70% of community social care services have no or ‘outdated’ CQC rating, analysis finds

Seven in 10 community social care services have no or an 'outdated' Care Quality Commission (CQC) rating of their performance, an analysis of inspection data has found.

The Homecare Association said its report showed that people with complex needs were at risk from "unsafe, poor-quality care" and that good providers were being squeezed out of the market by "cheap, unrated competitors".

The lack of updated ratings, due to a significant reduction in the number of annual inspections by the CQC, was a key finding from a government-commissioned review of the regulator by Dr Penny Dash, which reported last year.

Dash's review led health and social care secretary Wes Streeting to dub the CQC "not fit for purpose" in July 2024, since when it has had a change of leadership and embarked on a programme to improve its performance.

More services with no or 'outdated' rating

However, the Homecare Association found that the issue of out-of-date ratings had gotten worse since June 2024, when a similar analysis it conducted found 60% of community social care locations had either not been rated or had a rating that was over four years old.

As of August 2025, the proportion had grown to 70.3%.

While the percentage of locations with a rating that was more than four years old was static year on year, at about 37%, the proportion of uninspected, and hence unrated, locations rose sharply from 23% to 33.5%.

In numerical terms, there were 4,727 unrated locations as of August 2025, up 64% on the 2,879 recorded in June 2024.

Regulator 'struggling with growth in sector'

The Homecare Association found that the sector had grown rapidly in recent years, from 9,100 locations in 2017-18 to 14,137 in 2025, with a 12.4% rise in 2024-25 alone.

It concluded that such growth was outstripping the CQC's inspection capacity.

Three-quarters (77%) of unrated locations registered from 2022-24, though the Homecare Association found that some had been waiting more than five years to be inspected.

Backlog 'will never be cleared at current rates'

The Homecare Association said that the backlog would "never be cleared" at the CQC's current inspection rates, which it calculated as being 81 per month.

Assuming no growth in the number of services, the association said the regulator would need to inspect 393 per month to maintain a three-yearly inspection cycle.

Alongside its analysis of inspection timings, the association also examined CQC's findings from all 1,052 services visited by the regulator from June 2024 to August 2025, which highlighted significant differences in quality.

Significant differences in service quality

It found that outstanding-rated locations tended to deliver excellent care, while having strong governance systems to oversee the quality of services, while those with a good rating offered solid, person-centred care, but needed to improve on processes, such as medicine records.

Organisations with a requries improvement grade had the intent to provide good care but were let down by a lack of quality and assurance and process failures, such as not having sufficient evidence of providing staff supervision and having incomplete medicine documentation.

For those rated inadequate, there were failings in both care and governance, with people experiencing missed calls, unfamiliar workers, and uncertain communication when problems arose, and services demonstrating inadequate risk assessment and record-keeping procedures.

People 'at risk of harm from unsafe care'

Reflecting on the findings, Homecare Association chief executive Jane Townson said: "People relying on care at home, their families, and councils commissioning services cannot make safe, informed choices when most providers have no current rating, and good providers are being squeezed out of the market in some places by cheap, unrated competitors.

“Evidence shows that when CQC inspections do take place, they identify important quality differences - from excellent services that 'go above and beyond' to those with serious safety failings. This makes the current inspection gaps even more concerning for public protection.

"At current rates, we are heading towards a future where nine in ten home care services will lack a current quality rating. This is simply unacceptable for a sector supporting hundreds of thousands of people with complex needs who are at risk of harm from unsafe, poor-quality care. Urgent intervention is needed before the situation deteriorates beyond repair.”

'CQC needs to significantly increase inspection levels'

The association said the CQC needed to "substantially increase inspection throughput" to clear the backlog.

It urged the regulator to adopt a risk-based triage system, with rapid safety assessments for uninspected services followed by a full inspection within two years.

The association also called on the CQC to work with local authority commissioners to develop alternative ways of quality assuring uninspected services, and to commission and independent review of the resources needed to maintain a three-year inspection cycle.

Regulator 'working hard to improve'

The CQC's chief inspector of adult social care, Chris Badger, said: “In line with our commitment to increasing assessment numbers, the Homecare Association report echoes the need to make sure that we update the ratings of providers, minimise the number of unrated services, and give the public confidence in quality of care."

“It is essential that when people share concerns with us they’re acted on appropriately and we will continue to push for improvements on how CQC listens and acts on this information," he added.

"We are working hard to improve how we operate – making sure we have the right structure, processes, and technology in place to help us fulfil our vital role of helping people get good care and supporting providers to improve."