Quick links
- The Single Assessment Framework: What does the future hold?
- What is the CQC Single Assessment Framework?
- How SAF differs from previous CQC inspections
- The 5 key questions and quality statements explained
- Understanding the 6 evidence categories
- Complete evidence requirements by key question
- Well-Led – evidence requirements
- How to implement I and we statements in care plans
- Writing care plans for people who cannot communicate
- How to prepare your service for CQC assessment
- What to expect during your CQC assessment
- Understanding your CQC rating
- How ratings are calculated under SAF
- How to challenge your rating
- Key challenges and how to address them
- Frequently asked questions
The Care Quality Commission (CQC) Single Assessment Framework is the unified approach the CQC uses to regulate and inspect health and social care services in England. Introduced in late 2023, it sets out how quality is assessed using a consistent, evidence-led structure. It applies directly to home care and domiciliary care providers, defining how the CQC evaluates safety, effectiveness, leadership and the overall quality of care delivered in people’s homes.
A key benefit of the framework is its shift toward continuous assessment rather than periodic inspections. Instead of relying on one-off visits, the CQC collects evidence from multiple sources throughout the year, allowing ratings to be updated more frequently. This ensures a more accurate, current reflection of each provider’s quality of care.
For home care providers, understanding how the framework works and how to evidence compliance day-to-day, is crucial. This merged guide brings together everything you need to know about preparing for assessment: the five key questions, the quality statements, what evidence is required and how to organise it across the six evidence categories.
You’ll also learn how to implement the ‘I’ and ‘We’ statements, how to get your service assessment-ready and how platforms like CareLineLive can help you manage compliance, streamline documentation and maintain inspection-ready evidence at all times.
The Single Assessment Framework: What does the future hold?
The Single Assessment Framework has struggled to gain traction, as both providers and CQC staff have grown increasingly frustrated by its complexity and the introduction of new IT systems that are not fit for purpose. As a result, the project has largely failed to deliver on its aims.
In response, providers are now being encouraged to work more closely with the CQC. A new consultation on how services should be assessed, inspected and rated completed in December 2025.
There appears to be a genuine commitment from the CQC to create a framework that achieves alignment between providers and the regulator. The focus is on ensuring clarity, consistency, and sector-specific relevance, with the ultimate goal of establishing an approach that serves both the public and service providers effectively
What is the CQC Single Assessment Framework?
Definition and core purpose
The CQC Single Assessment Framework (SAF) is the Care Quality Commission’s unified model for assessing the quality of all regulated health and social care services in England. Its core purpose is to bring consistency, transparency and continuous evaluation to how the CQC monitors, inspects and rates providers, including home care services.
When it was introduced
The Single Assessment Framework was formally introduced in November 2023, with phased roll-out across all regions during late 2023 and early 2024.
What it replaced
SAF replaces the previous Key Lines of Enquiry (KLOEs) framework, prompts and ratings system that had been in place for nearly a decade.
Why the CQC changed the system
The CQC introduced the Single Assessment Framework to:
- Provide more frequent, up-to-date ratings – the old inspection cycle often left ratings unchanged for years
- Create a single, consistent structure across all service types – KLOEs varied by sector, making comparisons and expectations unclear
- Make regulation more evidence-led and dynamic – enabling inspectors to gather information continuously, not just during in-person visits
How SAF differs from previous CQC inspections
Under the previous system, the CQC relied heavily on scheduled inspections to form ratings, supported by the broad KLOE categories. The Single Assessment Framework replaced this with a modular, evidence-driven approach:
- Continuous monitoring instead of periodic inspections
- Quality statements replacing KLOEs
- Defined six evidence categories applied consistently across all services
- Use of “I” and “We” statements to focus on lived experience and culture
- Ratings updated more often based on cumulative evidence
The 5 key questions and quality statements explained
The five key questions CQC asks
CQC evaluates all services using 5 Key Questions. These questions remained unchanged from the previous system but are now answered through quality statements rather than Key Lines of Enquiry (KLOEs).
- Safe – Are people protected from abuse and avoidable harm?
- Effective – Do people’s care, treatment and support achieve good outcomes?
- Caring – Are people treated with compassion, dignity and respect?
- Responsive – Are services organized to meet people’s needs?
- Well-led – Is there effective leadership and governance?
