When talking to care home owners and managers who have achieved an ‘Outstanding’ rating from the CQC, one thing becomes clear: there’s no single secret formula. Some have achieved it through strong community connections, others by investing in staff development, and some by making small but meaningful changes to everyday care.
But while each home has its own unique approach, certain themes emerge time and again. Here’s what we found when speaking with outstanding rated care homes about what makes the difference.
1. Leadership That’s Timetabled In
In the CQC outstanding care homes we talked to, leadership isn’t just about decision-making—it’s about being present, visible, and engaged. But with the daily pressures of running a home, it’s easy for managers to get pulled into office-based tasks and crisis management, leaving little time to actively engage with residents and staff.
To avoid this, one home we spoke to has a timetabled leadership rota, where the manager and senior staff commit to dedicated time on the floor each day.
✔ One hour every morning is spent doing walk arounds, chatting to residents, checking in with staff, and spotting any small issues before they escalate.
✔ Fridays are dedicated to staff recognition, where managers personally acknowledge good work and encourage feedback.
✔ Monthly one-to-ones with carers ensure that concerns are addressed early and staff feel valued.
"If it’s not scheduled, it’s easy to let it slide," one manager told us. “But when leadership time is protected in the diary, it becomes part of the culture—not just an afterthought.”
2. Person-Centred Care in the Details
Person-centred care isn’t about grand gestures—it’s about the small details that make residents feel at home. This means going beyond clinical needs and focusing on what really matters to each individual.
One care home we spoke to found that seemingly minor details—like how residents like their cup of tea—made a huge difference. So they created a ‘Little Things list in each resident’s care plan, noting down personal preferences, from the way they like their hair brushed to their favourite radio station.
Another care home makes mealtimes more flexible—not in timing, but in choice. They introduced a ‘Visual Menu’ board, where residents can see plated examples of each meal option, making it easier for those with dementia to choose what they’d like to eat. "It’s reduced food waste and made mealtimes much more enjoyable," their manager explained.
Another home shared how they adjusted their morning routine after noticing that some residents became distressed when woken up early for personal care. Instead of a rigid schedule, they now start with those who naturally wake earlier and allow others to rest longer, significantly improving mood and well-being.
3. Strong, Supportive Staff Culture
Staff turnover is one of the biggest challenges in social care, but outstanding homes make staff satisfaction a priority—not just through wages, but through appreciation and engagement.
One home introduced a weekly staff spotlight, where one carer is nominated by their colleagues for going above and beyond. Their photo goes on a ‘Wall of Appreciation’, and they receive a small gift as a thank you.
Another home tackled staff exhaustion by introducing ‘Pause Points’—short, scheduled breaks where carers can take five minutes to sit, recharge, and chat without feeling guilty. “We used to see people skipping breaks because they felt too busy,” their manager said. “Now, we actively encourage short resets, and it’s made a big difference to morale.”
4. Engaged Families and a Welcoming Environment
Outstanding care homes don’t just support residents—they actively involve families and create an open, welcoming atmosphere.
One home set up a ‘Talk to Me’ initiative, encouraging staff and visitors to take a moment to chat with residents who don’t often have visitors. “Even if it’s just five minutes of conversation while making a cup of tea, it can brighten someone’s whole day,” their activities coordinator shared.
Another home created a ‘Family Time’ calendar, scheduling monthly themed afternoons where residents and relatives can take part in shared activities—whether it’s a 1940s singalong, a book club, or a craft session.
“It’s not just about visits,” said one care home owner. “It’s about keeping families involved in their loved one’s life in a meaningful way.”
5. Innovation and Adaptability
The care homes we talked to, do not just follow standard procedures—they are constantly looking for ways to improve. They listen to feedback, test new ideas, and adapt their approach based on what works best for residents and staff.
One home we spoke to found that residents were more engaged and active when they had a sense of purpose in their day. To support this, they introduced Resident Roles, where those who wanted to be more involved could take on small, meaningful tasks—such as folding laundry, watering plants, or setting tables for meals.
“We had one gentleman who used to run his own business and was restless with too much downtime,” their manager shared. “So we asked if he’d like to help ‘train’ new staff by telling them about the home from a resident’s perspective. It gave him a renewed sense of purpose and was invaluable for new team members.”
Another home noticed higher rates of resident anxiety in the evenings. Instead of simply increasing staffing, they introduced a ‘Twilight Comfort Hour’, where residents are offered warm drinks, soothing music, and quiet social spaces to help them unwind before bedtime. “It’s created a much calmer atmosphere at night,” the manager shared.
The Takeaway: Excellence is in the Everyday
The outstanding care homes we spoke to didn’t achieve their rating by following a formula—they got there by consistently looking for ways to improve the everyday experience for residents, staff, and families.
💡 They protect leadership time so that managers remain engaged with staff and residents.
💡 They focus on the small details that make care truly person-centred.
💡 They prioritise staff well-being because happy staff deliver better care.
💡 They foster family connections to create a true sense of community.
💡 They embrace change and test new ideas to see what works best.
For any care home aiming to improve, perhaps the best question to ask isn’t “How do we achieve Outstanding?” but rather, “How can we make each day better than the last?”
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