CQC Quality Statement

Understanding the CQC’s 34 Quality Statements

The Care Quality Commission (CQC) introduced a major change in 2023 with its Single Assessment Framework, replacing the old Key Lines of Enquiry (KLOEs) with 34 quality statements.

This new approach is designed to be simpler, more person-focused, and better at measuring real outcomes for people using health and social care services.

The framework is built around five key questions: Safe, Effective, Caring, Responsive, and Well-led. Each quality statement fits into one of these categories, helping services understand what good care looks like and how to keep improving.

This guide explains all 34 quality statements in detail. It’s designed for care providers, managers, and professionals who want to deliver high-quality care that meets CQC standards—and most importantly, meets the needs of the people they support.

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The Five Key Questions

The 34 quality statements are structured around five fundamental questions that the CQC uses to evaluate services:

  • Safe – Are people protected from abuse and avoidable harm?
  • Effective – Does the service achieve good outcomes for people?
  • Caring – Are people treated with compassion, dignity, and respect?
  • Responsive – Are services organised to meet people’s needs?
  • Well-led – Does the leadership promote high-quality, person-centred care?

Each question addresses critical aspects of care delivery, from the physical safety of environments to the cultural values that shape organisational behaviour.

Together, they create a comprehensive picture of quality that moves beyond compliance to embrace genuine excellence in care.

📚Related: Download Free Sample of 34 “SAFE” Quality Statement Checklist.

Explaining the New 34 CQC Quality Statements

Safe (8 Quality Statements)

The Safe domain within the CQC’s Single Assessment Framework is dedicated to ensuring that health and social care services protect individuals from abuse and avoidable harm.

Safety is not simply the absence of incidents—it is the presence of proactive, well-designed systems that anticipate risks and promote a culture of continuous improvement.

Examples include promoting a positive culture where safety concerns are addressed and lessons are learned, ensuring skilled and sufficient staffing, and upholding safeguarding practices to protect individuals from harm.

A strong learning culture is key to keeping people safe in care settings. Organisations should create an environment where staff feel safe to speak up about safety concerns, mistakes, or near misses—without being blamed.

This openness helps services investigate problems properly, find out what went wrong, and make changes to prevent them from happening again.

When transparency and accountability are part of everyday work, it builds trust and shows a real commitment to improving care.

Moving between services—like from hospital to home—is a critical time for patients. To keep people safe, care providers must plan these transitions carefully. This means clear communication between teams, proper handovers, and thorough discharge planning. The aim is to make the experience smooth and connected, so no one falls through the cracks.

Safeguarding means protecting people from abuse or neglect. Every care service must have strong procedures to spot and report concerns. Staff need training to recognise signs of harm and know what to do.

Working with safeguarding boards and other organisations is essential, because keeping people safe is everyone’s responsibility.

Risk management should be a collaborative process. This statement highlights the importance of engaging individuals, families, and carers in conversations about risk.

These discussions should balance safety with autonomy, supporting people to make informed choices—even when those choices involve positive risk-taking that enhances independence and wellbeing.

A risk-free life is neither realistic nor desirable; instead, services should aim for informed, supported decision-making.

The places where care is delivered must be safe and comfortable. This includes keeping buildings clean, equipment in good working order, and spaces well-lit and accessible.

A safe environment also means one that feels welcoming and supports emotional wellbeing.

Safe care depends on having the right staff in the right place at the right time.

Services must assess staffing needs based on the complexity of care and ensure adequate coverage across all shifts. Staff should receive thorough induction, ongoing training, and professional development to maintain competence.

Flexibility in deployment is key, allowing services to respond to changing needs and maintain high standards of care.

Infection prevention and control (IPC) is vital for protecting both service users and staff. Organisations must uphold rigorous hygiene standards, use personal protective equipment appropriately, and follow evidence-based protocols.

The COVID-19 pandemic highlighted the importance of adaptable IPC systems that can respond to emerging threats while maintaining routine safety measures.

Vigilance and consistency are essential to effective infection control.

Medicines are a central part of healthcare, and their safe management is critical. This statement covers the entire medicines pathway—from prescribing and dispensing to administration and review.

Services must ensure secure storage, accurate administration by trained staff, and regular monitoring for effectiveness and side effects.

People should be involved in decisions about their medications, and systems must be in place to learn from any errors, fostering a culture of safety and responsiveness.


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Effective (6 Quality Statements)

The Effective domain emphasizes delivering care, treatment, and support that lead to positive outcomes, guided by the best available evidence.

Effectiveness is assessed not only through clinical measures but also by the extent to which people experience genuine improvements in their health, wellbeing, and quality of life.

Examples include planning and delivering care based on legislation and evidence, regularly reviewing care to improve outcomes, and assessing individuals’ health, care, and communication needs.

