CQC Care Home Standards: From good to outstanding

When your care services business is at full stretch trying to cope with staff shortages and strained resources, it can be a challenge to achieve an outstanding rating from the CQC (Care Quality Commission).

It’s a difficult time for social care, with care homes closing at an increasing rate and the threat of losing valuable care workers. But it’s still crucial for your business, and your service users that you maintain high standards and aim to reach top ratings from the CQC.

If your business scores an inadequate rating on any of the criteria or is placed in special measures, your business will often need significant investment and change1. Almost three quarters of care homes in England that were rated as inadequate by the CQC improved their grade within 6 months2.

What it means for your care business to score outstanding

An outstanding CQC rating is recognition that you’re meeting the highest standards set. It’s also a testament that your care recipients are getting a first class service.

Achieving outstanding and staying at this level means that your business could likely have:3

  • More opportunity for staff to be innovative
  • Fewer safety incidents
  • A better staff retention rate
  • Lower levels of absenteeism
  • More appeal to clients and their families
  • Having an outstanding rating can be the deciding factor between someone choosing your care services over another provider.
  • How your care business can achieve outstanding

Here are some of the top things you need to do to achieve an outstanding rating:


Safeguarding - The key is to ensure that staff are well trained and that they understand what’s expected of them. Safeguarding is crucial in keeping everyone safe.
Managing risks - Managing risks can reduce the likelihood of having an incident. Should one happen, you’ll be better prepared to deal with it.
Safe recruitment - Ensure that you recruit staff based on your values, check suitability for the role, test core skills, and follow up on DBS checks and references.
Safe staffing - Base your staffing levels on the needs of those who receive your care and support. It’s important to plan and review staffing levels and manage performance.
Medicines - If you train staff and assess competence, you will reduce the risk of having an incident. Audits and proper investigation of incidents will show a willingness to improve.
Learning to improve safety - Ensure there is responsibility for incidents, demonstrate learning and make improvements. Consider implementing technology to help with this.


Legislation, standards and evidence – Make sure you deliver care in-line with legislation and that everyone understands the legislation. It’s crucial to communicate key changes and document this as you go.
Staff skills, knowledge and experience – Make sure your staff are competent before they deliver care. Customise inductions, continually develop staff and use technology to keep track.
Effective retention – Provide evidence that you recognise how low staff turnover benefits the standards of care. Demonstrate how you value your staff with support, wellbeing and incentives.
Staff support – Make sure staff know what’s expected of them. Supervise and support, get their feedback, follow performance management good practice and develop their skills.
Adaptation and design of premises – Make sure to carry out safety checks on your equipment and premises. The environment should reflect people’s needs and protect their dignity.


Kindness, compassion and emotional support - Ensure that these are part of your culture and that your staff are proud to deliver. Consider whether the service you’re providing is good enough for your own friends and family?
Involving people, providing information and accessing support - Be proactive in sharing information, empower staff to deliver what’s needed and create a culture where staff seek to support people with their needs.
Privacy, dignity and independence – Demonstrate human rights principles and document service user’s beliefs and needs. Honour differences and create policies and procedures to avoid discrimination.

Responsive to people’s needs

Care plans – Make sure care plans are detailed, clearly describe treatment and support needs. Include information about service users’ condition and how they should be involved in their care. Plan care with the person, not for the person.
Maximising independence – Make sure that staff understand the important of independence and encourage activities. Host the activities and help people achieve their personal goals.
Person-centred care – Provide a consistent person-centred approach to care, work closely with people to understand what’s important and involve them in decisions and regular reviews of their care.


A positive culture - Put people at the heart of your business, a positive culture starts at the top and managers / leaders should be open, visible and approachable. Avoid creating a blame culture.-
Vision, values and strategies - Make sure your vision is person-centred. Involve your staff in creating and renewing your vision and values and monitor progress.
Knowledge, experience and integrity - Appoint senior staff who have the ability to run a successful care service and who understand CQC standards. Ensure they lead by example and develop succession plans.
Governance - Ensure clear documented management structures at all levels and that legal requirements and implications are understood.

For a full list of the criteria and how to achieve an outstanding rating, it’s worth reading the Good and Outstanding Care guide for further information.

If you’d like to discuss managing your risks, care insurance or how to recognise and reward your employees with employee benefits, check out these areas on our website.


1. https://www.skillsforcare.org.uk/Documents/Standards-legislation/CQC/Good-and-outstanding-care-guide.pdf
2. https://www.theguardian.com/society/2016/may/25/being-judged-inadequate-not-all-bad-for-care-homes
3. https://strivecare.co.uk/9-practices-high-performing-care-homes/
4. https://www.cqc.org.uk/sites/default/files/20170420_celebratinggoodcare2017.pdf