Safe · KLOE 2
Managing risks during care and treatment
Is care and treatment planned and monitored to identify and manage risks, emergencies, and deterioration?
CQC wording, mental health care draft, pages 5 to 8.
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:
- Managing deterioration and emergencies
- Restrictive practice, including seclusion, segregation and physical and chemical restraint
- Managing periods of increased demand
- Clinical records
- Risk assessment and management
- Crisis planning
- Positive risk taking
- De-escalation
- Involving families and carers
- Blanket restrictions
- Sexual safety risk assessment
- Approach for delivering therapeutic observations
- Lone working
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 5 to 8. 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 exemplifies person centred risk management, ensuring each person’s risks are understood, reviewed and managed with exceptional rigour and compassion. Staff proactively seek creative and sector leading approaches to minimise restrictions and work seamlessly with partners when risks escalate beyond the service’s control.
- Working within an exemplary trauma informed and psychologically safe culture, staff anticipate and expertly manage deterioration, emergencies and clinical risks. Risk assessments for people with complex needs are consistently co-produced, proactively updated, and informed by timely specialist input.
Good
- The service proactively and holistically identifies, monitors and promptly acts on potential and unintended risks relating to a person’s care including deterioration, emergencies, co-occurring conditions and clinical risks. This reduces potential harm and protects people from exposure to the risk of avoidable harm.
- People and those close to them, and advocates are informed about and involved in the delivery and management of their care and individual treatments, including the potential risks and side effects. They are listened to when they raise concerns about the safety of care and are supported to plan for the event of a mental health crisis.
- People’s care plans and clinical records are accurate and kept-up-to date to allow the safe delivery of care and treatment. They reflect any foreseeable risks and how these should be managed.
- There is a balanced and proportionate approach to risk planning that supports people and those close to them, and advocates which respects people’s choices about their care and treatment.
- There are appropriate risk management policies, procedures and practices which make sure that any restrictions on people’s freedom, choice and control are necessary, lawful, proportionate and safe. This particularly includes where people lack mental capacity. People’s care plans reflect any foreseeable risks that may need restrictions.
- The service only ever uses restrictive practices as a last resort and only where it is lawful and legitimate. It reports any use of restrictive practices and has a strategy to reduce their use.
- Staff work proactively to meet people’s needs and always take a least restrictive approach to avoid the need for restrictive practices. Staff have the knowledge to identify unlawful restrictive practice. They understand what is causing people’s distress and have skills (where necessary) in de-escalation techniques.
- When people communicate their needs, emotions or distress staff support them consistently and can manage this in a positive way that protects their rights and safety.
- If seclusion or segregation is used, it is always appropriate and in line with best practice and there are clear plans to reduce or end it, and the arrangements are frequently reviewed.
Requires improvement
- Specific risks to an individual person are only partially or sometimes understood, and people’s care is not always well-monitored and assured. Management of deterioration, emergencies and clinical risks to reduce the risk of harm or exposure to the risk of harm may be inconsistent. People’s care plans may be incomplete, generic or difficult to access and do not always cover foreseeable risks and how they should be managed. Where people have more than one condition or diagnosis, their risk assessments are not always joined up.
- Risk assessments exist but may not be proportionate and do not always fully consider people’s choices or include the views of families and carers, where appropriate. This may lead to unnecessary restrictions or gaps in safety.
- People do not always feel listened to when they raise concerns about the safety of their care.
- The approach to imposing restrictions on people is not always proportionate and there may be examples of inappropriate use of restraint. Staff may lack knowledge to consistently identify unlawful restrictive practice, and their skills (where necessary) in de-escalation techniques may be limited. Staff do not always work to avoid the need for restrictive practices. The service does not consistently report use of restrictive practices and there is limited strategy to reduce their use.
- If seclusion or segregation is used, it is not always appropriate, plans to reduce or stop using it are not always clear, and the arrangements are not regularly reviewed.
Inadequate
- Risks to an individual person are not understood or are ignored, leaving them exposed to avoidable harm or the risk of harm occurring. Deterioration, emergencies and clinical risks are not managed well. Care plans are either missing, incomplete or inaccurate and do not predict foreseeable risks. Where people have more than one condition or diagnosis, their risk assessments are not joined up. The approach to managing risk is inappropriate. People’s choices about care and treatment are not listened to or considered.
- People do not feel listened to when they raise concerns about the safety of their care. Their voices are ignored or dismissed.
- The approach to imposing restrictions on people is disproportionate. Restraint is used in place of other more appropriate options. Staff lack knowledge to identify unlawful restrictive practice and do not have skills (where necessary) in de-escalation techniques. Staff do not work to avoid the need for restrictive practices. The service does not report use of restrictive practices and there is no strategy to reduce their use.
- If seclusion or segregation is used, it is not appropriate, plans to reduce or stop using it are not clear, and the arrangements are not reviewed.
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.