Effective care documentation can support this – see how CareLineLive’s digital care plans help providers demonstrate person-centred practice
What are quality statements?
Quality Statements represent the essential commitments that providers, commissioners and system leaders are expected to uphold. These statements, articulated as ‘we statements’, outline the necessary actions to ensure the provision of high quality, person-centred care.
The use of ‘I statements’ aligns with the expectations of individuals and is rooted in the Think Local Act Personal, ‘Making It Real’ framework.
Understanding the 6 evidence categories
There are differences in the evidence categories examined by CQC within sector groups. This tailors the assessment framework by choosing distinct evidence categories across sectors.
The number of evidence categories that CQC needs to consider depends on the type or model of service, the level of assessment and whether the assessment concerns an existing service or new registration.
The six evidence categories explained
- People’s experience of health and care services
- Feedback from staff and leaders
- Feedback from partners
- Observation
- Processes
- Outcomes
Complete evidence requirements by key question
Home care providers must maintain specific evidence for each quality statement under the 5 key questions. Below is the complete evidence checklist organized by key question, showing exactly what CQC will request during assessment.
Safe – evidence requirements
Learning culture
Processes required:
- Duty of candour documentation
- Evidence of learning and improvement
- Incident, near misses and events records
Safe systems, pathways and transitions
Feedback from partners:
- Commissioners and other system partners
- Health and care professionals working in or with the service
Processes:
- People’s care records or clinical records
- Records of referral, transfer and transition of care
Safeguarding
Processes:
- Deprivation of Liberty Standards (DoLS) and Court of Protection (POA) records
- Mental Capacity Act records and training
- People’s care records or clinical records
- Safeguarding policy, records and training
Involving people to manage risk
Processes:
- Arrangements to respond to emergencies
- Arrangements to identify people in need of urgent medical treatment
- DoLS and Court of Protection records
- People’s care records or clinical records
- Records of restrictive practice
Safe environments
Processes:
- Business continuity plans (including response to extreme weather events)
- Environmental risk assessments
- Equipment maintenance and calibration records
- Health and safety risk assessments
- Infection prevention and control audit and action plans
Safe and effective staffing
Evidence required:
- Appraisal and supervision records
- Recruitment records
- Staff vacancy and turnover rates
- Staffing and staff skill mix records
- Training in communication with people with learning disabilities and autistic people
- Training, development and competency records
Infection prevention and control
Processes:
- Infection prevention and control policy
- Action on any National Patient Safety and Central Alerting System (CAS) alerts relating to IPC
- Evidence of minimising infection risk
Medicines optimisation
Processes:
- Administering and dispensing medicines procedures
- Medicines audits and action plans
- Medicines reviews
- PRN protocols
- People’s care records or clinical records
- Number prescribed medicine not having medicines review with GP in past 12 months
Effective – evidence requirements
Processes:
- Up-to-date care plans showing needs, outcomes and reviews
- Risk assessments aligned to current health conditions
- Clinical governance records (where applicable)
- Evidence of adherence to NICE guidance, best practice, or sector standards
- Documentation showing care reviews after hospital discharge
- Records showing continuity and consistency of staff
Outcomes:
- Demonstrable improvements in people’s health, wellbeing and independence
- Reduction in avoidable deterioration
- Evidence of progress toward agreed care outcomes
Assessing needs and working with other professionals
Feedback from partners:
- Notes from GPs, district nurses and allied health professionals
- Email correspondence or MDT meeting notes
- Feedback evidencing joint working to plan or adjust care
Processes:
- Assessment forms for new packages of care
- Pre-admission/initial needs assessments
- Record of input from external professionals
Staff Skills, competence and training
Processes:
- Training matrix and certificates
- Clinical competency assessments (catheter care, PEG feeds, medication where relevant)
- Shadowing records and induction checklists
- Supervision and appraisal documents showing reflective practice
Outcomes:
- Staff competency improving the quality of care delivered
Nutrition and hydration (where relevant)
Processes:
- Care plans for nutrition and hydration
- Monitoring charts (fluid intake, weight monitoring)
- Referrals to dietitians or SALT (speech and language therapy)
Caring – evidence requirements
People’s experience:
- Testimonials from people and families
- Complaints/compliments data
- Survey results showing people feel respected and listened to
Observation (where possible):
- Notes from spot checks and quality monitoring visits
- Senior staff observations of care interactions
