CQC Quality Statements Explained: What Each One Means for Your Care Home

The CQC's single assessment framework replaced the old key lines of enquiry (KLOEs) with 34 quality statements spread across five key questions. If you manage a care home, understanding what each statement actually asks for — and what evidence demonstrates compliance — is the difference between a confident inspection and a scramble through filing cabinets.

This guide breaks down every quality statement with the type of evidence CQC assessors typically look for. Use it as a reference when building your evidence portfolio or preparing staff for assessment conversations.

Quick reference

Key Question	Statements	Focus
Safe	S1–S7	Safeguarding, staffing, IPC, risk, environment
Effective	E1–E6	Needs assessment, evidence-based care, consent
Caring	C1–C4	Dignity, independence, responsiveness
Responsive	R1–R3	Person-centred care, integration, information
Well-Led	W1–W14	Governance, culture, partnerships, learning

How the quality statements work

Under the single assessment framework introduced in November 2023, CQC gathers evidence against quality statements rather than the previous KLOEs. Each statement sits under one of the five key questions and maps to a specific "We" statement describing what good looks like.

Evidence can come from six categories CQC uses to gather information:

1. People's experience — feedback from residents, families, advocates
2. Feedback from staff and leaders — supervision records, staff surveys, whistleblowing logs
3. Feedback from partners — GP letters, social worker correspondence, safeguarding board communications
4. Observation — what assessors see during site visits
5. Processes — your policies, audits, governance records
6. Outcomes — measurable results like falls data, infection rates, complaint resolution times

For each quality statement below, consider what evidence you hold across these six categories.

Safe (7 quality statements)

The Safe key question asks: are people protected from abuse, avoidable harm, and neglect? Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulations 12–18 set the legal baseline here.

S1 — Learning culture

What it means: You identify and respond to risks, and you learn from safety events including near-misses and incidents.

Evidence examples: Incident and accident logs with documented root cause analysis. Minutes from lessons-learned meetings. Changes to care plans following incidents. Staff training records showing updates after safety events. Your policy on duty of candour (Regulation 20).

S2 — Safe systems, pathways and transitions

What it means: People move safely between services, and staffing levels keep people safe at all times.

Evidence examples: Staffing rotas mapped against resident dependency levels. Handover documentation. Hospital transfer records including completed SBAR or similar tools. Admission and discharge checklists. Evidence of staffing reviews when occupancy changes.

S3 — Safeguarding

What it means: People are protected from abuse and neglect, and staff know how to recognise and respond to safeguarding concerns.

Evidence examples: Safeguarding policy referencing the Care Act 2014, sections 42–46. Training records (Level 1 for all staff, Level 2 for designated leads). Safeguarding referral log with outcomes. DBS check records. Evidence of Mental Capacity Act 2005 assessments and best interests decisions. DoLS applications and authorisations.

S4 — Involving people to manage risks

What it means: Risks are assessed and managed with the person's involvement, balancing safety with personal choice.

Evidence examples: Individual risk assessments signed or contributed to by the resident (or their representative where capacity is lacking). Care plans showing risk-positive approaches. Evidence that residents have been offered choices and that the reasoning behind risk decisions is documented.

S5 — Safe environments

What it means: The physical environment is safe, well-maintained, and suitable.

Evidence examples: Fire risk assessment (current, reviewed annually as per the Regulatory Reform (Fire Safety) Order 2005). Legionella risk assessment and water temperature records. Equipment maintenance logs (hoists, bath chairs, beds). COSHH records. Environmental risk assessments. PAT testing certificates.

S6 — Safe and effective staffing

What it means: There are enough qualified, skilled, and experienced staff to keep people safe.

Evidence examples: Dependency tool calculations (e.g., using a recognised tool such as the Telford or similar). Staffing rotas for the past 3 months. Recruitment files showing pre-employment checks per Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Induction records. Supervision and appraisal logs.

S7 — Infection prevention and control

What it means: Systems are in place to prevent, detect, and control the spread of infection.

Evidence examples: IPC policy reviewed at least annually. IPC audit results (monthly recommended). Hand hygiene audit records. PPE stock management records. Cleaning schedules and environmental cleanliness audits. Outbreak management plans. COVID-19 IPC arrangements aligned with UKHSA guidance.

