Safe · KLOE 5
Safe environments and infection, prevention and control
Are the premises and equipment suitable and safe for delivering care, and are potential risks within the care environment detected and managed appropriately to keep people and staff safe?
CQC wording, secondary and specialist hospital care draft v0.6, pages 13 to 15.
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:
- Premises and buildings (including gas, electrical and fire safety)
- Equipment
- Infection prevention and control
- Environmental risks (adverse weather such as heatwaves and flooding)
- Digital systems/technology assurance
- Physical and psychological safety (e.g. sexual safety and awareness of sensory / communication needs)
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 13 to 15. 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
- There is a culture of shared ownership for safety, where everyone feels empowered to identify and act on risks in the care environment, and improvements are celebrated and shared across the system.
- Systems for managing facilities, premises, equipment and technology are exemplary, ensuring that risks are appropriately identified and managed across their life cycle.
- The facilities, premises, equipment and technology are tailor-made and designed specifically to meet the needs of the people who use the service.
- The service maintains an unwavering focus on assessing and managing the risk of infection. Systems and processes for infection prevention and control are tailored to the premises and deeply embedded within the service.
- All staff take personal responsibility for infection prevention and control. Continuous learning and peer support are offered to all staff. Lead roles are clearly defined, highly skilled and visible in everyday practice.
Good
- People are cared for in safe environments that are designed to meet their physical and psychological needs.
- There is a comprehensive system to proactively manage risks in the care environment. Where infrastructure risks are identified, the service responds to them appropriately.
- The facilities, premises, equipment and technology systems are safe to use, well-maintained and consistently support the delivery of safe and effective care.
- Equipment, including technology used for delivering care and treatment, is suitable for the intended purpose, stored securely and used properly.
- There are arrangements, including clear roles and responsibilities, to monitor the safety and upkeep of the facilities, premises, equipment and technology. Any safety issues identified are quickly addressed.
- The service acts on alerts, recalls and safety information in a timely way.
- Staff carry out comprehensive risk assessments to consider how the environment can keep people safe from physical and psychological harm. For example, in relation to sexual safety or sensory needs.
- The service manages changes to the environment effectively to reduce any associated risks, restrictions to people’s liberty and distress.
- There are effective fire safety procedures in place. All staff know what to do if there is a fire. Where the provider is not responsible for the premises, staff take reasonable action to appropriately escalate concerns.
- There is a rigorous system for assessing and managing infection risks, incorporating current national guidance and best practice.
- Staff have clear roles and responsibilities around infection prevention and control. Information about the risk of infection is shared appropriately with relevant partners, including agencies, people using the service and visitors.
- The environment is safe for staff to work in.
Requires improvement
- Environments do not always meet people’s physical and psychological needs. The premises are not always suitable for the purposes for which they are being used.
- Systems to detect and control potential risks in the care environment are inconsistent. As a result, the facilities, premises, equipment and technology systems are not always safe to use, well-maintained, stored safely, cleaned or used properly.
- The arrangements to monitor the safety and upkeep of the facilities, premises, equipment and technology are not always clear. Some safety issues are not identified quickly or addressed in a timely way.
- The service does not always act on alerts, recalls and safety information in a timely way.
- Staff do not consistently consider how environments can keep people safe from physical and psychological harm.
- The service does not always consider how changes to the environment might affect people. It does not always mitigate risks associated with changing the environment, which occasionally results in restrictions to people’s liberty and causes distress.
- There are fire safety procedures in place, but they are not always effective. Staff do not always know what to do if there is a fire. Where the provider is not responsible for the premises, it does not always take reasonable action to appropriately escalate concerns.
- Infection prevention and control is not always appropriately managed. Staff do not always follow good practice in relation to infection prevention and control and information about the risk of infection is not always shared with partners.
- The environment is not always safe for staff to work in.
Inadequate
- The environment does not meet people’s needs and the premises are not suitable for the purposes for which they are being used.
- Systems to detect and control potential risks in the care environment are ineffective. As a result, the facilities, premises, equipment and technology systems are unsafe.
- The arrangements to monitor the safety and upkeep of the facilities, premises, equipment and technology are unclear. Safety issues are not identified quickly or addressed in a timely way.
- The service does not act on alerts, recalls and safety information in a timely way.
- The service does not consider how the environment can keep people safe from physical and psychological harm.
- The service does not consider how changes to the environment might affect people. It does not mitigate risks associated with changing the environment, meaning that changes often result in restrictions to people’s liberty and cause distress.
- Fire safety procedures are either ineffective or do not exist. Staff do not know what to do if there is a fire. Where the provider is not responsible for the premises, it does not appropriately escalate concerns.
- There is no system to assess and manage the risk of infection. Staff are not clear on their responsibilities around infection prevention and control. Information about the risk of infection is not known or shared.
- The environment is not safe for staff to work in.
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.