Services repeatedly rated requires improvement

Good care is the minimum that people receiving services should expect and deserve to receive.

Providers should therefore aim to achieve and sustain an overall rating of ‘good’ or ‘outstanding’. For services rated as requires improvement (RI) on one or more occasions, we will take proportionate action to help encourage prompt improvement from the provider, to achieve and sustain a rating of good. This includes services already rated as RI before 1 November.

Inspectors will use their judgement to take proportionate and flexible action to encourage the service to improve. They will take the following steps, depending on the risks or issues they identify and the circumstances of the service:

• At the first rating of RI, we will write to inform the provider that subsequent ratings of RI may constitute a breach of Regulation 17 (good governance) and suggest sources of help for the provider to seek improvement. The letter will be copied to the lead commissioner at the same time, where appropriate.
• Where there is a breach of the regulations, we will consider proportionate enforcement action, as stated in our published enforcement policy and guidance.
• We may request the provider to complete and return (within 28 days) an improvement action plan to demonstrate how and by when they will make improvements to the quality and/or safety of their service to achieve an overall rating of at least good. This will be requested under Regulation 17(3) Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• We may also request a meeting with the provider, registered manager and commissioner to discuss our concerns, improvements needed and support that may be available. After the meeting we will send a letter to the provider, confirming the points agreed. This may include requesting the completion of an improvement action plan.