In a previous Gallagher article, ‘What is the Care Quality Commission (CQC)?’, we explored the role of the CQC in assessing and rating care providers.
This guide provides further insight into the specific set of standards CQC inspectors use to help them form their evaluation of a service. These standards exist to help ensure care providers deliver consistent, high-quality care for their service users.
In this guide, we cover:
- What are the 5 CQC standards?
- How does the CQC use the 5 standards in their inspections?
- What are the 13 fundamental standards in the CQC framework?
- What types of organisations does the CQC inspect?
- How to meet CQC standards
What are the 5 CQC standards?
When the CQC carries out an inspection of a health or social care service, there are five key elements the inspector will consider when gathering their evidence. These are often referred to by more than one name—including the CQC 5 standards, the CQC 5 domains and the 5 CQC questions—but this is purely a case of different terminology used to present the same information.
The five questions the inspector will look to answer can be summed up as:
1. It is safe?
Are service users, staff and visitors protected from abuse and avoidable harm?
2. Is it effective?
Is the care, treatment and support offered achieving a good outcome? Does it help service users maintain a certain quality of life?
3. Is it caring?
Do the staff treat service users with kindness, compassion and dignity? Does the care facility as a whole have a caring culture?
4. Is it responsive?
Does the service effectively meet the servicer users’ needs? Can services be adapted if needs change?
5. Is it well-led?
Does the management ensure the care facility is providing high-quality, person-centred care?
How does the CQC use the 5 standards in their inspections?
Each of the five questions or standards is subdivided into constituent parts to help the inspector assess a care service. These are known as key lines of enquiry (KLoEs). Before an inspector visits a care facility, they will select which KLoEs they intend to use for the inspection. Each KLoE will have corresponding prompts/questions for the inspector to use, along with a list of potential sources of evidence to help form their decisions.
Examples of the KLoEs are outlined below.
Safe
- How do systems, processes and practices safeguard people from abuse?
- How are risks to people assessed and their safety monitored and managed?
- How does the service make sure that there are sufficient numbers of suitable staff?
- How does the provider ensure the proper and safe use of medicines?
- How well are people protected by the prevention and control of infection?
- Are lessons learned and improvements made when things go wrong?
Effective
- Are people’s needs and choices assessed and care, treatment and support delivered in line with current legislation, standards and evidence-based guidance?
- How does the service make sure that staff have the skills, knowledge and experience to deliver effective care and support?
- How are people supported to eat and drink enough to maintain a balanced diet?
- How well do staff, teams and services within and across organisations work together to deliver effective care?
- How are people supported to live healthier lives, have access to healthcare services and receive ongoing healthcare support?
Caring
- How does the service ensure that people are treated with kindness, respect and compassion?
- How does the service support people to be actively involved in making decisions about their care, support and treatment as far as possible?
- How are people’s privacy, dignity and independence respected and promoted?
Responsive
- How do people receive personalised care that is responsive to their needs?
- How are people’s concerns and complaints listened and responded to?
- How are people supported at the end of their life to have a comfortable, dignified and pain-free death?
Well-led
- Is there a clear vision and credible strategy to deliver high-quality care and support?
- Does the governance framework ensure that responsibilities are clear and that quality performance, risks and regulatory requirements are understood and managed?
- How are service users, the public and staff engaged and involved?
- How does the service continuously learn and improve?
- How does the service work in partnership with other agencies?
Source: Key lines of enquiry for adult social care services - Care Quality Commission (cqc.org.uk)
What are the 13 fundamental standards in the CQC framework?
The five CQC standards were formed out of the 13 CQC fundamental standards which preceded them. These are the minimum requirements a care provider needs to meet when providing care in England and form part of The Health and Social Care Act 2008 established by the CQC.
They are listed as:
- Person-centred care
- Dignity and respect
- Consent
- Safety
- Safeguarding from abuse
- Food and drink
- Premises and equipment
- Complaints
- Good governance
- Staffing
- Fit and proper staff
- Duty of candour
- Display of ratings
These standards are explained further on the CQC website, however, the five CQC standards cover all of these aspects and are currently the official guidelines inspectors use to assess a service.
What types of organisations does the CQC inspect?
The CQC monitors, inspects and regulates any service that provides health and social care, including:
- Care homes
- Domiciliary care agencies
- Hospices
- Hospitals
- GPs and clinics
- Ambulance services
- Mental health services
- Dental practices
How to meet CQC standards
To help meet CQC standards, it is important to demonstrate the following:
- A clean, tidy and safe environment
- Adequate risk assessments that are revisited regularly
- An experienced and qualified team with the relevant checks, e.g. DBS
- Sufficient staffing numbers, staff supervision and training
- A compliant reporting procedure
- Adequate insurance
You can read more about how the CQC rates healthcare facilities in our guide to the CQC. For specialist advice on care insurance, please get in touch with our team.
