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How are Carers Regulated?

How are Carers Regulated?

cqc logo - Who Regulates Home care and Live-in carers

Whether your parents’ care is provided by the local council or a private live-in care provider, they are most likely regulated by the Care Quality Commission (CQC).  An independent body, the CQC regulates all health and social care services in England.

The CQC regulates all types of organisations that directly provide health and social care to a consumer, however, where a company does not directly provide care (like a live-in care agency which arrange paid for introductions between carers and families who then become the employer), they are not regulated by the CQC. Those that are inspected and rated by the CQC have to satisfy a particular set of quality standards across different aspects that overall make for a good care service.

In this guide we will give you an overview of why a CQC rating is so important in the choice of care: which organisations are regulated by the CQC, what home care may be regulated, what a CQC rating means and where you can find them.

What is the CQC?

The Care Quality Commission (CQC) is the independent regulator for health and social care in England.  It’s aim is to make sure care services provide high-quality, safe, effective and compassionate care.  The CQC achieves this through the inspection, monitoring and rating of domiciliary (home) care providers.

The CQC outlines ‘the fundamental standards‘, below which care should never fall. This includes person-centric care, dignity and respect, food and drink standards, complaints procedure in place, obvious display of ratings and more. If a company falls short on any one of these points, the CQC will mark them so and offer advice to improve for their next inspection. If the CQC decides that a company’s standards are at a dangerous or unacceptable level, they have the power to suspend a company until problems have been resolved. 

In Wales, Scotland and Northern Ireland the regulators are different. Follow the links to find out more information for their respective regulatory bodies.

Which Home Care companies are regulated by the CQC?

Not all home care companies can be regulated by the CQC. Live-in and home care options are split into two categories: providers and agencies. Live-in carer providers are registered with and regulated by the CQC as they recruit, employ and manage their own carers.  Homecare, sometimes also known as Domiciliary care, agencies introduce you to carers for you to employ yourself.  In this case, as the employer you become responsible for the care provision, so domiciliary care agencies are not regulated by the CQC.  

In the case of a home care provider, it is unlikely that the specific carer that looks after your elderly relative has been directly inspected by the CQC. However, the CQC will have inspected randomly and thoroughly to test not only the carers that a provider employs but also that their recruitment, management and complaints procedures are all up to grade. This way carers are indirectly regulated. 

This doesn’t mean that a carer you find through an agency isn’t held to the same kind of home care regulations as a provider is, but it does mean that they aren’t regulated by an independent body like the CQC.  Part of the agency offer is likely to be extensive checks into potential carers they provide, including DBS checks. It is not in an agency’s best interests to supply you with a sub-par carer in their name, and so they will have inspected each carer carefully before recommending them to you.

CQC Home Care and Live-in Care Ratings

CQC Rating - How carers are regulatedOnce a home care provider has been inspected by the CQC, they will write up a report on their findings, publish a rating, and offer advice for improvements. The ratings are given for the overall standard of care and over 5 sub-categories: safe, effective, caring, responsive, well-lead. Each category is marked to a 4 level specification: Outstanding, Good, Requires Improvement, Inadequate.  While these categories are the same for all care providers, you can read the inspectors notes to find out specifics from their thoughts on any one company. 

How to find the CQC rating for a home care provider

The first place to look is on the provider’s website, as one of the CQC fundamentals is that the rating be obviously displayed. If a provider is especially proud of their rating it should be even easier to find. Often the rating shown on a provider’s website will be the overall one. To find the breakdown of the rating and the full report you can either click on it or search for it on the CQC website

On the CQC website, simply search by type of care, provider name, and/or area to find the company you’re after. You should then be directed to their page with the report from their most recent inspection. From this report you can see the breakdown in ratings over the 5 sub-categories, a further breakdown of each level with written comments for each, and a backlog of their previous report outcomes. The website is also where you can add a comment or review on a company.


What to do if you don't think standards of care are being met

If you don’t think a care provider is meeting the home care regulations or you have had a bad experience with them, you can report it to the CQC. To do so fill out a CQC Feedback Form on the CQC Website. This may lead to further investigation and help to improve a service for other people. 

The CQC don’t investigate individual complaints. For complaints you will need to go through a preliminary complaints procedure and then onto the Local Government and Care Services Ombudsman.

Find out more about how to complain about a carer.

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