CQC Inspection Backlog: What the 9,000-Assessment Target Means for Your Care Home

This article contains time-sensitive policy figures and regulatory context. Key sources: Penny Dash independent review of CQC (October 2024), DHSC "Better regulation, better care" response (2024), CQC business plan 2025/26. Figures quoted were accurate at publication; verify against current CQC publications for the latest position. Next scheduled review: Q2 2026.

Thousands of care homes across England are operating with CQC ratings based on inspections conducted before the pandemic. An ITV News investigation highlighted that many adult social care services had not received an inspection since 2020 or earlier, with some ratings based on visits from as far back as 2018. For residents, families, and commissioners relying on those ratings to make decisions, the published rating may bear little resemblance to the current reality of care.

CQC knows this is a problem. The question is what they are doing about it — and what it means for your preparation.

What the Penny Dash Review Found

In October 2024, Dr Penny Dash published her independent review of CQC, commissioned by the Secretary of State for Health and Social Care. The findings were blunt:

CQC's transition to the Single Assessment Framework had caused "significant operational failings"
Assessment volumes had dropped substantially during the transition period
The new regulatory platform and portal had technical problems that slowed assessor workflow
Provider confidence in CQC's ability to identify and act on quality concerns had declined
There were concerns about consistency in how the new framework was being applied across different assessment teams

The review did not recommend abandoning the Single Assessment Framework — it recommended fixing the implementation. That distinction matters because the framework itself, with its 34 quality statements and six evidence categories, is not going away. What is changing is the pace and consistency of how it is applied.

CQC accepted the review's recommendations and committed to an improvement programme. The Department of Health and Social Care's response, "Better regulation, better care," set out expectations including restoring assessment volumes and improving the reliability of CQC's operations.

The 9,000-Assessment Target

CQC's 2025/26 business plan set a target of completing 9,000 assessments by September 2026. To put that in context, CQC regulates approximately 28,000 adult social care locations in England. Even at 9,000 assessments per year, it would take more than three years to assess every service once.

But those 9,000 assessments will not be evenly distributed. CQC has indicated it will prioritise:

Services not assessed for the longest period — if your last inspection was 2021 or earlier, you are near the front of the queue
Services where data signals suggest risk — high safeguarding referral rates, statutory notification patterns, complaints data, and workforce indicators all feed into CQC's risk model
Services with current Requires Improvement or Inadequate ratings — these have always been subject to more frequent assessment
New registrations and services that have changed provider — these require initial assessment under the new framework

CQC also conducts focused assessments, which look at specific quality statements rather than the full framework. A focused assessment on "Safe and effective staffing" or "Safeguarding" can be triggered by data signals without a full assessment being scheduled. These count towards the 9,000 target and can result in rating changes.

The Shift to Continuous Assessment

The 9,000-assessment target is only part of the picture. Under the Single Assessment Framework, CQC is moving towards a model of continuous assessment that reduces reliance on periodic on-site inspections. This means:

Data monitoring is ongoing. CQC receives and analyses data continuously from multiple sources — statutory notifications submitted by providers under the Care Quality Commission (Registration) Regulations 2009, safeguarding referrals from local authorities, feedback submitted through CQC's public-facing "Give feedback on care" service, and national datasets on workforce, admissions, and outcomes.

Assessments can be remote. CQC can request evidence, conduct interviews, and review documentation without visiting your home. A remote evidence request followed by a focused assessment is a realistic scenario for many homes in 2026.

Ratings can change without a full inspection. A focused assessment on one or two quality statements can lead to a rating change for an individual key question, which can in turn affect the overall rating. You do not need a full reassessment to go from Good to Requires Improvement — a single focused assessment finding significant concerns under "Safe" can trigger a downgrade.

Third-party feedback carries weight. Under the SAF's evidence category framework, "People's experience of health and care services" and "Feedback from partners" are primary evidence sources. A pattern of negative feedback from residents' families, GPs, or local authority commissioners can trigger assessment activity independently of any inspection schedule.

