CQC safe: the 8 quality statements, the evidence for each, and what outstanding takes

The regulator hasn’t published a mapping between the quality statements and the draft topics. The right-hand column is our reading of each draft topic’s scope, the same reading as our CQC framework crosswalk.

Each quality statement below starts with CQC’s own wording, then what it means in practice and examples of the evidence to have ready. Each one also lists the regulations behind it, and Regulation 12, safe care and treatment, sits under all eight.

1. Learning culture

“We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.”

What it means: safety is a top priority for everyone, staff and people using the service alike. The service treats risks as a chance to put things right and learn. Staff and people using the service feel able to raise concerns, confident nobody will blame them. The service investigates and reports incidents and complaints, and the lessons lead to changes that improve care.

Evidence to have ready:

• An incident log that shows each incident reported, investigated and closed, with the actions and learning
• Duty of candour records where the duty applies: who you told, the apology and the written follow-up (our guide to the CQC duty of candour sets out each step)
• Complaints, how the service investigated each one and what changed
• Lessons-learned updates shared with staff, and a later check that the change held
• Where they apply, patient safety events recorded through Learn from Patient Safety Events, and incident responses in line with the Patient Safety Incident Response Framework

In the draft frameworks: safety culture, which widens learning culture to safety culture as a whole. Regulations: 12 (safe care and treatment), 16 (complaints), 17 (good governance) and 20 (duty of candour).

2. Safe systems, pathways and transitions

“We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.”

What it means: safety and continuity come first through a person’s whole care journey, including referrals, admissions, discharge and moves between services. The service knows the risks along that journey, manages them with the person and their other care providers, and lines up its safety policies with those partners.

Evidence to have ready:

• Admission, referral and discharge procedures, and records that show staff follow them
• The information that travels with people when they move, such as transfer forms and discharge summaries
• Notes from joint meetings with other services about shared risks
• Transition plans for young people moving to adult services, where relevant

In the draft frameworks: safe systems, pathways and transitions, unchanged. Regulations: 12 and 17, with 9 (person-centred care) to consider.

3. Safeguarding

“We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We make sure we share concerns quickly and appropriately.”

What it means: staff understand safeguarding and act on concerns straight away, working with partners. People who use the service know what being safe means to them and how to raise a concern. The service’s systems protect people from abuse and neglect and uphold their human rights, and it uses the Deprivation of Liberty Safeguards only when they’re in the person’s best interests.

Evidence to have ready:

• A safeguarding policy that says who staff report to and how concerns reach the local authority
• Safeguarding training records for all staff
• A log of safeguarding concerns: what was raised, the referral to the local authority, the notification to CQC and the outcome (our guide to CQC notifications covers when to report abuse)
• Mental capacity assessments, and Deprivation of Liberty Safeguards applications, authorisations and conditions (our DoLS guide covers the June 2026 change)
• How people using the service learn about staying safe and raising a concern

In the draft frameworks: safeguarding, unchanged, covering safeguarding and human rights, deprivation of liberty, bullying, harassment and discrimination, and sexual safety and empowerment. Regulations: 10 (dignity and respect), 11 (need for consent), 12 and 13 (safeguarding service users from abuse and improper treatment), with 9, 17 and 20 to consider.

4. Involving people to manage risks

“We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.”

What it means: people know about the risks in their care and how to keep themselves safe. Risk assessments are person-centred and proportionate, respect people’s choices, and staff review them with the person where possible. Staff respond to distress in ways that protect people’s rights and dignity, and use restraint only as a last resort, lawfully and safely.

Evidence to have ready:

• Person-centred risk assessments, dated and reviewed with the person
• Care plans that record people’s own choices about the risks they take
• Records of any restraint or restrictive practice: the reason, how long it lasted, who reviewed it and the plan to reduce it
• Plans for supporting people in distress, such as positive behaviour support plans, where relevant
• Plans for emergencies, and for spotting when someone’s health is getting worse

In the draft frameworks: managing risks during care and treatment, with the emphasis on managing the risk. Regulations: 9 (person-centred care), 11 (need for consent) and 12, with 10 to consider.

