What CQC Looks for Under the Single Assessment Framework

Practice guides · Published 16 August 2026 · Last updated 16 August 2026

The Care Quality Commission (CQC) regulates adult social care in England under the Health and Social Care Act 2008. Its single assessment framework, rolled out from late 2023, replaced the old key lines of enquiry (KLOEs) and the old model of judgement resting mainly on a site inspection every few years. Under the new framework, CQC gathers evidence on an ongoing basis, assesses against quality statements, and can update parts of its judgement without a full inspection. Site visits still happen, but they are one evidence-gathering tool among several. Details and current guidance are on cqc.org.uk.

The five key questions

The five key questions survive from the old framework and remain the backbone of ratings. For every service CQC asks whether it is:

• Safe: are people protected from abuse and avoidable harm?
• Effective: does care achieve good outcomes and reflect evidence-based practice?
• Caring: do staff treat people with kindness, dignity, compassion and respect?
• Responsive: is care organised around individual needs and preferences?
• Well-led: do leadership, governance and culture support high-quality, person-centred care?

Services are still rated outstanding, good, requires improvement or inadequate, both per key question and overall.

Quality statements: the we statements

Under each key question sits a set of quality statements, 34 in total across the framework, written as commitments from the provider's point of view, which is why they are called we statements. Examples include: we make sure there are enough qualified, skilled and experienced people to deliver safe care; we treat people as individuals; we have a proactive and positive culture of safety based on openness and honesty, in which concerns are listened to. Each quality statement replaces the old KLOEs and prompts, and links directly to the regulations underneath, chiefly the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which contain the fundamental standards such as person-centred care (Regulation 9), dignity and respect (Regulation 10), safe care and treatment (Regulation 12), safeguarding (Regulation 13), staffing (Regulation 18) and good governance (Regulation 17).

For a frontline team, the practical meaning is this: CQC is checking whether the we statements are actually true of your service. Every quality statement can be translated into a shift-level question. We involve people in decisions about their care becomes: can this resident describe how their care plan was written with them? We learn from safety events becomes: can staff describe a recent incident and what changed because of it?

The six evidence categories

For each quality statement, CQC collects evidence in defined categories:

1. People's experiences of health and care services: conversations with people using the service, families and advocates, surveys, complaints and feedback given directly to CQC.
2. Feedback from staff and leaders: interviews and conversations on site, staff surveys, and information staff send to CQC directly, including whistleblowing.
3. Feedback from partners: commissioners, local authorities, safeguarding teams, healthcare professionals who visit the service.
4. Observation: what assessors see during visits, including interactions, mealtimes, the environment and how staff support people.
5. Processes: policies, care plans, audits, rotas, training records, medication records, recruitment files and governance documents.
6. Outcomes: measurable results of care, such as pressure care outcomes, falls data or hospital admissions. Not every evidence category is used for every quality statement or service type; CQC publishes which categories apply where.

Notice how little of this is inspection-day performance. People's experiences, partner feedback and outcomes accumulate over months. A service cannot tidy its way to a rating the week before a visit, which is the point of the design.

Scoring

Evidence in each category is scored on a four-point scale, from 4 (evidence shows an exceptional standard) down to 1 (evidence shows significant shortfalls). Category scores combine into a score for each quality statement, quality statement scores build into a score for each key question, and those map onto the familiar ratings. The arithmetic matters less to frontline staff than the principle: judgements are now built from many small pieces of evidence, gathered over time, from multiple directions.

What this means on shift

• Conversations count as evidence. When an assessor asks how you protect someone's dignity during personal care, or how you would report abuse, your answer feeds a scored evidence category. Specific, honest answers about real people beat policy recitation.
• Observation counts. How you knock on doors, talk over lunch, respond to distress and speak about people in the office is evidence under the caring and safe questions.
• Records count, continuously. Care plans, MAR charts, daily notes and incident records are process evidence. They need to be right every week, not just before a visit.
• Speaking up counts. The framework explicitly values a culture where concerns are raised and acted on. Staff can also give feedback to CQC directly at any time through its website.

What managers should be doing

Registered managers should map their assurance activity to the quality statements rather than the old KLOEs: audits, surveys and governance reports organised by we statement make it straightforward to show evidence when CQC asks, including through provider information returns. Keep evidence of learning from incidents, complaints and safeguarding, because we learn, we improve is a theme running through the whole framework. And keep statutory notifications to CQC (under the 2009 registration regulations) accurate and prompt, since gaps there undermine the well-led picture fast.

Dos and don'ts

Dos

• Learn the five key questions and be able to connect your daily work to them.
• Read the quality statements for adult social care and turn each into a question about your own service.
• Give assessors specific, truthful examples about real people and real incidents.
• Keep care plans, daily records and MAR charts accurate every day, because processes are a scored evidence category.
• Treat feedback from people, families and visiting professionals as evidence you actively gather and act on.
• Raise concerns internally, and know that staff can contact CQC directly at any time.
• Record learning from incidents and complaints so improvement can be evidenced.

Don'ts

• Don't assume assessment only happens during a site visit; evidence is collected continuously.
• Don't coach staff in scripted answers; assessors triangulate what they hear against what they see and read.
• Don't ignore the observation category: everyday interactions are inspected evidence.
• Don't leave notifications, audits or action plans until an inspection is rumoured.
• Don't treat complaints and incidents as embarrassments to bury; the framework rewards visible learning.
• Don't rely on outdated KLOE-based toolkits; check current guidance on cqc.org.uk.