Well-led · KLOE 2
Workforce equity and culture
Is there an inclusive and fair culture that prioritises the safety and wellbeing of staff, supports speaking up and addresses workforce inequalities?
CQC wording, secondary and specialist hospital care draft v0.6, pages 52 to 56.
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 diversity
- Workplace discrimination and equitable treatment of staff
- Bullying, harassment and victimisation
- Gender pay gap
- Speaking up culture
- Staff feedback and surveys
- Freedom to Speak Up Guardian, whistleblowing
- Support and wellbeing of workforce
- Agency staff and volunteers
- Caseloads / workload and lone working
- Staff safety (including sexual safety)
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 52 to 56. 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
- Leaders and staff at all levels live the organisational values, which include a strong, shared commitment and effective action towards ensuring that equality, diversity and inclusion are embedded throughout the service.
- Leaders and staff share a commitment to and relentless focus on ensuring high-quality and effective care for all people and communities served by the service.
- Leaders at all levels are held to account for modelling inclusive behaviours and addressing poor culture, with clear consequences where expectations are not met. They demonstrate commitment to equality and diversity, leading by example to actively prevent discrimination and promote anti-racist principles and cultural awareness.
- Leaders and staff across all levels engage, understand, and are representative of the communities they serve.
- There is never any bullying, harassment and discrimination in the service’s practices. All staff, regardless of background, feel equally valued.
- There is an open, curious and transparent culture where staff feel psychologically safe to speak up about anything that gets in the way of providing high-quality care. The service uses innovative ways to ensure that processes for communication and sharing information are transparent and accessible.
- Speaking up is embedded as a cultural norm. Leaders actively seek challenge, respond visibly and demonstrate through their actions that raising concerns leads to learning and improvement, not blame.
- The service’s open learning culture and the high morale and wellbeing of its staff are conducive to the positive experience and outcomes of people using its services and those close to them.
- Feedback from staff, including complaints and concerns, is continuously taken into account to improve services and people’s satisfaction with them. These are seen as learning opportunities and leaders are held accountable for the commitments they make in this regard. Staff from all backgrounds are certain that their concerns will be listened to and acted on, without any fear of detriment.
- There are consistently high levels of satisfaction across the workforce, including among those with protected equality characteristics. Staff are proud of the service as a place to work, feel psychologically safe and speak highly of its open, inclusive and non-discriminatory culture.
- Staff wellbeing is a high priority for leadership. The service exceeds its statutory responsibilities for the health, safety and wellbeing of staff and is a modern employer with a variety of measures to support flexible ways of working to improve staff morale, retention and engagement.
Good
- The service prioritises equality, diversity and inclusion and proactively identifies and addresses workforce inequalities. Anti-racism practice, including cultural and stigma awareness, are core strategic principles and are reflected in the values of all staff and leaders.
- The service fosters a culture of compassion, openness, trust, inclusiveness and continuous improvement. Processes for communication and sharing information are transparent and accessible.
- Leaders are alert to and quickly address any examples of poor culture that may have a detrimental impact on staff and affect the quality of people’s care.
- Recruitment, disciplinary and capability processes are fair and are reviewed to ensure there is no disadvantage based on any specific protected equality characteristics. Recruitment processes and employment practices are lawful and free from exploitation.
- The service takes active steps to ensure staff and leaders are representative of the people and communities it serves.
- Leaders take action to improve where there are any disparities in the experience of staff with protected equality characteristics, or those from excluded and marginalised groups. Any interventions are monitored to evaluate their impact. Leaders make reasonable adjustments to support disabled staff to carry out their roles well.
- Leaders take steps to remove bias from practices to ensure equality of opportunity and experience for the workforce in their place of work, and throughout their employment. Checking accountability includes ongoing review of policies and procedures to tackle structural and institutional discrimination and bias to achieve a fair culture for all.
- There is zero tolerance for bullying, harassment and discrimination. The service supports staff who face discrimination, whether this comes from managers, colleagues or people using the service. There is a clear focus on supporting those with protected equality characteristics and those from excluded and marginalised groups.
- Staff receive personalised culturally sensitive and non-discriminatory support and feel listened to, valued and involved in decision-making. Staff from different backgrounds feel they are treated equally.
- The service meets its statutory responsibilities for the health and safety of staff. Steps are taken to support staff, and wellbeing is supported through resources, rest, and cultivating a positive work environment. There is culturally sensitive and non-discriminatory support for those who are struggling at work. This has a positive impact on the care they deliver to people.
- There are processes to enable staff to speak up and raise concerns. All staff, including temporary colleagues, can easily access these processes.
- There is a culture of speaking up as staff are empowered and supported to give feedback, raise concerns, and contribute to improvements. Staff actively raise concerns without fear of detriment. When they do, they are valued and supported and feel confident that they will be treated with compassion and understanding, and will not be blamed, or treated negatively, if they do so.
- Where in place, Freedom to Speak Up Guardians have access to dedicated time for their role, up-to-date training and work proactively with the leaders to remove barriers to speaking up and to improve the speaking up culture. When concerns are raised, leaders investigate sensitively and confidentially, and lessons are shared and acted on
Requires improvement
- Equality, diversity and inclusion are not sufficiently prioritised at this service. Anti-racism practice, including cultural and stigma awareness, are not core strategic principles and are not always reflected in the values of all staff and leaders.
- Leaders do not always identify or adequately address the causes of workforce inequality.
- The service is not sufficiently representative of its staff and local communities.
- Processes for communicating and sharing information are not always transparent and accessible.
- Staff, including those with protected equality characteristics, do not always feel they are treated equitably. Staff from different backgrounds feel their contributions are not valued.
- There is insufficient reassurance that all staff and leaders do not tolerate bullying, harassment and discrimination.
- Speaking up processes may be in place, but they are not sufficiently well advertised or understood.
- Staff are apprehensive about speaking up and are not certain that their concerns will be listened to and acted on.
- Feedback from staff, including complaints and concerns, is not always considered in a non-discriminatory way. There is insufficient reassurance that their feedback is used to make lasting improvements.
- Levels of satisfaction among staff across the service vary and may be lower for those with protected equality characteristics.
- The wellbeing of staff is not always sufficiently prioritised. Some staff do not feel psychologically safe. There are low levels of staff morale, pride and engagement across the service.
Inadequate
- The principles of equality, diversity and inclusion are insufficiently embedded in the culture of the service. Inequality is not identified and addressed. Anti-racism practice, including cultural and stigma awareness, are missing from the core strategic principles and are not evident in the values of staff and leaders.
- Staff, especially those with protected equality characteristics, do not feel they are treated equitably. Staff from different backgrounds report issues with cultural awareness, discrimination and racism.
- There are high levels of bullying, harassment, discrimination or violence, and the service is not taking adequate action to reduce this.
- Reporting systems may be in place, but they are inadequate. There is no reassurance that staff concerns will be listened to and acted upon.
- The culture of the service is closed and processes for communicating and sharing information are not transparent and accessible. There is no reassurance that whistleblowers will be treated fairly, without fear of detriment.
- Learning is not embedded in the organisational culture. There are high levels of defensiveness and lack of leadership accountability or ownership of staff feedback and concerns. Staff report feeling psychologically unsafe to raise concerns.
- The wellbeing of staff is a very low priority and there are no measures to support flexibility and to improve staff morale and engagement.
- Staff do not feel pride in their service and would not recommend it to others as a place to work or receive care.
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.