How do you move from Requires improvement to Good, and on to Outstanding?

To move from Requires improvement to Good, fix the quality statements with shortfalls first, because a single statement scoring 1 limits a key question to Requires improvement, and change the system behind each one so the evidence is recorded as part of daily work. An overall Good normally needs no key question rated Inadequate and no more than one rated Requires improvement.

How your report shows what to fix

An overall rating is built from the key questions, and each key question from its quality statement scores. Two or more key questions rated Requires improvement normally make the overall rating Requires improvement. Good normally needs no key question rated Inadequate and no more than one rated Requires improvement.¹

A key question that would score in the Good range is limited to Requires improvement if any of its statements scores 1.¹ A single weak statement can therefore hold a whole key question down, so fix those statements first.

A 90-day plan

1. Days 1 to 7, list every shortfall. From the report, list each quality statement with a shortfall, its score where shown, and CQC's words about it.
2. Days 8 to 14, find the system cause. For each one, ask what in the way you work allowed it. A missing check, a manual step, an unclear owner.
3. Days 15 to 60, fix the system. Change the process, the default or the tool, so the right thing happens without anyone remembering to do it.
4. Days 15 to 60, make evidence automatic. Every fix should leave a record as a by-product. If someone has to write it up later, it will lapse.
5. Days 61 to 90, test it. Audit a sample, time your evidence retrieval, and ask staff to explain the change.
6. Ongoing, report it monthly. Leaders read progress on every statement each month, and act on it.

When will CQC look again?

CQC decides when to assess based on risk and the information it receives, and evidence collected at any time can trigger an assessment. It no longer uses your rating as the main driver of when it returns.²³ Keep CQC informed through your usual contact, notify it of changes, and be ready at any point rather than on a date.

1. Key question ______ Quality statement ______
2. What CQC found ______
3. System cause ______
4. Change made ______ Owner ______ Done on ______
5. Evidence it creates, automatically ______
6. Audited on ______ Result ______

Copy template

Moving from Good to Outstanding

Outstanding normally needs at least 2 key questions rated Outstanding with the rest Good.¹ Choose the two where your team already does exceptional work, and gather evidence of what that work changes for patients. A service that has moved up from Requires improvement can show CQC the learning, the changes and the numbers behind them.

CQC is consulting on sector frameworks that would judge ratings at key question level with no scoring.⁴ The plan above applies under either method, because it changes the systems that produce the evidence.

Questions

Can I ask CQC to re-inspect after improving?

CQC decides when to assess based on risk and the information it holds, and evidence it receives at any time can trigger an assessment. Keep it informed through your usual contact.

What rating combination gives an overall Good?

Normally no key question rated Inadequate and no more than one rated Requires improvement, under CQC's current rating principles.

Why did one weak area pull our key question down?

Because a key question in the Good range is limited to Requires improvement if any of its quality statements scores 1.

Sources

1. 1CQC, 2025How we reach a ratingRead source
2. 2CQC, 2025Differences from our previous modelRead source
3. 3CQC, 2025How often we assessRead source
4. 4CQC, 2026Our initial response to our public consultation, Better regulation, better careRead source

Written by the wai team from Care Quality Commission guidance, checked on 15 October 2026. This is guidance, not legal advice. CQC does not endorse wai or any software.