News


Regulation shake-up: Everything providers need to know so far


Dementia: Care home design problems identified by inspectors


The Care Quality Commission is to move forward with planned changes to the way it inspects services after it’s ‘Better regulation, better care ‘ consultation showed ‘extremely positive’ feedback for its proposals, the regulator has said. The watchdog is now seeking views on


its four draft assessment frameworks setting out a separate approach to inspecting adult social care, mental health care, primary care and community services and secondary and specialist care (hospitals). The draft frameworks have been developed


by the chief inspectors for each area, based on ‘extensive feedback’ from ‘ internal and external engagement and consultation work over the last year, as well as the recommendations from the independent reviews carried out by Dr Penny Dash, Professor Sir Mike Richards and the Care Provider Alliance’ the Inspectorate said. Here’s everything adult social care


providers need to know about the reform of adult social care inspections so far:


What changes have been proposed? Separate frameworks are being re-introduced following strong lobbying from across the sectors involved, including adult social care (the watchdog said the vast majority (95 per cent) of those who responded to its consultation backed the move. The regulator is also set to change its


methods for inspection, assessing and awarding ratings for health and care providers’ services, including removing the use of scoring and re-introducing rating characteristics within each sector-specific framework, replacing quality statements with a ‘set of new supporting key lines of enquiry’ to ‘clearly indicate’ areas inspected during visits. It also said Its new approach aims to


strengthen equality and human rights, improve the timeliness and reliability of its


12 www.thecarehomeenvironment May 2026


work, enhance data systems, support more consistent inspector judgements, and boost collaboration with providers, based on consultation feedback.


What will happen next? The watchdog will now ask adult social care providers for feedback on the proposed framework for the sector, through feedback tools, meetings, events and other engagement activities – leading to its ‘development and refinement.’ It also said it plans to pilot its new approach


later in the year.


How has the sector reacted to the proposed changes? There is strong support for the reintroduction of the separate frameworks and changes to the way ratings are applied, although a slightly smaller proportion backed the latter, according to the consultation summary. However, there are several risks to the


reforms’ success, such as a ‘pervasive and deeply felt’ lack of trust in the CQC among providers, the authors of the consultation summary report said. This means that ‘several strategic risks


could undermine the reforms regardless of how well individual elements are designed,’ the report added. It concluded that the response shows the


sector ‘wants CQC to succeed’ but warned it will fail if reforms are not adequately piloted, it doesn’t fix technological barriers, it ignores systemic constraints on providers out of their control such as underfunding and workforce challenges, and does not ultimately bring ‘substantive improvement.’ Care England chief executive Professor


Martin Green OBE said he welcomed “sensible steps” such as the reintroduction of separate frameworks and “clearer lines of inquiry’” but added the replacement of scoring “is a concern.”


Inspectors consistently report that care home environments are too often not designed to enable independence, orientation, and meaningful engagement for people living with dementia, the Care Quality Commission (CQC) has warned. While the benefits of outdoor environments are well recognised, many homes do not provide safe, accessible outdoor areas that people can reach independently, the watchdog told The Care Home Environment.


Homes with limited or inequitable access to safe outdoor space within environments not designed to enable independent use means outdoor space is seldom used apart from by a very small number of residents with intense staff supervision, according to the watchdog. Other common issues inspectors report include: n Lack of views and engagement with nature (this could also be from inside if done well).


n Overly large, institutional layouts, often accommodating 18–20 people together rather than smaller, more navigable and homelike units, which leads to a lack of access to quiet , calm space.


n Poor internal layouts, including long corridors, dead ends, and a lack of points of interest that support movement and engagement.


n ‘Architectural incontinence’, where toilets are not visible or easily located from living spaces or beds, reducing independence and dignity.


n Unsafe or unsuitable staircases that restrict safe movement within the building, particularly in older or converted buildings.


n Environments with excessive or poorly managed noise, increasing distress and disorientation, such as call systems, banging doors, food and cutlery preparation.


n Over-reliance on signage rather than intuitive, legible design, with insufficient use of colour, contrast, and visual cues to support wayfinding.


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