Processes:
- Dignity and respect policy
- Care plans detailing personal preferences (e.g., “what matters to me”)
- Records showing advocacy involvement where needed
Promoting autonomy, choice and independence
Processes:
- Decision-making records demonstrating choice
- Mental Capacity Act assessments and best-interest decisions
- Care plans documenting people’s preferences, routines and independence goals
Outcomes:
- Evidence that people maintain or regain independence
- Reduction in reliance on supports due to reablement approaches
Building trusting relationships
Feedback from staff and partners:
- Evidence that staff know each person well
- Feedback from external professionals regarding compassion and responsiveness
Processes:
- Continuity of care rotas
- Communication logs with families and carers
Responsive – evidence requirements
Meeting people’s needs and personal preferences
Processes:
- Person-centred care plans
- Cultural, religious and personal preference documentation
- Records showing timely adjustments to care plans
People’s experience:
- Feedback confirming flexible, tailored support
- Complaints resolved quickly with evidence of follow-up
Timely access and continual review of care
Processes:
- Rostering records demonstrating punctuality and reliability
- Logs showing missed/late visits and corrective actions
- Records of care plan reviews, reassessments and changes
Feedback from partners:
- External professionals confirming timely communication
Concerns and complaints handling
Processes:
- Complaints policy and logs
- Evidence of learning and changes made following complaints
- Records showing transparent communication with people and families
Outcomes:
- Reduced repeat complaints
- Improved service responsiveness over time
Supporting people at end of life (where applicable)
Processes:
- End-of-life care plans
- Coordination with hospice, palliative teams or GPs
- Advanced care planning documentation
Well-Led – evidence requirements
Leadership, governance and culture
Processes:
- Governance framework, policies and meeting minutes
- Quality assurance audits and action plans
- Business continuity plans and risk registers
- Vision and values communicated across the service
Feedback from staff:
- Staff surveys, exit interviews and whistleblowing data
- Evidence staff feel supported, valued and safe raising concerns
Continuous learning and improvement
Processes:
- Quality improvement plans (QIPs)
- Lessons learned logs
- Incident and near-miss analysis showing themes and actions
- Records showing impact of improvement initiatives
Outcomes:
- Measurable improvements in care quality or safety
- Reduction in repeated issues (e.g., medication errors, missed visits)
Staff engagement, development and communication
Processes:
- Supervision, appraisal and training frameworks
- Team meeting notes and communication logs
- Workforce planning documentation
- Recruitment and retention strategy
Feedback from staff:
- Staff feedback evidencing inclusion, communication and leadership support
Partnership working and external accountability
Feedback from partners:
- Commissioner feedback
- MDT notes and professional correspondence
- Evidence of regulatory communication (notifications, updates, responses)
Regulatory compliance and oversight
Processes:
- PIR submissions
- Notifications to CQC (safeguarding, DoLS, deaths, incidents)
- Internal audits matched to quality statements
- Data security, GDPR and DSCR compliance records
How to implement I and we statements in care plans
In care planning
The ‘I’ statements work very well in conjunction with the Fundamental Standards and can be integrated into the care plan.
Providers should delve deep into their About Me assessments which will give information to act upon what is intrinsically important to a person.
What are ‘I’ statements?
Example ‘I’ statements for feedback questions:
- I can live the life I want and do the things that are important to me as independently as possible
- I am treated with respect and dignity
- I feel safe and am supported to understand and manage any risks
- I am supported to manage my health in a way that makes sense to me
- I have people in my life who care about me – family, friends and people in my community
What are ‘we’ statements?
“We” statements describe what the service and its staff must do to meet each quality statement. They translate the CQC’s expectations into clear, observable behaviours and organisational practices.
They answer the question: “What does good care look like from the provider’s side?”
These statements should be built into:
- Care planning
- Staff training
- Supervision
- Policies and procedures
- Quality assurance activities
Example ‘We’ statements:
- We make sure people are treated with dignity and respect in everything we do.
- We involve people in decisions about their care, supporting choice and control wherever possible.
- We ensure our staff have the right training, skills and support to provide safe and effective care.
- We learn from feedback, incidents and complaints and use this to continually improve our service.
- We work openly and honestly with people, families and professionals, sharing information in a timely and transparent way.
- We partner with external professionals to ensure coordinated, integrated support for people using our service.
