Effective · KLOE 5
Consent to care and treatment
Are people supported to understand, and exercise, their right to consent to care and treatment?
CQC wording, mental health care draft, pages 35 to 37.
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:
- Right and capacity to consent
- Advocacy and support
- Information and communication about people’s rights, including consumer rights
- Mental Capacity Act
- Mental Health Act
- Lawful, rights‑based decisions
- Independent advocacy
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 35 to 37. 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
- Capacity to consent is assessed with exceptional compassion, curiosity and respect. People are supported through a trauma-informed and culturally sensitive approach that enables them or their relevant representatives to fully understand their rights and play an active, empowered role in decisions about their care.
- People consistently receive clear, inclusive and accessible information about their rights, including the right to advocacy. Staff skilfully adapt their communication methods to meet individual communication needs, cultural backgrounds, past experiences, and preferences, ensuring every person feels listened to, valued and fully involved.
- Information and advice are exemplary in quality: always accurate, current, evidence-based and tailored to diverse communication needs. This ensures people can make genuinely informed decisions, even in complex or emotionally challenging circumstances.
- Openness and integrity are embedded throughout all care processes. People receive transparent, personalised explanations about all aspects of their care, including treatment options, therapeutic approaches, the Mental Health Act, community treatment orders, contracts and charges. The service’s values-driven culture means staff consistently go beyond expectations to ensure people feel safe, respected and in control.
Good
- Capacity to consent is assessed, and people (or their relevant representatives) understand their rights and are involved in decisions about their care.
- Decisions are made in line with the Mental Capacity Act 2005, involving carers or advocates when needed.
- People are supported to understand their rights to consent to care and treatment, including rights to advocacy. They understand they have the right to change their mind and withdraw their consent, and staff respect this.
- People’s rights are communicated in a way that meets their communication needs. This includes their human rights, rights under the Mental Capacity Act 2005, rights under the Equality Act (2010) and any other relevant legislation. These rights are promoted and protected.
- People are supported to access independent advocacy, including statutory or non-statutory when available, and advocates are appropriately involved by the service.
- Information and advice about consent is accurate, up-to-date, and meets people’s communication needs. Clear, transparent information about care and treatment is provided, including on contracts and charges where appropriate.
- The service has clear policies and procedures to follow when assessing capacity and making best-interest decisions. These are in line with appropriate legislation and staff document these decisions consistently and transparently.
- The laws and principles that apply to consent for children, young people and those with parental responsibility (or court appointed representatives) are understood and adhered to.
- Where people are subject to the Mental Health Act 1983 (MHA), consent to care and treatment provisions, rights to access independent mental health advocates and the MHA Code of Practice are complied with. Any departure from the Code of Practice guidance is clearly justified.
Requires improvement
- Capacity to consent is not consistently assessed in the appropriate circumstances. People (or their relevant representatives) do not always understand their rights and are not consistently involved in decisions about their care.
- People are not always supported to understand their rights to consent to care and treatment or their rights to advocacy.
- Decisions are not always made in line with the Mental Capacity Act 2005. Carers or advocates are inconsistently involved in decision making.
- Information and advice about consent is not always accurate or up-to-date or does not always meet people’s communication needs. Information about care and treatment, including on contracts and charges, where appropriate, is not always provided in a clear or transparent way that people can understand.
- The laws and principles that apply to consent for children, young people and those with parental responsibility (or court appointed representatives) are not always understood and adhered to.
- 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
- Capacity to consent is not appropriately assessed. People (or their relevant representatives) do not understand their rights and they are not involved in decisions about their care.
- People are not supported to understand their rights to consent to care and treatment or their rights to advocacy.
- Decisions are not made in line with the Mental Capacity Act 2005. Carers or advocates are rarely or never involved in decision making.
- Information and advice about consent is inaccurate or out-of-date, and is not provided in a way that meets people’s communication needs. Information about care, including contracts and charges, where appropriate, is unclear, not transparent, or difficult for people to understand.
- The laws and principles that apply to consent for children, young people and those with parental responsibility (pr court appointed representatives) are not understood or adhered to. This places children and young people at risk.
- 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.