A Good rating is not the same as a good experience. Can providers demonstrate both?

Confidence for Today. Assurance for Tomorrow.

A different conversation about Good

Discussion about CQC inspections often centres on what a provider must do to achieve or retain a Good rating. Yet a rating is only one part of the story. The more demanding question is whether people continue to experience safe, effective, compassionate and responsive care between inspections.

CQC’s “Returning to good” work for eligible adult social care services already rated Good places renewed attention on whether an existing judgement remains accurate. This should not be confused with the separate process of reassessing services rated Requires Improvement or Inadequate. Whatever the inspection route, providers need current, triangulated evidence of quality—not reliance on historic judgements.

At PGQ Solutions, we believe the strongest assurance considers five perspectives together: the inspector, Registered Manager, provider, person receiving care and their family.

Five perspectives. Five different expectations.

1 | The inspector

“Can I see that Good care is happening now?”

An inspector must assess the quality and safety of care from multiple sources: people’s experiences, observations, staff discussions, records and the provider’s response to risk. A compliant-looking audit cannot cancel out unsafe practice.

Assurance question: Does the evidence consistently support what people actually experience?

2 | The Registered Manager

“Can I demonstrate that my service is safe every day?”

Managers balance staffing, medicines, incidents, care planning, training and environmental safety. Effective management means recognising emerging concerns, acting promptly and being able to explain what has changed.

Assurance question: Can the manager describe what is working, what is not and the impact of their actions?

3 | The provider

“Can I independently assure myself that the service remains Good?”

Headline percentages and completed action plans provide information, not automatic assurance. Provider oversight must challenge findings, test controls and seek evidence that improvement is sustained.

Assurance question: What independent evidence might challenge our current understanding?

4 | The person receiving care

“Is my life better because of the care I receive?”

People experience quality through dignity, choice, relationships, independence, communication, safety and meaningful daily life. Their priorities must be central, not treated as an appendix to compliance records.

Assurance question: Does the service deliver what matters to the individual?

5 | The family

“Can I trust that my relative is safe when I am not there?”

Families may identify changes in wellbeing, engagement or communication that do not appear in performance dashboards. Their concerns and compliments provide essential context, while recognising that the individual’s wishes and confidentiality remain paramount.

Assurance question: Does the family’s experience reinforce or challenge the service’s assurance?

Where the five perspectives meet

A service may have accurate records, an optimistic management account and reassuring Board metrics, yet a person receiving care may report restricted choice or a relative may describe poor communication. None of these perspectives should be dismissed. Nor should any one of them be treated as the whole picture.

The PGQ Triangulation Model™ brings together people’s experiences, observed practice and recorded evidence. When the three do not agree, that discrepancy is a signal to investigate—not an inconvenience to explain away.

The Governance Iceberg™: what a Good rating cannot tell you

Beneath a visible rating sit leadership, staff competence, everyday practice, risk management, organisational culture and the effectiveness of oversight. The existence of systems is not proof that they work. An audit schedule is only useful if findings trigger proportionate action; a risk register only offers assurance when controls are implemented and tested.

The crucial distinction is between governance activity and governance effectiveness.

A practical example: hydration

Consider a fictional service reporting improved hydration monitoring, reviewed care plans and completed refresher training. Those actions matter—but what does the evidence show?

If records are complete but people still do not receive appropriate support, the improvement is not effective. If practice and outcomes have improved, the provider should be able to demonstrate how and why.

Five questions every Good-rated provider should ask

1.        Would people receiving care describe their experience in the same way as our quality reports?

2.        Would families recognise the improvements we say we have made?

3.        Would staff demonstrate the same standards that our audits report?

4.        Would the Registered Manager identify the same priorities as the provider or Board?

5.        Would independent scrutiny support our internal assurance ratings?

From inspection readiness to everyday assurance

PGQ Solutions supports providers through independent Regulation 17 governance reviews, Independent Inspection Readiness Reviews, leadership support, risk oversight and service improvement. Our approach tests whether evidence is reliable, risks are controlled, managers are supported and improvements are reflected in the experiences of people receiving care.

Understand the position. Control the risk. Evidence the improvement.

The final question: Good for whom?

For the regulator, Good is a judgement about service quality. For the provider, it is a measure of performance. For the manager, it may recognise sustained leadership. For families, it can offer reassurance. For the person receiving care, however, Good must be something they experience.

A Good rating should be the consequence of consistently good care—not the destination of the improvement journey.

If nobody inspected us tomorrow, what evidence would we have that people are safe, their lives are better and our governance is working?

About PGQ Solutions

Provider, Governance & Quality Solutions Ltd T/A PGQ Solutions provides independent governance, regulatory assurance, quality improvement and leadership support to adult social care providers across the UK.

Confidence for Today. Assurance for Tomorrow.  |  www.pgqsolutions.co.uk

Editorial note: This is an independent professional commentary, not official CQC guidance. Providers should consult the latest CQC published assessment and inspection guidance when making regulatory decisions.