Effective · KLOE 5

Consent to care and treatment

Are people supported to understand and exercise their right to consent to care and treatment?

CQC wording, secondary and specialist hospital care draft v0.6, pages 30 to 32.

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:

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 30 to 32. Contains public sector information licensed under the Open Government Licence v3.0.

CQC draft rating characteristics

These are CQC's draft characteristics. CQC says rating characteristics guide judgements, they are not a mechanical checklist.

The service goes out of its way to ensure that people are meaningfully involved in decisions about their care and treatment. The result is that every person feels listened to, valued and fully involved.
Capacity to consent is assessed with compassion, curiosity and respect. The service has a culturally sensitive approach that enables people, their families and carers to fully understand their rights and play an active, empowered role in decisions about their care.
People receive information that is fully tailored to their individual needs, cultures and histories, and is presented in a way that they can fully understand and engage with. This ensures people can make genuinely informed decisions, even in complex or emotionally challenging circumstances.
Openness and integrity are embedded throughout all care and treatment processes. People receive honest, personalised explanations about all aspects of their care. The values-driven approach means staff consistently go beyond expectations to ensure people feel safe, respected and in control.
Staff are fully invested in supporting people to make informed and proactive decisions about their care, including on advance care planning. They consistently take the time and attention to provide genuinely person-centred care.

People are supported to understand their rights to consent to care and treatment, including rights to advocacy. They understand they have the right to change their mind and withdraw their consent, and staff respect this.
Capacity to consent is assessed in a compassionate and inclusive way, and people (or their legal representatives) understand their rights and are involved in decisions about their care.
The laws and principles that apply to consent for children, young people and those with parental responsibility are understood and adhered to.
Information and advice about consent is accurate, up-to-date and tailored to meet people’s diverse communication needs and to support informed decision making.
Where applicable, information provided on contracts and charges is clear and unambiguous.
Decisions are made in line with the Mental Capacity Act 2005, involving carers or advocates, when needed.
Where people are subject to the Mental Health Act 1983 (MHA), consent to care and treatment provisions, rights to access independent mental health advocates and the MHA Code of Practice are complied with. Any departure from the Code of Practice guidance is clearly justified.
Advance care planning, including DNACPR and ReSPECT, is managed as a proactive and inclusive process. People are empowered to make informed decisions, and these are continuously reviewed.

People are not always supported to understand their rights to consent to care and treatment, or their rights to advocacy.
Capacity to consent is not consistently assessed in the appropriate circumstances. People (or their legal representatives) do not always understand their rights and are not consistently involved in decisions about their care and treatment.
The laws and principles that apply to consent for children, young people and those with parental responsibility are not always understood and adhered to.
Information and advice about care and treatment is not always accurate or up-to-date and does not always meet people’s communication needs.
Where applicable, information about contracts and charges, is not always provided in a clear or unambiguous way that people can understand.
Decisions are not always made in line with the Mental Capacity Act 2005. Carers or advocates are inconsistently involved in decision making.
Staff do not always adhere to the Mental Health Act Code of Practice. Deviation from Code of Practice guidance is not always clearly recorded.
Systems for advance care planning decisions, including DNACPR and ReSPECT, are in place, but are applied inconsistently. Decisions are not always informed, clearly documented or reviewed in a timely way.

People are not supported to understand their rights to consent to care and treatment, or their rights to advocacy.
Capacity to consent is not appropriately assessed. People (or their legal representatives) do not understand their rights and are not involved in decisions about their care and treatment.
The laws and principles that apply to consent for children, young people and those with parental responsibility are not understood or adhered to. This places children and young people at risk.
Information and advice about care and treatment is inaccurate or out of date and is not provided in a way that meets people’s communication needs.
Where applicable, information about contracts and charges is unclear or difficult for people to understand.
Decisions are not made in line with the Mental Capacity Act 2005. Carers or advocates are rarely or never involved in decision making.
Staff fail to comply with the Mental Health Act Code of Practice or other legislation.
There are no effective systems in place to ensure that decisions around advance care planning, including DNACPR and ReSPECT, take place in a consistent way. People do not feel empowered to make informed decisions and decisions may not be appropriately documented or reviewed.

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