The way adult social care is regulated in England continues to evolve.

During 2026, the Care Quality Commission (CQC) has been progressing work to rebuild and improve its regulatory approach following significant reviews of its previous systems and assessment methodology.

For care providers, people receiving care and their families, it is important to understand both what is changing and what continues to sit at the heart of good-quality care.

What Is the Care Quality Commission?

The Care Quality Commission is the independent regulator of health and adult social care services in England.

Its role includes registering relevant providers, monitoring and assessing services, publishing information about quality and taking regulatory action where required.

For people looking for care, CQC information can provide an important source of information about registered services.

Why Is CQC Changing Its Approach?

CQC introduced its single assessment framework across health and social care as part of an earlier programme of regulatory change.

However, subsequent independent reviews and feedback identified significant problems with aspects of the framework, its implementation, regulatory processes and supporting digital systems.

CQC has therefore been working on a wider programme to rebuild its approach to regulation and improve the experience of both the public and registered providers.

One of the major directions of travel is a move towards sector-specific assessment frameworks, rather than relying on one framework intended to work in the same way across all sectors.

The Five Key Questions Remain Important

Although CQC's assessment methodology is evolving, its five well-known key questions remain central to its approach.

These questions provide a useful way of understanding the different aspects of quality that matter within a care service.

What Has Been Happening in 2026?

Several important strands of CQC's improvement programme have been progressing during 2026.

CQC Is Testing the New Assessment Method

An important point for providers is that the new approach is being tested rather than simply being introduced everywhere at once.

CQC stated that pilot assessments would run between June and October 2026, followed by evaluation.

CQC also explained that these pilot assessments run alongside, rather than instead of, existing inspections.

This means providers should avoid assuming that every element of a draft or pilot approach is already the final regulatory methodology.

People's Experience of Care Remains Central

One of the important themes within modern care regulation is understanding what care is actually like for the person receiving it.

Policies and procedures remain important, but good governance is not demonstrated simply by having documents available.

Providers should also be able to demonstrate how their systems translate into people's everyday experiences and outcomes.

For a domiciliary care provider, this may include whether people:

• Feel safe receiving care in their home.
• Are treated with dignity and respect.
• Are involved in decisions about their care.
• Receive care that reflects their individual needs.
• Have their preferences and routines respected.
• Know how to raise concerns or make a complaint.
• Experience reliable and consistent support.

What Does This Mean for Safe Care?

Providers should continue to maintain robust systems for identifying and managing risks.

Depending on the service, this can include:

• Safeguarding.
• Medication management.
• Safe recruitment.
• Staffing and competency.
• Infection prevention and control.
• Risk assessment.
• Accident and incident management.
• Learning when things go wrong.

The important question is not only whether systems exist, but whether they are being implemented consistently and are helping to keep people safe.

Effective Care Is More Than Completing Tasks

Effective care should be based on an understanding of the person's needs and appropriate care planning.

Providers should consider whether staff have the knowledge, training, supervision and support required for their roles.

Care should also respond when people's needs change rather than continuing indefinitely with an outdated care plan.

Kindness, Dignity and Respect

The quality of interaction between care workers and people receiving care remains fundamental.

This can be seen in everyday behaviours such as:

• Listening to the individual.
• Respecting privacy.
• Seeking consent.
• Supporting independence.
• Communicating respectfully.
• Recognising cultural and individual preferences.

Care Should Respond to the Individual

People's needs are not static.

A good service should be able to recognise when someone's needs or circumstances have changed and adjust support appropriately.

This makes effective care reviews, communication and feedback particularly important.

Why Well-Led Services Matter

Good leadership and governance underpin many other aspects of quality.

Providers need systems that help them understand what is happening within their service.

This may involve reviewing:

• Care records.
• Medication records.
• Complaints and compliments.
• Safeguarding concerns.
• Accidents and incidents.
• Staff training and supervision.
• Recruitment records.
• Feedback from people receiving care.
• Quality audits and improvement actions.

Auditing is most useful when it leads to action. Identifying a problem without addressing it does not by itself improve the quality of a service.

How Can Adult Social Care Providers Prepare?

Providers do not need to wait for an inspection to consider whether their service is operating effectively.

Regular internal review can help identify improvements earlier.

What Do the Changes Mean for People and Families?

For someone receiving care, the technical details of a regulatory framework may understandably feel distant from everyday life.

What matters most is whether the service they receive is safe, respectful, reliable and responsive to their needs.

Families choosing a care provider can ask practical questions about how the service operates.

For example:

• Is the provider registered with CQC where required?
• How will care needs be assessed?
• How are carers recruited and trained?
• How are care visits monitored?
• What happens if someone's needs change?
• How are concerns and complaints handled?
• How does the provider monitor the quality of care?

CQC Is Also Addressing Older Ratings

CQC has acknowledged concerns about ratings that may no longer reflect a service's current performance.

During 2026 it has been working to increase assessment activity and address services with older ratings or services that have not yet been assessed following registration.

For people researching care, this is a useful reminder to look beyond a rating alone.

The date of the assessment, the full inspection or assessment report and other available information can provide important context.

Digital Regulation Is Also Being Rebuilt

CQC's improvement programme is not limited to inspection methodology.

The regulator has also acknowledged difficulties experienced with its digital systems and is investing in rebuilding its regulatory approach and digital services.

For providers, reliable regulatory systems are important for activities such as registration, submitting information and communicating with the regulator.

What Has Not Changed?

With so much discussion about regulatory reform, it can be easy to focus entirely on terminology and frameworks.

But the fundamentals of good care remain recognisable.

• People should be protected from avoidable harm.
• Care should reflect individual needs.
• People should be treated with dignity and respect.
• Staff should be suitable, trained and supported.
• People's rights, choices and independence should be respected.
• Concerns should be taken seriously.
• Services should learn when things go wrong.
• Leaders should understand and monitor the quality of their service.

Quality and Governance at Medipro24

At Medipro24, we recognise that quality is something that needs to be monitored and developed continuously.

Our approach to domiciliary care focuses on understanding individual needs, supporting safe care, listening to feedback and maintaining appropriate oversight of the services we provide.

As the regulatory environment develops, we will continue to review relevant CQC guidance and regulatory requirements and reflect appropriate changes within our quality and governance arrangements.