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Welsh regulator sets out new approach to care home ratings

A two-step approach will be followed when regulating care homes in Wales, the regulator has announced in new draft guidance.

Published ratings under the new system will appear from April 2024, subject to independent evaluation of the new system between September 2023 and December 2023.

The new system has two elements:

  • Recognising quality
  • Regulatory duty

The quality element will look at what “good” looks like across the inspection themes of wellbeing, care and support, leadership and management, environment  

Regulatory duty will consider inspection themes in relation to how well people’s preferred outcomes are being achieved, whether the service is safe and people’s human rights are being met in line with the relevant regulations and associated statutory guidance.

Until the end of March 2024, the Care Inspectorate Wales will operate a system of ‘silent’ unpublished ratings. In these, the rating will not be included within the inspection report nor published on the regulator’s website. This is to allow an assessment of consistency in applying ratings, as well as assessing the impact on service providers and inspection teams. Providers and inspection teams may provide feedback to this evaluation.

In the new inspection regime, four ratings can be awarded:

  • Excellent: outstanding, very strong, exceptional, superior, exemplary, superb, very high standard, very high quality, extensive, highly effective, highly creative, well above expectations, expertly done, innovative
  • Good: successful, strong, skilful, worthwhile, beneficial, valuable, positive, thorough, useful, powerful, purposeful, used well, consistently good, effective
  • Needs Improvement: inadequate, unsatisfactory, incompetent, irrelevant, limited, inconsistent, falls short, partial, sub-standard
  • Poor: insufficient, inefficient, none, no, inappropriate, ineffective, unsuitable, unable, weak, poor, not fit for purpose, restricted, at risk

In guidance, the Care Inspectorate says that excellent practice does not necessarily mean that the service is excellent. The practice must also be sustainable and exceed the requirements set out in the inspection framework (for that inspection theme). The theme level description provides a framework for applying excellent to an inspection theme.  

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