CQC update: new draft framework published

Following the public consultation, “Better regulation, better care”, that closed in December 2025, the Care Quality Commission (CQC) has now published a draft of its proposed new inspection framework on Tuesday 24 March 2026. Although this is not the final version, it gives care providers a good idea of the CQC’s intentions towards improving its inspection process and an idea of what to prepare for when it is finalised. Maria Blackwell, Care Specialist Technical Writer, explores the proposed changes and what it means for care providers.

Background

The CQC inspection framework was originally based on the Key Lines of Enquiry (KLOEs), which were then replaced with the single assessment framework (SAF). The SAF was introduced by a phased rollout starting in November 2023 with all services having adopted this by spring 2024. The SAF was published as a one-size-fits-all approach, where inspections for everything from hospitals to care homes were based on the same inspection framework.

Providers and inspectors have provided feedback that shows this framework was too complex. The feedback suggested the one-size-fits-all approach does not work in practice, for example, how “safe” looks different in a hospital and a care home. There was not enough transparency about how providers can achieve a better rating, for example, what “outstanding” looks like in practice. Providers, the public and CQC staff also found that the “quality statements” were too high-level and did not have the same level of detail as the original KLOEs system. There was also feedback provided by professionals to suggest that the SAF was not used consistently across different inspectors and quality was not being judged effectively.

What are the proposed changes?

Although the CQC is labelling the draft framework as KLOEs, instead framing it as “structured questions”, there are a lot of familiarities between the two. There is a reversion to more structured prompts and interrogative inspection style, rather than the narrative-based approach SAF.

One of the main changes proposed in the draft framework is a distinction between separate types of provisions, making the inspections more sector specific. This gives both providers and inspectors more focus and less of a blanket guidance across different types of settings. The four areas are as follows.

Adult social care.
Mental health care.
Primary care and community services.
Hospitals (secondary and specialist care).

Now, there are more distinct and detailed ratings characteristics, which describe what each rating looks like under the five areas: Outstanding, Good, Requires Improvement and Inadequate. This is under review to add clarity to the boundaries between these ratings, as previously it was difficult for providers to distinguish what they could do to improve. This should help providers to understand more clearly why they have been given the rating they have, following an inspection.

Part of the changes also include the recognition of what is within the control of the provider, and what is potentially an issue with the commissioning landscape. This should also help providers as they are less likely to be held accountable for something that is outside of their control.

The proposed new framework also has increased emphasis on real-life impacts on the people using services. By using the “I statements”, people receiving care are put at the heart of the framework, which have been drawn from the Making it Real Framework (co-produced by Think Local Act Personal).

What has not been looked at in this draft?

One of the main areas that has not been looked at within this draft of the new framework is environmental sustainability. The CQC has said that:

“We recognise further work is required to understand and establish an evidence-based approach in this area. We will work with the sector and other relevant stakeholders to determine the most appropriate and proportionate approach to consider environmental sustainability in future versions of our assessment approach.”

Next steps for providers

It is important to remember that this is not the final version of the framework. In case you were to be inspected prior to the final version being published, it is not advisable to make any major changes, as the draft could be revised or modified. It is still worth auditing yourself against the new proposed framework to see what rating you are currently working at, and what you would need to do to move up to the next rating. Get your digital and hard copy files in order and focus on ensuring that you are up to date with all your paperwork, such as auditing, reviews and risk assessments.

However, it is worth familiarising yourself with the draft and what the changes look like against how your service is running now. As the CQC is also increasing its inspection activity, it is advisable to always remain “inspection ready”.