CQC inspection preparation checklist

How CQC assesses services

The Care Quality Commission regulates health and adult social care in England. (Scotland, Wales and Northern Ireland have their own regulators: the Care Inspectorate, Care Inspectorate Wales and RQIA. The principles in this guide apply broadly, but the framework described here is CQC's.)

CQC assesses every service against five key questions. Is it safe, effective, caring, responsive and well-led? Under the single assessment framework these break down into quality statements, the "we" commitments that describe what good care looks like. Evidence is gathered from several sources: what people using the service and their families say, feedback from staff and partners, direct observation, your processes and records, and outcomes.

Two things follow from this that shape how you should prepare:

• Assessment is ongoing, not a single visit. CQC can collect evidence at any time, so readiness has to be your normal operating state rather than a sprint when a visit is announced.
• Your records are your evidence. If care was delivered well but the record is missing, late or vague, you cannot demonstrate it. Regulation 17 (good governance) explicitly requires accurate, complete and contemporaneous records for every person you support.

1. Care records and documentation

• Care plans are current and person-centred. Each plan reflects the person today, not the person at admission. Reviews are dated, and changes after incidents or health events are traceable.
• Daily notes are contemporaneous. Entries are made during or immediately after care, timestamped and attributed to a named staff member. Retrospective gap filling is one of the most common findings at inspection.
• Risk assessments are specific and reviewed. Generic, copy pasted risk assessments are easy for an inspector to spot. Each one should name the risk, the controls and the review date.
• Incident records show learning. Every incident has what happened, what you did, who was informed and what changed as a result.
• The record cannot be quietly edited. Inspectors place weight on records that are tamper evident. An audit trail showing who wrote what and when is strong evidence of good governance.

2. Medication

• MAR charts are complete. No unexplained gaps, correct use of omission codes, and PRN medicines backed by protocols. See our MAR chart best practice guide for detail.
• Storage is safe and monitored. Medication room and fridge temperatures logged daily and actioned when out of range.
• Controlled drugs are accounted for. The CD register balances, entries are witnessed and stock checks are regular.
• Medication audits happen and lead to action. An audit that found nothing, filed away, is weaker evidence than an audit that found three issues with a dated action plan.

3. Staff files and training

• Recruitment files are complete. DBS checks, references, right to work and interview records for every member of staff.
• The training matrix is live. Mandatory training in date for everyone, with expiry dates tracked and refreshers booked before they lapse.
• Supervision and appraisal are recorded. Regular one to ones with notes, not just a signature sheet.
• Staff can talk about safeguarding. Inspectors ask front line staff how they would recognise and report abuse. Rehearse this in team meetings.

4. Safeguarding and notifications

• The safeguarding log is current and cross referenced to incident records and local authority referrals.
• Statutory notifications have been submitted. Deaths, serious injuries, abuse allegations and other notifiable events must be reported to CQC. Keep your own log of what was sent and when.
• Duty of candour is evidenced. Where things went wrong, you can show the person and their family were told, with an apology and an explanation recorded.

5. Environment and safety

• Certificates are in date. Gas safety, electrical installation, PAT testing, legionella risk assessment and fire risk assessment.
• Fire drills and equipment checks are logged, with personal emergency evacuation plans for the people you support.
• Infection prevention and control audits are recent and actions closed.
• Equipment is serviced. Hoists, beds and other equipment have service records within date.

6. Governance and the well-led question

Well-led is where providers most often fall down, because it is about the system rather than individual acts of care. Inspectors want to see a loop: audits find issues, actions are assigned, actions are completed, and the same issues do not recur.

• A live audit schedule covering care records, medication, health and safety, and infection control.
• Action logs with owners and dates, and evidence that completed actions actually changed practice.
• Analysis over time. Trends in incidents, falls, medication errors and complaints, with what you did about them.
• Feedback loops. Surveys or meetings with people you support, families and staff, with visible "you said, we did" outcomes.

On the day

• Agree in advance who greets inspectors, who can pull records quickly, and where they can work.
• Be able to produce any person's full record fast. Long waits while paper files are hunted down set the tone badly. Digital systems that export a complete, timestamped record in one click remove this stress entirely.
• Be honest about known issues. An open problem with a credible improvement plan reads far better than a problem the inspector discovers themselves.