CQC's new assessment frameworks — everything changing in 2026–27
The single framework is becoming four. Quality statements are being replaced by key lines of enquiry. Scoring is being removed. Here is exactly what changes, when, and what it means for your evidence — updated as CQC publishes.
Nothing has changed yet. The Single Assessment Framework is still the operative framework and you are still assessed under it (see how the Single Assessment Framework works today). Four draft sector frameworks have been published, feedback closed on 12 June 2026, and CQC is piloting the frameworks with providers from June to October, with a final evaluation in November. Its November 2025 plan put the start at the end of 2026.
CQC’s own instruction to providers, published 26 May 2026: “We are currently asking for feedback on our draft assessment frameworks, but until we implement the new regulatory approach later this year, please continue to refer to the current published guidance on how we assess quality and performance.” CQC’s latest update, on 27 August 2026, gives no start date.
New to any of this? Start with what the CQC is and how it regulates, then come back — this guide assumes you know the basics.
Note the distinction: this reform changes CQC’s ASSESSMENT FRAMEWORK, not the fundamental standards. Regulations 9 to 20A are unaffected.
Wondering about KLOEs specifically? Below, we cover why they are coming back, including what CQC’s own review said about why the quality statements did not work.
Looking for where a specific quality statement lands? Use our free CQC framework crosswalk tool: it maps all 34 quality statements to the topics replacing them, sector by sector. You can also get it for your sector by email, as a spreadsheet you can work in and a PDF you can share.
This page is our running reference for the assessment reform. We update it monthly, and whenever CQC publishes something material. Everything below comes from the regulator’s own publications, linked at the foot of the page, and where ours differs from theirs, theirs is correct.
Three changes, landing together
CQC set all three out in its March 2026 update, following its Better regulation, better care consultation.
- One framework becomes four. Separate, sector-specific frameworks replace the single merged model.
- Quality statements are replaced by key lines of enquiry framed as structured questions, supported by rating characteristics.
- Scoring is removed. Rating judgements will be made directly at key question level.
What is not changing: the five key questions — safe, effective, caring, responsive, well-led — and the four rating levels of outstanding, good, requires improvement and inadequate. Both have been constant since 2014, through every framework generation.
That single fact is the most useful thing on this page. If your governance is organised around the five key questions, the reform is a remapping exercise. If it is organised specifically around the 34 quality statements, you have more work to do — but it is still remapping, not rebuilding.
What changes and what stays the same
| Area | Today | In the drafts |
|---|---|---|
| Frameworks | One for every type of service | Four: adult social care, mental health, primary care and community, hospitals |
| What CQC assesses against | 34 quality statements | Key lines of enquiry, written as questions |
| How a rating is reached | Scores build up to a rating | Inspectors judge each key question against rating characteristics |
| Five key questions | Safe, effective, caring, responsive, well-led | No change |
| Rating levels | Outstanding, good, requires improvement, inadequate | No change |
| The regulations | Regulations 9 to 20A | No change |
How CQC assesses services today: the Single Assessment Framework
The Single Assessment Framework (SAF) is the model the Care Quality Commission uses to assess every health and social care service it regulates, from care homes, domiciliary agencies and GP practices to dental practices, clinics and hospitals. CQC rates most of them. Dental practices get a “Regulations met” or “Not all regulations met” judgement for each key question. The framework replaced the older, separate inspection regimes with one shared structure, so the same questions apply across sectors.
It has three layers. At the top sit the five key questions. Beneath those sit quality statements, written as “we statements” that describe what good care commits to: our free CQC quality statements crosswalk lists and maps all 34. Underneath those, CQC gathers evidence in a small number of evidence categories, such as people’s experience, feedback from staff, observation and processes.
- Safe: protection from avoidable harm, including safeguarding, medicines, risk and incidents.
- Effective: good outcomes, best practice and consent (MCA and DoLS).
- Caring: dignity, compassion, respect and involvement.
- Responsive: person-centred care, and complaints acted on.
- Well-led: governance, accountability and a learning culture.
The five key questions stay the same in the new frameworks, so preparation organised around them carries over. For the day-to-day checklist, see our CQC inspection checklist and how to prepare.
