The 5 Key Questions
CQC inspectors assess care services against five key questions. Each question represents a fundamental area of quality that every care home must demonstrate.
The five key questionscome from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Inspectors evaluate each question and award a rating of Outstanding, Good, Requires Improvement, or Inadequate for each one, as well as an overall rating. The five questions must all be “Good” or above for a service to receive an overall Good rating.
Is the service Safe?
People are protected from abuse and avoidable harm. Safeguarding systems are in place, risks are assessed and managed, and staffing is sufficient to keep people safe.
Key areas inspectors assess:
- Safeguarding and protection from abuse
- Staffing levels and skill mix
- Medicines management and safety
- Assessment and management of risk
- Learning from safety incidents
- Safe recruitment practices
- Premises and equipment safety
Is the service Effective?
People's care, treatment and support achieves good outcomes, promotes a good quality of life, and is based on the best available evidence. Staff are competent and work within their scope of practice.
Key areas inspectors assess:
- Assessment of needs and choices
- Delivery of evidence-based care and treatment
- Staff competence, training, and development
- Consent to care and treatment
- Nutrition and hydration needs met
- Physical, mental, and emotional wellbeing outcomes
- Cooperation with other providers and professionals
Is the service Caring?
People are treated with kindness, dignity, and respect. Staff involve people in decisions about their care and ensure their preferences and needs are understood and met.
Key areas inspectors assess:
- Kindness, compassion, and dignity
- Treating people as individuals
- Respecting people's independence and privacy
- Involving people in decisions about their care
- Emotional support and wellbeing
- Listening to and acting on people's views
Is the service Responsive?
Services are organised so that they meet people's needs. Care is personalised, people's preferences and choices are respected, and services adapt to changing needs.
Key areas inspectors assess:
- Personalised care and support planning
- Responding to people's changing needs
- Access to care and support when needed
- End of life care and palliative support
- Complaints handling and learning from feedback
- Equality, diversity, and human rights
Is the service Well-led?
Leadership, management, and governance assure the delivery of high-quality, person-centred care. There is a clear vision and strategy, an open and fair culture, and continuous learning and improvement.
Key areas inspectors assess:
- Clear vision and strategy
- Open, inclusive, and fair culture
- Governance and accountability systems
- Continuous learning and improvement
- Engaging with people who use services
- Working in partnership with stakeholders
- Leadership and management capability
Understanding the Ratings
After an inspection, the CQC rates each of the five key questions and gives an overall rating. A service can be rated Outstanding, Good, Requires Improvement, or Inadequate. For more details, see our page on Inspection Process & Ratings.