CQC’s single assessment framework (SAF) was designed to bring greater clarity and consistency to how services are evaluated. But its rollout only led to deeper confusion about what ‘good’ care should look like. Following the launch of its consultation in October, CQC must now reset the narrative by offering clearer, more accessible guidance.
SAF: A brief background
Introduced by CQC in 2024, the SAF brought together Key Lines of Enquiry (KLOEs), prompt questions and ratings characteristics from its previous two frameworks – healthcare and adult social care services. The intention was to streamline assessments across these increasingly complex sectors and hold all services to the same standard.
However, the launch was met with scepticism from providers, stakeholders and people using services. An independent review by Dr Penny Dash described the SAF as poorly communicated externally and internally, lacking transparency and using vague language with limited information on what care looks like under each category. CQC responded to this by proposing significant changes to the SAF with the launch of a consultation on 16th October 2025.
What improvements is CQC proposing?
CQC has pledged to make the following improvements to its assessment framework, with a full rollout expected this year:
- Reintroduce ratings characteristics to clarify the regulator’s expectations for quality and safety. In March, following feedback, CQC published four draft sector specific assessment frameworks for adult social care, mental health, primary and community care, and hospitals.
- Re-introduce assessment frameworks that are specific to each sector, which clearly reflect and articulate the context of those sectors. CQC’s chief inspectors will lead the development of these frameworks in partnership with each sector.
- Publish more detailed supporting guidance that shows the key standards and sources of evidence CQC will consider for services in each sector.
- Make assessments frameworks simpler and clearer by removing content that could duplicate or overlap across key questions and simplify language to make frameworks easier to understand.
Why are these changes important?
These proposed reforms offer a unique opportunity for CQC to lead meaningful transformation and set a new tone for collaboration and improvement. Clearer, less complex guidance will help providers understand what ‘good’ care looks like and prepare for inspections properly, rather than feeling left to interpret broad guidance on their own. However, for these reforms to succeed, guidance needs to be delivered in multiple forms and communicated effectively to ensure maximum engagement.
How can CQC signal the road to outstanding?
Here are some of Delphi’s recommendations for how CQC should best communicate to providers what they need to achieve an outstanding rating under the new framework:
- Translate ratings characteristics into real-world examples: Publish case studies from a range of services that demonstrate outstanding practice across all KLOEs and feature before and after scenarios – anonymised if necessary.
- Publish checklists on what providers need to do to achieve an outstanding rating, beyond basic compliance: Provide recommendations for each ratings characteristic, for example, clearly demonstrating its expectations.
- Deliver workshops, webinars and Q&A sessions: Make guidance more accessible, allowing for human interaction and relationship building.
- Include clear, jargon-free and consistent language: Prevent confusion over what high-quality care looks like across all guidance and reports.
- Publish blogs from anonymised inspectors or CQC team members: Content could include, ‘Key reasons why providers do not achieve outstanding’, ‘What inspectors most commonly see across high-performing services’ and ‘Top 10 examples of innovative practices emerging’.
- Celebrate and share innovation: Showcase examples of outstanding care and transformation on the CQC website and social media to help providers rise to the challenge of achieving an outstanding rating.
- Do not just revive old guidance: Make it relevant to the challenges providers face today and tailor it to as many services as possible.
As CQC prepares to publish its revised framework, it should ensure that guidance is clear, consistent and transparent, and delivered in a way that helps providers understand not only what outstanding care looks like but how to work towards it in practice. For providers navigating these expectations, practical support can make the difference between broad guidance and meaningful improvement.
Read the May issue of CMM for an interview with CQC about the implementation of the new assessment framework.
Scott McMurray is a Director at Delphi Care.
Email: [email protected] LinkedIn: @Delphi-Care-Solutions-Ltd