CQC’s Proposed Framework. PGQ Solutions consider What Providers Need to Know as Regulation Evolves

The regulatory landscape for health and social care is entering another important period of change. Following significant sector feedback on the Single Assessment Framework, the Care Quality Commission is now proposing a move away from the current Quality Statements towards clearer, sector-specific assessment frameworks, supported by structured Key Lines of Enquiry-style questions.

The five key questions remain central:

Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?

However, rather than assessing against broad Quality Statements, CQC is proposing supporting questions that look and feel more like the previous KLOEs. These are intended to give providers clearer expectations around what inspectors will look for, what evidence is relevant, and how judgements may be formed.

CQC is also proposing to reintroduce rating characteristics. This is significant because providers have often asked for clearer descriptions of what Outstanding, Good, Requires Improvement and Inadequate look like in practice. If implemented well, this should support greater consistency and give providers a clearer benchmark for improvement.

Another key proposal is the removal of scoring from the assessment methodology. Future judgements are expected to rely more heavily on structured professional judgement, informed by evidence and aligned to rating characteristics. This means providers will need to focus less on isolated evidence uploads and more on demonstrating a coherent, embedded and measurable picture of quality.

What does this mean for providers?

For adult social care, the change should be seen as an opportunity to reset internal assurance arrangements. Providers should not wait for the final framework before acting. The fundamentals of good care remain unchanged: safe systems, effective governance, capable leadership, skilled staff, robust risk management, meaningful care planning and strong evidence that people experience good outcomes.

The proposed approach is likely to place even greater importance on:

• clear governance and accountability;
• evidence that actions lead to sustained improvement;
• person-centred care planning;
• risk assessment that is current, practical and understood by staff;
• learning from incidents, complaints, safeguarding and audits;
• staff competence and leadership visibility;
• feedback from people, relatives, staff and professionals;
• outcomes that can be demonstrated, not just described.

A provider may have policies, audits and meeting minutes in place, but the question will increasingly be: what difference has this made for people using the service?

A shift from compliance evidence to lived experience

One of the most important messages for providers is that regulation is becoming less about having documents available and more about being able to show that governance is embedded. Evidence must connect.

For example, if an audit identifies a gap, there should be an action plan. If the action plan is completed, there should be evidence of checking whether the improvement worked. If the issue relates to staff practice, there should be evidence of supervision, competency review, training or observation. If the matter affects people’s care, the care plan and risk assessment should be updated, and staff should be able to explain the change in practice.

This is what closed-loop governance looks like. It is also what supports safer, more consistent and more person-centred care.

Preparing now

Providers should consider reviewing their current systems against the five key questions and begin mapping how they evidence quality, risk and outcomes. This should include reviewing audit schedules, governance meetings, care records, incident analysis, safeguarding oversight, quality assurance reports and board-level reporting.

Services that have not been inspected for some time should be particularly proactive. A long period without inspection does not reduce regulatory risk; in many cases it increases the need for strong internal assurance. Providers should be able to demonstrate that they know their service, understand their risks and are acting before external scrutiny identifies the gaps.

How PGQ Solutions supports providers

Provider Governance & Quality Solutions Ltd, known as PGQ Solutions, was established to support providers at exactly these critical points: regulatory change, inspection readiness, enforcement pressure, acquisition due diligence, governance improvement and service turnaround.

Founded by experienced senior health and social care leaders, PGQ Solutions provides practical, hands-on support to providers, operators, investors and leadership teams. Our work includes mock inspections, independent audits, CQC readiness reviews, governance frameworks, regulatory action planning, evidence mapping, clinical and operational assurance, safeguarding review, service improvement planning and support during periods of transition.

We have recently supported providers with inspection preparation, regulatory improvement, complex governance reviews, care home closure and decommissioning support, buyer due diligence, CQC registration work, investor assurance and the development of practical audit and oversight tools. We have also developed PGQ Solutions Care Compass, our own auditing and assurance platform, designed to help providers evidence quality in a more structured and accessible way.

As CQC’s approach continues to evolve, providers need more than generic compliance advice. They need clear, practical support that translates regulatory expectations into everyday operational delivery.

That is where PGQ Solutions adds value: helping providers understand what good looks like, evidence it clearly, and embed improvement in a way that can be seen, heard and felt across the service.