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CQC readiness checklist for UK home care providers
What to have in place for assessments, records, visits and incidents — and how to test it yourself before an assessor does. By AJG Advisory · 9 min read.
What "ready" actually means now
Being CQC-ready is not a binder you build in March and close in April. CQC now works closer to continuous assessment than periodic inspection: it builds a picture from information it already holds — notifications, complaints, safeguarding referrals, feedback from people who use your service, and data from commissioners and local authorities — and adds to it what you submit through the provider portal. It can arrive at your door without warning, and it can start as a desk-based assessment of the evidence you send.
The five key questions have not changed: is your service safe, effective, caring, responsive to people's needs and well-led. Underneath them sit quality statements, written as "we statements", each connected to the regulations CQC would consider when forming its judgement. Separately, CQC has published a draft adult social care assessment framework which would replace quality statements with key lines of enquiry, and move away from numerical scoring towards rating characteristics. That is still a draft — CQC has been refining it and has not published a final version or a go-live date.
The practical consequence is simple: don't prepare against a document that is still being written. Prepare against the things that survive any version of the framework — a current assessment you can show the care plan came from, records that say what actually happened, a rota that matches the attendance you can prove, and incidents that were reported, investigated and learned from. Those four are the ones that fail services, and they are the four below.
This checklist is our operational reading of CQC's published assessment framework and its draft adult social care assessment framework, summarised in plain English rather than copied from CQC's wording. Check the current framework on cqc.org.uk before your assessment — the wording is still moving.
Assessments
Assessments: what an assessor will follow
Everything else is judged against your assessment. If the assessment is thin, the care plan, the rota and the notes all look thin too.
- Every person has an assessment that was done with them, not about them, and covers physical, mental, emotional, sensory, social and communication needs — not just the tasks.
- You can trace each care plan instruction back to the assessment finding that produced it. If you can't, an assessor will ask where it came from and "we've always done it that way" is the answer that hurts you.
- Screening tools are completed, scored and — critically — followed by an action. A MUST score with no food and drink record attached is worse than not doing the tool.
- Risk is recorded as what the person wants to do and what staff do to reduce the harm, so the person keeps choice. A long list of things they must not do reads as restrictive practice.
- Where capacity is in doubt for a specific decision, there is a best-interests record showing who was consulted and why the decision was made.
- Advance care planning is in the file where it exists: ReSPECT or a do-not-attempt-CPR decision, with who agreed it and when — and the carer can find it at 7am on a Sunday.
- The assessment has been reviewed since the last change in need, incident, hospital admission or new professional advice, and at least every six months. Review dates are tracked, not remembered.
- Communication and accessibility needs are recorded and actually followed by every carer — reasonable adjustments that exist on paper only are a finding.
Records
Records: what an assessor will follow
Records are where CQC tests whether the service you describe is the service you deliver.
- Notes are written on the day of the visit, by the person who was there, and are signed so you can see who wrote them.
- A competent care worker who has never met the person can read the file and give safe, consistent care. Test this with a real temp carer, not in theory.
- Nothing important lives in two places. If a note sits in a WhatsApp thread, a paper file and the rota app, the versions will drift and someone will be asked which is correct.
- Sensitive information is protected and its access logged: key safe codes, home addresses and medication details should only reach the staff who need them, with a record of who looked.
- Medication records are current — MAR chart completed for every dose, refusals and missed doses recorded with the action taken, and the chart reconciled after any prescription change.
- Staff records are current for everyone who worked a visit in the period you are asked about: DBS, right to work, induction, training, competency and supervision.
- You can show that a record was created and later changed, by whom and when, and that changes cannot be quietly deleted. An audit trail you control is not an audit trail.
- Data protection is demonstrable: where records are held, who can see them, how they are backed up, and what you would do in a breach for CQC, the ICO and the people affected.
- Archived and deceased records can still be produced on request. Losing history is a governance problem, not tidiness.
Visits
Visits: what an assessor will follow
This is the part most providers underestimate. The rota is a plan; CQC assesses what happened.
- You can show the rota as planned, as published, and every change made afterwards with who made it and when. Carers should never see a rota that was still being built.
- Actual arrival and departure times are recorded, not the times you hoped for — and you can show where the carer was when they checked in.
- Late, missed and unattended visits surface somewhere with a reason and the action taken, rather than disappearing into a coordinator's memory.
- Double-up calls are handled properly: each carer has their own assignment, their own check-in and check-out, and their own record of what they did.
- You can name who regularly visits each person, and what you do about the calls no regular carer covered.
- Call durations that don't match the plan are reviewed. A 30-minute visit closed after six minutes either means the care wasn't delivered or the record is wrong — and you should know which.
- Contracted hours, worked hours, travel and mileage all reconcile, so you can prove staffing was safe and pay is right without rebuilding the week by hand.
- Any delegated clinical or healthcare task is only carried out by staff trained and signed off for it, with a record of who authorised it and on what basis.
- Sickness, holiday and vacancies are visible before the rota is published, so short-notice cover isn't the only plan.
Incidents
Incidents: what an assessor will follow
Incidents don't have to be perfect. They have to be reported, acted on, and connected to learning. Unreported incidents are the finding that ends assessments badly.
- Staff know exactly what counts as an incident — falls, medication errors and near misses, injuries, safeguarding concerns, missing episodes, an allegation against a colleague — and they report it without being chased.
- Every incident records what happened, the immediate action, and who was told: the person, their family where consent allows, the GP, the commissioner, and CQC where a notification is due.
- Duty of candour is evidenced: the apology and explanation were given, by whom, and are written in the record.
- Safeguarding concerns are raised in the right place, a section 42 referral is made where needed, and the outcome is closed out in writing.
- There is an investigation with a root cause, actions with named owners and dates, and evidence the actions actually happened — not a closed box.
- You can see trends: medication errors by month, falls by person, who was involved and whether the numbers are moving in the right direction.
- You know which incidents must be notified to CQC, and you can show each notification was made and when.
- Staff concerns and family feedback land somewhere that is answered, with the same trail as complaints — a safety culture where raising something is normal.
Run the check yourself
Don't wait for an inspector to be the first person to walk the route. Do this in an afternoon, once a month.
- Pick five people at random — not the five you'd choose. Include one person with complex needs, one recently admitted and one who rarely has notes.
- Follow one person all the way through: assessment, care plan, rota, notes, medication, incidents. Write down every point where you had to ask someone rather than find it.
- Ask a carer you haven't briefed to open a visit and tell you what they would show an inspector. Their hesitation is your training gap.
- List the gaps as owners and dates, not as intentions. "Coordinator to check" is not an action; a name and a deadline is.
- Repeat it monthly. A readiness habit that runs four times a year is a panic that runs four times a year.
Where My Care Manager fits
Every item above is a record you should be able to pull out in seconds, which is why we built the platform around one chain: assessment to care plan, care plan to rota, rota to a visit the carer checks into on their phone, and that visit feeding the note, the medication record, the incident, the timesheet and the invoice. Nothing is re-typed between systems, because re-typing is where the evidence breaks. Care plan sections link to CQC quality statements and the Fundamental Standards, sensitive details are protected and logged, and every change leaves an audit trail you can hand over.
Core is £74.99 a month for one provider with unlimited staff logins, with optional add-on modules.