Ratings rules
Find out how we work out quality ratings for care
services.
Introduction
We work out the quality rating for a care service by looking at
how well the service meets the desired outcomes set out in the national minimum
standards. We call these judgements.
We use a set of guidelines, called the Key lines of regulatory assessment, to judge
how well services are meeting outcomes.
Generally speaking, the more outcomes that are graded as
excellent the more likely a service is to achieve
3 stars.
The more outcomes that are graded as poor the
more likely a service is to be rated as 1 or zero
stars.
The rules for calculating this are set out below.
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.
Quality rating judgement tool
This is the tool inspectors use to calculate the quality rating
for a service following a key inspection. Service managers can also
use the tool to confirm they have been rated correctly.
Rules for each quality rating
3 star
service (Excellent)
It must be possible for a service to be ‘3 star’. In other
words, the expectation is not for perfect services but for
particularly good services, well managed, and with a sustained
track record of high performance.
- Services cannot be 3 star if any outcome group is scored as
being poor, and;
- outcomes relating to safety and management must be at least
good and;
- at least one outcome relating to safety and management must be
excellent and;
- at least 50% of outcome groups must be judged as either good or
excellent (for example, if there were 7 outcome groups for your
type of service, 4 of the outcome groups would need to be good or
excellent) and;
-
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. By brand new we mean that the service, as
it is registered, did not operate before registration. Those
services can only achieve a 2 star, good, rating.
But;
-
there are times when a service is already registered with us but
has to make application for registration due to changes in the way
it is to be run. It will be possible for those services to achieve
an 'excellent', 3 star, rating at their first key inspection as
long as the first four bullet points (listed above) are met.
To achieve an excellent rating the service will need to have
demonstrated excellent and good practice consistent with the Key
Lines of Regulatory Assessment (KLORA). Excellent services will
have a sustained track record of delivering good performance and
managing improvement. Read more about this
rule.
2 star service (Good)
A '2 star' service may have some excellent outcomes.
- Services cannot be good if any outcome group is scored as poor,
and;
- outcomes relating to safety and management must be at least
good, and;
- at least 50% of outcome groups must be judged as at least
good
1 star service (Adequate)
A '1 star' service may have some outcomes that are good, even
excellent.
- Outcomes involving safety and management must be at least
adequate and;
- at least 50% of outcome groups must be at least adequate
0 star service (Poor)
A '0 star' service may have some strengths. It 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.
- One or more outcome groups that focus on safety and management
are judged poor or
- It does not meet the rules for a 1 star, 2 star or 3 star
service.
Outcome groups relating to safety and management
The outcome groups relating to safety and management in
different service types are:
Care Homes for Older People
- Health and personal care
- Complaints and protection
- Management and administration
Care homes for Younger Adults
- Personal and healthcare support
- Concerns, complaints and protection
- Conduct and management of the home
Domiciliary Care Agencies
- Personal care
- Protection
- Organisation and running of the business
Nurses Agencies
- Complaints and protection
- Management and administration
Adult Placement Schemes
- Managing an adult placement scheme