Why do health and social care providers fail CQC inspections?

Between 2023 and 2025, 196 health and social care providers in England were rated “Inadequate” by the Care Quality Commission (CQC). These included 47 domiciliary care providers and 111 care homes, all of which faced serious and systemic issues related to safety, governance, safeguarding, and the quality of care.

But here’s the real issue: these failures weren’t usually about single incidents, staff shortages, or funding pressures. They were often due to something far simpler, and far more alarming:

“The absence or poor implementation of fundamental policies and procedures.”

Yes, the root cause behind many CQC failures is structural: policies are missing, not embedded in daily practice, or simply not understood by the workforce.

In this blog, Dr Richard Dune unpacks what’s really happening behind the scenes, and more importantly, what providers can do to go from “Inadequate” to “Good” or “Outstanding” by putting structure, leadership, and accountability at the heart of care delivery.

The patterns behind poor ratings

When the CQC turns up for an inspection, they’re not there to admire your filing system or fancy cloud-based compliance platform. What inspectors are really assessing is:

“Can this provider deliver safe, effective, person-centred care consistently, and prove it?”

Too often, the answer is no. Inspectors repeatedly encounter the same systemic failures discussed below.

Common failures in CQC reports

• Risk assessments are outdated, templated, or missing entirely, particularly for high-risk needs like choking, epilepsy, diabetes, or mobility

• Medication errors abound. PRN (as required) medication lacks clear protocols. Medication Administration Records (MARs) are often incomplete or inaccurate

• Mental Capacity Act 2005 duties are ignored. There's no evidence of best interest decisions, capacity assessments, or DoLS authorisations

• Quality assurance cycles are non-existent. There’s no auditing process, no learning loop, and no response to recurring failures

• Recruitment and deployment are unsafe. Staff are not properly vetted, inducted/onboarded, or supervised. Some haven’t had relevant statutory and mandatory training in years.

The five most cited regulatory breaches

• Regulation 12 - Safe care and treatment

• Regulation 13 - Safeguarding service users from abuse

• Regulation 17 - Good governance

• Regulation 18 - Staffing and training

• Regulation 19 - Fit and proper persons employed.

What’s telling is that these breaches aren’t about “bad people doing bad things.” They’re almost always due to systems not being in place to support good care.

Why policies and procedures alone don’t work

Most providers do have policies and procedures. The problem? They sit in folders or fancy software systems. Or PDFs. Or cloud drives.

A policy that isn’t read, understood, or put into practice isn’t worth the paper it’s written on. The CQC inspectors know this. That’s why they don’t just ask if you have a policy. They ask how you implement it and how it’s impacting practice and service user outcomes.

Let’s be clear: Having a policy is not enough - it must be embedded, audited, and understood.

This is exactly where ComplyPlus™ comes in, not just as a document library but as a complete policy implementation system. It supports providers from paper to practice by embedding regulatory expectations into daily workflows and linking with statutory and mandatory training, supervision and appraisals.

The ComplyPlus™ 10-Policy Framework

To support providers in closing the gaps identified in CQC inspections, we developed the ComplyPlus™ 10-Policy Framework.

This isn’t just a set of policies but a starting point. It’s a strategic toolkit that maps to the most common reasons providers fail inspections. Each area is matched to CQC regulations, failure themes, and practical fixes that enable long-term sustainability.

Let’s explore the top 10 compliance areas and how ComplyPlus™ supports each one.

1. Governance and quality assurance

• Common failure - No audit cycle, no quality dashboard, no governance oversight

• Relevant CQC regulation(s) - Regulation 17: Good governance

• Fix with ComplyPlus™ - Build monthly audit schedules, integrate quality dashboards, and establish governance logs for management review. Our system tracks non-conformities and lessons learned, creating a living governance cycle.

2. Risk assessment and safety

• Common failure - No personalised risk assessments for choking, falls, epilepsy, etc.

• Relevant CQC regulation(s) - Regulation 12: Safe care and treatment

• Fix with ComplyPlus™ - Tailored templates with built-in escalation protocols and review reminders. Risk alerts are integrated into care planning software to trigger action before harm occurs.

3. Medication management

• Common failure - PRN protocols unclear, MARs inaccurate, medication audits missing

• Relevant CQC regulation(s) - Regulation 12: Safe care and treatment

• Fix with ComplyPlus™ - Implement eMAR systems, weekly medication audits, and competency checks for all staff involved in medication. Digital records create full traceability and reduce error margins.

4. Recruitment and safer staffing

• Common Failure - Staff start without DBS clearance or verified references

• Relevant CQC regulation(s) - Regulation 19: Fit and proper persons employed

• Fix with ComplyPlus™ - Integrated pre-employment checklist, automated reminders for vetting, and links to rota systems so unvetted staff are not deployed unsupervised.

5. Training and competency

• Common failures - No record of mandatory training or skill-specific training (e.g. epilepsy)

• Relevant CQC regulation(s) - Regulation 12: Safe care and treatment and Regulation 18: Staffing

• Fix with ComplyPlus™ - Training is tracked by individual, role, and care package. You can view gaps instantly and evidence competence through assessments, not just attendance certificates.

