The Care Quality Commission (CQC) monitors, inspects and regulates health and social care services in England to ensure they meet fundamental quality and safety standards. This article describes a review of 60 CQC inspection reports of community substance misuse services in England, to identify the topics that were evaluated negatively and were most frequently made the subject of requirement notices. Each report contains four types of statements: descriptive, evaluative, advisory and requirement notices. The evaluative and advisory statements, as well as the requirement notices, were recorded and categorised by topic, and frequency charts were constructed to show how often different topics were rated positively or negatively. The article highlights overall shortcomings of the English substance misuse treatment system and discusses possible causes, aspects of the inspection process and the potential effect of these reports on practice.