A Good rating with an Outstanding heart, standing on 2016 evidence
What CQC currently publishes about Farleigh Hospice, what the register records underneath it, how it sits against 66 rated hospice peers in England, and the one thing no outside read can see.
The 30-second read
Position
Rated Good, with Caring Outstanding, published 17 May 2024. Underneath: 30 of 33 scored statements are recorded as based on the previous rating, and the last routine inspection was December 2016.
What's changing
The six shifts from the guide you downloaded are the rules this analysis is scored against. The one with teeth here: each key question judged on its weakest statement, not the average.
The pattern
Caring sits 12th of 64 scored hospices. Safe sits 60th of 64 at 66/100 with three statements scored 2 — on the draft reading it would read Requires improvement.
The 30 minutes
Where your current evidence sits against the new statements — which no register read can show — narrowed to the first three moves.
Taken by Alexey Litvin, GreenM’s CEO. Nothing to prepare — we bring the analysis.
Overall rating
Goodpublished 17 May 2024
Caring
Outstanding95/100 · 12th of 64 hospices
Safe
66/100cohort average 75 · 60th of 64
Last routine inspection
Dec 20169.7 years ago
Carried forward
30/33
Of 33 scored statements, 30 are recorded as “based on the previous rating” — the 2024 assessment freshly examined three.
Scored 2 · safe
3 statements
Safeguarding, safe environments and infection prevention & control each carry a 2 — the level the draft descriptors read as Requires improvement.
The clock
9.7 yrs
Since the last routine inspection (6 December 2016). The draft frameworks are piloting June–October 2026, at volume.
What’s changing under that rating
CONSULTATION CLOSED 12 JUN 2026 · LIVE END-2026
The six shifts from the guide you downloaded are the rules this analysis is scored against — below is what they do to Farleigh’s own register position. The timeline is short: pilots run June–October 2026, CQC has targeted 9,000+ reports by September, and the frameworks take effect end-2026.
Outcomes over processContinuous, intelligence-ledInequalities & efficiency in scopeWorkforce up-weighted in well-ledDescriptor-led, not score-ledSector-specific KLOEs
Peer benchmark · hospices rated under the current framework
N = 67 RATED · 64 SCORED · NATIONAL
All 67 hospice services in England rated under the current framework (adult and children’s, in-patient and at-home; 64 carry area scores). A strong cohort: 24 of 67 rated Outstanding, one below Good. Farleigh ranks 36th of 64 — mid-table overall, top-quartile on Caring, bottom-five on Safe.
Ranked by overall area score (GreenM analysis of the register)
1 · Ashgate Hospice, Chesterfield
96
2 · St Margaret’s Somerset, Taunton
96
3 · Douglas Macmillan, Stoke-on-Trent
95
… 28 services between …
32 · Little Bridge House, Barnstaple
79
32 · Oakhaven Hospice, Lymington
79
… two more at 79 …
36 · Farleigh Hospice, Chelmsford
78
… three more at 78 · 25 below · floor 70 …
Five areas · Farleigh vs cohort average
Five key questions · score vs cohort
AREA SCORES PER CQC · PUBLISHED 17 MAY 2024
Key question
Score vs cohort
Farleigh
Cohort avg
Delta
Safe
66 · Good
75.0
−9.0
Effective
75 · Good
78.4
−3.4
Caring
95 · Outstanding
87.3
+7.7
Responsive
75 · Good
83.3
−8.3
Well-led
79 · Good
80.5
−1.5
Judged, not calculated — what the draft reading does to these five
WEAKEST STATEMENT GOVERNS
Under the draft frameworks each key question is judged against written descriptors, so a weak statement can no longer be averaged away. Applied to Farleigh’s own recorded statement scores, two of the five key questions would read differently:
Key question
Published
What governs it
On this reading
Safe
Good · 66
Three statements scored 2 — Safeguarding, Safe environments, Infection prevention & control — each recorded as “based on the previous rating for Safe”; 6 of 8 carried forward.
WOULD READ REQUIRES IMPROVEMENT
Caring
Outstanding · 95
Four statements at 4, but Workforce wellbeing and enablement sits at 3 — and the weakest statement, not the average, sets the band. All five carried forward.
WOULD READ GOODdown from Outstanding
Well-led
Good · 79
Holds — but the only statement above the floor is Governance at 4. Six of seven sit at 3; Environmental sustainability is unscored, and an unknown can only move a judged band down.
HOLDSmargin: one statement
Effective
Good · 75
All six statements at 3 — the Good floor. Nothing flips, nothing is spare: one statement slipping takes the key question with it. 5 of 6 carried forward.
HOLDS · NO HEADROOM
Responsive
Good · 75
All seven statements at 3, all carried forward. Same shape as Effective: on the floor, with no statement above it.
HOLDS · NO HEADROOM
Illustrative outcome under the draft frameworks — CQC has not re-assessed Farleigh Hospice under them.
Caring is above the cohort average — and still flips. The average was never the unit of judgement. That is the point of the change, and it is why a 95 built on carried-forward evidence is worth 30 minutes of attention.
Last routine inspection. The inspector’s summary records: “Some aspects of medication management were not always carried out in the safest possible way.”
20 APR 2017
That report published — 9.3 years ago.
17 MAY 2024
Current rating published: Good, Caring Outstanding; medicines management noted as improved from the last inspection. Three statements freshly examined — staffing, pathways & transitions, monitoring outcomes — the other 30 carried forward.
NOW · AUG 2026
Draft sector frameworks piloting June–October 2026; in force end of 2026. The next judgement reads the weakest statement first — and most of Farleigh’s statements were last examined in 2016.
