What is it?
The single assessment framework is the new assessment regime that CQC will use across all services and providers they regulate; it is based on the existing five key questions and ratings system. CQC say that it sets out how they will view quality of service and how they will make judgements.
CQC want services and providers to create cultures that will learn and improve. The framework sets expectations for how services and providers need to work together, and within systems, to plan and deliver safe, person-centred care.
The new framework is for providers, local authorities and integrated care systems. It is intended to provide CQC with an up-to-date view of quality and it will cover all sectors and service types from the point of registration onwards.
Reasons for change
CQC say that the new framework is designed to simplify things so they can focus on what really matters to people, to better reflect how care is delivered by different types of service as well as across a local area, and to establish one single framework that connects their registration activity to their assessments of quality.
Implementation
Following the initial release of details back in July 2022, the latest update from CQC (December 2022) confirms a further postponement into 2023 to allow for a phased rollout.
From spring, they will be ensuring that the required technology is in place and is working. In the summer, a staged launch is planned for a new online provider portal. CQC say that providers will be able to apply to register with CQC and make ongoing changes to registration through this portal. Towards the end of 2023, CQC plans to gradually start to carry out assessments under the new framework. By this point, CQC intends that all online interactions with providers will be via the portal.
CQC say that they will provide regular updates and more detail during the year. In the future, CQC will base their assessments of quality in all types of services, and at all levels, on this single assessment framework. In the meantime though, the current methods to monitor, assess and rate providers will continue.
What’s different with the new framework?
The existing five key questions (safe, effective, caring, responsive and well-led) and four quality ratings (outstanding, good, requires improvement and inadequate) will continue to be used under the new framework.
The existing key lines of enquiry (KLOEs) and prompts will be replaced with new ‘quality statements’.
Quality statements
Under each key question, there is a set of topic areas and quality statements (expressed as ‘we statements’). The quality statements describe what CQC believe high-quality and person-centred care looks like and the statements will link to the relevant regulations to assist services and providers.
For each quality statement, CQC will state which evidence they will always need to collect and consider. This will vary depending on the type of service and the level at which CQC are assessing. For example, the evidence required when a new service is registering will differ from a service already in operation.
CQC has developed six categories for the evidence required to assist providers in organising information under the different quality statements. These categories are detailed further below. The below is a list of the five key questions and quality statements headings under each. To read the statements in full, together with the list of relevant regulations, click here.
Evidence categories
The evidence categories detail the types of evidence that CQC intend to use to understand the quality of care being delivered against a particular quality statement.
The number of evidence categories and the sources of evidence that CQC will consider will vary according to the service type, the level of assessment and whether the assessment is at the point of registration or for an existing service. CQC say that they will set out the types of evidence they will focus on in each required evidence category when they are assessing a quality statement.
Each evidence category has an initial schedule for ongoing assessment; this sets out the length of time before CQC need to collect evidence for that category in each service type. CQC’s current ambition is to update the information they hold on a service across all required evidence categories within a two-year period. The six evidence categories are outlined in the table below:
Changes in the assessment process:
How CQC will reach a rating
Quality of care will continue to be rated as either ‘outstanding’, ‘good’, ‘requires improvement’, or ‘inadequate’. A new scoring framework will be used which will translate into one of the ratings for the five key questions. Scores will also be the basis for CQC’s view of quality at an overall service level.
CQC say that initially, only the ratings will be published, however they also intend to publish the scores in future. CQC believe that the system will provide better clarity about how they have reached a judgement on quality, to show if a service is close to another rating and to show whether quality is moving up or down within a rating.
To assess a particular quality statement, CQC will take into account the evidence they have in each of the required evidence categories. Depending on what they find, they will give a score for each evidence category (e.g. a maximum score of 4 reflects an exceptional standard of care whereas the lowest score of 1 reflects significant shortfalls in the standard of care).
As CQC are moving away from assessing at a single point in time, in future they will likely assess different areas of the framework on an ongoing basis. Scores for different evidence categories could therefore be updated at different times.
CQC point out that any changes in evidence category scores can then update the existing quality statement score. This in turn could then have an impact on the rating.
CQC say they will follow these stages to produce a key question and overall rating for a service:
- Review evidence types within the evidence categories for each quality statement.
- Score each of these evidence categories.
- Combine these scores to give a score for the related quality statement.
- Combine the quality statement scores to give a total score for the relevant key question.
- This score generates a rating for each key question.
- Aggregate the key question ratings to give the overall rating.
Implications for providers:
The system is changing. These are the key points that services and providers need to be aware of and need to be preparing for:
- We can expect the portal to open in the summer with a view to rolling out assessments under the new framework commencing towards the end of the year.
- Fundamentally, the new framework will bring a degree of flexibility to the CQC that services and providers will need to be prepared for. There will be real-time, ongoing review and monitoring which will allow the amendment of scores and even ratings at short notice and at any time without a site visit.
- Judgements about quality will be made more regularly, instead of only after an inspection and assessments will not be tied to set dates or driven by a previous rating.
- CQC will use a wide range of information and sources to gather evidence (including from service users, their families and providers’ employees) to assess and they won’t be reliant upon site inspections solely for the source of their evidence.
- Feedback from people’s experiences will be central to CQC judgements and this will be valued as highly as other sources of evidence. It follows, therefore, that there will be increased scrutiny of how providers encourage, enable and act on feedback received.
- CQC say they will always treat any negative feedback about poor cases as a concern. They will review further and gather more evidence, even if other available evidence sources haven’t previously indicated any issues.
- In relation to frequency of assessments, a service’s rating will no longer be the main factor when deciding when next to assess. Evidence collected or information received at any time can trigger an assessment.
- In addition, the frequency of visits will also increase where concerns exist such as the risk of a poor or closed culture going undetected, or where there are concerns about transparency and availability of evidence. A visit is also more likely to be required if it is deemed to be the only way to gather people’s experience of care or, to ensure the right people and activities will be available to assess quality.
- Ultimately, any changes in evidence category scores can allow CQC to update the existing quality statement score. This could then impact upon the rating of the service or provider.
Further updates will be provided as the year progresses. Brabners is here to help care home operators navigate the challenges that may lie ahead. For all enquiries, please do not hesitate to contact the team on 0333 004 4488 or at hello@brabners.com.
Updated Jan 2026
