Prepared for Jessica Waryszniuk · Buttercup Care Limited (Pro Target Care)
CQC published your current rating on 29 June 2021, after a focused inspection that reviewed safe, effective, responsive and well-led. Caring was not inspected that year: the Good on your profile for it is carried through from the comprehensive inspection published in August 2019. The rating stands and it was earned. What has changed is the framework it will next be re-read under, and how continuously the evidence behind it is now expected to hold up.
The 30-second read
Current overall rating
GoodPublished 29 June 2021
Age of that rating
5.2 yearsInside the 6-year threshold CQC has named for adult social care, until June 2027
Key questions inspected in 2021
4 of 5Caring carried through from the 2019 report
Registration
Since May 2018Homecare agency, personal care, Hertfordshire. One location.
Since your rating was published. The median rating age across the register is 4.4 years, and 36.6% of dated ratings are already past six.
Of 1,023 homecare agencies that carried a pre-framework Good into an assessment under the current framework, 206 (20.1%) came out below Good.
Of those 206 agencies, 99% had well-led rated below Good and 94% had safe. A rating rarely moves because of the care itself.
Two published reports sit behind the Good on your profile, and they are not the same age. This is the clock your next assessment starts from.
Safe
Good
Inspected 2021
Effective
Good
Inspected 2021
Caring
Good
Carried from 2019
Responsive
Good
Inspected 2021
Well-led
Good
Inspected 2021
CQC's own report for the 2021 inspection states it: caring was not inspected, and the rating from the previous comprehensive inspection was used in calculating the overall rating. The evidence behind that one key question was gathered in May 2019, just over seven years ago.
The six shifts from the guide you downloaded are the rules this analysis is scored against, so they are not repeated here. What follows is what they do to a five-year-old Good in domiciliary care.
Two of them decide how your Good re-reads. Shift 05 removes the arithmetic: each key question is judged against a written description of what Good looks like, so a weak area is no longer averaged away by its neighbours. Shift 06 retires the 34 cross-sector quality statements and replaces them with adult social care key lines of enquiry, three to seven per key question, which means evidence currently held against the old codes has to be re-mapped before the next comprehensive assessment. Illustrative outcome under the draft frameworks: the descriptors are still in draft, and CQC has published no decision about any individual service.
Your own rating carries no statement-level scores, so there is no score of yours to place against the cohort. What can be measured is what happened to agencies in exactly your position: holding a Good from the old framework, then assessed under the new one.
Homecare agencies that held a Good under the previous framework and have since been re-rated under the current one. 206 (20.1%) came out below Good; 817 held Good or better. Among the 206 that fell, 99% had well-led below Good and 94% had safe below Good.
Share sitting below Good today. Homecare n = 2,147; all sectors n = 7,471. Homecare is the steadier end of adult social care, which is the honest reading of your sector rather than a reassuring one: the exposure here is not the grade, it is the age of the evidence behind it and the fact that well-led is where a change lands.
From the inspector narrative · 3 strengths · 3 watch items
Inspectors recorded that people "felt safe and received continuity in their care from regular, consistent staff". Continuity is among the hardest things for a domiciliary agency to evidence, and it was recorded from the people themselves.
The report notes the registered manager checked staff practice "through spot checks and working alongside staff during care visits", and that people, relatives and staff spoke highly of the manager.
Inspectors recorded quality assurance systems monitoring all aspects of the service, and a manager who "actively sought feedback from people, relatives and staff with a view to developing and improving the service".
The 2019 report recorded audits of visit notes and medicines records that "did not identify concerns", with a lack of action on key issues. The 2021 inspection found the improvements made. Under continuous monitoring this is the item most likely to be re-read, because an audit trail is now evidence in its own right.
The 2019 report recorded medicines not always given as prescribed, and records "not always completed with enough detail". By 2021 inspectors recorded medicines managed safely. Medicines records are among the first documents a domiciliary assessment reads.
The 2019 report attributed the gap in part to the registered manager also acting as a care worker and being "less able to spend time overseeing the running of the service". Workforce and leadership capacity move closer together under the draft framework's treatment of well-led.
These three closed items are most of what we would walk through live: what evidences them today, on an ordinary day, rather than in the weeks before a visit. The 30-minute walkthrough starts from them.
These are read between assessments, not at one. The line worth holding on to is the one from the guide: silence is a signal too, and a provider submitting nothing does not read as low risk. For a single-location agency the practical question is not whether the systems exist, but whether what they show on an ordinary Tuesday would answer a key line of enquiry without anyone assembling it first.
Everything above comes from public sources: your two published reports, the 2023 monitoring note, and the register itself. That is a complete picture of your published position and no picture at all of your current one. We cannot see what your care plans, medicines records, spot checks, complaints log and staff files hold today, or how much of it would answer an adult social care key line of enquiry as written rather than as it was judged in 2021. That gap is not something we are holding back. It sits genuinely outside the data, and it is what the 30 minutes is for.
The guide left you four first moves. These are your version of them, drawn from your two reports and this cohort. Each turns on something only your side can see, which is why they are topics for the call rather than tasks on a list.
Caring is the only rating on your profile carried through from 2019. What has changed in how you evidence it since then sits entirely on your side.High · before the next assessment window
The 2019 report named audits that ran without identifying concerns; the 2021 report found that closed. Whether today's audit trail evidences the finding as clearly as the fix depends on what your records look like unprompted.High · the item most exposed to continuous monitoring
Well-led is below Good in 99% of the agencies in this cohort that lost a Good from the previous framework. What your governance evidence reads as against a written descriptor is the part no external data can answer.High · the highest-leverage single exercise
Domiciliary evidence is distributed across visit notes, rotas, medicines charts and phones. Which systems hold it, and who owns each, is the second of the guide's four moves, and it is specific to how you run visits.Medium · ongoing
Continuity of staff was recorded as a strength in 2021 by the people using the service. Workforce moves into well-led under the draft framework, which turns rota and retention data into evidence rather than context.Medium · ongoing
Evidence gathered against the old structure has to answer questions written in a different one. Which of your existing material carries across untouched, and which needs re-framing, depends on what you hold.Medium · best done before the framework finalises
