CQC
May 28, 2025
How to Prepare for the CQC’s Single Assessment Framework in 2025: A Practical Guide for Healthcare Providers
If you're a care provider in the UK, you're likely already feeling it. The Single Assessment Framework (SAF), introduced by the Care Quality Commission (CQC), is reshaping how inspections are conducted across the healthcare sector.
What used to be a predictable, albeit paperwork-heavy, cycle has now become an always-on evaluation model that demands real-time compliance visibility, tighter governance, and fast access to evidence.
The pressure is mounting. Teams are stretched. Systems are siloed. And inspections are no longer once-a-year surprises, they can be triggered by data trends, public concerns, or even AI-driven risk profiling from the CQC itself.
So, how do you prepare for a constantly evolving regulatory landscape while continuing to deliver safe, high-quality care?
This guide will show you how.
What the CQC’s Single Assessment Framework Means in Practice
The Single Assessment Framework is not just a checklist. It’s a complete shift in how and when the CQC assesses care providers.
Rather than a scheduled inspection every few years, assessments now combine structured evidence gathering, service user feedback, workforce insights, and external data to make real-time judgments on quality and safety.
The framework organises evidence into six distinct categories, and understanding these is crucial for your preparation:
People's experience - Patient feedback, surveys, complaints, and satisfaction data
Feedback from staff and leaders - Staff surveys, leadership interviews, stakeholder input
Processes - Policies, procedures, and operational frameworks
Outcomes - Clinical indicators, safety metrics, and measurable results
Feedback from partners - External stakeholder perspectives and collaborative relationships
Observation of care - Direct assessment of care delivery and environmental factors
For care homes and supported living services, the CQC indicated that no quality statements underpinning the key questions “caring”, “responsive” and “well led” will prioritise “outcomes” evidence.
This tells you where to focus your preparation efforts. The goal? To build a continuous and dynamic view of care quality.
For care providers, this also means inspection readiness is no longer optional. It has to be embedded into your operations.
Just 7,000 inspections and assessments were carried out between 2023 and 2024, compared to over 16,000 between 2019 and 2020.
The target for 2024-25 is 16,000 assessments, but the framework's implementation challenges mean the approach you knew is no longer fit for purpose.
The single assessment framework replaces the previous key lines of enquiry (KLOEs) with 34 quality statements, but here's what many providers don't realise: not all 34 quality statements are assessed on any inspection.
For adult social care, this has typically increased from 5 to 10-12 quality statements per assessment.
This selective approach creates both challenges and opportunities. You can't prepare for everything, but you can prepare strategically.
What's Really Causing Inadequate Ratings in Care Homes
Before we dive into preparation strategies, let's be clear about what's actually going wrong.
Recent inspections have revealed recurring patterns that are pushing care homes toward inadequate ratings – and understanding these failures is your roadmap to avoiding them.
Staffing and Training: The Foundation That's Cracking
Insufficient staffing levels are creating cascading failures across care delivery. When residents' basic personal care needs like bathing and oral hygiene go unmet, it's not just about dignity, it's about the fundamental safety standards that the CQC expects to see embedded in your operations.
But here's what's more concerning: staff often lack proper training to manage specific health conditions like diabetes and epilepsy.
This isn't about having generic care training – it's about showing competency in the specific clinical skills your residents actually need.
Under the quality statements framework, this gap becomes impossible to hide.
Medication Management: Where Small Errors Have Big Consequences
Medication failures continue to be a common pathway to inadequate ratings.
Incorrect dosages, improper storage, poor hygiene during administration – these aren't just process failures, they're direct threats to resident safety that CQC assessors will identify immediately.
The new evidence categories mean inspectors will look at your medication outcomes, not just your policies. If your medication management isn't demonstrably safe through measurable results, your rating will reflect that reality.
Documentation and Risk Management: Your Silent Killers
Inadequate or outdated care plans and risk assessments don't just hinder care delivery, they show inspectors that your governance systems are failing.
Under the Single Assessment Framework, where inspectors may assess fewer quality statements but dig deeper into each one, weak documentation becomes a critical vulnerability.
The quality statement approach means inspectors are looking for evidence that you understand each resident as an individual with specific needs and risks.
Generic care plans and tick-box risk assessments won't demonstrate this understanding.
Environmental Safety: The Basics That Aren't Basic Enough
Physical environments continue to cause inadequate ratings through seemingly basic issues: unsecured furniture, trip hazards, and malfunctioning call bells.
These environmental hazards pose direct risks to residents' well-being, but they also signal something deeper – a lack of systematic attention to safety culture.
Leadership Failures: The Root Cause Behind the Symptoms
Weak management structures and oversight failures create the conditions where all other problems flourish. Frequent changes in management and ineffective governance create instability that prevents consistent quality improvement – exactly what the CQC's continuous assessment approach is designed to identify.
