What does Outstanding look like for a care service rated Good?

What is the difference between Good and Outstanding?

CQC's own definitions are short. On its ratings page, Good means the service is performing well and meeting CQC's expectations. Outstanding means the service is performing exceptionally well.

Newer reports also carry a percentage score. Good runs from 63 to 87%, and Outstanding starts at 88%. If your report shows a score near the top of the Good band, read the key question ratings and the detail underneath before you decide how far away Outstanding really is.

Those definitions tell you where the line is. They do not tell you what it looks like on a Tuesday afternoon, when the lounge is busy, two carers are on a break and a relative has just arrived with a question. That is the picture this post is about.

Is CQC changing what Outstanding means?

It is changing how it describes it. In its March 2026 update, CQC said it is moving from a single assessment framework to separate frameworks for each sector, adult social care included. The five key questions stay. Each framework will carry rating characteristics describing what outstanding, good, requires improvement and inadequate care looks like in that sector. CQC also reported support for removing scoring and making rating judgements directly at key question level.

CQC's June 2026 update explains that pilots of the new approach run between June and October 2026, with final evaluation in November 2026. Pilot judgements have no legal standing and will not affect any service's rating.

So as I write this in September, nobody outside CQC can tell you exactly what the final adult social care description of Outstanding will say. My advice is not to build your plan around a draft. Build it around what CQC has said will stay, alongside what will matter whatever the wording: the five key questions, what people tell you about their own care, and the regulations you already work to.

What does Outstanding care feel like day to day?

The clearest place to look is the current quality statement on person centred care, which CQC plans to replace with structured questions under the new framework. It says providers make sure people are at the centre of their care and treatment choices, and decide in partnership with them how to respond to changes in their needs. Its I statements put it in the person's words. One reads: "I am in control of planning my care and support."

That sentence is a useful test. In many Good services, care is planned well for people. In Outstanding care, it is planned with them, and you can see their influence in how the day runs.

Here is how I would picture the difference. This is my own view, not CQC wording, and it is meant to help you look at your service with fresh eyes.

Everyday area	Where Good often settles	What going further looks like	How you would know
Care planning	Plans are accurate and reviewed on time	Plans read like the person and show what they chose	Ask someone what their plan says about them, and compare
Daily routine	The day is organised well around staffing	The day bends to what people want, even when it is harder	Look at when people get up, eat and go to bed
Feedback	Surveys are collected and filed	People and families can point to something that changed because they spoke up	Ask a family what happened after their last suggestion
Staff	Training is up to date	Staff can explain why they work the way they do for each person	Ask a carer on a late shift about one person's preferences
Consistency	Good on most days	Good on every shift, including weekends and nights	Visit at a time you normally would not

Why do services get stuck at Good?

One common mistake is treating Outstanding as something extra. A sensory room, a new activity programme or a technology project can all be good things. But if the weekend medicines round is still rushed, or people still wait for help at breakfast, the extras sit on top of care that is still Good.

The second mistake is chasing the rating. A plan written to impress an inspector tends to produce evidence folders rather than change. Staff can feel the difference, and so can the people they support.

The third is leaving people out. Regulation 9 already asks providers to work in partnership with the person, and to involve them, or someone lawfully acting for them, in planning, managing and reviewing their care. That is a legal requirement. Doing it so well that people genuinely shape the service is where Outstanding care begins.

How do I build a realistic plan?

Start with one key question rather than five. Choose the one where you already feel strongest, because that is usually where the gap to Outstanding is smallest.

Then ask the people you support and their families what would make the biggest difference to them. Write their answers down in their words. Pick two or three changes from that list, and give each one an owner, a check and a date. The check should be something you can see or hear: a conversation, an observation, or a record that matches what the person tells you.

Review it every month with your team. When something works, keep it and make it part of how every shift runs. When it does not, change the action rather than adding paperwork.

Over time, the evidence builds itself. It comes from people's experience rather than from a folder made for inspection day.

When is this not the answer?

If one of your key questions is already shaky, steady that first. Exceptional care in one area will not carry a service where safety or leadership is slipping.

If your team is stretched by vacancies or high agency use, focus on stability before ambition. Consistent care depends on people who know the people they support.

And if your service is Good, your team is settled and the people you support are happy, there is nothing wrong with staying exactly where you are. Good is a strong rating. Not every service needs to chase a higher one.

Where should I start?

Pick one key question and ask three people you support what would make their day better. Then spend an hour on a shift you rarely see, and notice what is the same and what is different.

If you would like someone alongside you, my Outstanding rating support helps services find the gap between good and exceptional without chasing a rating, and my quality assurance audits test whether your own checks would see it. When you are ready, book some time with me and we can talk about what Outstanding could look like for your service.