CQC Single Assessment Framework
Also known as: Single Assessment Framework, SAF, CQC five key questions
The CQC Single Assessment Framework is the Care Quality Commission’s model for assessing health and social care providers in England using one consistent framework built around five key questions — safe, effective, caring, responsive and well-led — evidenced through quality statements.
The Single Assessment Framework (SAF) is how the Care Quality Commission (CQC) assesses the quality and safety of care in England. It replaced the separate inspection frameworks CQC previously used for different sectors with a single, consistent structure that applies to adult social care, hospitals and primary care. The framework is organised around five key questions, a set of quality statements, and defined evidence categories.
The five key questions
Every service is assessed against the same five key questions. Each question asks whether the service delivers a specific dimension of good care:
- Safe — people are protected from abuse and avoidable harm.
- Effective — care, treatment and support achieves good outcomes, is based on the best available evidence, and helps people to maintain quality of life.
- Caring — staff treat people with compassion, kindness, dignity and respect.
- Responsive — services are organised to meet people’s needs and preferences.
- Well-led — leadership, governance and culture support the delivery of high-quality, person-centred care.
Quality statements
Under each key question sit a number of quality statements. These are written as “we statements” — short commitments from the point of view of a provider (for example, “We make sure people are at the centre of their care”) — and they are paired with the “I statements” that describe what good care feels like from the person’s perspective. Quality statements replaced the older key lines of enquiry (KLOEs) and are the standards providers are expected to meet.
Evidence categories and scoring
CQC gathers evidence against each quality statement from six evidence categories, which include people’s experience of care, feedback from staff and leaders, observation, processes, and outcomes. Assessors give a score of 1 to 4 for each quality statement. These scores combine into a score for each key question, which converts into one of four ratings: outstanding, good, requires improvement or inadequate.
Frequently asked questions
What are the five key questions in the CQC framework?
The five key questions are: is the service safe, is it effective, is it caring, is it responsive to people’s needs, and is it well-led? Every provider assessed by CQC is judged against these same five questions.
What is the difference between the Single Assessment Framework and the old CQC framework?
The Single Assessment Framework uses one consistent structure for all sectors, replaces key lines of enquiry (KLOEs) with quality statements, introduces numerical scoring (1–4) for each quality statement, and allows CQC to update part of an assessment at any time rather than only after a full inspection.
What are quality statements?
Quality statements are the standards under each key question. They are expressed as “we statements” describing what a provider commits to, and are linked to “I statements” describing what good care looks like from the person’s point of view.
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