CQC single assessment framework: what this means for health and social care services providers and the post-implementation review

This article was authored by Grace Davies, Associate.

In March 2024 the Care Quality Commission (CQC) introduced and rolled out across England the single assessment framework, after initially being presented in 2021.

In this article we consider what the new single assessment framework means for those who are providing health and social care services and what the impact so far has been.  

Single assessment framework

This new framework simplified the process to align with the CQC’s aims to ensure that all providers of health and adult social care are consistent with one another and meet the quality standards and deliver safe and effective care services.

Whilst The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 remains unchanged as the underlying legislation, the CQC’s new framework is based upon five key questions: is the service safe, effective, caring, responsive and well-led? Providers of health and social care services must be able to demonstrate these requirements are being delivered.

The new framework provides  “quality statements”, which are “commitments that providers, commissioners and system leaders should live up to”. Quality statements are used as a framework during CQC inspections/assessments, streamlining the key lines of enquiry into 34 quality subsections (within the five key questions above).

The aims of this single assessment include simplifying the process, driving improvements in the quality and safety of health and social care, and better reflecting how these services are actually provided.

Framework Review

Following the implementation, the CQC commissioned an initial review (known as a Phase 1 Review) by Professor Sir Mike Richards, Former Chief Inspector of Hospitals at CQC.

As with all new changes and the implementation of a new system, the review allowed for various recommendations to be made in order to improve and enhance the framework. These were set out in a report published in October 2024. In summary, a more flexible application of the assessment framework was recommended, along with clearer definitions of what would constitute good or outstanding care and improvements to the provider portal and platform.

To build on the findings and recommendations of the Phase 1 Review, as well as an external review/survey by the Care Provider Alliance (CPA), a second phase of the review is currently being undertaken.

The Phase 2 Review includes internal and external engagement across all health and social care providers.

The terms of reference for the Phase 2 Review include an “understanding of what providers want from assessment, including learning from regulation elsewhere within the UK” and “changes required within the assessment framework to establish consistency in assessment in the different sectors.”

What does this mean for providers?

The Phase 2 Review is an opportunity for health and adult social care providers to engage with the regulator to provide insights and to identify any challenges or areas for improvement with the framework. Health and adult social care providers will likely welcome the further guidance in relation to what the new assessment framework will look like, but in the meantime CQC assessments will continue whilst the review is underway and any recommendations are being implemented.

Health and adult social care providers can look to prepare ahead of any potential assessment, by ensuring their understanding of what may be required to ensure compliance.

With the single assessment framework being primarily evidence-led, a good understanding of what the quality statements look like, as well as what evidence may be collated and required to support the statements, and to demonstrate how the five questions underpinning the assessment framework are being met (see above) is key.