Four sector-specific frameworks
CQC’s Better regulation, better care consultation, which ran at the end of 2025 and drew over 1,600 responses, proposed moving away from a single assessment framework to separate frameworks “more specific and relevant to the health and care sectors that we regulate”. CQC reported “overwhelming support” for the proposal and published four drafts:
- Adult social care
- Mental health care
- Primary care and community services
- Hospitals (secondary and specialist care)
This mirrors a structural change CQC had already made to itself. During 2025 it restructured into operational inspectorates built around sector expertise, led by four Chief Inspectors: Professor Bola Owolabi CBE (Primary Care and Community Services), Dr Toli Onon (Hospitals), Chris Badger (Adult Social Care and Integrated Care) and Dr Arun Chopra (Mental Health).
What it means if you operate across sectors
The working assumption that one internal assurance model serves every registration may not survive four frameworks. If you hold registrations in more than one sector, map the differences before implementation rather than after — the five key questions will still be common, but the questions beneath them and the rating characteristics will not be.
Key lines of enquiry (KLOEs) are coming back
Two things replace quality statements, in CQC’s own words.
Key lines of enquiry, framed as structured questions
The regulator describes them as “key lines of enquiry framed as structured questions that describe what we will look for on our assessments”, and says “these replace the current quality statements”.
If you registered before 2023, this will be familiar. Key lines of enquiry were CQC’s assessment structure for years, until the Single Assessment Framework brought in quality statements, written as “we statements”. The reform is, in effect, a return to the earlier structure.
For reference, the framework being replaced currently has 34 quality statements: eight under safe, six under effective, five under caring, seven under responsive and eight under well-led.
What KLOEs were
KLOE stands for key line of enquiry. They sat between the five key questions, often called the five domains, and the evidence. A question as broad as “is this service safe?” is hard to answer directly, so the regulator broke each key question into KLOEs, and each KLOE carried prompts: the specific things an inspector would look for.
That structure gave inspectors a set list to work through and gave providers something concrete to prepare against. Its drawback was that separate frameworks covered different sectors, with a great deal of duplication between them.
Why CQC replaced them in 2023
When it announced the Single Assessment Framework in July 2022, the regulator gave three reasons: to make things simpler, to better reflect how care is actually delivered, and to have one framework connecting registration to assessment. The new framework merged the sector frameworks into one and replaced the KLOEs and their prompts with the 34 quality statements. The five key questions and the four ratings stayed as they were.
Why they are coming back
In October 2024 CQC published a review of the Single Assessment Framework and its implementation, which it had asked Professor Sir Mike Richards to carry out. Simplicity and an accurate picture of care were two of the framework’s key objectives, and the review found it met neither: the framework “is not simpler than the previous approach and does not accurately reflect the quality of care delivered”.
The review also recorded what people wanted: “A large number of people I spoke to advocated going back to the previous approach based on the 5 key questions and prompts/KLOEs.” The draft frameworks do that, and they answer the review’s other findings one by one:
- One framework did not fit every service. Staff in every sector said a single framework “doesn’t take account of the major differences in size, complexity or function between services/organisations”. The drafts give each sector its own framework.
- Scoring had almost no support. The review found “virtually no support for the use of scoring for each evidence category”, and some called it “a pseudoscience”. The drafts remove scoring.
- Inspections slowed down. In the review’s words, “It takes longer to look at less.” Only 1,379 inspections took place under the framework between December 2023 and September 2024: 885 in adult social care, 350 in primary care, 97 in mental health and 47 in hospitals.
- Some quality statements were in the wrong place. The review said workforce wellbeing and enablement “might be better placed under well-led”. In every draft it moves to well-led.
Rating characteristics return, rebuilt for each sector
Alongside the questions sit rating characteristics: descriptions of “what outstanding, good, requires improvement and inadequate care looks like in each sector”.
The frameworks CQC used until 2023 had them too, beside the key lines of enquiry and prompts. The Single Assessment Framework dropped them and built ratings from scores.
For the drafts, the regulator wrote new ones. Through online and in-person engagement it asked people what good quality care looks like, developed rating characteristics for good from those answers, then defined the other three levels around it.