5. Safe environments

“We detect and control potential risks in the care environment. We make sure that the equipment, facilities and technology support the delivery of safe care.”

What it means: the service keeps its premises, equipment and technology safe, in good repair and suited to people’s needs, and staff use equipment properly. The service monitors the safety of its premises, and leaders consider psychological safety as well as physical safety, including sexual safety and sensory needs.

Evidence to have ready:

• Premises safety records, such as the fire risk assessment and the gas and electrical safety checks, with the date each falls due
• Equipment servicing and maintenance records, and how the service acts on equipment alerts and recalls
• Plans for heatwaves, flooding and other environmental risks
• Checks on digital systems and technology
• Risk assessments for staff who work in people’s homes, where relevant

In the draft frameworks: safe environments and infection prevention and control, merged into one topic. Regulations: 12, 15 (premises and equipment) and 17.

6. Safe and effective staffing

“We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development. They work together effectively to provide safe care that meets people’s individual needs.”

What it means: recruitment is safe and thorough, for agency staff and volunteers too, and fair to people with any protected characteristic. Staffing levels and skill mix meet people’s needs. Staff get the training, supervision, appraisal and development their role needs, and managers deal with poor performance.

Evidence to have ready:

• Recruitment records with DBS checks and references, including for agency staff and volunteers
• Rotas, and how the service sets staffing levels and skill mix to match people’s needs
• A training matrix that shows each person’s role-relevant training and when it’s due
• Supervision and appraisal records, and professional revalidation where it applies
• Records of how managers handled performance concerns

In the draft frameworks: safe staffing. Regulations: 12, 18 (staffing) and 19 (fit and proper persons employed).

7. Infection prevention and control

“We assess and manage the risk of infection. We detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.”

What it means: the service manages the risk of infection in line with current national guidance, keeps premises and equipment clean and hygienic, gives staff clear infection control roles, and shares information about infection risk with partners, people using the service and visitors.

Evidence to have ready:

• Who leads infection prevention and control, and the policy they work to
• Cleaning schedules and hygiene audits, with the actions taken
• Outbreak records: what happened, who you told and what you learned
• Staff training on hand hygiene, infection control and personal protective equipment
• Food hygiene records where you prepare food, and clinical waste arrangements

In the draft frameworks: merged with safe environments. Regulations: 12 and 15, with 17 to consider.

8. Medicines optimisation

“We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.”

What it means: people take part in decisions about their medicines, and their care plan records the support they need and their preferences. Everyone who prescribes, supplies or gives medicines follows the law, national guidance and the Mental Capacity Act 2005. Accurate information goes with people when they move between services, nobody uses medicines to control people’s behaviour inappropriately, and the service manages controlled drugs safely.

Evidence to have ready:

• Medicines administration records, complete and checked, and the audits of them
• Policies for ordering, storing and disposing of medicines, and the controlled drugs register
• Medicines reviews held with the person, and the mental capacity assessments and best-interest decisions behind any covert administration
• Protocols for medicines given only when needed (PRN medicines)
• Medicines errors and near misses, with the learning from each
• STOMP reviews (stopping over medication of people with a learning disability), where relevant

In the draft frameworks: safe medicines and treatments for adult social care; safe delivery of treatments and medicines for mental health and for primary care and community services; safe delivery of medicines and treatments for hospitals. Regulations: 9 and 12, with 11 to consider.

Our guide to the CQC well-led key question covers its eight quality statements the same way.

The draft frameworks describe each rating for each topic, in what CQC calls rating characteristics. The regulator wrote them by first asking people what good care looks like, then describing the other ratings around that. They’re drafts and may change before they start. They’re also the plainest account yet of what CQC will look for.

The lines below come from the adult social care draft, version 9. The mental health, primary care and community services, and hospitals drafts ask some questions in different words, and each topic lists more characteristics than we quote here.

Safety culture

CQC’s question: “Is there a positive and equitable safety culture where risks are proactively managed, concerns are listened to, incidents are thoroughly investigated, and lessons are learned to improve care?”

