are rated as requires improvement, then the overall rating will normally be requires improvement.
  6. If two or more of the key questions are rated as inadequate, then the overall rating will normally be inadequate.

Where a regulatory history has been continued

For newly registered services that were previously operated by another provider, we continue the previous regulatory history (rating and report) on our website. We use this history to take a proportionate, risk-based approach to planning the first inspection after a registration change. The first inspection will make new judgements and produce new ratings. Ratings from the previous provider are not used to produce a new aggregated rating. Find out more about why and when we continue the ‘regulatory history' (report and rating) of a service.

Rating limiters

There are a small number of events and circumstances that are sufficiently serious to limit a rating for the well-led question. These circumstances are set out below and describe when well-led can never be rated better than requires improvement.

  1. The location has a condition of registration that it must have a registered manager but it does not have one, and satisfactory steps have not been taken to recruit one within a reasonable timescale.
  2. The provider has any other condition of registration that is not being met without good reason.
  3. Statutory notifications were not submitted in relation to relevant events at the location without good reason.
  4. The provider has not returned PIR information where requested by CQC, or has not supplied the information in another format, indicating that the service is unable to demonstrate an understanding of the importance of keeping and using management information to deliver a good, safe service.

In addition, the overall rating for a service cannot be better than requires improvement if there is a breach of regulations. This is because providers rated as good are meeting the standards set out in the regulations and display the characteristics of good care (i.e. to be rated as good means more than just meeting the standards set out in the regulations – CQC enforcement policy).

Inspectors should use their judgement about whether to treat any incident as a breach of regulations in the normal way, considering the impact on people, the history of the service regarding any previous incidents, and how it responded to them. Where an incident has a low impact, inspectors should consider the proportionate action to take – this may include making a recommendation – and reflect this in their report.

When we would not rate

Sometimes we will not be able to award a rating after an inspection. This could be because:

  • the service is new
  • we don’t have enough evidence
  • the service has recently been reconfigured, such as being taken over by a new provider.

In these cases we will use the term ‘inspected but not rated’.

We may suspend a rating if we identify significant concerns that lead us to re-consider our previous rating. The rating will be suspended until we have investigated the concerns and/or re-inspected the service.