Care providers in Wales will soon be given ratings as the Care Inspectorate Wales (CIW) continues to prepare for its pilot scheme. The changes have been planned for some time, but the implementation has been delayed on several occasions.

Providers regulated by the Care Quality Commission (CQC) will already be used to the English ratings system. When the CQC was formed in 2008, one of its first tasks was to create a rating system to grade providers following an inspection. Since then, the inspection and ratings processes have undergone continual refinement, but the CQC still struggles to ensure the consistency of ratings between different services and providers.

To provide some assurance about the consistency of the new process, CIW will roll out a seven-month pilot scheme starting later this year. From June 2023 onwards, CIW will start providing silent ratings at all inspections of care homes and domiciliary support services as part of the pilot phase. The ratings are ‘silent’ which means they will not be published. CIW will then appoint an organisation to carry out an independent evaluation of the rating pilot. The idea is that CIW can use the evaluation to assess their consistency in applying ratings and the impact on service providers and inspection teams. CIW will then publish the findings from the evaluation and any potential amendments to their approach.

From April 2024, CIW will begin publishing ratings for care homes and domiciliary support services within inspection reports.

There may be some understandable apprehension amongst providers about the new rating system. When the system works well, ratings can provide a clearer picture of quality, helping people to make more informed choices about their care and support. Positive inspection outcomes can also help to boost staff morale and provide a public reflection of the great work being done on the ground.

Things are different where the system has not been properly thought through or is not well implemented. A poor rating, especially where it is perceived to be undeserved, can be demotivating to an already depleted workforce and can create commercial difficulties. In England, commissioning decisions are often linked to ratings and clauses in contracts with local authorities can also require providers to maintain a certain rating. Not only does that increase pressure on staff and leaders, but it also means that ratings – which might not fairly reflect the quality of care – can have serious consequences for providers.

Whilst CIW has yet to publish much detail about the new process, the hope is that the new rating system will work fairly and consistently across the board. However, it is always sensible to consider what the risks of the new system might be and how to adapt to the changes. Welsh providers can prepare early by thinking about how they can ensure they are presenting CIW with a balanced picture of the care and support provided and highlighting evidence of good practice. Given that it is not anticipated that ratings will be published until April 2024, it also makes sense to engage with any opportunities to shape CIW’s inspection strategy and provide feedback along the way.

For more information or advice about inspections, please contact Freya Cassia or another member of the regulatory team.