What This Means Practically

If your last CQC assessment was before the Single Assessment Framework launched in November 2023, your next assessment will be under a different system than the one you were last assessed against. The five key questions remain the same, but the evidence framework has changed. Preparing for your next assessment means understanding the current framework, not the one you last experienced.

Here is what to do:

1. Check Your CQC Profile

Log into your CQC provider portal and review your statutory notification history. Are there gaps? Under-notification is one of the data signals CQC monitors. Under Regulation 18 of the CQC (Registration) Regulations 2009, you are required to notify CQC of deaths, serious injuries, safeguarding incidents, events affecting service continuity, and other specified events without delay.

If you have been under-reporting — even unintentionally — correct this now. A sudden spike in notifications after years of low reporting will itself draw attention, but the alternative (continued under-notification) is a regulatory breach.

2. Review Your Rating Against Current Reality

Look at your published CQC rating and ask honestly: does it still reflect the quality of care you provide? If your team, resident cohort, or operational circumstances have changed significantly since your last inspection, your evidence needs to reflect your current position.

If you have improved since a Requires Improvement rating, have evidence ready to demonstrate it. If quality has dipped since a Good rating, identify the issues and address them now rather than waiting for an assessor to find them.

3. Assess Yourself Against the 34 Quality Statements

The quality statements are published on CQC's website and describe what good care looks like under each key question. Work through them systematically and ask:

Do we have current evidence for this statement?
Would that evidence satisfy an independent assessor?
Are there gaps we know about but have not addressed?

Our CQC Readiness Assessment tool is built for exactly this exercise. It walks you through each quality statement and produces a gap analysis you can act on.

For a detailed walkthrough of each quality statement and how they map to CQC's framework, see our complete CQC compliance guide for small care homes.

4. Prioritise the High-Risk Areas

CQC enforcement data consistently shows that the most common breaches are:

Regulation 12 — Safe care and treatment (medicines management, risk assessments, clinical monitoring)
Regulation 17 — Good governance (audit programmes, action tracking, oversight systems)
Regulation 18 — Staffing (adequate numbers, training, competency)

If you have limited time and resources — and most small homes do — focus on these three areas first. A home that can demonstrate safe medicines management, a functioning audit programme, and adequate staffing with training records is covering the most frequently assessed ground.

5. Get Your Evidence Organised Now

The worst time to organise your evidence is after CQC makes contact. Under the continuous assessment model, you may receive a request for specific evidence with relatively short notice. Having an evidence pack organised by quality statement and evidence category means you can respond quickly and confidently.

This does not require software (though it helps). A well-structured digital filing system, maintained weekly, is sufficient. What matters is that evidence is current, findable, and tells a coherent story about the quality of care in your home.

6. Brief Your Team

Your staff are evidence sources. CQC assessors will speak to them and ask about safeguarding procedures, residents' care needs, how they raise concerns, and what training they have received. Staff who can speak confidently about the care they provide and the processes they follow are your strongest asset in any assessment.

Ensure every staff member knows:

The names and key needs of the residents they support
How to raise a safeguarding concern and to whom
The home's complaints procedure
What to do in an emergency (fire, medical emergency, significant incident)
Where to find key policies and procedures

The Bottom Line

CQC's 9,000-assessment target for 2025/26 is an acceleration, not a return to pre-pandemic inspection levels. But combined with the shift to continuous assessment, data monitoring, and focused assessments, it means the regulatory temperature is rising.

The homes that will fare best are not the ones that scramble when they hear assessors are coming. They are the ones whose day-to-day operations already produce the evidence CQC needs to see — because that evidence is a byproduct of genuinely good governance, not a performance assembled for an audience.

If you have not been assessed since before November 2023, your assessment under the Single Assessment Framework is coming. The question is not whether, but when. The time to prepare is now, while you still have the luxury of choosing your own timeline.

Our free CQC Readiness Assessment takes about 15 minutes and gives you a clear picture of where you stand against the current framework. Start there.