When your ratings fall short, make sure safety is standing tall

Care homes across the UK are facing a tough reality: CQC ratings aren’t what they used to be. In fact, more than half of homes have been marked as ‘inadequate’ or ‘requires improvement’ in recent years. For dementia care, the picture is even starker, as between 2019 and 2022, the number of homes rated ‘inadequate’ jumped from 2% to 9%.

And now, the CQC itself has admitted the system is broken. With inspections too few and reports years out of date, their chief executive has said ratings can no longer be trusted. So where does that leave care organisations?

It leaves us leaning on what still matters and what still works: health and safety. It’s a cornerstone of the CQC’s approach and one of their five key questions. Even if your home hasn’t had a recent inspection, annual service reviews still measure your commitment to safety. That’s where trust lives.

Care homes are high-risk environments. Residents are often physically and mentally vulnerable, and when safety fails, the consequences can be devastating. Here’s what happens when organisations get it wrong.

In Glasgow, a resident died after an e-cigarette sparked a blaze. A faulty fire alarm zone map meant the wrong area was evacuated. The company admitted to health and safety breaches and paid a heavy price.

After repeated warnings, a Buckinghamshire home failed to fix fire doors, improve record-keeping, or clean up visibly dirty conditions. The result? Deregistration and closure.

In Nottingham, inadequate alarms and escape routes led to prosecution. The judge called it “a tragedy waiting to happen.” The company was fined £120,000, and its director received a suspended sentence.

So, how do you know if you’re doing enough? The Health and Safety Executive says success rests on three pillars:

• Strong leadership and management

• A trained, competent workforce

• A culture where employees feel involved

From there, ask yourself:

• How do we show our commitment to safety?

• What risks do residents face, and how are we controlling them?

• Do we have effective checks in place?

• Are we learning from mistakes?

• Is safety woven into our daily routines?

The HSE recommends a Plan–Do–Check–Act approach:

• Plan: Decide what needs to change and how you’ll make it happen.

• Do: Profile risks, organise activities, and put systems in place.

• Check: Monitor work, investigate incidents, and learn from near misses.

• Act: Review, improve, and embed lessons learned.

Consistent with our policy when giving comment and advice on a non-specific basis, we cannot assume legal responsibility for the accuracy of any particular statement. In the case of specific problems, we recommend that professional advice be sought.