Who Are the CQC and What Do They Do?

The Care Quality Commission (CQC) is central to maintaining safety, transparency, and accountability in health and social care. Their standards guide how services are delivered, regulated, and improved, from residential care and domiciliary services to GP practices and hospitals.

Understanding the CQC helps care providers lead with confidence, prepare teams effectively, and embed a stronger culture of quality. That starts with knowing who the CQC are, who they regulate, and how their work affects the people and services they oversee.

For an introduction to who the CQC are and what they do, our Understanding CQC course offers practical training to improve awareness and understanding of the CQC for those working in adult social care in England.

Who Are the CQC?

The Care Quality Commission, or CQC, oversees how care is delivered across England. Their role is to make sure services meet national standards of safety, effectiveness, care, responsiveness, and leadership, whether in someone’s home, a hospital, care home, GP practice, or community setting.

Set up under the Health and Social Care Act 2008, the CQC was created to protect people’s rights and promote accountability across the care sector. Rather than delivering care themselves, they oversee how well care is being provided by organisations of all sizes. This includes private, voluntary, and public services.

At the core of their work are the Fundamental Standard, the standards below which a service’s care and support provision must never fall. These cover areas such as safeguarding, person-centred care, staffing, governance, dignity and respect, and consent. The CQC ensures these standards are being met by registering providers, inspecting services, and enforcing improvements where necessary.

The CQC protects people using care services. A key part of their role is listening to those with lived experience, including residents, patients, and families, and using that feedback to inform decisions and drive improvement.

Their decisions are shaped by what people say about care. Feedback from residents, patients, families, and staff plays a central role in how services are assessed and how change is driven.

 What Services Do the CQC Regulate?

The CQC is responsible for making sure health and social care services in England provide safe, consistent, and lawful support. Any organisation offering regulated care must register with the CQC and demonstrate that they meet the required standards from the outset.

Here are the main types of services that fall under their scope:

• Care Homes: Residential care and nursing homes for older people, people with physical and learning disabilities, and those with long-term health conditions.
• Domiciliary Care Services: Care and support delivered in an individual’s own home.
• Hospitals: NHS and independent hospitals offering acute, maternity, or specialist treatment.
• Clinics: Community-based clinics, minor injury units, and private outpatient services.
• General Practitioners (GPs): Primary care services offering diagnosis, treatment, and ongoing patient support.
• Dental Practices: NHS and private dental providers.
• Ambulance Services: Emergency response services and non-emergency patient transport.
• Mental Health Services: Inpatient and community support, including services for individuals detained under the Mental Health Act.
• Hospices and Palliative Care Providers: Services that support individuals at the end of life and their families.

What is the Role of the CQC?

The CQC actively shapes how care quality is defined, delivered, and improved across the sector. For providers and staff, understanding their responsibilities helps ensure services remain compliant, trusted, and fit for inspection.

Registering Services

Before delivering regulated care, providers must apply for CQC registration. This includes demonstrating how they meet the Fundamental Standards, submitting supporting evidence, and outlining how services will be delivered safely. Only once approved can a service legally operate.

Inspecting and Monitoring

Registered services are monitored through regular inspections and ongoing review. The CQC uses a mix of data analysis, feedback from people using services, staff, and families, and a service’s past performance. Inspections may be comprehensive or focused and announced, or unannounced, depending on risk and concerns.

Publishing Reports and Ratings

Following inspection, a detailed report is published online, including a service’s rating: Outstanding, Good, Requires Improvement, or Inadequate. These ratings help the public make informed choices and highlight where providers are meeting or falling short of expectations. Providers must also ensure that their rating is clearly displayed on their premises and website.

Taking Action on Poor Care

If a service doesn’t meet the required standards, the CQC has legal powers to intervene. This can include issuing warning notices, setting improvement deadlines, applying fines, restricting certain activities, or, in serious cases, suspending or closing services. These steps are taken to protect the safety and wellbeing of those receiving care.

Listening to Feedback

The CQC regularly gathers feedback from people using services, family members, staff, and whistleblowers. This insight plays a key role in monitoring and inspections. Concerns raised can directly shape the timing, focus, or depth of an inspection, making it easier to respond to risks early.

