What is the Care Quality Commission (CQC) and what does it do?

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. It registers care providers, monitors and inspects them, publishes ratings of outstanding, good, requires improvement or inadequate, and takes action when care falls short of the fundamental standards. Its remit includes care homes, home care agencies, hospitals, GP practices and dentists.

At a glance

• CQC was established in April 2009 and works under the Health and Social Care Act 2008. It covers England only.
• Providers of regulated activities must register and show they meet the fundamental standards.
• Services are assessed against five key questions (safe, effective, caring, responsive, well-led) and, in most cases, given one of four ratings.
• CQC does not investigate individual complaints, apart from certain Mental Health Act complaints. Use the provider’s complaints route first.
• CQC is consulting on and piloting sector-specific assessment frameworks, so the detail of how inspections work is changing.

What does the CQC do?

CQC states its purpose as regulating health and adult social care, working with the public, systems and providers to protect people and to promote and improve the quality of care. Its vision is that everyone receives safe, effective and compassionate care. In practice its work falls into four areas:

• Registration: care providers carrying out regulated activities must be registered with CQC to operate.
• Monitoring, inspection and rating: CQC monitors services, inspects them and, in most cases, publishes a rating to help people choose care.
• Enforcement: it acts to protect people and hold those responsible for poor care to account.
• An independent voice: it publishes its views on major quality issues, including an annual State of Care report to Parliament. The 2025 to 2026 edition was laid before Parliament on 22 October 2026.

CQC also protects the rights of people restricted under the Mental Health Act. The services it covers include care homes, services in people’s homes, clinics, dentists, GP services, hospitals, community services and mental health services. For wider findings see our State of Care in England 2026 report.

What are the fundamental standards?

The fundamental standards are the legal minimum every registered service must meet. They are set out in Part 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. They include:

Read our guide to duty of care in social care to see how several of these work in practice, and care home staffing levels for Regulation 18.

What are the five key questions and four ratings?

CQC asks five key questions of every service: is it safe, effective, caring, responsive and well-led? The evidence collected is used to rate the service as outstanding, good, requires improvement or inadequate. A service receives ratings for each key question and an overall rating.

Each rating has a practical meaning for families. Outstanding and good suggest the service meets or exceeds expectations. Requires improvement means there are concerns that the provider must fix, and inadequate signals serious failings. Our guides explain the detail: CQC ratings explained, what requires improvement means, how often CQC inspects care homes and how to read a CQC inspection report.

Check the age of a rating before relying on it. See how old care home ratings are.

What powers does the CQC have, and what can it not do?

Under the Health and Social Care Act 2008, CQC registers, inspects and monitors providers. Since its April 2015 enforcement policy, CQC has been able to act on breaches of regulations and to prosecute providers directly. A special measures framework applies to providers with serious quality failures.

There are limits. CQC does not investigate individual complaints about a service, except certain complaints about the Mental Health Act 1983. Families with a problem about a relative’s care should complain to the provider first, and then to the council or the Local Government and Social Care Ombudsman where relevant. Our guide to how to complain about a care home explains the steps.

CQC does, however, ask for people’s experiences. It says it uses feedback to reach its judgements, and you can give feedback on any service through its website.

What is changing in how the CQC assesses care?

CQC has been rebuilding its approach. It consulted on its Better regulation, better care proposals at the end of 2025, with the consultation closing on 11 December 2025. In its initial response, updated on 25 March 2026, CQC set out plans to:

• replace its single assessment framework with four draft sector-specific frameworks, including one for adult social care;
• keep the five key questions;
• replace quality statements with key lines of enquiry;
• bring back rating characteristics describing outstanding, good, requires improvement and inadequate; and
• remove scoring, so that ratings are holistic judgements made at key question level.

At that point the draft frameworks were to be tested and piloted over the following months, with no implementation dates given. The final position may have moved on, so check CQC’s website for the current approach, and see our explainer on CQC rating changes.

Who regulates care in Scotland, Wales and Northern Ireland?

CQC covers England only. Scotland has the Care Inspectorate, Wales has Care Inspectorate Wales (CIW), and Northern Ireland has the Regulation and Quality Improvement Authority (RQIA). See Care Inspectorate grades, CIW ratings and RQIA inspections.

Frequently asked questions

What does the CQC do in simple terms?

CQC checks whether health and care services in England are safe, effective, caring, responsive and well led. It registers providers, inspects them, publishes ratings and takes enforcement action when services fail to meet the fundamental standards.

Does the CQC inspect every care home?

CQC monitors registered care homes, and sets no single fixed inspection interval, because how often it inspects depends on risk. See our guide to how often CQC inspects care homes for the current picture.

Can I complain to the CQC about a care home?

You can share your experience, and CQC uses feedback in its judgements, but it does not investigate individual complaints. Complain to the provider first, then to the council or Ombudsman. Our complaints guide explains each step.

When was the CQC set up?

The House of Commons Library records that CQC was established in April 2009. It replaced earlier regulators and now works under the Health and Social Care Act 2008, registering and inspecting health and social care providers in England.

Is the CQC part of the NHS?

No. It is an executive non-departmental public body, sponsored by the Department of Health and Social Care, and it regulates NHS and independent services alike.

Where to get help next

Before choosing a service, read how to choose a care home and look up its latest report. To compare services by area and rating, use our care finder, and see how we rank providers on this site.

Sources

• CQC: About us
• CQC: How we do our job
• House of Commons Library: The Care Quality Commission
• legislation.gov.uk: The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
• CQC: Initial response to the Better regulation, better care consultation
• GOV.UK: State of health and adult social care in England, 2025 to 2026

See also: Outstanding-rated care homes

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.