CQC ratings explained: the 4 ratings and the 5 key questions

For the regulator behind them, see what the CQC is and how it inspects.

Every service CQC rates gets one of four ratings, overall and for each of the five key questions. Each rating is public, and most providers must display theirs.

Outstanding is the highest rating and Inadequate the lowest. A Good rating means the regulator found the service performing well and meeting its expectations. The score bands apply to each key question. The overall rating has no score of its own: CQC combines the five key question ratings using the rules further down this page.

CQC rates at up to five levels, and the type of service decides which ones apply:

1. Each key question, for the service. For example, how safe a care home is, or how effective the surgery service at a hospital is.
2. The service overall. For example, the rating for a care home, or for the surgery service at a hospital.
3. Each key question, for a location. For example, how safe a hospital is as a whole.
4. The location overall. For example, the rating for a hospital.
5. One rating for an NHS trust. The trust’s rating for well-led, from the regulator’s trust-level assessment of the eight well-led quality statements and a moderation check.

Outside NHS trusts, no provider gets a rating as a whole: a company that runs several care homes or clinics has a rating for each one.

In a hospital, CQC rates each service, such as maternity or critical care, and then combines those ratings. Its rules for combining them depend on how many ratings it combines. With 4 to 8, for example, the combined rating is normally Outstanding when 2 or more are Outstanding and the rest Good, and normally no higher than Requires improvement when 2 or more are Requires improvement. Inspectors can depart from these rules using professional judgement, and the report then records why.

Some services get no rating at all, including primary dental services, children’s homes and medical laboratories. For each key question, they get a judgement of “Regulations met” or “Not all regulations met”. A provider running two kinds of service from the same location, such as a care home and a home care agency, gets ratings for each service and no overall rating.

When a service changes provider, CQC keeps showing the previous provider’s ratings on its website. Its first assessment after the change produces new ratings, and the old ones don’t count towards them.

Two rules stop a weak area hiding behind strong ones:

• If a key question scores in the Good range but any quality statement under it scores 1, CQC limits the rating to Requires improvement.
• If a key question scores in the Outstanding range but any quality statement under it scores 1 or 2, CQC limits the rating to Good.

So strong scores elsewhere can’t make up for a serious weakness: fix the low-scoring statement first. If you’re already rated Requires improvement or Inadequate, read what to do next. The free care home audit tool lists every quality statement behind a rating, so you can see where you stand on each.

A score of 3 means the evidence shows “a good standard”, and a score of 4 “an exceptional standard”. CQC rates a key question Good when it scores 63 to 87% with no quality statement at 1, or when it scores 88% or more but a statement at 1 or 2 holds it at Good. An Outstanding key question needs at least half of its statements at 4 and none below 3. For an Outstanding overall rating, a service normally needs at least two key questions rated Outstanding and the other three Good.

Under CQC’s draft frameworks, scores go, and rating characteristics describe what outstanding, good, requires improvement and inadequate care look like in each sector. The regulator used rating characteristics until 2023, beside its key lines of enquiry, so the drafts bring them back. In the adult social care draft, the caring topic on kindness, compassion and dignity describes the two ratings like this:

• Good: “There is a culture of kindness and respect across teams. People feel cared for with kindness, compassion, dignity and respect.”
• Outstanding: “There is a visible culture of kindness and respect across all staff in all roles, which is embedded into every interaction.”

The drafts may change before they start. Our guide to rating characteristics covers what the drafts say, and our guides to safe and well-led quote the good and outstanding lines for each of their topics.

In April 2026, CQC published research it commissioned from the King’s Fund on what makes care outstanding. It sets out five principles: truly person-centred care; a culture of compassionate and inclusive leadership; equity and inclusion; learning built into everyday practice, to drive improvement and innovation; and a purposeful approach to making a positive difference for people using services, staff and the wider system. The researchers say the principles don’t describe CQC’s current Outstanding rating.

Checking a rating

Search for the service on CQC’s website. It has a page for each provider and for each location where the provider delivers care, with the latest ratings.

How often CQC re-assesses

CQC sets no fixed interval. The regulator either plans a service’s next assessment, in an order it sets by risk, or carries one out in response to concerning information. In May 2026 the regulator listed its priorities for each sector, including services whose ratings are several years old, and said it can’t tell an individual service when it will next assess it.

The legal duty to display your rating

Once CQC has rated you, Regulation 20A requires you to show your most recent rating:

• on at least one sign at each premises where you carry out regulated activities, apart from people’s own homes that you visit;
• at your principal place of business, showing your overall rating and the rating for each premises or activity, unless that place has a rating of its own;
• on every website you run, or that someone runs for you, with CQC’s web address and the address of the page that holds your latest assessment.

Signs and websites must show each rating legibly and conspicuously, in a place people using the service can access, with the date of the rating. CQC’s display guidance gives you 21 calendar days from publication to put the rating up, even if you’ve asked for a review of it, and you can add a note saying a review is under way. The regulator offers posters and a website widget that meet the rules, and you can use your own materials if you prefer.

Failing to display your rating is an offence even when no one comes to harm, and CQC can prosecute it without first serving a warning notice. If you take over a service, you don’t have to display the previous provider’s rating. If you choose to, the display guidance says you must make clear that the previous provider earned it.

Outstanding is rare and hard-won: a commercial asset that helps win tenders, reassures families and makes recruitment easier. Good is the realistic target for most providers: it signals a safe, well-run service and keeps commissioners comfortable.

Requires improvement is a warning. You must display it, it weakens confidence with local authorities and ICBs, and CQC has told you how the service must improve. Inadequate is serious: it normally triggers special measures and close monitoring, and if things don’t improve it can lead to enforcement action reaching the provider’s registration.

Because CQC publishes ratings and most providers display them on their premises and website, they shape reputation, referrals and revenue long after the assessment itself. Read the rating for each key question as well as the overall one: a service rated Good overall can have one key question, such as safe, rated Requires improvement. If yours isn’t where you want it, read what to do next.