Why ‘Requires Improvement’ Care Homes Often Fail Again

This blog breaks down why “Requires Improvement” services so often slip back into poor outcomes, and what leaders can do to turn an inspection rating into a practical, measurable improvement plan that actually sticks.

Introduction

Care home compliance is one of the biggest challenges facing providers in the UK. Despite significant effort following a ‘Requires Improvement’ rating from the Care Quality Commission (CQC), many care homes fail to achieve sustained compliance — and are rated ‘Requires Improvement’ again at their next inspection.

This isn’t usually due to a lack of commitment or care. More often, it’s because compliance is treated as a one-off inspection exercise, rather than an embedded, ongoing process that runs through every part of the organisation.

In this article, we explore what care home compliance really means, why providers often struggle to maintain it, and what practical steps care homes can take to achieve lasting improvement.

Before we dive in, we would love to hear your thoughts below!

Poll: What do you think is the main reason care homes remain rated ‘Requires Improvement’?

Poll: How confident are you that your current compliance efforts improve patient outcomes?

Cast your vote and see what matters to your peers!

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What Is Care Home Compliance?

Care home compliance refers to how well a provider meets the CQC’s regulatory requirements, as set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations.

In practice, this means demonstrating consistent compliance across the five Key Lines of Enquiry (KLOEs):

  • Safe
  • Effective
  • Caring
  • Responsive
  • Well-led

True compliance is not just about having policies in place — it’s about being able to evidence, in real time, that safe, effective care is being delivered consistently.

Why Care Home Compliance Breaks Down After a ‘Requires Improvement’ Rating

Many care homes respond to a ‘Requires Improvement’ rating with urgency — but that urgency often fades once the inspection pressure passes.

Here are the most common reasons compliance improvements fail to stick.

Compliance Is Treated as a Short-Term Fix

After a CQC “Requires Improvement” rating, most care homes can produce an action plan quickly, and on paper it often looks solid: audits scheduled, policies updated, training booked, spot checks introduced. The problem is that many plans focus on activity rather than impact.

A service might complete a medication audit every week, for example, but if the same errors keep appearing (missed signatures, unclear protocols, inconsistent chart checks), the audit is only documenting risk, not reducing it. CQC inspectors are looking for evidence that leaders understand what’s driving the issue, have put proportionate controls in place, and can show sustained improvement over time.

Poor Oversight and Governance Systems

One of the most common reasons “Requires Improvement” services fail again is that governance exists as paperwork rather than practice. There may be policies, audits, meeting minutes, and quality reports, but they don’t connect into a clear story of oversight.

In stronger services, governance is visible: leaders can explain what they monitor, what the data is telling them, what they’ve escalated, and what has changed as a result. In weaker services, audits are completed inconsistently, actions aren’t followed through, and recurring issues aren’t tracked to closure. Without a rhythm of review, clear ownership, and proof that learning is embedded, “Requires Improvement” becomes a holding pattern rather than a turning point.

Training Happens, But Competence Isn’t Assured

A lot of care homes respond to “Requires Improvement” by booking more training — and that’s a sensible first step. But training completion is not the same as competence, and CQC teams will often probe what happens after the e-learning module or classroom session.

If staff can’t confidently explain safeguarding processes, demonstrate safe medicines practice, or evidence person-centred care in day-to-day routines, the service remains exposed. This is where homes fall into a common trap: they measure success by attendance certificates rather than by observed practice. Sustained improvement usually comes from a tighter loop, induction that’s role-specific, supervision that’s regular and meaningful, and competency checks that are documented and repeated.

Inconsistent Evidence and Record Keeping

Evidence is central to care home compliance. Even when care is good, providers often struggle to demonstrate this to inspectors because:

  • Records are incomplete or inconsistent
  • Paper systems are fragmented
  • Evidence is stored across multiple locations
  • Managers lack real-time visibility

CQC does not rate intentions — it rates evidence. If compliance activity can’t be easily tracked, reviewed, and evidenced, it may as well not exist.

Compliance Is Seen as the Manager’s Job Alone

Another common issue is that compliance responsibility sits with one individual — often the registered manager.

When compliance is not shared staff don’t understand how their daily actions affect ratings, issues go unreported and improvement relies on one person’s capacity. Sustainable care home compliance requires organisation-wide ownership, where staff understand expectations and contribute to continuous improvement.

Lack of Real-Time Insight Into Risk

Many care homes rely on retrospective audits to identify compliance issues — sometimes weeks or months after problems occur.

This reactive approach means:

  • Risks escalate unnoticed
  • Patterns of non-compliance are missed
  • Opportunities for early intervention are lost

Modern compliance requires real-time insight, allowing providers to act before issues impact residents or inspection outcomes.

 

How to Achieve Sustained Care Home Compliance

Improving care home compliance — and maintaining it — requires a shift in approach.

1. Embed Compliance Into Everyday Practice

Compliance should be part of daily routines, not an inspection checklist. This includes:

  • Regular, meaningful audits
  • Ongoing staff engagement
  • Continuous learning and reflection

2. Strengthen Governance and Accountability

Clear oversight structures help ensure compliance issues are identified and addressed early. This means:

  • Defined responsibilities
  • Regular review of audit outcomes
  • Clear action tracking

3. Centralise Evidence and Oversight

Having a single source of truth for compliance activity makes it easier to:

  • Monitor trends
  • Evidence improvements
  • Demonstrate compliance to inspectors

4. Focus on Prevention, Not Reaction

The most effective compliance systems help providers spot risk before it becomes a regulatory issue.

How Cloda Supports Sustainable Care Home Compliance

Sustained care home compliance requires a shift from reactive fixes to proactive, embedded systems.

Cloda helps care homes by making procedures easier to access, understand and embed within your organisation. 

  • Just Ask Cloda: Staff can ask Cloda about any care process and she will provide the answers they need directly from your best practice procedures.
  • Multilingual Support: Staff can ask Cloda questions in their own language, and she replies in their language.
  • Comprehension of Procedures: Cloda offers comprehension quizzes before staff acknowledge policies, helping to ensure understanding, reinforce learning, and strengthen accountability.
  • Streamline Training Management: The integrated Training Room allows managers to assign, track, and monitor staff training requirements — streamlining training compliance.
  • Microlearning Resources: Your Best Practice Policies and Procedures can be converted into podcast enabling staff to learn on the go, perfect for mobile home support teams.
  • Demonstratable compliance: Every interaction — from policy updates to staff acknowledgments — is logged digitally. This creates a clear, auditable trail that simplifies compliance reporting for inspections, audits, and regulatory reviews.

Care Home Compliance Is a Continuous Process

CQC ratings reflect more than policies — they reflect leadership, culture, and systems.

Care homes that successfully improve their ratings tend to:

  • Make procedures easy for staff to access and understand
  • Embed compliance into daily practice
  • Use data to inform decisions
  • Maintain clear oversight and accountability
  • Evidence improvement consistently

We believe care home compliance should support better care — not create additional administrative burden.

Conclusion

A “Requires Improvement” rating doesn’t mean a care home can’t deliver good care, it usually means the service can’t deliver it consistently, safely, and in a way that can be evidenced. And that’s why the same issues return: action plans focus on activity over impact, governance isn’t embedded, training isn’t translated into competence, and documentation doesn’t clearly show oversight or learning. The shift that changes outcomes is moving from reactive firefighting to a steady rhythm of leadership, supervision, and quality monitoring that staff can feel on every shift.

If you’re ready to see how Cloda can transform policy engagement and compliance in your organisation, contact info@cloda.ai.


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Máire Brookfield
Máire Brookfield
Director of Product Management
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