Effective (6 quality statements)

The Effective key question asks: does care achieve good outcomes and help people maintain quality of life? This maps primarily to Regulations 9, 11, 12, 17, and 18.

E1 — Assessing needs

What it means: People's needs are assessed accurately, and care is delivered in line with current legislation and best practice.

Evidence examples: Pre-admission assessments covering physical, mental health, nutritional, and social needs. Evidence of using validated tools (Waterlow for pressure ulcer risk, MUST for malnutrition, Abbey Pain Scale for non-verbal residents). Assessments reviewed after significant changes.

E2 — Delivering evidence-based care and treatment

What it means: Care and treatment is delivered in line with legislation and current evidence-based good practice.

Evidence examples: Care plans referencing NICE guidelines (e.g., NG97 for dementia, CG161 for falls). Policies updated to reflect current legislation. Evidence that staff are aware of and apply best practice guidance.

E3 — How staff, teams and services work together

What it means: Staff work collaboratively and share information to deliver joined-up care.

Evidence examples: Multidisciplinary team meeting notes. Evidence of timely GP referrals and follow-up. Communication with community nurses, physiotherapists, speech and language therapists. Handover records showing continuity.

E4 — Supporting people to live healthier lives

What it means: People are supported to manage their health and wellbeing, and to access healthcare services.

Evidence examples: Records of health appointments attended (dentist, optician, podiatry, GP reviews). Screening participation records. Nutritional monitoring (weight charts, MUST scores, food and fluid charts where indicated). Oral health care plans per NICE NG48.

E5 — Monitoring and improving outcomes

What it means: Outcomes for people are routinely monitored, and care is adjusted accordingly.

Evidence examples: Key performance indicators tracked monthly (falls rates, pressure ulcers, infections, hospital admissions, weight changes). Audit results showing trends over time. Evidence that audit findings lead to action plans with deadlines and named owners.

E6 — Consent to care and treatment

What it means: People's consent is sought in line with legislation, and staff understand and apply the Mental Capacity Act 2005.

Evidence examples: Signed consent forms. Mental capacity assessments where capacity is in doubt (decision-specific, time-specific). Best interests decision records. DoLS applications and authorisations tracked and reviewed. Training records for MCA/DoLS.

Caring (4 quality statements)

The Caring key question asks: does the service treat people with compassion, kindness, dignity, and respect? This maps to Regulations 9, 10, and 13.

C1 — Kindness, compassion and dignity

What it means: People are treated with kindness, empathy, and compassion, and their dignity is upheld.

Evidence examples: Resident and family feedback (surveys, compliments, complaints). Observation records showing personalised interactions. Dignity audits. Named examples of how staff have responded to individual preferences or cultural needs.

C2 — Treating people as individuals

What it means: Care is personalised and takes account of people's strengths, abilities, aspirations, and culture.

Evidence examples: "This is me" or "About me" documents in care plans. Evidence of life history work. Activities tailored to individual interests. Cultural, religious, and dietary preferences documented and met.

C3 — Independence, choice and control

What it means: People are supported to be as independent as possible and to make choices about their own care.

Evidence examples: Care plans showing goals for independence. Evidence of residents choosing daily routines (mealtimes, activities, waking/sleeping times). Use of assistive technology. Risk assessments that support positive risk-taking.

C4 — Responding to people's immediate needs

What it means: People can get help, support, and information when they need it.

Evidence examples: Call bell response time audits. Staffing levels during peak demand periods. Evidence that staff are visible and accessible. Complaint records showing timely responses.

Responsive (3 quality statements)

The Responsive key question asks: are services organised to meet people's needs? This maps primarily to Regulations 9, 16, and 17.

R1 — Person-centred care

What it means: Care is designed and delivered around what matters to the individual.

Evidence examples: Person-centred care plans with "I" statements. Resident involvement in care plan reviews (documented). Evidence of advanced care planning conversations. Activity programmes reflecting individual preferences and assessed needs.

R2 — Care provision, integration and continuity

What it means: Care is joined up, and people experience smooth transitions.

Evidence examples: Discharge and transfer documentation. Coordination with other services (district nurses, mental health teams, palliative care). Named key workers for each resident. Evidence of consistent staffing where possible.

