How we determine the aggregated ratings of online services, independent doctors and clinics

Using professional judgement

To ensure that we make consistent decisions, we follow a set of ratings principles and apply professional judgement when rating at key question level and service level. Our ratings must be proportionate to all available evidence and the specific facts and circumstances.

If we identified concerns in the inspection we will consider the following criteria and use our professional judgement to decide whether to depart from applying the ratings principles – particularly where we need to aggregate ratings that range from inadequate through to outstanding:

• The extent and impact of the concerns on people who use services and the risk to quality and safety, taking into account the type of setting. If concerns have a very limited impact on people, it may reduce the impact on the aggregation of ratings.
• Our confidence in the service to address the concerns, or where action has already been taken.

We can’t predict what future models of care and configurations of services will look like. To enable us to be flexible and respond to change, we will base our approach to aggregation for future models of care on these principles.

Where a rating decision is not consistent with the principles, we will record the rationale clearly in the inspection report and the decision using internal quality control and consistency processes.

Updating ratings

Ratings from previous inspections are carried forward and aggregated with updated ratings following any recent inspection of a key question. A change in a key question rating can result in a change in an overall rating for a provider when we apply the ratings aggregation rules.

Where there is a change of ownership or address at an existing location, CQC’s website and internal systems will continue to display the provider’s ‘regulatory history' (rating and inspection report under a previous provider).

After we have published an inspection report, you must display your updated ratings in relevant locations and on your website.