Safe · KLOE 3
Safe systems, pathways and transitions
Are there systems to enable collaborative working across care pathways and services, to ensure that safety and continuity of care are prioritised?
CQC wording, draft v9, pages 8 to 10.
Draft, not the current assessment framework
CQC's adult social care draft v9, dated 19 March 2026. The current quality statements remain in use.
CQC draft scope
What this proposed KLOE covers
Scope of this key line of enquiry and topic areas include:
- Care co-ordination and information sharing
- Continuity and transitions of care (including from children to adult services)
- Referrals
- Delegation (for example, clinical/healthcare activities)
How would this apply to your service?
The draft applies one framework across adult social care, but useful evidence depends on your service and people.
Source: Adult social care assessment framework, draft v9, 19 March 2026, pages 8 to 10.
HLTH analysis
What this could mean in practice
Safe, continuous care depends on effective co-ordination, timely information sharing and clear responsibility across services and transitions.
Transitions, referrals and delegated activities should be planned around each person's needs, circumstances and expected outcomes. Staff and partners should know what information to share, who owns each action and when needs outside the service's remit should be escalated.
Evidence and conversations to explore
- Transition and referral experiences
- Information sharing and action ownership
- Oversight of delegated activities
Questions worth asking
- What happens when a person moves between services or receives support from several teams?
- How are responsibilities and follow-up actions agreed and communicated?
- How quickly are needs outside the service's remit recognised and escalated?
HLTH's interpretation of CQC's 19 March 2026 draft. This is not current CQC guidance, an official interpretation, a checklist or a rating prediction. Reviewed 17 September 2026.
CQC draft rating characteristics
How the draft describes each rating
These are CQC's draft characteristics. CQC says rating characteristics guide judgements, they are not a mechanical checklist.
Outstanding
- There is a strong culture of collaborative working, which supports the delivery of joined-up care. The service has introduced innovative and efficient ways to deliver care and support that is more joined-up for people, actively working with other services.
- Care journeys are proactively planned and co-ordinated across services from the earliest stage. People receive enhanced care at each step of the care journey and their outcomes demonstrate this.
- Safety policies and processes are co-developed and reviewed with partners and communities.
- Transitions, referrals and discharges are co-designed with people and those close to them. Arrangements reflect individual circumstances, goals and preferences. Equity and inclusion are actively prioritised to remove barriers and support continuity.
- Multi-disciplinary teams work cohesively across boundaries with shared accountability. Where appropriate, partners hold joint ownership of safety and manage shared risks comprehensively.
Good
- Safety and continuity are maintained across people’s care journeys through collaborative working with people, staff and partners. This includes where people are moving between or accessing multiple services.
- Shared systems and processes for safe care are managed collaboratively, including proactive risk identification, monitoring and learning.
- Plans and information for care during transitions are established and shared before people move between services.
- Plans consider people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. People experience a smooth process and there is continuity of care.
- Staff can access the information they need to assess and understand people’s needs, and to plan and deliver care.
- Staff work together proactively with teams in other services, commissioners and people using the service to deliver co-ordinated, timely, consistent and person-centred care, support and treatment. Actions are appropriately owned and followed up.
- The service has appropriate systems and processes to manage its responsibilities in relation to delegated healthcare activities safely, in line with good practice.
- When people have needs that are outside of the service’s remit, staff adapt support and escalate issues to relevant agencies.
Requires improvement
- Safety and continuity are not consistently prioritised when people move between services. Planning and co-ordination are inconsistent, and information sharing may be unreliable.
- Care plans are not routinely updated before transitions, causing or increasing the risk of harm.
- Referrals are not timely enough to maintain or improve people’s health and wellbeing. Care, support and treatment is not consistently carried out as directed by healthcare professionals.
- Systems and processes for managing delegated healthcare activities are not consistently followed.
- Some staff do not know how and when to share information externally.
- Some people do not know which service to contact about the care and support they receive.
- When people develop care, support and treatment needs that are outside of the service’s remit, this is not consistently recognised or escalated appropriately to ensure these needs are met.
Inadequate
- Safety and continuity are not considered priorities for people’s care journeys. There is no joined-up approach between staff and partners involved in people’s care.
- Planning and co-ordination is insufficient or absent when people move between different services.
- The service does not take responsibility for coordinating care and support, leaving it to other agencies to manage. People may be harmed as a result.
- Information sharing and communication with other services is consistently poor. Information is not shared with other services, including when people move between services, or is insufficient when it is shared.
- The service does not engage with other services or make timely referrals for appropriate care, support and treatment, meaning people’s health and wellbeing can deteriorate. Staff lack knowledge about how and when they should refer concerns.
- The service does not have effective systems or processes to manage delegated healthcare activities.
- People do not know which service is responsible for their care and support, or who to contact about it.
- When people develop care, support and treatment needs that are outside of the service’s remit, this is not recognised or escalated.
Want to know how your service would fare?
Book a mock inspection run against the draft KLOEs, or call 020 8090 5346 to speak to one of our experts.