Where rated hospices lose points
STATEMENT-LEVEL · N = 67
The cohort’s six weakest statements are five Safe statements and outcome monitoring — the territory of Farleigh’s three 2s. Nationally, among services rated below Good, well-led is below Good in 98% and safe in 95%.
Safeguardingcohort 2.96 · FH 2
Medicines optimisationcohort 2.96 · FH 3
Safe environmentscohort 2.96 · FH 2
Infection prevention & controlcohort 2.97 · FH 2
Safe & effective staffingcohort 2.99 · FH 3
Monitoring & improving outcomescohort 3.00 · FH 3
Show what inspectors typically find behind each
Safeguarding
2.96/4 cohort avg · 10% below Good · FH 2
Where this scores low, inspectors record thresholds applied inconsistently, low-level concerns not logged, lessons not cascaded.
Safe environments
2.96/4 cohort avg · 12% below Good · FH 2
The cohort’s most-failed statement: premises and equipment checks not evidenced on the day, and risk actions without a closing loop.
Infection prevention & control
2.97/4 cohort avg · 6% below Good · FH 2
Typically: audit schedules not demonstrably followed, practice varying between in-patient and community arms.
Medicines optimisation
2.96/4 cohort avg · 7% below Good · FH 3
In hospices: anticipatory prescribing, syringe-driver checks, PRN protocols and CD audit trails that exist in practice but not as connected evidence.
Safe & effective staffing
2.99/4 cohort avg · 9% below Good · FH 3
Vacancy and agency reliance are sector-wide; scores separate on whether skill-mix decisions are visible as a governed process.
Monitoring & improving outcomes
3.00/4 cohort avg · 7% below Good · FH 3
The gap inspectors name is trend, not tools: outcomes collected but not connected to visible changes in care — where the outcomes-over-process shift raises the bar.
From the inspector narrative — the 2024 report
3 STRENGTHS · 3 WATCH ITEMS
⌂ Strength
Workforce innovation, recognised nationally
The report records an innovative Virtual Clinical Nurse Specialist role and a Trainee CNS Pathway, presented at the Hospice UK conference in 2023 — and that the service “had won the Hospice UK award for innovation around workforce planning and training.”
⌂ Strength
Ward-to-Board governance, rebuilt recently
Inspectors describe a Clinical Quality report created in a 2022/23 “review of Ward to Board Governance”, with risks reviewed at Clinical Quality Group and reported by exception to the Clinical Governance Committee and Board. Governance is the only well-led statement scored 4.
⌂ Strength
Patient-led outcome measurement
IPOS is used at admission and at intervals as needs change, to monitor outcomes and identify improvement. A patient’s words, quoted in the report: “We always feel we are heard.”
⚠ Watch
Vacancy rates, recorded at the visit
The report notes the in-patient unit vacancy rate at 20% for registered nurses and 40% for healthcare assistants, with the trainee pipeline as the mitigation. Workforce moves up inside well-led under the draft frameworks.
⚠ Watch
A survey question that is not there yet
Inspectors record that “a specific question on transition of care was not included on the current service user questionnaire” — leaders said it can be added to future surveys. Small, named, and easy to close.
⚠ Watch
Three Safe statements, unexamined since 2016
Safeguarding, safe environments and IPC carry scores of 2 recorded as “based on the previous rating for Safe”. The 2024 visit did not re-open them — so the register’s current answer on each is nearly a decade old.
What this analysis can’t see
Everything above comes from the published register. What it cannot show is where Farleigh’s evidence sits today — what your safeguarding, environment and IPC records would demonstrate if re-examined this quarter, and whether the caring evidence behind the 95 still reads Outstanding against descriptors written this year. That is not a gap in your operation; it is the limit of an outside read — and it is exactly what the next assessment will test. It is what the 30 minutes are for.
What we’d work through together
SIX ITEMS · 30 MINUTES
1
The three Safe statements still scored 2 on the register
Time-sensitive
2
What stands behind the Caring Outstanding when it is judged per statement
Time-sensitive
3
The map from 33 scored statements to the new sector-specific questions
Time-sensitive
4
The Ward-to-Board framework as the spine of continuous evidence
Continuous
5
The workforce story that currently reads two ways
Continuous
6
IPOS as the proof layer for outcomes-over-process
Continuous
Show what each item turns on
1. Turns on what your current safeguarding, environment and IPC evidence shows — only your systems hold the answer that would replace a 2016-based score. 2. Turns on whether the caring evidence behind the four 4s, gathered under the old method, still reads Outstanding against this year’s descriptors — visible only from inside. 3. Turns on which systems hold which evidence, and who owns each — the guide’s “list every system, name an owner” step, made specific to Farleigh. 4. Turns on what the Clinical Quality Group packs already produce on an ordinary day, and how far that stands as continuous evidence without assembly. 5. Turns on your current vacancy, retention and skill-mix data — an award-winning pipeline and a recorded 20%/40% vacancy rate are the same story told two ways. 6. Turns on how far IPOS trends already connect to visible changes in care — the difference between collecting outcomes and evidencing them.
The next assessment reads the weakest statement first
Pilots are running now, June to October, 9,000+ reports targeted by September — and most of Farleigh’s recorded statement scores rest on 2016 evidence. GreenM are data and AI specialists: we connect the evidence your systems already hold so it reads cleanly against the new statements — inspection-ready before the inspector, not assembled the week before. In 30 minutes, the six items above narrow to the three that matter first at Farleigh.
