CQC Framework Changes
The CQC framework changes at the end of 2026. Here's what to do with the next six months.
If you run a care service in England, the way you are assessed is about to change. Not tweaked. Changed.
CQC is replacing the single assessment framework with four sector-specific frameworks — one for adult social care, one for hospitals, one for primary care, one for mental health. The draft adult social care framework was published on 24 March 2026. Consultation closed on 12 June. Pilots are running now, through to October. Final evaluation is due in November, and implementation is set for the end of this year.
That gives you roughly six months. I want to be straight with you about how to use them.
How we got here
In October 2024, Dr Penny Dash published her review into the operational effectiveness of CQC. It was not a gentle read. It identified scoring that confused people, quality statements that overlapped each other, and inspectors reaching inconsistent judgements on similar evidence.
CQC accepted the findings and consulted on a different approach under the title *Better regulation, better care*. One of the proposals was to stop applying a single framework across every kind of service. The response was overwhelmingly supportive, which will surprise nobody who has tried to apply a hospital-shaped quality statement to a domiciliary care round.
So adult social care is getting its own framework back. That matters more than it might sound.
What is actually changing
**The 34 quality statements become 24 key lines of enquiry.** They are split across the five key questions: six under Safe, six under Effective, three under Caring, four under Responsive, five under Well-led.
**Numerical scoring is being removed.** The evidence-category scores that produced your rating are going. In their place, CQC is introducing rating characteristics — written descriptions of what outstanding, good, requires improvement and inadequate look like against each key line of enquiry.
**The five key questions stay.** Safe, effective, caring, responsive, well-led. Those are not going anywhere.
**The four-point rating scale stays.** Outstanding, good, requires improvement, inadequate.
So the architecture of the judgement is familiar. What changes is how the judgement is reached and, critically, what evidence you need to hold to support it.
Why this is more than a relabelling exercise
Here is the part I think providers are underestimating.
Under scoring, you could work backwards. You knew roughly what evidence sat in which category, you knew the score bands, and a certain kind of provider got quite good at assembling evidence that scored well without necessarily changing much on the floor.
Rating characteristics do not work that way. A characteristic is a description of a service, not a total. An inspector reads the description, looks at your service, and forms a view about which description fits. You cannot accumulate your way to "good." You either look like the description or you do not.
That is a shift from evidence-gathering to evidence of practice. The providers who have been running genuine quality assurance will find this easier. The ones who have been running a folder will find it harder.
What I would do between now and December
**Read the draft framework yourself.** Not a summary. Not a webinar slide. The actual draft. You are going to be assessed against the final version of this document, and the final version will not be far from the draft. Sit down with it and your management team for two hours.
**Map your current evidence to the 24 key lines of enquiry.** Take each one and ask a plain question: if an inspector asked me to show this, what would I hand them, and would it be current? Where the answer is "we'd have to pull something together," that is a gap. Write it down.
**Pay attention to where things have moved.** Some quality statements have been merged. Some have been split differently. Evidence you had comfortably filed under one heading may now sit somewhere it does not naturally fit. This is the most common thing I find when I do this exercise with providers — the evidence exists, but it is filed against a structure that no longer applies.
**Look hard at Well-led.** Five of the 24 key lines of enquiry sit under Well-led. That is a fifth of the framework, and Well-led is the key question that most often drags a rating down. If your governance is a monthly meeting with no audit trail, fix that now rather than in November.
**Do not wait for the final version.** I hear this a lot: "we'll start when it's published." The final framework is due to be published this summer, with implementation at the end of the year. If you start when it lands, you have weeks, not months, and you will be doing it alongside everyone else who waited.
**Talk to your staff about it.** Under rating characteristics, what your care workers say and do carries real weight. A member of staff who can explain how they support someone, in their own words, is worth more than a policy that says the same thing. That comes from culture and supervision, not from a document.
What I do not know yet
I want to be honest about the limits here. The framework is still in draft. The consultation responses have not been fully published. The pilots are live and CQC has said explicitly that they are testing whether the methodology works — which means detail could still move.
Anyone telling you they know precisely how the final version will read is guessing. What we do know is the structure, the direction, and the timetable. That is enough to prepare properly, and preparing properly is not the same as predicting.
The honest summary
This is a better framework than the one it replaces. Sector-specific assessment makes sense. Clearer descriptions of what good looks like make sense. Removing scoring that nobody could explain makes sense.
But a better framework is still a change, and change catches out providers who are running on autopilot. The services that will do well at the end of this year are the ones using this summer to check whether their evidence describes what actually happens, rather than what they hope happens.
If you want a second pair of eyes on where your service sits against the draft framework, I'm happy to have a conversation. That is a lot of what I do.
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*Tiffany Nelson supports adult social care providers in England with CQC registration and inspection preparation. [tiffanynelsonconsulting.co.uk](https://www.tiffanynelsonconsulting.co.uk) | [Connect with me on LinkedIn](https://www.linkedin.com/in/tiffany-nelson-177784281)*
**Sources:** CQC draft adult social care assessment framework (published 24 March 2026); CQC *Better regulation, better care* consultation; Review into the Operational Effectiveness of the Care Quality Commission, Dr Penny Dash (October 2024); CQC improvement plans and 2026 updates.