The CQC single assessment framework explained

The five key questions

Every assessment still asks the same five questions of a service. They are the top level of the framework and the level at which ratings are published.

• Safe — people are protected from avoidable harm and abuse
• Effective — care, treatment and support achieve good outcomes
• Caring — people are treated with kindness, dignity and respect
• Responsive — services are organised around people's needs
• Well-led — leadership, governance and culture support good care

Quality statements replaced key lines of enquiry

Beneath each key question sit quality statements, written as commitments in the first person — 'we' statements — that describe what good looks like from the perspective of the people running the service, alongside the 'I' statements that describe what people using the service should experience. They are the standard your evidence is judged against.

• Written as plain commitments rather than inspection prompts
• Grouped under the key question they belong to
• Used consistently across health and social care sectors
• Published and maintained by CQC at cqc.org.uk

Evidence categories

CQC gathers evidence against each quality statement under defined categories, so assessment is not limited to a single site visit. Providers who only collect paperwork tend to be strong on processes and weak everywhere else.

• People's experience of health and care services
• Feedback from staff and leaders
• Feedback from partners such as commissioners and health professionals
• Observation of care and the environment
• Processes — policies, audits, records and monitoring
• Outcomes of care for the people you support

Scoring and ratings

Evidence categories are scored, the scores roll up to the quality statement and key question, and the result maps to one of the four familiar ratings: outstanding, good, requires improvement or inadequate. Assessment is continuous, so a score can change without a full re-inspection when CQC receives new information.

What this means in practice

Because assessment is ongoing and draws on several evidence categories, readiness is a monthly habit rather than a pre-inspection push. The providers who cope best keep a rolling audit programme, capture feedback from people and staff routinely, and can show what changed as a result.

• Map your audits and evidence to quality statements, not just to policies
• Collect feedback from people, relatives, staff and partners on a schedule
• Record the outcome of every action, not only that it was raised
• Keep a well-led evidence pack ready between assessments

Official source

CQC publishes the framework, the quality statements and the scoring approach on its own website, and updates them from time to time. Always check cqc.org.uk for the current wording before you rewrite internal documents.