Why do our care audits never seem to change anything?

What does CQC expect from audits?

Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 is about good governance. CQC's guidance says providers must have effective governance, including assurance and auditing systems or processes, and that these must assess, monitor and drive improvement in the quality and safety of the service, including the experience of people using it.

The word that matters there is drive. An audit that finds a problem and files it has assessed and monitored. It has not driven anything.

The guidance goes further than that headline. It says providers must be able to show how they have analysed and responded to the information gathered, used it to make improvements, and shown that those improvements have been made. It also says providers must monitor progress against their improvement plans and act without delay where progress is not achieved as expected. That is a description of a loop, not a folder.

The regulation itself sets the test plainly: systems or processes must be established and operated effectively. Having the audit tool is the first half. Operating it effectively is the second.

Is any of this changing with CQC's new frameworks?

CQC is rewriting how it assesses services. Its August 2026 update says it has continued testing and piloting draft assessment frameworks across all sectors through the summer, and is developing new sector specific frameworks, guidance and methods.

The regulations are a different matter. Regulation 17 sits in the 2014 Regulations, and nothing in CQC's August update suggests any change to what it asks of providers. So whatever the new adult social care framework looks like, governance that drives improvement will still be the requirement. I would not wait for the new framework before fixing your audit loop.

Why do audits stop at the finding?

In my view there are four common reasons, and many services will recognise at least one.

The first is that the audit is the goal. The care plan audit is due on the 15th, it is done on the 15th, and the box is ticked. The findings go into an action plan that nobody reopens until the next audit finds the same things.

The second is that actions have no owner, or have several. "Senior team to review" means nobody will. One name per action is the only way anyone knows who to ask.

The third is that nobody checks whether the action worked. A refresher session on recording fluids is an action. Fewer gaps in fluid charts over the next month is the result. Only the second tells you the person is drinking enough.

The fourth is that audits are read one at a time. The medicines audit, the falls log and the complaints file each tell part of a story. Read separately, each looks manageable. Read together, they might all point to the same unsettled night shift.

What does a closed loop look like?

This is the loop I would build into every audit you run. It needs a habit more than a new form.

Step	The question to answer	What good looks like
Find	What exactly is wrong, and for whom?	A finding specific enough that someone could fix it tomorrow
Decide	What will change, and is it in proportion to the risk?	One action per finding, sized to the risk to people
Own	Who is responsible?	One name, agreed with that person face to face
Check	How will we know it worked?	Something you can see or hear: an observation, a conversation, a record that matches what the person says
Look across	Does this finding appear anywhere else?	A monthly look at audits, incidents and complaints side by side
Tell	Who needs to know the result?	Staff, and where appropriate the people you support and families, hear what changed

The last row is easy to skip. The Regulation 17 guidance says providers should have communication systems so that people who use the service, and those who need to know, learn the results of quality reviews and the actions that follow. Staff who never hear what happened to their audit stop taking audits seriously.

How do I get audits to ask better questions?

The guidance says audits should, where possible, include the experiences of people who use the service. That one line changes most audits for the better.

A care plan audit that only checks dates and signatures will tell you the plan was reviewed. It will not tell you whether the plan still describes the person. Add one question that can only be answered by talking to them: does this plan match how they tell you they want their day to go?

The same applies elsewhere. A medicines audit can count signatures, and it can also ask a person whether they get their tablets at the time they prefer. A falls audit can count falls, and it can also ask what the person was trying to do when they fell.

CQC's current quality statement on governance, management and sustainability puts it simply: information is used effectively to monitor and improve the quality of care. Better questions give you better information.

Where does the provider fit in?

Regulation 17 guidance says the system must include scrutiny and overall responsibility at board level or equivalent. In a smaller provider, that might be the owner and the nominated individual rather than a board.

Scrutiny is more than a signature on the monthly report. It means asking which actions are overdue and why, which findings keep coming back, and what the people using the service are saying. A provider level meeting that only ever hears that everything is fine has stopped scrutinising.

When is this not the answer?

If an audit has found something that puts a person at immediate risk, deal with that first and record what you did. Building a better audit loop comes afterwards.

If your audits are already closing the loop, with clear owners, real checks and a monthly look across findings, you probably do not need to change much. Doing fewer audits well is often better than adding more.

And if the problem is that the manager has no time to do any of this because they are covering shifts, the answer is staffing and support, not a better audit tool.

Where should I start?

Pick last month's audits, all of them, and lay the findings side by side. Look for anything that appears twice. Then pick three findings, give each one a single owner and a check you can see, and put a date in the diary to look again.

If you would like a second pair of eyes, my quality assurance audits are designed to test whether your own governance finds, fixes and checks, and my nominated individual services can strengthen provider oversight. When you are ready, book some time with me and we can look at your audit cycle together.