This is the part most commentary has missed, and it matters more than the change in question wording: inspectors will judge each key question against these descriptions.
Put together, the structured questions tell an inspector what to look for, and the characteristics tell them what the answer needs to look like for each rating, with no scores in between.
The end of scoring
CQC’s March 2026 update records that “feedback from the consultation also showed support for our proposal to remove scoring from our assessment methodology and make rating judgements directly at key question level. The rating characteristics will therefore support this change.”
How ratings work today
Under the current framework, evidence is scored on a four-point scale; those scores build a score for each quality statement; quality statements build a score for each key question; and the five equally-weighted key questions aggregate into an overall rating. A rating limiter can cap an otherwise-strong result where one area is weak. We break this down in CQC ratings explained.
How ratings will work
Scoring goes. An inspector will judge each key question directly against the published rating characteristics for your sector, and those judgements produce the rating.
This is not a sudden reversal
Worth knowing, because it changes how alarmed you should be: CQC had already stopped scoring at evidence-category level in December 2024. Its own change history records “our decision to stop scoring at evidence category level” on 6 December 2024. The 2026 reform completes a step back from score arithmetic that began eighteen months earlier.
The practical consequence
Scoring gave ratings the appearance of objectivity, but someone always had to decide whether a piece of evidence was a 2 or a 3. The scores packaged the judgement rather than removing it.
What changes is that the packaging goes — and with it, the arithmetic you could point at. Under the new approach, ambiguity in your evidence becomes ambiguity in the judgement. Providers with complete, dated, owned and retrievable evidence are in a stronger position than before; providers whose evidence is scattered are more exposed. We set out that argument in full in why this reform makes your evidence matter more.
Why it matters
If your evidence is filed against the 34 quality statements, you’ll need to re-file it under the new questions. Two statements also move to a different key question in every draft: person-centred care goes from Responsive to Caring, and workforce wellbeing goes from Caring to Well-led.
Without scoring, an inspector judges each key question against your sector’s rating characteristics. Any gaps or loose ends in your evidence feed straight into that judgement.
CQC framework crosswalk for your sector: plan where your evidence goes
Work out which evidence has to move, and who moves it, before an inspector assesses you under the new frameworks. It covers adult social care, mental health, primary care and community services, and hospitals.
- All 34 quality statements, each mapped to its new topic
- Columns to fill in: where your evidence is, who owns it, its status and the action needed
- Every change marked, so you can filter the rows that need work
- A PDF of your sector’s mapping, to share with your team
- All four sector drafts side by side, on a separate sheet
- The updated version when CQC publishes the final frameworks
| Quality statement (current) | Becomes | Change | Where is our evidence? | Owner | Status | Action needed? |
|---|---|---|---|---|---|---|
| Learning culture | Safety culture | Renamed | ||||
| Safe systems, pathways and transitions | Safe systems, pathways and transitions | Unchanged | ||||
| Safeguarding | Safeguarding | Unchanged |
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Who it matters to, and who it doesn’t
It matters to you if:
- You run a service in England that CQC rates. The four drafts cover adult social care, mental health, primary care and community services, and hospitals.
- Your audits, evidence or board reports follow the 34 quality statements.
- You run services in more than one of those sectors, because each one gets its own questions.
It doesn’t change things for you if:
- You provide care outside England. CQC regulates health and adult social care in England only.
- You want to know what the law requires. The regulations, 9 to 20A, stay the same for everyone.
- Your role is local authority assurance. Local authorities have their own CQC framework, built around their Care Act duties, and the four drafts cover registered providers.