Dignity and Rights: Where Compliance Meets Humanity
Recent downgrades have highlighted instances where residents aren't treated with respect, where consent isn't sought for care decisions, and where engagement in meaningful activities is limited.
The Willows Care Home's downgrade from 'good' to 'inadequate' in 2024 exemplifies how neglect of residents' rights directly impacts ratings.
This matters more under the new framework because the "I" statements that correspond to each quality statement put residents' experiences at the center of every assessment.
Preparation Strategies for Care Homes
Care homes face unique challenges under the new framework. Specific comments from adult social care providers included concerns about inspector knowledge: "Some inspectors don't have knowledge about things that matter in care homes – dementia, learning disabilities, rehabilitation".
This knowledge gap creates an opportunity for well-prepared care providers. Your preparation should include:
Evidence Portfolio Development
Build comprehensive documentation that tells your story clearly, even to inspectors who may lack sector-specific expertise. This isn't about creating more paperwork – it's about making your existing good practice visible and accessible.
Staff Engagement and Training
Provider feedback noted that "the number of people who are spoken to on site should be standardised. Otherwise, inspectors may not get a balanced view". Ensure your entire team can articulate your care philosophy and demonstrate understanding of quality statements.
Outcome Measurement
While providers feel that "Process measures are over-emphasised" and "More emphasis should be given to outcomes", this presents an opportunity. Develop robust outcome tracking that goes beyond process compliance.
Person-Centered Evidence
The framework emphasizes the "Making It Real" principles developed by Think Local Act Personal. This framework focuses on personalised care and support, containing jargon-free principles that focus on what matters to people.
Care home assessments will usually start on the same day that the email is sent (no advance notice). This means your preparation must be ongoing and your compliance should be continuous, not reactive.
Documentation Strategy: Where documentary evidence is requested, this should be provided within the specified timeframes. Ensure your evidence is digitally accessible and well-organized.
Alternative Assessment Methods: Under the single assessment framework, the CQC may decide that an on-site visit is not required. Your digital evidence portfolio may be your primary assessment tool.
Staff Interview Preparation: The CQC may wish to interview the registered person or staff members, even if they do not intend to carry out an on-site visit. This remote interview capability means your team's communication skills are more critical than ever.
Move From Reactive to Proactive Compliance with Safe Workplace
We've covered a lot of ground here, but it all comes down to this: the old way of preparing for CQC inspections – the last-minute scramble, the box-ticking exercises, the crossing your fingers and hoping for the best – that's not going to work anymore.
You need a fundamentally different approach.
One that treats compliance not as a burden to bear, but as continuous quality improvement that's built into everything you do. One that gives you real-time visibility into your performance across all six evidence categories.
One that makes you genuinely ready for assessment at any moment, not just when you think they might be coming.
This is exactly why we built Safe Workplace. We've seen too many good healthcare providers struggle with fragmented systems, siloed data, and reactive approaches that leave them vulnerable when assessments come. We knew there had to be a better way.
Safe Workplace gives you a centralised compliance dashboard. One place where you can see your performance across all the areas that matter. It automates evidence collection from audits, training records, policy updates, and incident reports.
It provides anonymous reporting and incident tracking that creates the psychological safety culture inspectors are looking for. And it gives you audit-ready reporting at the click of a button.
But here's what really sets us apart: it's designed specifically for the reality of modern healthcare compliance. It tracks regulatory changes in real-time so you're always ahead of evolving requirements. The platform centralises incident reporting with the transparency that builds trust. It provides board-ready reporting that shows genuine governance and oversight.
Remember, from 2023 to 2024, only around 7,000 inspections were carried out because of rollout challenges. This reduced activity means when your assessment does come, inspectors will be looking for evidence of sustained quality over time, not just point-in-time compliance.
The SAF demands continuous readiness. You need to monitor changes daily, capture feedback ongoing, log incidents in real-time, and identify gaps proactively.
Providers relying on static spreadsheets and PDF audits are missing early warning signs and entering inspections underprepared.
Safe Workplace eliminates that risk. It turns compliance from a reactive scramble into proactive quality improvement that's embedded in your daily operations.
Ready to Transform Your CQC Preparation?
The Single Assessment Framework isn't going away. If anything, it's going to become more sophisticated and demanding as the CQC refines its approach. The healthcare providers who thrive will be those who embrace this change and build robust systems for continuous quality monitoring.
You have three options:
Keep doing what you've always done and hope the next assessment goes better than the last one
Try to build internal systems and spend months reinventing wheels that already exist
Partner with experts who understand both the regulatory landscape and the technology needed to navigate it successfully
We'd obviously love for you to choose option three, and we think once you see Safe Workplace in action, you'll understand why so many providers are making the switch.
Ready to see how Safe Workplace can transform your CQC preparation? Book a personalized demo to see exactly how Safe Workplace works with your specific challenges.
Don't wait until the next assessment notice arrives. Start building your continuous compliance capability today.
