Winning a tender for social care often requires a minimum rating from the Care Quality Commission (often “requires improvement” is enough, although some tenders require a minimum rating of “good”). Social care providers registered with CQC need to actively manage their relationship with the regulator as well as auditing the service they provide to make sure they never get a rating of “inadequate” (which is likely to get any contracts they currently have suspended, as well as making winning new tenders more difficult), always striving for a rating of “outstanding”.

The Care Quality Commission (CQC) is an independent regulator of health and adult social care in England. The CQC is responsible for inspecting and rating services, monitoring the quality of care, and taking action to protect people who use services.

The CQC has a number of powers, including:

• Inspecting services: The CQC inspects a wide range of health and adult social care services, including hospitals, care homes, GP surgeries, and mental health services.
• Rating services: The CQC rates services on a five-star scale, with one star being the lowest rating and five stars being the highest rating.
• Monitoring the quality of care: The CQC monitors the quality of care by collecting data on a range of indicators, such as staff turnover, patient complaints, and the use of restraint.
• Taking action to protect people: The CQC can take action to protect people who use services, such as issuing warning notices, requiring services to improve, and suspending or cancelling registrations.

The CQC’s role is to ensure that people who use health and adult social care services receive safe, effective, compassionate, and high-quality care. The CQC plays an important role in protecting people who use services and in ensuring that the quality of care is continuously improved.

Here are some of the things that the CQC does to inspect and rate services:

• Conduct unannounced inspections: The CQC conducts unannounced inspections of services to ensure that they are meeting the required standards.
• Collect data: The CQC collects data on a range of indicators, such as staff turnover, patient complaints, and the use of restraint.
• Interview staff and service users: The CQC interviews staff and service users to get their views on the quality of care.
• Review documentation: The CQC reviews documentation, such as policies and procedures, to ensure that they are in line with the required standards.

The CQC’s ratings are based on a number of factors, including:

• The quality of care: The CQC assesses the quality of care by looking at things like the care planning process, the level of staff training, and the quality of communication between staff and service users.
• The safety of care: The CQC assesses the safety of care by looking at things like the use of medication, the prevention of falls, and the management of risk.
• The effectiveness of care: The CQC assesses the effectiveness of care by looking at things like the achievement of goals, the improvement in health and wellbeing, and the satisfaction of service users.
• The responsiveness of care: The CQC assesses the responsiveness of care by looking at things like the timeliness of care, the flexibility of services, and the involvement of service users in decision-making.

The CQC will also assess how well-led the organisation is. There is a close relationship between the leadership and management of the organisation and the other lines of enquiry. Getting a bad rating in one of the areas listed above is likely to link to a poor rating in the well led category.

For small social care providers, it is all too easy for the owner of the business to get bogged down in the day-to-day running of the business rather than leading and managing the service. It is important to be able to invest time each day to being a leader, even if you also have to spend time in frontline service delivery.

CQC want to see that the “leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture.” Deliver that, and the rest should fall into place.