CQC Single Assessment Framework (SAF)

The Care Quality Commission (CQC) has made changes to how health and social care services in England are checked. This new method is called the Single Assessment Framework (SAF). It makes the process simpler and focuses more on the people receiving care.

The reason for the new introduction in November 2023 was to make it easier for the Care Quality Commission (CQC) to check the quality of care. The new Single Assessment Framework (SAF) replaces the old separate frameworks with one simple system.

This helps the CQC focus on what really matters to people and better match how care is delivered across different areas. It uses the same five key questions (Safe, Effective, Caring, Responsive, Well-led) to keep things clear and consistent.

The new framework puts people at the centre of care. It focuses on safety, improving services, and making sure care providers work together. ‘I statements’ are used to show what people receiving care should expect.

This approach makes sure the CQC checks what is most important to people while helping care services get better.

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CQC Single Assessment Framework

The Care Quality Commission (CQC) Single Assessment Framework (SAF) is a new way of checking health and social care services in England. Its aim is to make the process simpler and easier to understand for all types of care services.

Key points about the SAF:

• Five Key Questions: It still asks if services are safe, effective, caring, responsive, and well-led.
• Quality Statements: These replace the old Key Lines of Enquiry (KLOEs) and explain what care providers need to do using 34 “we statements.”
• Evidence Categories: The CQC collects evidence from six areas, including people’s experiences, staff and partner feedback, processes, and outcomes.
• Ratings: The ratings (Outstanding, Good, Requires Improvement, Inadequate) stay the same.
• Person-Centred Care: The SAF focuses on a more detailed and personal look at services.
• Unified Framework: It replaces separate systems with one set of rules for all care services.

The SAF started in November 2023 and will be fully in place by March 2024. Care providers should learn about the new quality statements and update their services to meet the new rules.

The six categories of evidence that the Care Quality Commission (CQC) uses

The CQC Single Assessment Framework uses six areas to collect evidence:

1. People’s experiences with health and care services
2. Feedback from staff and leaders
3. Feedback from partners
4. Observations of care
5. Processes used in care
6. Results of care.

Using these 6 quality checks, CQC can get a complete picture of what a service offers, which makes it better than the KLOE method.

Explaining the New CQC Approach

This approach helps CQC understand not just if rules are followed, but how well the service is actually working for the people it supports.

1. People’s Experiences with Health and Care Services

This focuses on hearing directly from people who use the services. It includes personal stories, surveys, and feedback about their care.

The aim is to understand how services affect those receiving care.

2. Feedback from Staff and Leaders

This gathers views from staff and managers working in care services. It includes their opinions on the quality of care, challenges they face, and ideas for improvement. This helps understand the service from an insider’s perspective.

3. Feedback from Partners

This collects opinions from external organisations like:

• Other healthcare providers
• Social services
• Community groups
• Commissioners
  These partners give insights into how services work together within the healthcare system.

4. Observations of Care

Inspectors watch care being provided to see:

• How staff interact with people
• The quality of care
• If best practices are followed
• The overall care environment

5. Processes Used in Care

This looks at how care is organised and includes:

• Planning care
• Managing risks
• Giving medication
• Following safety rules
• Keeping good records

6. Results of Care

This examines the outcomes of care, such as:

• Improvements in health
• Recovery rates
• Quality of life
• Managing long-term conditions
• Success of treatments

By using all this information, the CQC gains a full picture of care quality, focusing on real results rather than just ticking boxes.

These six categories in the new CQC framework make the checks clearer and fairer. They help gather and review information about the quality of care in an easy way.

The CQC might focus on different areas when checking care. The number of areas they check can change depending on the type of service and how detailed the check needs to be.

How do the six evidence categories affect a care service’s rating?

The six evidence categories are important in deciding the overall rating of a care service under the new CQC Single Assessment Framework.

These categories include:

1. People’s experiences with health and care services
2. Feedback from staff and leaders
3. Feedback from partners
4. Observations of care
5. Processes used in care
6. Outcomes of care

Here’s how they affect the rating:

• Evidence scoring: The CQC gives each category a score based on the collected information.
• Quality statement scoring: The scores from each category are added up to create a score for each quality statement.
• Key question rating: The scores from quality statements form a rating for each of the five key questions (safe, effective, caring, responsive, and well-led).
• Overall rating: The ratings for the five key questions are combined to give the care service its overall rating.

The scoring uses a 4-point scale:

• 4: Exceptional care
• 3: Good care
• 2: Care needs improvement
• 1: Poor care

This system gives a more up-to-date and clearer picture of service quality, helping both providers and the public see if care quality is improving.

Understanding the NEW CQC Scoring Method

The new CQC scoring system is simpler and clearer for measuring care quality than the old method.

These are the main parts of the new system:

• Four-point scale: CQC now uses a 1 to 4 scale for each quality check:
  • 4: Shows excellent care
  • 3: Shows good care
  • 2: Shows some problems
  • 1: Shows big problems
• Pyramid structure: The scores are organised into five pyramids based on the five key questions (Safe, Effective, Caring, Responsive, Well-led).

• The CQC still checks services based on five main questions
  • Are the services safe?
  • Are the services effective?
  • Are the services caring?
  • Are the services responsive?
  • Are the services well-led?