A holistic assessment is the foundation of person-centred care.

Services must carry out thorough evaluations that encompass not only medical needs but also psychological, social, cultural, and spiritual aspects.

These assessments should be timely, inclusive of the individual and those important to them, and serve as the basis for truly personalised care planning.

Ongoing reassessments are essential to ensure care remains responsive to evolving needs and circumstances, recognising that people’s lives and situations are continually changing.

Care and treatment must be rooted in the most reliable and up-to-date evidence, including clinical guidelines, research insights, and established best practices.

Services are expected to stay informed about developments in their field, apply evidence-based approaches, and engage in clinical audits to assess performance against recognised standards.

In situations where evidence is limited or still emerging, services should make thoughtful, transparent decisions in collaboration with the person receiving care, clearly explaining the reasoning behind treatment options and exploring alternatives together.

Delivering effective care relies on strong collaboration and clear communication.

Within organisations, teams and departments must work in harmony—sharing information appropriately and coordinating efforts toward shared goals.

Externally, services should build effective partnerships with other healthcare providers, social care organisations, voluntary sector groups, and community resources.

Multidisciplinary teamwork, consistent communication, and integrated care pathways help reduce duplication, improve outcomes, and ensure people experience care as connected and coherent rather than fragmented.

Healthcare services play an important role in promoting good health and preventing illness, not just treating it when it happens.

This statement emphasises the need for proactive support that helps people stay healthy, avoid deterioration, and manage long-term conditions well.

This involves providing health education, encouraging positive lifestyle changes, promoting physical activity and healthy eating, tackling social factors that affect health, and connecting people with community resources that improve wellbeing.

The focus moves from reacting to illness to empowering people to live as healthily as possible.

High-quality services systematically use data to understand the impact of care on people’s lives.

This includes tracking clinical results, functional progress, quality of life indicators, and individuals’ experiences of care.

Organisations should analyse this information to identify trends, benchmark performance, highlight areas for improvement, and celebrate achievements.

Outcome monitoring should be central to continuous quality improvement and strategic planning—creating a cycle of measurement, learning, and enhancement.

Respecting individual autonomy means ensuring people give informed and valid consent for their care and treatment.

Services must provide clear, accessible information about proposed interventions, including potential benefits and risks, and allow time for questions and consideration of alternatives.

Staff should be well-versed in the principles of consent, including assessing capacity and understanding how to proceed when capacity is lacking.

While the Mental Capacity Act and its codes of practice offer the legal framework, the heart of this statement is about building genuine partnership and honouring personal choice.

Caring (5 Quality Statements)

The Caring domain centres on ensuring that staff engage with people in ways that reflect compassion, kindness, dignity and respect.

These qualities elevate clinical expertise into truly person-centred care, recognising and honouring the humanity of every individual involved.

Examples include treating individuals with kindness and respect, tailoring care to personal needs and preferences, and supporting staff wellbeing to enable person-centred care.

15. Kindness, Compassion and Dignity


The essence of caring lies in the quality of interactions between staff and the people they support.

Staff should consistently show genuine empathy, treat individuals with kindness, and actively uphold their dignity.

This includes respecting privacy, communicating with warmth and respect, demonstrating patience, and acknowledging the vulnerability that often accompanies illness or disability.

Even small acts of compassion can profoundly shape a person’s experience, creating meaningful moments that go beyond clinical care.

Every person brings a unique set of values, preferences, cultural background, beliefs, and life experiences to their care journey.

Services must recognise and respond to this individuality by tailoring care to meet specific needs, rather than relying on standardised approaches.

This involves respecting cultural and religious practices, accommodating communication preferences, embracing diversity, and ensuring care plans reflect what matters most to each person.

Truly individualised care begins with curiosity and respect for the whole person, not just their diagnosis.

Supporting people to retain control over their lives and care is a cornerstone of person-centred practice.

Services should promote independence, offer meaningful choices, and respect decisions—even when they differ from professional advice.

Wherever possible, individuals should be supported to do things for themselves.

This may include providing aids and equipment, offering options in daily routines, involving people in care planning, and encouraging positive risk-taking that promotes autonomy.

The aim is to enable, not override, recognising that independence and self-determination are vital to wellbeing and dignity.

Care must be responsive to people’s needs as they arise.

Staff should be present, attentive, and quick to act when individuals require assistance, experience discomfort, or express concerns.

Prompt responses to call bells, timely support, and well-organised services help prevent delays and demonstrate that people’s needs are valued.

Being responsive not only prevents small issues from escalating but also reinforces trust and respect, ensuring people feel heard and cared for in the moment.

Staff who feel supported, valued, and empowered are far better able to provide compassionate, person-centred care.

This statement recognises that caring for the workforce is inseparable from caring for people who use services.

