How do we move from Good to Very Good with the Care Inspectorate?

What is the difference between Good and Very Good?

It helps to read the two descriptions side by side, because the wording shows exactly where the gap sits. These come from the Care Inspectorate's page on what its evaluations mean.

	Good (4)	Very Good (5)
Strengths	A number of important strengths which, taken together, clearly outweigh areas for improvement	Major strengths in supporting positive outcomes for people
Areas for improvement	Improvements are required	Very few, with minimal adverse impact on people's experiences and outcomes
The test for people	Improvements are needed so people consistently have outcomes as positive as possible	Performance does not require significant adjustment

The word I would underline is consistently. A service at Good has often got plenty right. It may be very strong on the days the right people are on shift. I read that word as the gap between what you do at your best and what everyone gets every day.

So you may not be looking for something brand new. You are looking at where your strongest work stops.

How are grades reached?

Grades attach to specific things. In its guidance on how it inspects regulated services, the Care Inspectorate says that where it inspects more than one quality indicator under a key question, the overall evaluation for that key question will be the lower of them. So one indicator can hold a key question at Good even where the rest sit higher.

Not every inspection can move a grade. Some inspections cover selected quality indicators, and the guidance says core and promise assurance inspections, for services performing well, are not evaluated. They do not provide a validation of previous evaluations either, so they will not confirm or move your grade. Your inspector will explain the type of inspection at the start, so ask if it is unclear.

Daily life carries real weight. The same guidance says inspections are unannounced because it is important to observe how services operate on a day to day basis and the outcomes people experience. An improved folder will not carry a grade by itself. What people experience on an ordinary Tuesday has to match it.

The other thing to read is your own quality framework. The framework for care homes for adults and older people is one example, and other service types have their own. It describes what may be expected in a service operating at a very good level and at a weak level, and it says these illustrations are not a definitive description. The inspection guidance says the illustrations can help staff understand what very good outcomes look like, and that is how I would use them.

What can keep a service at Good?

The trap I would watch for first is adding more. New audits, new forms and new meetings can all feel like progress, and each one takes time away from the people you support. If your Good report already showed sound systems, extra paperwork is unlikely to be what is missing.

Another is treating Very Good as a single project. Grades sit against particular quality indicators, so a general push tends to spread your effort thinly. Pick the lowest first.

The third is measuring your best shift. If you only ever walk the floor on a weekday morning, you will see your service at its most settled. Ask what happens at the weekend, on a late or with agency staff on shift.

And then there is chasing the grade itself. A change made for the inspector's benefit rarely helps the people you support. The Health and Social Care Standards are written from the point of view of the person, with descriptive statements that explain what achieving each outcome looks like in practice. Let those set the aim, and let the grade follow if it does.

How do I find the real gap?

Start with your last report. Find the quality indicator with the lowest evaluation, and read what the inspector wrote about it, including any areas for improvement. Close those first, and be able to show they stayed closed.

Then take that indicator's section of your framework, and read the very good illustration with your senior team. For each line, ask two questions. Is this true for everyone we support, or for most? How do we know, other than our own opinion?

Then go and test it. Sit with a few people and ask what their day is like. Speak to families and to the newest member of staff. Look at the same thing on a different shift. The Care Inspectorate also publishes self evaluation tools, which its framework says can help services assess how they are doing against key areas. Use them, and write down the uncomfortable answers.

What does the difference look like day to day?

The Care Inspectorate does not describe it this way, so treat these as my own illustrations. They are the kind of test I would apply, and they are not a list of what an inspector will look for.

Where you might look	What may hold you at Good	What a stronger picture looks like
Personal plans	Up to date, though some read alike	Each one sounds like the person, and staff can tell you what it says
Choice	Offered at set points in the day	People shape how their day goes, including on quieter shifts
Staff knowledge	Strong among long serving staff	New and agency staff get what they need before they support someone
Learning from incidents	Recorded, with actions closed	The team can say what changed and whether it worked
Leadership	Audits are completed on time	Audit findings change practice, and someone checks that the change lasted

The last two rows matter more than they look. A very good evaluation describes a service that takes opportunities to strive for excellence within a culture of continuous improvement. A team can show you that culture by telling you what they tried, what did not work and what they did next.

What about Excellent?

The description moves on again. The Care Inspectorate says an evaluation of excellent describes performance that is sector leading, with a demonstrable track record of innovative, effective practice or very high quality performance from which others could learn. It also says it can be confident that performance is sustainable.

Notice the words track record and sustainable. That takes time. If you are at Good today, I would not set Excellent as next month's target. Get to where Very Good is simply how your service runs, and hold it there.

When is this not the answer?

If you have requirements still open, deal with those first. They are based on regulations and carry their own timescale, and my post on improvement plans after low grades is the better place to start.

If your team is stretched by turnover or vacancies, stabilising it may be the honest priority. Consistency is very hard to build with a team that keeps changing. You must care to care, and that includes the people doing the caring.

If your last inspection was some time ago, check where you stand now rather than assuming the old grade still describes you. You may also find a stable Good suits this stage of your service. That is a respectable place to be, and it is your decision to make.

And if you are looking for someone to guarantee a grade, I am not the right person. Nobody can do that.

Where should I start?

Take your last report and find the lowest quality indicator. Read its very good illustration with your senior team this week, and pick one line you could test on a weekend shift.

If you would like a second pair of eyes, I work with services in Scotland, including quality audits built around the Care Inspectorate's own frameworks. When you are ready, book some time with me and we can go through it together.