- We create a positive culture where staff feel valued, listened to and able to raise concerns without fear.
Writing care plans for people who cannot communicate
When a client is unable to communicate preferences and needs, care plans should still be as person-centred as possible.
There may be an advanced care plan in place or the client may have given authority through Lasting Power of Attorney or a person appointed by the Court of Protection will be the decision maker.
How to prepare your service for CQC assessment
Preparing for CQC assessment under the Single Assessment Framework requires organising evidence across 6 categories, training staff on quality statements and ensuring your systems can produce documentation quickly.
Start preparation 3-6 months before expected assessment.
Steps to prepare for your assessment
Before your assessment
Make sure that all of your registered details and contact information are correct and up-to-date.
Evidence collection strategy
Collecting evidence of good practice helps you evaluate and improve your service. Being open, honest and transparent is essential, including highlighting areas of complaint and negative feedback and how they have been managed.
Be methodical and dedicated
Devote time and commitment to evidence collection. Dedicate a window of time for evidence management that suits your business and available resources.
Appoint a dedicated member of staff to champion evidence collection.
Your champion can be creative in ways of collecting evidence through surveys, quality assurance questionnaires, regular reviews and actively encouraging feedback from all stakeholders.
Consider the whole circle of care
Focus on the service user, their families, friends, advocates and unpaid carers. Meet the needs of those with protected equality characteristics and those likely to have poorer experiences or experience inequalities.
Storing evidence
Create evidence folders for your clients and carers. If you’re a CareLineLive customer, use the client or carer journal feature and create categories for each key question.
Add subfolders for each quality statement and evidence category to highlight strengths and areas for improvement.
What to expect during your CQC assessment
CQC assessments under the Single Assessment Framework may not include a site visit. CQC determines assessment methods based on your service type, history and current evidence.
Understanding the 4 possible assessment approaches helps you prepare effectively.
Evidence CQC typically requests
CQC draws from evidence across its six evidence categories. Below is a streamlined checklist of what home care providers are most often asked to supply during assessment.
People’s experience
- Feedback from people using the service
- Complaints and compliments
- Evidence of
Staff and leadership feedback
- Staff survey feedback
- Supervision and appraisal notes
- Training matrix and competency records
Feedback from partners
- Communications with GPs, district nurses and commissioners
- MDT notes or professional correspondence
Processes (core documents and records)
- Care plans and risk assessments
- Medication records and medicines audit results
- Incident, accident and safeguarding logs
- Recruitment, DBS and induction documentation
- Policies: safeguarding, infection control, medicines, complaints
- Rostering data showing continuity and punctuality
- Notifications submitted to CQC
Governance and improvement
- Internal audits and action plans
- Quality improvement plans
- Business continuity documentation
Outcomes
- KPIs such as missed visits, medication errors, etc.
- Evidence of measurable improvement or maintained quality
Understanding your CQC rating
CQC assigns ratings at two levels: overall service rating and ratings for each of the 5 key questions.
Each rating reflects quality across multiple quality statements.
Where appropriate, CQC will continue to describe the quality of care using four ratings:
- Outstanding
- Good
- Requires improvement
- Inadequate
How ratings are calculated under SAF
Under the Single Assessment Framework, CQC ratings are built from the ground up. Instead of relying mainly on inspections, ratings now come from continuous evidence gathered across quality statements, the 5 Key Questions and the overall performance of the service.
Here’s how the calculation works:
- Evidence is reviewed for each quality statement
CQC collects and reviews evidence from the six evidence categories: people’s experience, staff feedback, partner feedback, observation, processes and outcomes.
Each quality statement is judged as being fully met, partially met, or not met. - Each of the 5 key questions is rated
Evidence from the relevant quality statements is then combined to determine a rating for each Key Question:
Safe, Effective, Caring, Responsive, Well-Led.
This is professional-judgement-based and considers:- The strength of evidence
- Any risks or concerns
- Whether issues are isolated or systemic
- Whether the provider has taken action to improve
- Some issues carry more weight than others
A serious concern in medication, safeguarding or leadership can lower the Key Question rating – even if other areas look strong.
Safe and Well-Led are particularly influential in the overall rating. - Key Question ratings combine into an overall rating
The overall service rating is not an average. Inspectors consider:- How many Key Questions are Good or Outstanding
- Whether any are Requires Improvement or Inadequate
- The seriousness and impact of concerns
- Evidence of good governance or lack of it
A single Inadequate in Safe or Well-Led can significantly reduce the overall rating.