Organisations should promote staff wellbeing through reasonable workloads, emotional support, opportunities for development, recognition of achievements, and creating positive working environments.

Enabling staff to work to their full potential benefits everyone, creating a positive cycle where valued staff provide better care, which in turn enhances job satisfaction.


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Responsive (7 Quality Statements)

The Responsive domain focuses on how services are organised and delivered to effectively meet people’s needs.

Responsiveness requires flexibility, accessibility, and a commitment to reducing inequalities in access, experience, and outcomes.

Examples include providing care and treatment that meet each person’s needs, making it easy for people to give feedback and be involved, and ensuring care is well-coordinated, flexible, and supports personal choice.

Person-centred care represents the golden thread running through all CQC quality statements.

This statement emphasises planning and delivering care based on what matters to each individual, involving them as equal partners in decision-making, and ensuring care plans are truly personalised rather than templated.

Person-centred approaches require services to be flexible, creative, and willing to adapt systems and processes to accommodate individual needs and preferences.

It demands a fundamental shift from asking ‘What’s the matter with you?’ to ‘What matters to you?’

People should experience their care as seamless and coordinated, even when multiple teams or organisations are involved in their support.

This statement requires effective integration across services and continuity of staff where possible.

It also calls for smooth coordination of different elements of support, along with systems that ensure important information follows the person throughout their care journey.

Integration relies not only on technical solutions like shared records, but also on strong professional relationships and collaborative working.

The goal is to create a joined-up experience that supports safety, consistency, and better outcomes.

People need accessible, clear, and timely information to understand their condition, make informed decisions, and navigate the healthcare system confidently.

Information should be provided in formats that meet people’s needs, including different languages, easy-read versions, audio formats, or large print.

Services should ensure people understand key information about their care, know who to contact with questions or concerns, and have access to resources that support self-management and informed decision-making.

Information is power, and providing it appropriately enables people to be active participants in their care.

Services should actively seek and genuinely value the views, experiences, and ideas of people who use services, their families, and communities.

This goes beyond satisfaction surveys to genuine co-production, where people are involved in designing, delivering, and evaluating services.

Organisations should create multiple channels for feedback, respond transparently to concerns and suggestions, and demonstrate how people’s input has influenced service development and improvement.

Listening without action is meaningless; this statement requires services to show they have heard and responded.

Everyone who needs care should be able to access suitable services, no matter their background, characteristics or circumstances.

This statement asks services to find and tackle barriers that stop people from accessing care.

These barriers might include physical inaccessibility, money problems, lack of digital access, language differences or discrimination.

Reaching out to underserved communities, offering flexible appointment options and providing culturally sensitive care all help make access fairer.

The aim is to remove the obstacles that stop people from getting the care they need, when they need it.

Everyone who needs care should be able to access appropriate services, regardless of their background, characteristics, or circumstances.

Services should actively identify and remove barriers to access—whether physical, financial, digital, linguistic, or cultural.

This includes addressing discrimination, offering flexible appointment systems, providing culturally competent care, and reaching out to underserved communities.

The goal is to ensure that no one is excluded from receiving the care they need, when they need it—making equity a lived reality, not just an aspiration.

Anticipatory care planning ensures that people receive care aligned with their wishes as their health or circumstances change.

Services should support individuals in making plans for the future, including advance care planning for those nearing the end of life, contingency planning for fluctuating conditions, and discharge planning for hospital patients.

Planning should involve meaningful conversations, clear documentation of preferences, and coordination with relevant services to ensure plans can be acted upon when needed.

Thoughtful future planning offers reassurance and ensures that people’s voices are respected—even when they are unable to speak for themselves.

Well-Led (8 Quality Statements)

The Well-Led domain focuses on leadership, management, and governance that enable delivery of high-quality, person-centred care.

Effective leadership creates the conditions in which good care can flourish, setting the tone and direction for the entire organisation.

Examples include having inclusive leaders with the right skills and experience, keeping clear roles and strong governance, and focusing on ongoing learning, new ideas, and improvement.

Effective organisations have a clear vision and set of shared values that everyone supports, from board members to frontline staff.

Leaders should clearly explain the organisation’s goals, encourage a positive and inclusive culture, and create a workplace where learning and improvement are supported and recognised.

The organisation’s culture should show person-centred values in everyday actions and interactions.

When the vision and values are firmly in place, they naturally guide how people behave, even without strict rules or supervision.

The quality of leadership directly affects the quality of care.

This statement expects leaders at all levels to be skilled in their roles, show compassion in how they treat staff and people who use services, and promote inclusion and diversity.

Good leaders inspire and motivate others, set a positive example through their actions, support learning and development, and have the courage to make tough decisions that bring about positive change.

Leadership is not just about job titles; it can and should be shown by people at every level.