Timeline
| When | What happened |
|---|---|
| July 2022 | Single Assessment Framework announced. |
| December 2023 | SAF assessments begin. |
| July 2024 | Dr Penny Dash’s interim report published; a period of external review of CQC follows, alongside Professor Sir Mike Richards’ review. |
| 6 December 2024 | CQC stops scoring at evidence-category level. |
| Late 2025 | Better regulation, better care consultation — over 1,600 responses. |
| December 2025 | CQC reports the stuck-assessment backlog cut from ~500 reports to 4, and 4,308 assessments published against a 9,000 target. |
| March 2026 | Returning to Good and Outstanding programme begins for lower-risk GP practices. |
| 24 March 2026 | Four draft sector frameworks published; scoring removal confirmed. |
| 12 June 2026 | Feedback on the draft frameworks closes. |
| June to October 2026 | Frameworks piloted and tested with providers; final evaluation in November. |
| 27 August 2026 | CQC’s latest update: it plans sector-specific engagement on the frameworks this autumn and gives no start date. |
| September 2026 | CQC’s target date for publishing at least 9,000 assessments. |
| End of 2026 | When CQC planned to start the new approach (its November 2025 plan). Its 27 August update doesn’t repeat the date. |
Who gets assessed next
Running alongside the framework reform — and more immediately relevant to most providers — CQC is working through an assessment backlog. It says it remains “on track to meet our target to publish reports for at least 9,000 assessments across all sectors by September 2026”.
In its May 2026 update CQC published the criteria it is prioritising by. Aged ratings feature in every sector.
| Sector | Ageing-rating triggers |
|---|---|
| Adult social care | Ratings over 6 years old; services registered over a year and never assessed; never-assessed services the data flags as very high risk. |
| Mental health | Inadequate not assessed for over 12 months; outstanding over 8 years; requires improvement over 3 years; good over 5 years. |
| Primary care & community | Ratings older than 7 years; services registered a year or more and not assessed. |
| Hospitals & specialist | Never-assessed services by time since registration; increased focus on the independent sector. |
Two programmes worth knowing about
Returning to Good and Outstanding. Began March 2026. Focused assessments of lower-risk NHS GP practices rated good or outstanding whose last inspection report was published between 2017 and 2022 — reviewing, in CQC’s words, “non-clinical quality statements safely and robustly”.
A lighter-touch route in adult social care. For services rated good across all five key questions, with a registered manager, ratings over six years old, no significant risk in the data and no ongoing enforcement. It leans on “people’s experiences and outcomes, supported by observation and targeted, risk-based review of records” — with the explicit caveat that “if concerns arise during planning, we will revert to the usual approach”.
If your rating is old and your data profile is clean, you have moved up the queue, not down. A six-year-old “good” is now a reason to visit you. And the lighter-touch route converts to a full assessment the moment anything looks off during planning.
What to do now — and what to wait for
Do now
- Check how old your published rating is. The cheapest preparation available, and almost nobody does it. If it falls into one of the bands above, plan on the assumption you are in scope this year.
- Keep collecting. Whatever the new frameworks ask for, they will ask you to evidence things that happened during the transition. Evidence you don’t capture in 2026 cannot be recreated in 2027.
- Anchor your model to the five key questions rather than to quality statements. That is the layer that survives.
- Keep it dated, owned and signed. Every assurance framework of the last decade has wanted to know what you found, when, who owned it, what you did and whether it worked. No consultation will change that.
- If you operate across sectors, start mapping where your registrations will diverge.
Wait for
- Rebuilding anything around the new question wording. The frameworks are still drafts in pilot. Rebuilding now means rebuilding twice.
- Retraining staff on new terminology. Wait for the final published frameworks.
Stop
- Building internal dashboards or board reports that reproduce CQC’s score arithmetic. Scoring is going. Report on evidence coverage, currency and ownership instead — those survive the change.
What we don’t know yet
- The final wording. CQC planned to publish the final frameworks in summer 2026. We haven’t seen them yet, so this page is based on the drafts.
- What the pilots will change. CQC is piloting the drafts with providers from June to October 2026, with a final evaluation in November.
- The start date. CQC planned to start at the end of 2026. Its latest update, on 27 August 2026, gives no date.
- The guidance. CQC said it would write guidance for providers before it starts.
- Where unrated services fit. CQC doesn’t rate services such as dental practices, and hasn’t said which of the four frameworks will apply to them.
We’ll update this page as CQC publishes each of these.
Free tools to get ready with
Each one covers all 34 quality statements. Browse any of them online, or request a copy scoped to your service.
Frameworks change. Your evidence shouldn’t have to.
