A guide to the CQC’s quality statements

The big news for 2022 is the Care Quality Commission’s quality statement announcement in July 2022 of its new approach to regulation. It ushers in major changes to the way the CQC works in order to deliver its ambitious new strategy (revealed May 2021). One of the biggest changes ushered through is the introduction of quality statements that replace the key lines of enquiry – the prompts the CQC use to investigate services in line with the five key questions.

In December 2022 the CQC announced that based on the feedback on its phased approach to rolling out changes, it needed to do more testing before extending them to other services. It is expected that by the end of 2023, the new assessment framework will start to be used.

What are the CQC’s quality statements?

Quality statements are the commitments that providers, commissioners and system leaders should live up to. Expressed as ‘we statements’, they show what is needed to deliver high-quality, person-centred care. The quality statements replace the CQC’s key lines of enquiry.

The quality statements show how services and providers need to work together to plan and deliver high-quality care.

Each key question- safe, effective, caring, responsive and well-led has a number of quality statements that the CQC will use to assess quality within a service.

What evidence is used to support the quality statements?

Six evidence categories are used to show the types of evidence the CQC uses to understand the quality of care being delivered against a quality statement.

They are:

  • People’s experiences.
  • Feedback from staff and leaders.
  • Observations of care.
  • Feedback from partners.
  • Processes.
  • Outcomes of care.

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Safe: quality statements used to assess care

  • Learning culture
    We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.
  • Safe systems, pathways and transitions
    We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.
  • Safeguarding
    We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We make sure we share concerns quickly and appropriately.
  • Involving people to manage risks
    We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.
  • Safe environments
    We detect and control potential risks in the care environment. We make sure that the equipment, facilities and technology support the delivery of safe care.
  • Safe and effective staffing
    We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development. They work together effectively to provide safe care that meets people’s individual needs.
  • Infection prevention and control
    We assess and manage the risk of infection. We detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.
  • Medicines optimisation
    We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

Effective: quality statements used to assess care

  • Assessing needs
    We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.
  • Delivering evidence-based care and treatment
    We plan and deliver people’s care and treatment with them, including what is important and matters to them. We do this in line with legislation and current evidence-based good practice and standards.
  • How staff, teams and services work together
    We work effectively across teams and services to support people. We make sure they only need to tell their story once by sharing their assessment of needs when they move between different services.
  • Supporting people to live healthier lives
    We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce their future needs for care and support.
  • Monitoring and improving outcomes
    We routinely monitor people’s care and treatment to continuously improve it. We ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.
  • Consent to care and treatment
    We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

Caring: quality statements used to assess care

  • Kindness, compassion and dignity
    We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.
  • Treating people as individuals
    We treat people as individuals and make sure their care, support and treatment meets their needs and preferences. We take account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.
  • Independence, choice and control
    We promote people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing.
  • Responding to people’s immediate needs
    We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.
  • Workforce wellbeing and enablement
    We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

Responsive: quality statements used to assess care

  • Person-centred care
    We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.
  • Care provision, integration, and continuity
    We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.
  • Providing information
    We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.
  • Listening to and involving people
    We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.
  • Equity in access
    We make sure that everyone can access the care, support and treatment they need when they need it.
  • Equity in experiences and outcomes
    We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this. 
  • Planning for the future
    We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Well-led: quality statements used to assess care

  • Shared direction and culture
    We have a shared vision, strategy and culture. This is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and our communities in order to meet these.
  • Capable, compassionate and inclusive leaders
    We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively. They do so with integrity, openness and honesty.
  • Freedom to speak up
    We foster a positive culture where people feel that they can speak up and that their voice will be heard.
  • Workforce equality, diversity and inclusion
    We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.
  • Governance, management and sustainability
    We have clear responsibilities, roles, systems of accountability and good governance. We use these to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.
  • Partnerships and communities
    We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.
  • Learning, improvement and innovation
    We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.
  • Environmental sustainability – sustainable development
    We understand any negative impact of our activities on the environment and we strive to make a positive contribution in reducing it and support people to do the same.

Want to know more about remote CQC inspections? Head over to our comprehensive remote inspection topic page.