Article

The CQC 2026 assessment framework: what is changing, what is not, and what to do now

Four draft sector frameworks, one common architecture. An ex-CQC inspector on what actually changes, the count that is about to be reported wrongly, and why you should not rebuild your governance around a draft.

By Klaudiusz Zembrzuski, ex-CQC inspector.

Status of this page

CQC has published draft sector assessment frameworks. They are drafts, issued for feedback, and they are not the framework your service is assessed against today.

The current published assessment framework remains in force while CQC pilots and evaluates the proposed approach.

The timeline, confirmed with CQC:

We have read the four drafts and the consultation response in full and checked every number on this page against them. Where something is a reasonable inference rather than a statement in the documents, we say so.

The short answer

If you are hoping for one line to take back to your team, it is this.

The five key questions are not changing. Your evidence is not wasted. Do not rebuild your governance system around a draft.

What is changing is the layer above your evidence: how CQC organises its questions, how it describes each rating level, and how it arrives at a rating. That is a real change, and it is worth understanding. It is not a reason to start again.

What is not changing

The five key questions. Safe, effective, caring, responsive and well-led appear in all four drafts, unchanged. They have anchored CQC assessment since 2014 and they survive this transition intact.

The four rating levels. Outstanding, good, requires improvement and inadequate.

The law. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 are unaffected by a change to CQC's assessment method. The fundamental standards remain statutory duties: safe care and treatment, safeguarding, good governance and the duty of candour do not move because an assessment framework is redrafted.

Your evidence. Incidents, complaints, safeguarding records, audits, risk registers, staffing records, training records, meeting minutes and action plans all carry across. The questions they answer are being regrouped and renamed, not abolished. The same is true of your written framework: the sample policy library is anchored to the five key questions and the statutory regulations, both of which survive this transition.

What is changing

One framework becomes four

CQC proposed moving away from a single framework towards frameworks specific to each sector. In its February 2026 summary of consultation responses, CQC recorded that 94 per cent of respondents agreed with that approach.

There are four drafts, matching the four chief inspector portfolios CQC described in the consultation: hospitals, mental health, primary and community care, and adult social care.

This is a return, not an invention. CQC used sector-specific key lines of enquiry and rating characteristics from 2014 until the Single Assessment Framework replaced them.

Quality statements become supporting questions

The Single Assessment Framework, introduced in 2023, replaced the previous key lines of enquiry, prompt questions and rating characteristics with quality statements written at the level of a good service.

The drafts reverse that. Each key question now contains named supporting questions, each with a scope list of topic areas and a table describing what each of the four rating levels looks like.

In practice this means you can once again read what CQC is asking, in a question, rather than inferring it from a statement about what good looks like.

Rating characteristics come back at every level

Under the Single Assessment Framework, quality statements described a good service. Respondents told CQC that this left them unable to see what separated requires improvement from good, or good from outstanding.

The drafts set out characteristics at all four levels. CQC recorded 94 per cent agreement with publishing clear rating characteristics for each rating.

For a provider preparing for assessment, this is arguably the single most useful change on this page. You will be able to read the description of the rating above yours.

Scoring goes, professional judgement returns

Alongside the Single Assessment Framework, CQC introduced scoring. Quality statement scores were awarded on a scale of one to four, built up from evidence category scores, with ratings calculated from percentage scores.

CQC's proposal removes that. In CQC's own words, the approach moves:

from a five-stage process (evidence gathering, evidence category scores, quality statement scores, key question ratings, overall ratings) to a simpler four-stage process where key question ratings are awarded directly based on professional judgement with reference to rating characteristics.

CQC recorded 79 per cent agreement with awarding ratings directly at key question level. That is the lowest agreement figure of the framework proposals, and the consultation response is candid about why: support was conditional on inspectors having the sector expertise to exercise judgement credibly.

Simplification, and what it actually removes

Respondents described the current 34 quality statements and 40 to 45 rating prompts as excessive, and pointed out that the same issue was assessed in several places at once. One example raised was the imbalance between three quality statements under caring and seven under safe.

Agreement with simplifying the frameworks and removing duplication was 97 per cent, the highest figure in the consultation.

The number to be careful with

You will see the figure 24 attached to adult social care and assume that is the new national number. It is not, and the difference matters if you run services in more than one sector.

We counted the supporting questions in all four drafts, reading the document bodies rather than the contents lists. All four contain the same 26 assessment concepts. Adult social care displays 24 headings because two of its headings each cover two concepts:

Hospitals, primary care and community services, and mental health each display all 26 separately.

Two of the drafts mislead anyone counting from their contents page. The mental health draft leaves safeguarding out of its contents list, though the body carries it in full with its supporting question and an eight-item scope list. The primary care draft runs its contents onto a second page, where the last three well-led headings sit. Counting from those contents pages alone gives 25 and 23. Both are 26.

If you have seen a different count published elsewhere, that is probably why.

Where the sectors genuinely differ

Most of the difference between the four drafts sits in the scope lists and the examples, not in the questions. The areas that are genuinely sector-specific:

Caring is the least sector-specific key question of the five. The drafts ask substantially the same thing of a care home, a general practice and a mental health ward.

One deliberate omission worth knowing: CQC states in the adult social care draft that it has not included environmental sustainability, and that further work is needed to establish an evidence-based approach. It appears in the other three.

What this means for your evidence

The drafts ask a harder question than the current framework, and it is the same question in every one of the 26 areas. Having the document is not the answer.

Reading the rating characteristics across all four drafts, the pattern that separates good from requires improvement is consistent:

  1. A proportionate control exists.
  2. It is used in ordinary practice, including by temporary staff and under pressure.
  3. It reaches everyone it should, including people at risk of exclusion.
  4. The service monitors whether it is working.
  5. Findings become owned, timely action.
  6. Action is checked for effectiveness.
  7. Something measurably improves.
  8. The learning is retained and spread.

A completed audit is evidence of activity. It becomes assurance when you can show the finding, the decision, the action, who owned it, whether it worked and what changed as a result.

This is the honest reading of the drafts rather than a phrase CQC uses. We think it is the most useful single thing on this page, because it is what most services are already half doing and can finish without waiting for a final framework.

What to do now

Do not rebuild. These are drafts. Rebuilding your governance system around wording that has not been finalised is the most expensive mistake available to you right now.

Do close your loops. Every one of the eight steps above is testable today, against the current framework, with the evidence you already hold. Nothing in that list depends on which wording CQC settles on.

Do check your weakest interface. Referrals, handovers, discharge, shared care and delegated activity recur across safe, responsive and well-led in all four drafts. The drafts consistently ask what the provider did when a partner failed. Context is recognised, but mitigation and escalation remain your evidence.

Do read the sector draft that applies to you, especially its scope lists. That is where the sector-specific expectations sit, and it is the fastest way to spot something you do not currently evidence at all.

Do not pay anyone to make you compliant with a draft. Including us. There is no such thing yet.

What would change this page

We will update this page when any of the following happens, and we date every change:

Related guidance

Sources

Percentages, response numbers and the description of the five-stage to four-stage change are taken from the consultation response document. Counts of supporting questions are our own, taken from the bodies of the four drafts.

Where this page says what the drafts are likely to mean in practice, that is our reading as an ex-CQC inspector, not CQC guidance, and we have marked it as such.

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