• Quality statement scores: Scores are given based on quality statements, and they are added up for each key question.
• Key question ratings: Each key question gets a rating like Outstanding, Good, Requires Improvement, or Inadequate.
• Overall rating: The scores for all key questions are combined to give the overall rating for the service.
• Dynamic ratings: The rating can change over time based on new evidence.
• Transparency: The new system is clearer, helping providers see where they need to improve.
• Future plans: In the future, CQC will publish more detailed reports to show exactly how ratings are decided.

This new system makes it easier for providers to see how well they are doing and where they can do better.

The new CQC Single Assessment Framework is a big change in how healthcare services are checked. It uses a clearer and fairer scoring system to help improve care quality.

The goal is to give care providers useful feedback that shows how well they are doing and where they can improve.

CQC Ratings	Quality Score
Outstanding	88% – 100%
Good	63% – 87%
Requires improvement	39% – 62%
Inadequate	38% or lower

How do the quality statements differ from the previous KLOEs

The new Quality Statements from the Care Quality Commission (CQC) are different from the old Key Lines of Enquiry (KLOEs) in several ways:

• Fewer items: The 335 KLOEs have been reduced to just 34 Quality Statements.
• Applies to all services: These Quality Statements now cover all types of care services.
• Focus on results: They focus more on the outcomes (results) rather than how things are done.
• Less detailed: The new statements are not as detailed, giving care providers more freedom to decide how to meet the standards.
• Less repetition: There’s less overlap between different areas, especially in the “Caring” and “Responsive” sections.
• Clearer and shorter: The new statements are easier to understand and use.
• Organised evidence: Each statement is assessed using six main types of evidence.
• “We statements”: The Quality Statements are written from the care provider’s point of view, making expectations clearer.

These changes make the process simpler, clearer, and more consistent for all care services.

What is the cqc single assessment framework?

The Care Quality Commission (CQC) Single Assessment Framework (SAF) is a new way to assess health and social care services in England. It is a new CQC Framework on how to offer personalised care and support, meant for people working in health, care, housing, and those who use these services.

It was introduced in 2023 to make the process simpler and more consistent across all care sectors.

Key points about the CQC Single Assessment Framework include:

• Five key questions: It still focuses on whether services are safe, effective, caring, responsive, and well-led.
• Quality statements: The SAF replaces the old Key Lines of Enquiry (KLOEs) with 34 “we statements” written from the provider’s point of view.
• Evidence categories: The CQC collects evidence in six areas: people’s experience, feedback from staff, feedback from partners, processes, outcomes, and sector-specific evidence.
• Rating system: The same four ratings (Outstanding, Good, Requires Improvement, Inadequate) are used.
• Person-centered approach: It focuses more on assessing services in a personal and individual way.
• Unified expectations: The framework creates one set of rules for all care services, replacing different rules for different types of care.

The SAF started in November 2023 and will be fully used by March 2024. Care providers should review the new quality statements to make sure their services meet the updated standards.

What are the main benefits of the new CQC Single Assessment Framework?

So in terms of benefits, these are the things the SAF offers

The new CQC Single Assessment Framework (SAF) has several benefits:

• Simpler System: It replaces many frameworks with one, so all services are checked the same way.
• Fairer Assessments: Using the same rules for all services makes evaluations more accurate.
• Less Paperwork: A simpler process saves time for both care providers and inspectors.
• Focus on Results: It looks at real-life outcomes and person-centred care instead of just ticking boxes.
• Clearer Rules: The new quality statements make it easier for providers to understand what is expected.
• Up-to-Date Ratings: The SAF ensures ratings reflect current service quality.
• Better Evidence Use: It gathers information from multiple sources to give a balanced score.
• More Transparency: Providers can see exactly how their ratings are worked out.

These changes aim to make care checks fairer, clearer, and focused on what matters most to people.

What challenges have care providers faced with the new SAF framework?

The rollout of the CQC’s Single Assessment Framework (SAF) has brought several challenges for care providers:

• Technical Problems: The new provider portal has faced issues like difficulties uploading documents, delays with password resets, and inefficiencies that waste time.
• Complexity: The SAF’s 34 quality statements are seen as too complicated, and its “one-size-fits-all” approach doesn’t account for differences between service types. The rigid scoring system also limits inspectors’ flexibility.
• Lack of Support: Many providers feel unsupported due to changes in CQC management, unclear guidance, and a confusing website for information.

Other issues include inconsistent inspections, insufficient training for new CQC staff, and high staff turnover, which has reduced expertise. These problems have created frustration and made it harder to build trust between providers and the CQC.

How Caring for Care Can Help with Mock CQC Test Preparation

At Caring for Care, we know how important it is to be ready for a CQC inspection. Our mock CQC tests are made to help care home managers and staff practice and get ready for the real inspection.

We offer mock inspections that are just like the real CQC checks. These tests give your team a chance to practice with questions and situations that could come up during the inspection.

Our expert team will give you feedback on what went well and what can be improved. We cover all five key areas: Safety, Effectiveness, Caring, Responsiveness, and Well-led.

The mock test helps you find areas where care can be better and ensures your care home is ready. We focus on the rules and guidelines of the CQC to make sure your team knows what to expect and is ready for every part of the inspection.

Our mock CQC test service builds your staff’s confidence, reduces stress about the inspection, and helps you be prepared to get the best rating possible.

For more information or to book a mock CQC test, contact us at:

Email: enquiries@caringforcare.co.uk
Phone: 01782 563333

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We are here to help you get ready for your CQC inspection!