Safe · KLOE 6
Safe staffing
Are there enough qualified, skilled and experienced staff to keep people safe and meet their needs, with strategies to manage demand and capacity safely?
CQC wording, secondary and specialist hospital care draft v0.6, pages 15 to 17.
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:
- Workforce capacity and capability
- Safe recruitment (including DBS)
- Staffing levels and skills mix
- Skills and qualifications/revalidation
- Learning, development and competency
- Support and supervision
- Performance management
- Agency staff, volunteers and unpaid carers
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 15 to 17. 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 uses comprehensive and values-based recruitment practices to ensure that staff appointed are highly qualified and have demonstrable experience in delivering the highest standard of care. People with lived experience and carers routinely participate in recruitment, shaping decisions and strengthening the quality of the workforce.
- Staffing levels and skill mix are proactively optimised using real-time intelligence on levels of demand, acuity tools specific to the service, and feedback from people. The service anticipates emerging pressures early and acts decisively to ensure staffing levels can deliver safe and personalised care. This results in safety and continuity for people using the service, including during periods of pressure on the system.
- The service demonstrates exemplary foresight with regard to its workforce, using demand and capacity modelling, population trends, and escalation data to anticipate fluctuations and plan staffing well ahead of need
- Staff development is a priority. Staff are proactively supported to acquire advanced specialist skills, and they are empowered to lead improvement, share learning and influence practice across the system.
- Support, supervision and appraisal systems are exemplary. They are psychologically safe, reflective, restorative and embedded across all roles. Leaders prioritise wellbeing and emotional safety for staff, recognising the demands of delivering care and celebrating professional growth and innovation.
Good
- Recruitment practices are rigorous and safe. This makes sure that all staff, including agency staff and volunteers, are suitably skilled, qualified, experienced and competent to carry out their role.
- There are appropriate staffing levels and skill mix to meet people’s needs. Where there are not enough staff to meet required levels, the service makes short-term adaptations to ensure people continue to receive consistently safe, good quality care that meets their needs.
- The service has a clear strategy to manage fluctuating demand and capacity. This is continuously reviewed and is used to anticipate changes in future demand.
- The service takes action to protect staff from fatigue, and leaders understand its impact on the safety of those who use services.
- Staff have the right qualifications, skills, knowledge and experience to deliver safe care.
- Staff receive training appropriate and relevant to their role. Staff at all levels have opportunities to learn and develop their practice.
- Staff receive the support they need to deliver safe care. This includes supervision, appraisal, development and, where needed, professional revalidation.
- Recruitment, disciplinary and capability processes are fair and are reviewed to ensure there is no disadvantage based on protected equality characteristics.
Requires improvement
- Inconsistent recruitment practices result in staff not always being suitably skilled, qualified, experienced or competent to carry out their role.
- There are periods of under-staffing or inappropriate skill mix, which are not addressed quickly and effectively and result in people’s needs not being met. Agency, bank and locum staff are not always used in a way that protects people’s safety.
- The service has a strategy to manage fluctuating demand and capacity, but it is infrequently reviewed and not always used effectively to anticipate changes in future demand.
- There is limited understanding about how staff fatigue can affect patient safety.
- Staff do not always receive appropriate and timely training. There are few opportunities for staff to learn and develop.
- Systems to ensure staff receive adequate supervision, appraisal and development are deficient.
- Although the service has recruitment, disciplinary and capability processes in place, they do not always ensure there is no disadvantage based on protected equality characteristics.
Inadequate
- Recruitment practices are unsafe. Staff are not suitably skilled, qualified, experienced or competent to carry out their role.
- Substantial staff shortages and inappropriate skill mix are common. Agency, bank and locum staff are not used effectively to make sure people continue to receive safe care.
- The service does not have a strategy to manage fluctuating demand and capacity.
- Staff fatigue is not considered.
- Staff do not receive appropriate training.
- Staff are not given opportunities to develop and they do not receive supervision or appraisal.
- The service’s recruitment, disciplinary and capability processes do not ensure there is no disadvantage based on protected equality characteristics.
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.