Understanding the New CQC Inspection Framework: What Every Health and Social Care Provider Needs to Know

The Care Quality Commission (CQC) has begun one of its most significant transformations in recent years — changing how it inspects and assesses health and social care providers across England.

These changes affect all registered services, including primary care, hospitals, community health, care homes, and domiciliary care. Whether you’re a small independent provider or part of a large organisation, understanding the new framework is essential to staying compliant and confident.

Why Has the CQC Changed Its Approach?

The CQC’s previous model focused heavily on periodic inspections that provided a snapshot of quality at a single point in time. While effective in some areas, this approach often struggled to keep pace with rapidly changing services.

The new framework aims to be:

  • More dynamic – using ongoing evidence to build a continuous picture of quality

  • More consistent – applying a single set of standards across all types of health and social care

  • More transparent – helping providers and the public better understand how judgements are made

  • More responsive to risk – enabling quicker action when concerns are identified

The Move to a Single Assessment Framework (SAF)

The biggest change is the introduction of the Single Assessment Framework (SAF), which replaces the previous sector-specific frameworks.

Under SAF, providers will be assessed against Quality Statements, which describe what good care looks like in plain language. These replace the older Key Lines of Enquiry (KLOEs), prompts, and ratings characteristics.

For example, a Quality Statement might say:

“We involve people in decisions about their care in a way that meets their needs and preferences.”

This shift is designed to make expectations clearer and more meaningful to both staff and people who use services.

Six Categories of Evidence

To assess providers, the CQC will draw on six categories of evidence:

  1. People’s experience of care

  2. Feedback from staff and leaders

  3. Feedback from partners

  4. Observation

  5. Processes

  6. Outcomes

Not every category will apply to every service, but understanding how your organisation can evidence each of these is crucial.

How Ratings Will Be Determined

The familiar four ratings — Outstanding, Good, Requires Improvement, and Inadequate — remain in place.

However, the way these ratings are reached is changing. Instead of relying solely on inspection findings, the CQC will continuously collect and review evidence to update assessments over time. Ratings can therefore be changed without a full inspection if significant new evidence emerges.

This new approach aims to make ratings a more accurate reflection of the service at any given moment.

Continuous Assessment Instead of Snapshot Inspections

One of the most significant shifts is moving away from inspections as the main driver of ratings. Instead, the CQC will use routine data collection, ongoing feedback, digital evidence submissions, and targeted inspections when needed.

This means providers should be ready to demonstrate quality at any time, not just in preparation for an inspection visit.

Digital Provider Portal

The CQC is rolling out a new digital provider portal to make it easier to submit evidence, review information, and communicate with inspectors.

While the portal has experienced some early technical challenges, it’s expected to become a central part of the regulatory process. Providers who get familiar with it early will likely find the transition smoother.

What’s Staying the Same

Amid the change, some core principles remain consistent:

  • The five key questions remain:

    • Is the service safe?

    • Is it effective?

    • Is it caring?

    • Is it responsive?

    • Is it well-led?

  • The fundamental standards and legal regulations under the Health and Social Care Act remain in force.

  • Providers must still maintain strong governance, safeguarding, incident reporting, and quality assurance systems.

Practical Steps for Providers

Here are some simple actions to help prepare for the new framework:

  • Map your service against the Quality Statements and identify evidence you already have

  • Review your feedback mechanisms for people using services, staff, and partners

  • Organise evidence logically so you can access it quickly when needed

  • Ensure data quality by regularly checking KPIs and records for accuracy

  • Train staff and leaders so everyone understands their role in demonstrating quality

  • Engage early with the provider portal to avoid last-minute issues

  • Adopt a ‘continuous readiness’ mindset, rather than preparing just before inspections

Common Challenges to Expect

The transition has not been without difficulties. Some providers have reported confusion over how the new scoring works, technical issues with the portal, uncertainty around inspection timings, and increased administrative pressure.

Acknowledging these challenges early can help organisations plan and adapt rather than react under pressure.

In Summary

The new CQC inspection framework represents a cultural shift towards continuous, evidence-based regulation.

For providers, this change offers both challenges and opportunities. By embracing the new model early — embedding continuous quality assurance into everyday practice — organisations can not only stay compliant but also use the framework to drive real improvement.

The key is to stay organised, stay informed, and make quality everyone’s business.

✅ Top Tip: Don’t wait for your next inspection. Treat every day as inspection day — because under the new framework, it effectively is.

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