Effective · KLOE 3
Outcomes
Does the service monitor outcomes and compare performance to improve the effectiveness of care for all?
CQC wording, mental health care draft, pages 30 to 33.
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:
- Clinical audits
- Research and clinical trials
- Peer review
- Benchmarking
- Quality improvement initiatives
- Monitoring and improving outcomes
- Inequalities in outcomes
- Approved mental health outcome measures including quality of life
- Equity in analysis of outcomes by protected equality characteristics
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 30 to 33. 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
- Outcomes for people who use services are consistently better than expected. They are recorded using approved outcome measures, and compared with other similar services. Inequalities are addressed so outcomes are equitable for all.
- Effective use of benchmarking, learning and quality improvement initiatives mean people consistently experience positive and improving outcomes that are better than agreed expectations in legislation, standards and evidence-based guidance, with quality of life and equity considered in outcome measures.
- There are proactive, rigorous and inclusive systems that continually monitor, understand, and enhance people’s outcomes. All staff are actively engaged in activities to monitor and improve quality and outcomes (including, where appropriate, monitoring outcomes for people once they have transferred to other services). Opportunities to participate in benchmarking and peer review are proactively pursued, including participation in approved accreditation schemes.
- High performance is recognised by credible external bodies.
- The service uses outcomes measures to review performance and drive improvements, including by comparing outcomes across groups with different characteristics, such as protected equality characteristics.
- Care is culturally sensitive and non‑discriminatory, leading to consistently better outcomes for marginalised communities and individuals.
- Leaders and staff build strong partnerships with system partners and communities to understand and address discrimination and inequality in the local and wider system, including intersecting factors affecting outcomes.
- Leaders and staff use data and research proactively and work in evidence‑based ways with partners and communities to understand issues affecting equity in outcomes. This drives high‑quality, equitable outcomes by recognising barriers, acting on insights, allocating resources and embedding learning and innovation.
Good
- People have positive consistent outcomes that meet agreed expectations as set out in legislation, standards and evidence-based clinical guidance because they receive effective care and treatment that meets their needs.
- There are effective approaches to routinely collect and monitor information about people’s care and treatment and their outcomes. Outcome measures consider quality of life. This information is used to improve care.
- Where relevant, the service participates in local and national clinical audits and other monitoring activities such as reviews of services, benchmarking and peer review and approved service accreditation schemes. Accurate and up-to-date information about effectiveness is shared internally and externally, and all staff understand it. The information is used to improve the quality of people’s care, treatment and outcomes, and this improvement is checked and monitored.
- Staff and leaders use benchmarking with similar services to identify where improvements in outcomes are needed, and to address these.
- Leaders know of, and act on, any disproportionality in outcomes by protected equality characteristics.
- People have good outcomes because their rights are understood and acted upon. Experiences of discrimination or inequality are used to improve outcomes as well as care.
- Leaders and staff understand discrimination and inequality factors that intersect to disadvantage groups and take action with partners and communities. Evidence shows improvements in outcomes for marginalised groups.
- Leaders and staff consistently use data, research and engagement to identify equity barriers and allocate resources to improve people’s outcomes.
- The service complies with equality and human rights law by preventing discrimination, providing culturally sensitive and non‑discriminatory care and making reasonable adjustments to support equity in outcomes.
- The service analyses outcomes for people with different protected equality characteristics to identify and address health inequalities, taking action to achieve equitable outcomes.
Requires improvement
- People are at risk of not receiving effective care or treatment. There is a lack of consistency in the effectiveness of the care, treatment and support that people receive.
- People’s outcomes from their care and treatment are below expectations when compared with similar services. Information on outcomes is not always monitored regularly or thoroughly. The results of monitoring are not always used effectively to improve quality. Participation in external audits and benchmarking is limited.
- Outcomes for people are below expectations compared with similar services. Meeting expectations as set out in legislation, standards and evidence-based clinical guidance is variable.
- Outcomes of people’s care and treatment are not always monitored regularly or thoroughly. Participation in benchmarking is limited. The results of monitoring are not always used effectively to improve quality.
- People do not consistently feel their experiences of discrimination or inequality are acted upon in ways that improve outcomes.
- Leaders and staff lack consistent understanding of discrimination and inequality factors that affect outcomes. Links with communities and use of data are inconsistent, limiting their ability to improve outcomes.
- Leaders and staff are reactive in working toward equitable outcomes. Systems to gather, use and monitor information about equity in outcomes may be missing, weak or poorly used.
- The service does not fully comply with equality and human rights law but is aware of non‑compliance and taking steps to address it.
Inadequate
- People’s care is ineffective or there is insufficient assurance in place to demonstrate otherwise.
- There is very limited or no monitoring of the outcomes of care and treatment. People’s outcomes are very variable or significantly worse than expected when compared with other similar services. Necessary action is not taken to improve people’s outcomes.
- Outcomes for people are very variable or significantly worse than expected when compared with other similar services.
- There are very limited or no monitoring of the outcomes of care and treatment. Necessary action is not taken to improve people’s outcomes.
- People’s experiences of discrimination and inequality are not acted upon, and positive outcomes are declining.
- Leaders and staff are unaware of discrimination and inequality affecting outcomes and do not consider this when delivering the service. They do not use data or community insight to understand or address outcome disparities.
- Leaders and staff do not recognise unequal outcomes or take action to improve them. People feel their protected equality characteristics, ethnicity or culture negatively affect their outcomes.
- The service does not comply with legal equality and human rights requirements and is not aware of areas of non‑compliance.
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.