 Highlighting Good Practice

Alongside identifying risks, the CQC also recognises and promotes well-led, person-centred care. By highlighting examples of innovation, strong leadership, and high-quality outcomes, they encourage learning and raise expectations across the sector.

What Is a CQC Inspection?

Inspections are how the CQC checks that care services meet legal requirements and are delivering safe, effective, and person-centred care. These inspections can be announced or unannounced and vary in scope depending on the type of service, any previous concerns, and the outcomes of ongoing monitoring.

Inspections are structured around five key questions (Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?) and result in a public rating that reflects how well the service is performing. These inspections play a major role in driving improvement and informing choice.

What Do They Inspect?

Inspectors assess services against the five key questions. These are underpinned by the Fundamental Standards of care. During an inspection, they’ll review:

• How safe the environment is
• Whether care is effective and achieves good outcomes
• Whether staff are caring, compassionate, and respectful
• How well the service responds to individuals needs and preferences
• Whether the service is well-managed and has clear leadership

They can involve examining policies, training records, incident logs, and evidence of compliance.

For a more detailed look at how to prepare, read our guide on Preparing for a CQC Inspection.

How Do They Inspect?

CQC inspections combine multiple methods, including:

• Site visits
• Staff interviews, including leadership and frontline workers
• Observations of care and interaction
• Review of records, including care plans and audits
• Feedback from people using the service, family members, and other professionals

Inspectors use a structured framework to ensure consistency but tailor their approach based on risk, previous ratings, and service type.

Why Do They Inspect?

CQC inspections serve several purposes:

• Protecting individuals by identifying risks and poor practice
• Holding providers accountable for meeting legal standards
• Encouraging improvement by highlighting areas for development
• Providing transparency to help people make informed choices about their care

Every inspection is designed to ensure that care is safe, respectful, and focused on the individual.

What Are the CQC Fundamental Standards?

The Fundamental Standards illustrate the standard below which a service’s care and support provision must never fall. They form the baseline for what “good care” should look like and guide everything the CQC inspects, reports on, and enforces.

If a provider isn’t meeting the standards, the CQC can step in. This might mean issuing improvement notices, limiting the kind of care a service can provide, or, in serious cases, suspending or cancelling registration altogether.

Key areas covered by the Fundamental Standards include:

• Person-Centred Care: Care and treatment must reflect the individual’s needs and preferences.
• Dignity and Respect: People must be treated with compassion, kindness, and respect at all times.
• Consent: No care or treatment should happen without the individual’s clear agreement or a best-interest decision.
• Safety: Care must not put people at risk. Risks must be assessed and managed appropriately.
• Safeguarding from Abuse: People must be protected from abuse, neglect, and improper treatment.
• Premises and Equipment: The care setting must be safe, clean, and suitable for the support being provided.
• Staffing: There must be enough qualified staff to meet people’s needs safely.
• Fit and Proper Staff: Staff must have the right skills, experience, and character.
• Duty of Candour: Providers must be open and honest when things go wrong.
• Complaints Handling: There must be a clear system in place to receive and respond to complaints

Understanding Ratings and Reports

Every CQC-inspected service receives a public rating, helping individuals and families make informed choices about care. These ratings reflect how well a service is performing against the five key questions: Are they safe, effective, caring, responsive, and well-led?

Each service is graded using the following scale:

• Outstanding: Exceptionally high-quality care that goes above the standard expectations.
• Good: Care that consistently meets the required standards.
• Requires Improvement: Some standards are not met; changes are needed.
• Inadequate: Significant concerns; the CQC will likely take action.

Alongside the rating, the CQC publishes a detailed report on its website. These reports explain what inspectors found, how the service was performing in each key area, and what needs to improve (if anything).

Build Confidence with Our Understanding CQC Course

If you’re looking to improve your understanding of the CQC, strengthen inspection readiness, or upskill your team, our Understanding CQC course is built to support you at every level.

Designed for care providers, managers and frontline staff, this CPD-certified online course covers:

• What the CQC is, what they do, and why they matter
• The Fundamental Standards 
• How inspections work and how to feel prepared
• What to expect before, during, and after inspection

Our Understanding CQC course gives your team the confidence to meet inspection standards with clarity and assurance. You can also browse our full range of CPD-certified health and social care e-Learning courses, all included within our Learning Management System.