- Ratings can change more frequently
Because the SAF uses continuous assessment, ratings can be updated whenever new evidence becomes available – not just after an inspection.
Improvements can be recognised sooner and concerns can trigger earlier reassessment.
How to challenge your rating
If you believe your CQC rating is unfair or based on incorrect information, there is a clear process you can follow to challenge it.
Act quickly – tight timescales apply once you receive your draft report.
- Read the draft report carefully
Go through every section of the draft report and check it against your own records, policies and evidence.
Highlight anything that is factually incorrect, missing key context, or not supported by the evidence you hold. - Use the factual accuracy check
CQC gives you a limited window (usually 10 working days) to submit a factual accuracy check.
In your response:- Clearly reference the specific paragraph or section
- Explain why it is inaccurate or misleading
- Attach supporting evidence (policies, records, emails, data, etc.)
- Suggest corrected wording if appropriate
- Challenge the rating if the evidence doesn’t support it
If you believe the rating doesn’t fairly reflect the evidence (for example, concerns are overstated, improvements not considered, or strengths ignored), set this out clearly in your factual accuracy response. Link your argument to:- Specific quality statements
- The evidence you supplied
- How the judgement doesn’t align with CQC’s own rating characteristics
- Keep a clear audit trail
Keep copies of:- Your draft report
- Your factual accuracy submission
- All supporting evidence
- CQC’s response
This is vital if you later decide to use CQC’s complaints process or seek legal advice.
- Use the complaints process if needed
If you’re still unhappy after the factual accuracy outcome, you can make a formal complaint to CQC. Focus on:- Process issues (e.g. evidence not considered, bias, failure to follow procedure)
- Clear, specific examples rather than general dissatisfaction
- Focus on improvement in parallel
Challenging a rating doesn’t stop you from improving. In fact, you should:- Create an action plan for each area of concern
- Record improvements and outcomes
- Be ready to present updated evidence if CQC returns or reviews your rating
This dual track – challenge where appropriate, improve regardless – gives you the best chance of securing a fair rating and demonstrating strong, responsive leadership.
Key challenges and how to address them
The Care Provider Alliance (CPA) launched a review of the Single Assessment Framework commissioned by CQC, gathering insights from social care providers.
The review identified several critical issues:
The 9 main provider challenges (according to CPA review)
- Overlapping quality statements
The quality statements are excessive and often overlap, making the guidance intended to support them unclear and insufficiently tailored to the specific type of service being evaluated - Administrative burden
Preparing for assessments and conducting self-assessments within services can impose a considerable administrative burden and is open to individual interpretations of quality statements - Uncertainty about standards
Concerns have emerged regarding providers’ uncertainty about inspectors’ interpretations of what ‘good’ looks like - Flexible application issues
The flexible application of a sample of quality statements during assessments can lead to missed critical information during inspections - Provider distress
Providers assessed under the SAF have reported feelings of disorientation and distress which have also affected staff retention - Challenging outcomes
The process of challenging assessment outcomes has proven to be a complex, time-consuming and frustrating administrative endeavour, often resulting in minimal to no satisfactory resolutions for providers - Inspector knowledge
Inspectors do not always have sufficient knowledge of a wide diversity of service types - Report quality
Reports frequently lack clarity, accuracy and timeliness resulting in ratings that fail to provide meaningful insights to the public - Communication challenges
Effective communication with the CQC has become increasingly challenging for providers. There is often no dependable pathway through online systems and providers frequently receive little to no acknowledgment or feedback
Frequently asked questions
How long after PIR submission does inspection usually take place?
CQC are not currently giving timeframes for this.
What are the timeframes for inspection of new services?
There are no timeframes published currently.
You will receive an email asking you to register. Currently, only nominated individuals and registered managers can create an account.
CQC state that registering on the portal will not affect your existing registration.
Additional resources
From CQC:
- CQC Single Assessment Framework guidance
- Provider portal access
- Quality statement details
- Evidence category specifications
From CareLineLive:
- Detailed quality statement series (Safe, Effective, Caring, Responsive, Well-led)
- Webinar on the Single Assessment Framework
- Regular blog updates on regulatory changes
- Compliance section resources
