Understanding CQC's Five Key Questions: A Care Home Manager's Guide

Every CQC inspection is built around five fundamental questions. Understanding what inspectors are looking for - and how to demonstrate excellence in each area - is essential for any care home manager.

Safe

The core question: Are people protected from abuse, avoidable harm, neglect and discrimination?

What CQC Looks For:

Safeguarding policies and procedures that are followed in practice
Appropriate risk assessments that are regularly reviewed
Safe medication management following NICE guidelines
Effective infection prevention and control
Adequate staffing levels with appropriate skills
Safe premises and equipment
Systems to learn from incidents and prevent recurrence

Outstanding Practice Example:

"The service had developed an innovative falls prevention programme tailored to each resident's specific risk factors. This resulted in a 40% reduction in falls over 12 months. Staff could clearly articulate how they identified fall risks and the individualised interventions in place."

Effective

The core question: Is the care, treatment and support provided achieving good outcomes and promoting a good quality of life based on best available evidence?

What CQC Looks For:

Care based on comprehensive, holistic assessments
Staff with the knowledge and skills to deliver effective care
Good nutrition and hydration practices
Effective pain management
Collaboration with other healthcare professionals
Proper consent processes and MCA compliance
Monitoring and evaluation of care outcomes

Outstanding Practice Example:

"The service had implemented a research-based approach to dementia care that significantly improved residents' quality of life. Staff had completed advanced training and could demonstrate how they applied this learning. Outcome measures showed sustained improvements in wellbeing indicators."

Caring

The core question: Do staff treat people with compassion, kindness, dignity and respect?

What CQC Looks For:

Consistent dignity and respect in all interactions
Privacy maintained during personal care
Residents involved in decisions about their care
Emotional support provided sensitively
Independence promoted and encouraged
Strong relationships between staff and residents
Families and friends welcomed and involved

Outstanding Practice Example:

"Staff knew each resident as an individual, not just as someone with care needs. They could describe residents' life histories, interests, and preferences in detail. Residents and families consistently described feeling valued, listened to, and genuinely cared for."

Responsive

The core question: Are services organised so that they meet people's needs?

What CQC Looks For:

Person-centred care planning that reflects individual needs
Flexible routines that adapt to residents' preferences
Meaningful activities based on personal interests
Effective complaints handling that leads to improvement
Good end of life care planning and delivery
Responsive to changing needs
Access to services regardless of protected characteristics

Outstanding Practice Example:

"Care plans were living documents that truly reflected each person's unique needs, preferences and aspirations. The service had developed innovative ways to understand and meet residents' individual interests, including partnerships with local community groups and bespoke activities."

Well-Led

The core question: Is the leadership, management and governance of the organisation promoting high-quality, person-centred care, supporting learning and innovation, and promoting an open and fair culture?

What CQC Looks For:

Clear vision and values that staff can articulate
Effective and visible leadership
Robust governance systems that drive improvement
Open culture where concerns can be raised
Staff who feel supported and valued
Strong partnerships with other organisations
Continuous improvement culture
Innovation that benefits residents

Outstanding Practice Example:

"The registered manager had created a culture of excellence where staff felt empowered to suggest improvements. Regular governance reviews identified trends and drove quality improvement. The service shared its learning with the wider sector, influencing best practice beyond its own walls."

Key Takeaways

The five questions are interconnected - excellence in one area often supports excellence in others
Evidence is essential - document your practices and their outcomes
Outstanding requires going beyond compliance to demonstrating innovation and excellence
The best care homes embed quality in their culture, not just their policies

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