We recommend that:

  1. CQC fully embraces the principles of right-touch regulation.
  2. Given its important role in encouraging improvement and innovation, CQC makes the most of its privileged observer position by sharing good practice, engaging in improvement-focused conversations with providers, and working with organisations that have a direct role in improvement.
  3. CQC appreciates the value of supportive, consistent and stable relationships between local CQC teams and providers and actively encourages these. This will enable open, honest and collaborative dialogue.
  4. CQC continues to invest in improving the training, as well as the conduct and behaviour of its inspection teams, to ensure greater credibility, consistency and objectivity, and to allow for transparent, well-informed and constructive provider and system assessments.
  5. CQC better reflects operational circumstances in its inspections and reports, and highlights providers’ positive achievements alongside their shortcomings. Trusts would like to see CQC build on improvements it has made in acknowledging the operating context they are working in, as witnessed over the most recent winter period.
  6. While retaining its impartiality and objectivity, CQC could reflect on the tone and delivery of its inspection activities, including its inspections, reports and ratings, to make sure its outputs do not have an unintended adverse impact on providers.
  7. CQC re-evaluates the success of its single-word ratings against their intended purpose, and considers the addition of a narrative rating qualifier as part of its new provider assessments reports, in the context of the Ofsted inquiry findings.
  8. CQC fully delivers on the potential of its new single assessment framework, which promises to provide greater objectivity and a more ‘live’ picture of quality. Ratings, particularly for providers considered lower risk, should reflect this.
  9. CQC takes the opportunity to explore entire patient pathways, rather than only assessing individual care settings. CQC's new role in assessing integrated care systems and local authorities could make it possible to build a system-wide picture of the challenges that impact on services, and how these might be tackled.
  10. It is for CQC to act on feedback about its credibility and work with providers to regain their trust. It should consistently act with openness and transparency, meaningfully collaborate with those it regulates, and display a positive learning attitude.