Effective · KLOE 1
Assessing needs
Are people’s needs holistically assessed and reviewed with them to maximise the effectiveness of their care, treatment and support?
CQC wording, secondary and specialist hospital care draft v0.6, pages 22 to 24.
Draft, not the current assessment framework
CQC's secondary and specialist hospital care draft v0.6, published 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:
- Assessing people’s needs (including accessibility and communication needs)
- Person-centred approach to assessment
- Carer assessments and support
- Care planning
- Clinical assessment tools
How would this apply to your service?
The draft applies one framework across secondary and specialist hospital care, but useful evidence depends on your service and people.
Source: CQC, Hospitals (secondary and specialist care) assessment framework, draft v0.6, 19 March 2026, pages 22 to 24. Contains public sector information licensed under the Open Government Licence v3.0.
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
- The service has a determined focus on ensuring that people’s needs, preferences and aspirations are fully recognised and met. Staff ensure that people, their families and carers are equal partners in the assessment of their needs. People are confident that what matters to them has been accurately captured and meaningfully reflected in their care plans. This creates a strong sense of trust and psychological safety.
- The service demonstrates an exceptional and unwavering commitment to equity and inclusion. Care, treatment and support is personalised, fair, and meaningfully removes obstacles to participation and wellbeing.
- People’s needs, emotions and levels of distress are anticipated with insight and professional curiosity. Staff consistently demonstrate compassionate, attuned and person‑centred care that mitigates the risk of deterioration. They recognise early warning signs, respond sensitively, and create a safe, calm environment where people feel valued and understood.
- When reviewing and updating people’s needs assessments, staff demonstrate real curiosity about what matters to them.
- Carers are genuinely encouraged and actively supported to be active partners in people’s care. Their needs are holistically assessed and met, which enables them to provide safe, effective and compassionate care to the people they support.
- People feel safe and empowered when making decisions about their care.
- Risk assessments are collaboratively agreed, person-centred and proportionate. They allow for positive risk taking, where clinically appropriate.
Good
- People, their families and carers are actively involved in the assessment of their individual needs. They are confident that their needs have been assessed and are fully understood. They are supported to maximise their involvement.
- Care plans reflect people’s physical, mental, emotional, sensory, communication, cultural and social needs, including those related to protected equality characteristics.
- Staff use a range of assessment tools to assess and anticipate people’s needs, emotions and level of distress to ensure these are understood and reflected in their assessment and care plans.
- Assessments are person-centred and consider the person’s physical, wellbeing, and communication needs, to enable them to receive care or treatment that has the best possible outcomes. Where people have more than one condition, this is reflected in assessments and care plans.
- Assessments are accurate, timely, and kept up-to-date. They are reviewed regularly together with people, their families and carers.
- The needs of people’s carers are also assessed and met. This supports their health and wellbeing and helps them to provide safe and effective care to the people they support.
- Risk assessments are person-centred, proportionate, and reviewed regularly together with people, their families and carers.
Requires improvement
- People are not consistently or meaningfully involved in the assessment of their needs. They are not confident that their individual needs have been appropriately assessed or they do not always understand the assessment process.
- Care plans do not consistently reflect people’s holistic needs or their right to fair treatment under the Equality Act 2010.
- Care assessments do not consider the full range of people’s diverse needs, including those related to communication, nutrition, hydration and pain relief.
- People’s needs, emotions or levels of distress are not consistently or routinely assessed, or there are no tools available to support staff to understand and reflect them in assessments and care plans.
- Assessments are not consistently up-to-date, or there are delays in completing them. They are not always routinely reviewed.
- The needs of carers are not consistently considered to help them provide safe and effective care. Risk assessments are not consistently person-centred or proportionate. They may not be reviewed regularly, or are not reviewed together with people, their families and carers.
Inadequate
- People are not routinely involved in the assessment of their needs, or assessments are not carried out in a way they understand.
- Care plans do not reflect people’s diverse needs and their right to fair treatment under the Equality Act 2010.
- Care and treatment decisions are not based on a full assessment of a person’s needs, including those related to communication, nutrition, hydration and pain relief.
- People’s needs, emotions or levels of distress are not included in their assessment. Staff do not have the knowledge or tools available to support them to understand people’s needs.
- Assessments are delayed, not completed or not updated. They are not routinely reviewed.
- The needs of carers are not considered, and they are not helped to provide safe and effective care to the people they support.
- Risk assessments about care are not person-centred or proportionate. They are not reviewed regularly, or reviewed together with people, their families and carers.
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.