6. Mental capacity and consent

• Common failures - No capacity assessments or best interest decisions documented

• Relevant CQC regulation(s) - Regulation 11: Need for consent

• Fix with ComplyPlus™ - Decision-specific MCA templates, audit tools, and staff training. Assign an “MCA Champion” to lead practice and monitor compliance across teams.

7. Safeguarding and whistleblowing

• Common failures - Safeguarding logs empty or missing. Concerns go unreported

• Relevant CQC regulation(s) - Regulation 13: Safeguarding service users from abuse and improper treatment

• Fix with ComplyPlus™ - Clear reporting pathways, supervision prompts, and safeguarding discussion built into staff meetings. Whistleblowing posters and log audits reinforce transparency.

8. Care planning and person-centred support

• Common failures - Generic care plans copied and pasted across service users

• Relevant CQC regulation(s) - Regulation 9: Person-centred care and Regulation 10: Dignity and respect

• Fix with ComplyPlus™ - Co-produced care planning templates, quarterly review cycles, and tracking against the Accessible Information Standard. Include family and advocates in outcome setting.

9. Complaints and learning culture

• Common failures - Complaints ignored or dismissed; no lessons learned

• Relevant CQC regulation(s) - Regulation 16: Receiving and acting on complaints and Regulation 20: Duty of candour

• Fix with ComplyPlus™ - RCA tools, centralised complaints tracker, and leadership-led reflection sessions. Learning logs can be shared in team meetings to foster a just culture.

10. EDI – Respect, culture and identity

• Common failures - Cultural or religious needs ignored; no language support

• Relevant CQC regulation(s) - Regulation 10: Dignity and respect

• Fix with ComplyPlus™ - Cultural assessment templates, language/format preferences captured in care plans, and mandatory EDI training for all staff.

It’s about structure, not just staff

Yes, recruitment is hard. Budgets are tight. Inspections are stressful. But the most consistent reason providers fail is a lack of internal structure.

Even the most passionate staff can’t deliver great care without the right systems. When policies aren’t understood, audits don’t happen, and training isn’t linked to real risks, care quality deteriorates - and ratings follow.

Outstanding care isn’t accidental - it’s operational.

Well-led services have governance cycles. They review and act on data. They embed learning. That’s the real difference between “Requires improvement” and “Good.”

How ComplyPlus™ helps providers succeed

At The Mandatory Training Group, we created ComplyPlus™ to solve this exact problem. We saw providers drowning in documents and failing inspections - not because they didn’t care, but because they didn’t have the systems to succeed.

ComplyPlus™ goes beyond checklists and templates. It’s a compliance engine built to drive actionable change across every part of your service.

ComplyPlus™ includes:

• Editable policy suite - Instantly compliant and ready for customisation

• Digital audit tools - From medication to MCA, with automatic tracking

• Training platform - CPD-accredited courses mapped to service risk

• Train-the-Trainer model - Build in-house capability that lasts.

It’s designed to integrate with your existing setup, no new software platforms, no massive learning curves. Just structured compliance, made simple.

Your next steps - Don’t wait for a warning notice

Whether you’re preparing for your first inspection or recovering from a poor outcome, the time to act is now. The inspection window may be unpredictable, but your preparation doesn’t have to be.

Here’s what you can do today:

• Audit your policies - Are they up to date, embedded, and understood by staff?

• Review your risk tools - Are high-risk needs actively monitored and updated?

• Track training - Is every member of staff trained to meet the needs of those they support?

• Set up a compliance rhythm - Monthly audits, quarterly reviews, annual governance cycles

• Book a demo - Let us show you how ComplyPlus™ works and where your blind spots may be.

Final word

CQC failures don’t usually come out of nowhere. They are predictable, preventable, and, most importantly, fixable.

If your care team lacks structure, your systems don’t track quality, and your policies don’t live in daily practice, then it’s only a matter of time before inspectors see through the surface.

But with the right tools, leadership, and commitment, you can embed excellence into everything you do.

Don’t wait for a warning notice. Don’t scramble after an inspection. Get ComplyPlus™. Be inspection-ready. Always.

Embed compliance. Prevent CQC failures. Stay inspection-ready with ComplyPlus™

ComplyPlus™ by The Mandatory Training Group helps you move beyond static policies to fix the root causes of CQC failures. From risk assessments to governance, it builds the structure, evidence, and accountability that inspectors expect.

Explore the ComplyPlus™ suite:

• ComplyPlus™ E-Learning Courses (CPD-accredited online courses)

• ComplyPlus™ Compliance Centre - Live dashboards, inspection readiness

• ComplyPlus™ LMS - Sector-specific learning management system

• ComplyPlus™ TMS - Internal training tracking & CPD audits

• ComplyPlus™ Policies & Procedures - Fully editable & CQC/Ofsted-ready

• ComplyPlus™ Legal - Contracts, employment docs, and HR templates.

Don’t wait for a warning notice. Discover how ComplyPlus™ helps you embed quality care into everything you do - and stay inspection-ready, always.