Caring · KLOE 3
Independence, choice, and control
Are people empowered to maintain their independence and to make choices about their care and plans for their future, where they are able to?
CQC wording, mental health care draft, pages 43 to 45.
Draft, not the current assessment framework
CQC's mental health care draft, 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:
- Supporting communication and choice
- Access to friends and family (visiting rights) and community
- Specialist/adaptive equipment
- Supporting independence, activities and wellbeing
- Complex care needs
- End of life decisions and palliative care
- Involved, lawful decisions
- Co-production in decisions; flexible, personalised care.
- Support for community participation
How would this apply to your service?
The draft applies one framework across mental health care, but useful evidence depends on your service and people.
Source: CQC, Mental health care assessment framework, draft, 19 March 2026, pages 43 to 45. 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
- People and those close to them and advocates are genuine partners in care, with lived experience and preferences shaping all decisions through embedded co‑production.
- Staff create the conditions for true shared decision‑making, building trust, offering accessible information and enabling choices that reflect each person’s identity, culture and care and treatment goals.
- Care is highly flexible, personalised and seamless, adapting responsively to individual needs, transitions and complex circumstances.
- People are proactively empowered to have a voice, develop confidence and manage their own health, with exceptional support to maximise long‑term independence.
- People’s rights, relationships and life choices are fully supported, including decisions at the end of life, within a rights‑based, person‑led approach rooted in the Human Rights Act and Mental Capacity Act and strengthened by strong community involvement, where appropriate.
Good
- People are supported to have choice and control over their own care, and to make decisions about their care, treatment and wellbeing, where possible.
- Staff work with people to support, empower and enable them to achieve their goals. This includes what matters to them about their future care preferences around independence and care interventions.
- Staff respect people as autonomous individuals. They understand the power they have as care givers and act accordingly to protect and promote people’s human rights under the European Convention on Human Rights.
- People are supported to receive visits from people they want to see and to be accompanied to appointments. This is done in accordance with relevant legislation, considering the person’s age, and appropriate balance between their right to a private and family life, their independence, choice and control, risk and safety. The laws and principles that apply specifically to protecting children are adhered to when making decisions about appropriate access and visiting.
- In line with relevant legislation and assessment, people can choose to take part in their local communities and meaningful activities that support their identity, and maximise their dignity, independence, health and wellbeing.
- There is a range of appropriate equipment and technology to support and maximise people’s independence, and to result in a good experience and outcomes from care and treatment.
- Children, their parents or carers are supported to plan for their future, ensuring their changing needs are considered and they have time to make informed choices about their future.
- People who may be approaching the end of their life are identified to ensure their needs are met and the right support is provided. Where appropriate, end of life care planning is encouraged, including people’s preferences and informed decisions about resuscitation. People are informed and assured that they can update their choices. This information is shared with other services and staff appropriately.
- Where people are subject to the Mental Health Act 1983 (MHA), care and treatment follows the empowerment and involvement guiding principle, and the MHA Code of Practice is complied with. Any departure from the Code of Practice guidance is clearly justified.
Requires improvement
- Some staff do not consider involving people and those close to them as an important part of providing care.
- People are not encouraged or enabled to manage their own care.
- Information is not always accessible to all. People say that staff do not always explain things clearly, give them time to respond, or help them to understand the information they are given about their care and condition. This includes during referral, discharge, transition or transfers.
- Equality considerations are not always taken into account and reasonable adjustments in line with the Equality Act (2010) are not always made.
- People’s choices about their care and treatment, including in the context of end-of-life care, are not treated as a high priority.
- Staff do not always adhere to the Mental Health Act Code of Practice. Deviation from Code of Practice guidance is not always clearly recorded.
Inadequate
- People are not involved in their own care or treatment, and neither are those close to them.
- People do not know how to seek help or are ignored when they do so. Their basic care needs are not met.
- People do not know or understand what is going to happen to them during their care. They do not know who to ask for help.
- People are unable to access the care they need. Services are not set up to support people who may be approaching the end of their life, people who have complex needs, or those in vulnerable circumstances.
- Services are not set up to provide accessible information, or reasonable adjustments in line with the Equality Act (2010).
- The service does not support people to feel part of their local community. People may feel isolated and disconnected from their lives.
- Staff fail to comply with the Mental Health Act Code of Practice or other legislation.
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.