Good:

• “Safety is a shared priority for everyone, including staff and people using the service.”
• “When an incident has happened, staff are open and transparent with people and those close to them. All incidents are recorded, investigated and outcomes are communicated to those involved.”

Outstanding:

• “When an incident has occurred, the people affected are partners in helping to understand what has gone wrong.”
• “Leaders demonstrate visible commitment to safety. They are open, responsive and able to show clear, sustained improvements in safety outcomes for people.”

Managing risks during care and treatment

CQC’s question: “Are risks to each person monitored and managed so that their care and treatment is safe and supportive?”

Good:

• “People’s care plans reflect any foreseeable risks and how they should be managed.”
• “Staff anticipate and proactively seek to identify what is causing people’s distress, and always take a least restrictive approach.”

Outstanding:

• “A rights-respecting culture is embedded in the service and reducing restrictive practices is a shared priority, which is reflected in decision-making about managing risks.”
• “Improvements to risk management are implemented promptly and sustained, and learning is identified, acted on and shared internally and externally.”

The other three drafts ask whether care and treatment are “planned and monitored to identify and manage risks, emergencies, and deterioration”.

Safe systems, pathways and transitions

CQC’s question: “Are there systems to enable collaborative working across care pathways and services, to ensure that safety and continuity of care are prioritised?”

Good:

• “Plans and information for care during transitions are established and shared before people move between services.”
• “Staff can access the information they need to assess and understand people’s needs, and to plan and deliver care.”

Outstanding:

• “Care journeys are proactively planned and co-ordinated across services from the earliest stage.”
• “Transitions, referrals and discharges are co-designed with people and those close to them.”

Safeguarding

CQC’s question: “Does the service work with partners and people to protect their rights to live in safety and be free from abuse and improper treatment?”

Good:

• “Staff can identify abuse and improper treatment. They recognise early indicators of potential abuse or poor care, even when these do not meet the threshold for formal safeguarding concerns.”
• “People are deprived of their liberty lawfully. Any potential deprivation of liberty is recognised promptly and appropriate authorisation is sought.”

Outstanding:

• “Safeguarding is a shared, strategic priority embedded across the whole service.”
• “All staff and people who use the service are actively involved in reviewing and improving safeguarding practice.”

Safe environments and infection prevention and control

CQC’s question: “Are potential risks within the care environment detected and managed appropriately to enable safe delivery of care for people and staff?”

Good:

• “The service monitors and acts on equipment alerts, recalls and safety information.”
• “The service manages the control and prevention of infection well. Infection prevention and control roles are clear.”

Outstanding:

• “There is a culture of shared ownership for the safety of the care environment where everyone is empowered to identify and act on risks, and improvements are celebrated and shared across the system.”
• “People are engaged as partners in infection prevention and control. They are involved in identifying and managing risks.”

Safe staffing

CQC’s question: “Are there enough qualified, skilled and experienced staff who receive adequate support, supervision and development to keep people safe and meet their needs?”

Good:

• “Actions are taken to protect staff from fatigue, and leaders understand its impact on the safety of those who use services.”
• “Staff and volunteers receive training that is appropriate to their role. This is embedded into practice and refreshed at regular intervals.”

Outstanding:

• “Staffing levels are safe and optimised to enable proactive, personalised care.”
• “Supervision is an empowering process for staff, which fosters a culture where reflective practice and continuous learning are a shared priority.”

The other three drafts add “with strategies to manage demand and capacity safely” to this question.

Safe medicines and treatments

CQC’s question: “Are medicines and treatments safe and delivered in a timely way, in line with people’s needs and preferences?”

Good:

• “The administration of PRN medicines (medicines taken when required) is guided by clear protocols, and there are timely reviews.”
• “Controlled drugs are stored, recorded, administered and disposed of in line with legislation and guidance.”

Outstanding:

• “People are treated as partners in assessing their medication needs.”
• “The service uses creative and innovative ways to avoid using covert administration of medicine.”