Special measures: adult social care services

People who use adult social care services have the right to expect high-quality, safe, effective and compassionate care. We want to ensure that services providing inadequate care do not continue to do so. Where care is judged to be inadequate, it is essential that the service improves quickly for the benefit of people who use it.

The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide, or we will seek to cancel their registration.

How special measures works

There are two routes into special measures.

Route 1: Services rated as inadequate overall will go straight into special measures.

Route 2: If a service is rated inadequate for one of the five key questions, we will inspect it again within six months of the report being published. If the service remains inadequate in any key question at the second inspection, it will enter special measures.

Once a service is in special measures, we will re-inspect within six months to check that sufficient progress has been made. If, following inspection, we feel sufficient progress has been made, we will remove the service from special measures.

If sufficient progress has not been made when we re-inspect and there are inadequate ratings for any key questions, we will begin to take action to prevent the service from operating, either by proposing to cancel their registration or to vary the terms of their registration. We will then closely monitor the service until it either closes or substantial and rapid improvements are made. We will carry out a further inspection within six months and, if an inadequate rating remains in any key question, we will take action to stop or limit the operation of the service.

Special measures does not replace CQC’s existing enforcement powers: it is likely that we will take enforcement action at the same time as a service going into special measures. In some cases we may need to take urgent action to protect people who use the service or to bring about improvement, in accordance with our enforcement policy.

We have published detailed guidance about our approach to special measures for adult social care services.