Do the CQC fundamental standards change under the new single assessment framework?

No. The 14 fundamental standards come from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and are not changing. What’s changing is how CQC assesses you against them — the assessment method, not the underlying standards.

Do I need to meet all of the fundamental standards?

Yes. CQC describes them as “the standards below which your care must never fall”, so every one that applies to your service must be met at all times. You should be able to show this through up-to-date policies, risk assessments and records — and by actually following them in practice.

What’s the difference between the fundamental standards and the 5 key questions?

The fundamental standards are the specific legal requirements your care must never fall below. The 5 key questions — safe, effective, caring, responsive and well-led — are the lens CQC uses to assess and rate how well you meet those standards overall. In short, the standards are the “what” and the key questions are the “how it’s judged”.

What happens if I fail a CQC inspection?

If care doesn’t meet the standards, CQC can take action ranging from requiring an improvement plan to formal enforcement, and your rating can be lowered. The most reliable way to avoid this is to keep the right policies, risk assessments and records current and to evidence that you follow them.

Who is not regulated by CQC?

CQC regulates providers of health and adult social care carrying on regulated activities in England — so services outside England, and activities that aren’t “regulated activities”, generally fall outside its remit. If you’re unsure whether you must register, check CQC’s scope of registration guidance before assuming you’re exempt.

Meeting CQC Regulations in Plain English | BarkerScott

In plain English

CQC sets 14 “fundamental standards” — the level below which your care must never fall. It then judges you against 5 key questions (safe, effective, caring, responsive, well-led) using “quality statements”. To pass, you need the right policies, risk assessments and records in place — and to actually follow them. CQC’s assessment method is changing through 2025–2026, so keeping documents current matters more than ever.

First, who are the CQC?

The CQC is the independent regulator of health and adult social care in England. It registers providers, checks they meet the law, inspects and assesses them, and can take action where care isn’t good enough.

Who are the CQC? — official CQC video

The 14 fundamental standards

These come from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. CQC describes them as “the standards below which your care must never fall”. In plain terms:

Person-centred care

Care and treatment tailored to the individual and their needs and preferences.

Visiting and accompanying

People can receive visits and be accompanied at appointments (added April 2024).

Dignity and respect

People are treated with dignity and respect at all times, including privacy.

Consent

Care and treatment given only with consent (or a lawful basis where consent can’t be given).

Safety

Care and treatment provided in a safe way, with risks assessed and managed.

Safeguarding from abuse

People are protected from abuse and improper treatment.

Food and drink

People have enough suitable food and drink to keep them in good health.

Premises and equipment

Premises and equipment are clean, secure, suitable and properly maintained.

Complaints

A system to handle and respond to complaints, investigated thoroughly.

Good governance

Systems to assess, monitor and improve quality and safety, and keep good records.

Staffing

Enough suitably qualified, competent and experienced staff.

Fit and proper staff

Robust recruitment and checks so only fit and proper people are employed.

Duty of candour

Being open and honest with people when something goes wrong.

Display of ratings

Displaying your CQC rating where people can see it, including on your website.

Every one of these needs to be reflected in your written policies and procedures — and evidenced in practice.

How CQC assesses you: the 5 key questions

CQC assesses all services against five key questions. It asks whether your service is:

Safe — are people protected from avoidable harm?
Effective — does care achieve good outcomes and follow best practice?
Caring — are people treated with compassion, dignity and respect?
Responsive — is the service organised around people’s needs?
Well-led — is leadership, governance and culture supporting good care?

Under CQC’s Single Assessment Framework, the old “Key Lines of Enquiry” were replaced by quality statements — short “we statements” describing what good care looks like (for example, “We work in partnership with people”). You’re expected to show how you live up to them.

Introducing quality statements and evidence categories — official CQC video

Heads-up: CQC’s assessment approach is changing (current as of June 2026)

CQC is overhauling how it assesses providers. Scoring at “evidence category” level stopped on 2 December 2024, and following its “Better regulation, better care” consultation (closed December 2025) CQC is developing sector-specific frameworks and proposing to replace quality statements with KLOE-style “supporting questions”, with final frameworks expected around summer 2026. The fundamental standards themselves are not changing — but the way you’re assessed is, which is exactly why out-of-date policies are risky.

Walkthrough of CQC’s new regulatory approach — official CQC video

What you actually need to do (and document)

Meeting the standards isn’t about having a folder of policies — it’s about having the right ones and using them. In practice you should be able to show:

Up-to-date policies covering each relevant standard (safeguarding, consent, IPC, medicines, complaints, governance, data protection, and more).
Risk assessments for your premises, equipment, activities and people.
Records that prove you follow them — training logs, audits, supervision, incident reports, meeting minutes.
A clear Statement of Purpose, the right registered people in post, and evidence that staff and directors are fit and proper.
Regular audits and improvements — CQC wants to see you spot problems and act.

Practical application of the assessment framework — official CQC video

What an inspection looks like

Inspections combine on-site visits, conversations with people and staff, and review of your evidence. Knowing what inspectors look for — and having your paperwork ready — takes most of the stress out of it.

CQC inspections: how we do them and why it matters to you — official CQC video

Frequently asked questions