R3 — Providing information

What it means: People receive clear, accessible information about their care and the service.

Evidence examples: Service user guide provided at admission. Information in accessible formats (large print, Easy Read, translated where needed). Evidence that residents and families know how to raise concerns. Displayed complaints procedure.

Well-Led (14 quality statements)

The Well-Led key question asks: does leadership and governance ensure high-quality, person-centred care? This is the largest group, mapping to Regulations 5, 17, 18, and 20. It also underpins all other key questions.

W1 — Shared direction and culture

What it means: There is a clear, shared vision for the service and a positive, open culture.

Evidence examples: Written vision and values statement. Evidence that staff can articulate the service's purpose. Staff survey results. Whistleblowing policy and evidence it is accessible to staff.

W2 — Capable, compassionate and inclusive leaders

What it means: Leaders have the skills, knowledge, experience, and integrity to lead effectively.

Evidence examples: Registered manager qualifications (Level 5 Diploma in Leadership for Health and Social Care or equivalent). Leadership CPD records. Evidence of manager's fitness per Regulation 5 (fit and proper persons: directors). CQC notifications submitted on time.

W3 — Freedom to speak up

What it means: People, staff, and partners can speak up and their concerns are responded to.

Evidence examples: Whistleblowing policy and log. Freedom to Speak Up Guardian (if appointed). Staff meeting minutes showing open discussion. Anonymous feedback mechanisms. Evidence of action taken following concerns raised.

W4 — Workforce equality, diversity and inclusion

What it means: Equality and diversity are promoted across the workforce.

Evidence examples: Equality and diversity policy. Training records. Workforce demographic monitoring. Evidence of reasonable adjustments for staff with disabilities. Recruitment practices that demonstrate fair and inclusive processes.

W5 — Governance, management and sustainability

What it means: There are effective governance systems that ensure accountability, performance monitoring, and continuous improvement.

Evidence examples: Governance meeting minutes (monthly recommended). Quality assurance frameworks. Audit schedule and completed audits. Action plans with evidence of completion. Financial sustainability indicators. Business continuity plan.

W6 — Partnerships and communities

What it means: The service works in partnership with others to deliver care and support.

Evidence examples: Relationships with local authority commissioners. Healthwatch engagement. Links with community groups, volunteers, faith organisations. Evidence of responding to community needs.

W7 — Learning, improvement and innovation

What it means: The service learns, improves, and innovates.

Evidence examples: Quality improvement projects with documented outcomes. Benchmarking against similar services. Engagement with research or pilot projects. Evidence of implementing recommendations from inspections, complaints, or incidents.

W8 — Environmental sustainability

What it means: The service considers its environmental impact and takes steps to reduce it.

Evidence examples: Environmental sustainability plan. Waste management and recycling records. Energy efficiency measures. Evidence of working toward the NHS net zero commitment where applicable.

W9–W14 — Additional governance statements

The remaining well-led statements (W9 through W14) cover specific governance areas including robust information governance (Regulation 17), accurate and timely notifications to CQC (Regulation 18), financial governance, and effective use of resources. Evidence includes Data Protection Impact Assessments, Caldicott Guardian arrangements, CQC notification logs, and budget management records.

Pulling it all together

The volume of evidence across 34 statements can feel overwhelming. A practical approach:

1. Map what you already have. Most care homes hold 70–80% of the evidence CQC wants — it is just not organised against the quality statements. Start by listing what you already collect and matching it to the relevant statement.

2. Prioritise gaps in Safe and Effective. These two key questions generate the most enforcement action. If you only have time to strengthen evidence in two areas, make it these.

3. Keep evidence current. Assessors look at the past 12 months most closely. A brilliant audit from 2023 carries little weight if nothing since supports it.

4. Use a consistent filing structure. Whether paper or digital, organise evidence folders by key question and quality statement code (S1, S2, E1, etc.). This makes retrieval during inspection straightforward.

For a complete walkthrough of how the single assessment framework applies to smaller services, see our CQC compliance guide for small care homes. If you need guidance on organising this evidence into a usable portfolio, our guide to building a CQC evidence pack covers filing structures and common mistakes.

You can also use our CQC Readiness Self-Assessment to identify which quality statements need the most attention in your service, or the Evidence Gap Checker to quickly highlight missing documentation.