CompliantCare maps your evidence to the five key questions — the layer that has survived every framework generation since 2014. When CQC publishes the final sector frameworks, the new questions map to evidence you already hold. You don’t restructure, and you don’t start your preparation over.
More on the reform
- Rating characteristics explained: what replaces scoring in the drafts.
- Which services CQC will assess next: if your rating is over six years old, the backlog matters more than the reform.
- Adult social care is the outlier: mental health and primary care differ on zero of the 34 statements; adult social care differs on eight.
- What happens to your existing rating: it does not expire, and that is not the question that matters.
- The evidence worth collecting now: nine statements survive unchanged in all four drafts.
Common questions
Has the CQC framework changed yet?
No. As at October 2026 the Single Assessment Framework is still the operative framework and CQC's current published guidance still applies. CQC told providers on 26 May 2026 to 'continue to refer to the current published guidance on how we assess quality and performance' until the new approach is implemented later in the year.
What is replacing the Single Assessment Framework?
Four sector-specific frameworks — adult social care, mental health care, primary care and community services, and hospitals (secondary and specialist care). Each keeps the five key questions but replaces quality statements with key lines of enquiry framed as structured questions, supported by rating characteristics.
What are CQC rating characteristics?
Descriptions of what outstanding, good, requires improvement and inadequate care looks like in each sector. The frameworks CQC used until 2023 had them too, beside the key lines of enquiry. For the drafts, CQC asked people what good care looks like, then defined the other rating levels around that. They replace scoring as the basis for reaching a rating.
Is CQC getting rid of scoring?
Yes. CQC confirmed in March 2026 that consultation feedback supported its proposal to remove scoring from its assessment methodology and make rating judgements directly at key question level. CQC had already stopped scoring at evidence-category level in December 2024.
Are key lines of enquiry coming back?
Effectively, yes. CQC's March 2026 update says the new frameworks will use 'key lines of enquiry framed as structured questions that describe what we will look for on our assessments', which 'replace the current quality statements'. KLOEs were the assessment structure until the Single Assessment Framework brought in quality statements in 2023.
What does KLOE stand for?
Key line of enquiry. Until 2023, CQC broke each of the five key questions into several KLOEs, and each KLOE had prompts setting out what inspectors would look for. The draft frameworks bring key lines of enquiry back, framed as structured questions.
How many KLOEs were there?
It varied by sector, because separate frameworks covered different sectors before the Single Assessment Framework, each with its own key lines of enquiry and prompts.
Are the five key questions changing?
No. Safe, effective, caring, responsive and well-led remain, as do the four rating levels of outstanding, good, requires improvement and inadequate. They have been constant through every framework change since 2014.
When does the new CQC framework start?
CQC published four draft frameworks on 24 March 2026 and closed feedback on 12 June 2026. CQC is piloting them with providers from June to October 2026, with a final evaluation in November. In November 2025 CQC planned to start at the end of 2026; its latest update, on 27 August 2026, gives no start date.
Do I need to rewrite my policies for the new framework?
Almost certainly not. The five key questions are unchanged, so evidence organised around them carries across. If your policies, board reports or audit schedule are structured specifically around the 34 quality statements, expect remapping rather than rewriting.
How many quality statements are there currently?
34 — eight under safe, six under effective, five under caring, seven under responsive and eight under well-led. These are being replaced during the reform.
References
- CQC — Our March update (draft frameworks, scoring removal)
- CQC — Priorities for delivering more assessments and tackling aged ratings (May 2026)
- CQC — Rebuilding CQC: progress during 2025
- CQC — Assessment guidance for providers
- CQC — Assessment framework (key questions and quality statements)
- CQC — Piloting, testing and evaluation of new assessment method (June 2026)
- CQC: Rebuilding our regulatory approach and digital services (August 2026)
- CQC — Our improvement plans for 2026
- CQC — About us (who we are)
- CQC — Assessment framework for local authority assurance
- CQC: Review of CQC's single assessment framework and its implementation (Professor Sir Mike Richards, October 2024)
- CQC: Our new single assessment framework (July 2022)
For general information only and reflects our understanding of CQC's approach as of October 2026. The framework is changing during 2026 — always check cqc.org.uk for the current framework for your sector.