Your questions answered

Updated 7 May 2008

Get answers to frequently asked questions about quality ratings.

  1. What are quality ratings?
  2. How are quality ratings decided?
  3. What makes an Excellent (3 Stars 3 star) service?
  4. What makes a Good (2 Stars 2 star) service?
  5. What makes an Adequate (1 Stars 1 star) service?
  6. What makes a Poor (0 Stars 0 star) service?
  7. Does every service have a published quality rating?
  8. What does ‘Not yet rated’ mean?
  9. What does ‘Suspended rating’ mean?
  10. How can a quality rating for a care service change?
  11. What happens when a care service disagrees with its quality rating?
  12. What happens to a care service rated as Poor?
  13. I am a care service provider, where can I get more information about quality ratings?
  14. What if I have further questions?

1. What are quality ratings?

We have introduced quality ratings to tell people simply and clearly how well a care home or care service is doing against national standards.

We give a registered service stars to show how good they are. The more stars we give them, the better we think they are.

So if we give:

  • 3 stars 3 Stars - this means it is excellent
  • 2 stars 2 Stars - this means it is good
  • 1 stars 1 Stars - this means it is adequate
  • 0 stars 0 Stars - this means it is poor.

2. How are quality ratings decided?

We decide the quality rating for a care service following a key inspection. Key inspections are major assessments of the quality of a service.

This inspection includes information gathered from:

  • interviews with the staff and the people who are using the service
  • information given to us by the care service
  • surveys filled in by people using the service, their relatives and other professionals involved in their care
  • a visit to the service by our inspectors (the service does not usually know when we are coming to visit)
  • the history of the service 

We use all of the evidence that we gather to work out the quality rating for a care service.

To ensure we interpret this evidence consistently, we use guidelines called key lines of regulatory assessment (KLORA).

We apply these guidelines to help us form a judgment about how well the service is meeting each of the outcome groups in the national minimum standards.

We use the word 'outcome' to describe what the experience is like for the people receiving the service.

Once we have used KLORA to reach a judgment about each outcome area of the national minimum standards, we apply a set of rules to calculate the overall quality rating for the service.

Generally speaking, the more outcome groups that are graded as excellent the more likely a service is to achieve 3 stars.

The more outcome groups that are graded as poor the more likely a service is to be rated as 1 or zero stars.

However, in awarding a quality rating we take particular account of how safe and how well managed a care service is.

As they are especially important to quality we have stricter rules for those outcomes relating to safety and management. Services can only be as good as their 'poorest' rating in these areas.

3. What makes an Excellent (3 Stars 3 star) service?

We award an excellent quality rating to particularly good services, well managed, and with a sustained track record of delivering good performance and managing improvement.

A service is excellent if:

  • No outcome group is scored as being poor
  • All outcomes relating to safety and management are good or better and at least one of them is excellent
  • At least half of the outcome groups must be judged as either good or excellent

A brand new service cannot be excellent at the first key inspection following registration, as it would lack a track record of performance over time.

4. What makes a Good (2 Stars 2 star) service?

We award a good quality rating to a service where:

  • At least half the outcome groups are good or better
  • No outcome group is poor
  • All outcomes relating to safety and management are good or better

A service awarded a good quality rating may have some excellent outcomes.

5. What makes an Adequate (1 Stars 1 star) service?

We award an adequate quality rating to a service where:

  • At least half the outcome groups are adequate or better
  • All outcomes relating to safety and management are adequate or better

A service awarded an adequate quality rating may have some outcomes that are good, even excellent.

6. What makes a Poor (0 Stars 0 star) service?

We award a poor quality rating to a service where any of the outcome groups that focus on safety and management are judged poor or it does not meet the rules for an adequate service.

A poor service may have some good or even excellent outcomes, or it may be a generally low performing service. The key issue is that it does not perform as a safe service.

7. Does every service have a published quality rating?

Every care home or care service will have a published quality rating following their key inspection.

However, some services will be classed as not yet rated or having a suspended rating.

8. What does ‘not yet rated’ mean?

Some care services will not yet have a published quality rating. This is because of the following reasons:

  • Some care services are newly registered and will not receive their first key inspection and quality rating until six months after their registration. Usually, care services without any inspection reports on the website are newly registered.
  • We have not carried out a key inspection this year. Some services have told us that they would like us to publish the rating that we gave them prior to 2008. Other services have not agreed to this and so we will not publish their quality rating until after their next key inspection. All care services will have a quality rating within three years.

9. What does ‘suspended rating’ mean?

These are services that are not meeting the required standards for a regulated service. We have sent them a legal notice stating that we propose to cancel their registration. Services have the right to make an appeal against our proposals to the Care Standards Tribunal. If the tribunal uphold our decision, then the care service will close and we will remove all the service details (name, address etc) from our website.

10. How can a quality rating for a care service change?

A rating can only be changed following the next key inspection of a care home or care service.

If we get information that suggests that a current quality rating is wrong we may bring forward the next key inspection to an earlier date.

11. What happens when a care service disagrees with its quality rating?

We have set up our new quality rating review service (QRRS) to let providers bring any concerns about their quality rating to our attention.

12. What happens to a care service rated as poor?

If a care home or care service is rated as poor, we ask them to fill in an improvement plan.

They must use the improvement plan to tell us what action they will take to improve the quality of their service.

If a care home or care service is rated as adequate, we may also ask them to fill in an improvement plan.

13. I am a care service provider, where can I get more information about quality ratings?

Go to our quality ratings for care services page on CSCI Professional.

14. What if I have further questions?

Contact the customer services team:

Telephone: 0845 015 0120 or email enquiries@csci.gsi.gov.uk

Created: 4/28/2008 Last updated: 5/19/2008