A culture of openness, where staff feel safe to speak up, is vital for spotting and fixing problems before they cause harm.

Services should have clear policies and procedures for raising concerns, appoint people such as Freedom to Speak Up Guardians or champions. Protect staff from negative treatment when they raise genuine issues, and show that concerns are taken seriously and acted on.

How leaders respond to people speaking up shapes the organisation’s culture.

When staff see that concerns are listened to and dealt with, it builds trust and confidence.

But when concerns are ignored or staff are punished for speaking up, it creates a culture of silence.

Organisations should create positive workplaces where diversity is respected and everyone is treated fairly.

This means having leaders who reflect the workforce and the communities they serve and using fair hiring and promotion processes.

It also involves dealing firmly with discrimination and harassment, making reasonable adjustments for disabled staff, and supporting employees with different needs.

A diverse and inclusive workforce is better able to understand and meet the needs of different communities, bringing a range of ideas that improve problem-solving and innovation.

Strong governance and management systems are the foundation for quality and accountability.

This means having clear structures and processes for decision-making, managing risks, checking quality, overseeing finances, and following regulations.

Governance should be transparent, with clear accountability and sensible delegation of responsibilities.

Services need to be run sustainably, balancing quality and safety with financial stability and planning for future challenges and opportunities.

Good governance provides the framework that allows high-quality care to be delivered consistently.

No organisation works alone, and this statement highlights the importance of working together.

Services should cooperate effectively with partners, including other health and social care providers, local authorities, voluntary organisations, and community groups.

Strong partnerships help provide joined-up care, avoid duplication, tackle wider health issues, and make sure people can access the full range of support they need.

Organisations should also take an active part in local and regional planning, recognising their role in the wider health and care system.

No organisation operates in isolation, and this statement recognises the importance of collaborative working.

Services should work effectively with system partners, including other health and social care providers, local authorities, voluntary organisations, and community groups.

Effective partnerships enable integrated care, reduce duplication, address wider determinants of health, and ensure people can access comprehensive support.

Organisations should contribute actively to local and regional planning and priority-setting, recognising their role in the broader health and care system.

High-performing organisations are always looking to improve.

This statement highlights the importance of learning from different sources, such as incidents, complaints, audit results, and good practice from elsewhere.

Services should have structured approaches to improving quality, encourage new ideas and creative problem-solving, and give staff time to take part in improvement work.

A learning culture supports both small improvements and major changes, recognising that there are always ways to make care better and that yesterday’s high standards may become tomorrow’s baseline.

Healthcare organisations have significant environmental footprints, and services must consider their environmental impact as part of responsible practice.

This includes reducing waste, improving energy efficiency, minimising carbon emissions, supporting active travel, and procuring sustainably.

Environmental sustainability is increasingly recognised as a quality issue, as climate change and environmental degradation have direct and indirect impacts on health and wellbeing.

Services have both an opportunity and a responsibility to model sustainable practices and contribute to planetary health.


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Implementing the Quality Statements

  • Making the Statements Part of Daily Work
    Understanding the 34 quality statements is only the first step. The key is to make them part of everyday practice so that quality is at the heart of how services work.
  • Checking Performance
    Organisations should regularly check how well they meet each statement using audits, observations, feedback from staff and service users, incident reports, and outcome data. Honest self-checks show what works well and what needs improvement, creating a continuous cycle of reflection and action.
  • Involving All Staff
    Quality is everyone’s responsibility. Staff at all levels should receive training, clear guidance, and opportunities to help improve services. When people see how their work makes a difference, motivation and engagement increase.
  • Focusing on Priorities
    No organisation can improve everything at once. Use reviews, risk assessments, and feedback to identify the areas that need the most attention. Focusing on clear priorities leads to real improvements.
  • Using Quality Improvement Methods
    Techniques like Plan-Do-Study-Act cycles, driver diagrams, or Lean principles can turn ideas into practical improvements. Changes should be tested on a small scale, guided by data, and involve the people affected.
  • Getting Ready for CQC Inspections
    The main aim is improvement, not just meeting rules, but inspections check how well services follow the statements. Keep clear evidence, ensure staff understand the statements, and show real improvements. When quality is part of everyday work, it will naturally show during inspections.

Conclusion

The CQC’s 34 quality statements provide a clear, person-centred framework for improving health and social care. They cover not just technical standards but also the culture and relationships that shape people’s experiences.

For providers, the statements guide continuous improvement and regulatory compliance. For people using services, they show a commitment to safe, effective, and compassionate care.

True success requires more than meeting requirements—it needs strong leadership, committed staff, and ongoing investment in systems. When embedded into daily practice, the statements drive real improvements and better outcomes.

As care evolves, the framework offers a stable yet flexible foundation for innovation, collaboration, and a focus on what matters most: helping people live well with dignity and compassion.

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