CQC vs CIW: how home care regulation differs in Wales

The short answer

The Care Quality Commission (CQC) regulates adult social care in England. Care Inspectorate Wales (CIW) regulates social care in Wales. They are separate regulators, with separate registers and separate inspection frameworks — and any agency providing regulated home care in both countries needs to be registered with both. A CQC registration does not carry across the border, and neither does a CIW one.

At a glance

The frameworks read differently

CQC inspects against five key questions — Safe, Effective, Caring, Responsive, Well-led — broken down into quality statements. The structure leads with safety and quality, and evidence is gathered against each statement.

CIW reads in a different order. Its inspections lead with Well-being: are the people using the service achieving the personal outcomes that matter to them? Care and Support, Leadership and Management, and Environment follow. The Welsh framework rests on two pieces of law — the Social Services and Well-being (Wales) Act 2014 and the Regulation and Inspection of Social Care (Wales) Act 2016 — both of which write wellbeing into the centre of what regulated care is for.

In practice this means that an agency that's strong on CQC evidence already covers most of what CIW asks for. The gap is rarely the substance of the care; it's the language used to evidence it and the explicit wellbeing-led care planning Wales expects.

Ratings, or the absence of them

CQC publishes a public rating against the five key questions and an overall rating: Outstanding, Good, Requires Improvement, Inadequate. People searching for a provider see those ratings before they see anything else.

CIW does not give star ratings. Its inspection reports describe findings against each theme and record whether the service is compliant with regulations. For a UK agency moving from England to Wales, this is often the most jarring change: the marketing language of "Good-rated by CQC" doesn't have a CIW equivalent. The substance is similar; the optics are different.

Inspections — frequency and style

CQC inspects on a risk-based cycle: a Good or Outstanding domiciliary service can go two to three years between comprehensive inspections; a service with concerns may be revisited within months. Most domiciliary inspections are announced with short notice — usually 24 to 48 hours — to allow access to people's homes and the registered manager.

CIW's working pattern includes at least one inspection per service per year for most regulated services, and a higher proportion are unannounced. Domiciliary services see a mix; unannounced visits at the office are common. The cadence is generally more frequent than CQC's equivalent.

The Welsh language: the Active Offer

One feature has no CQC equivalent: the Active Offer. Welsh services must offer care in Welsh proactively — not only on request. Care plans, communication and where possible the carer-client relationship should reflect the person's language preferences without them having to ask. CIW inspects this, and a service that has no Welsh-language provision is unlikely to be judged compliant.

For a cross-border agency, this is the biggest planning task. It's not just translating policy documents — it's recruiting, scheduling and recording in a way that gives Welsh-speaking clients the choice they're entitled to.

If you're operating in both countries

Three practical things matter:

• Two registrations, two registered managers. Each regulator wants its own registered manager and a clear line of accountability for the services in that jurisdiction.
• Two notification streams. Some events you'll need to notify both regulators of (a death of a person receiving care, a safeguarding allegation). Build a single internal trigger that splits to the right form for each regulator.
• One evidence model, two frames. Capture the same operational evidence — care plans, MAR charts, training records, complaints — and present it in the language each regulator uses. Digital records that can be filtered and exported by jurisdiction save the office a lot of time.

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