1. Introduction

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. It monitors, inspects and regulates services to make sure they meet fundamental standards of quality and safety.

They publish their findings, including performance ratings, in order to help people choose care. It carries out a mix of announced and unannounced inspections, which aim to get to the heart of people’s experiences.

Click here to view the Key Lines of Enquiry: Pre-Inspection Tool for Providers, which has been developed by Policy Partners Project to aid staff preparing for inspections.

2. Standards of Care

The CQC sets out what good and outstanding care looks like and it ensures services meet fundamental standards below which care must never fall. They form part of changes to the law recommended by Sir Robert Francis, following his inquiry into care at Mid Staffordshire NHS Foundation Trust.

2.1 Fundamental Standards

Below are the Fundamental Standards that all services aim to achieve. These standards form the basis of the contents structure of this Adult Policies, Procedures and Practice (APPP) resource.

  • Person centred care: care or treatment is tailored to the individual person who uses services (also known as the service user) and meets their needs and preferences.
  • Dignity and respect: all service users must be treated with dignity and respect at all times while receiving care and treatment from staff. This includes making sure they have privacy when they need and want it, everybody is treated as equals, they are given any support they need to help them remain independent and involved in their local community.
  • Consent: the service user (or anybody legally acting on their behalf) must give consent before any care or treatment is given to them.
  • Safety: service users must not be given unsafe care or treatment or be put at risk of harm that could be avoided. Staff must assess the risks to their health and safety during any care or treatment. The employer has to ensure  staff have the qualifications, competence, skills and experience to keep people who use the services safe.
  • Safeguarding from abuse: service users must not suffer any form of abuse or improper treatment while receiving care. This includes:
    • neglect;
    • degrading treatment;
    • unnecessary or disproportionate restraint;
    • inappropriate limits on their freedom.
  • Food and drink: service users must have enough to eat and drink to keep them in good health while they receive care and treatment.
  • Premises and equipment: the places where service users receive care and treatment and the equipment used must be clean, suitable and looked after properly. The equipment used in care and treatment must also be secure and used properly.
  • Complaints: service users must be able to complain about their care and treatment. The company has a system in place so they can handle and respond to a complaint. Managers must investigate it thoroughly and take action if problems are identified.
  • Good governance: The company has plans to ensure they can meet these standards specified by the CQC. It has effective governance and systems to check on the quality and safety of care. These must help the service improve and reduce any risks to the health, safety and welfare of service users.
  • Staffing: The company must have enough suitably qualified, competent and experienced staff to make sure they can meet these standards. Staff must be given the support, training and supervision they need to help them do their job.
  • Fit and proper staff: The company must only employ people who can provide care and treatment appropriate to their role. It has robust recruitment procedures in place and carries out relevant checks, such as on applicants’ criminal records and work history.
  • Duty of candour: The company must be open and transparent with service users about their care and treatment. Should something go wrong, managers must tell the service user (or their legal representative) what has happened, provide support and apologise.
  • Display of ratings: The company must display the CQC rating for each service in a place where people can see it. It must also be included on the website and also make the CQC’s latest report on their service available to service users.

Where the CQC finds poor care, it will use its powers to take action.

3. Key Lines of Enquiry

As part of the CQC’s approach to inspecting adult social care services, inspectors follow Key Lines of Enquiry (KLOEs). Click on the links to access more detailed information on the CQC website.

3.1 Is the service safe?

3.2 Is the service effective?

3.3 Is the service caring?

3.4 Is the service responsive?

3.5 Is it well-led?