Well-led · KLOE 1
Strategic direction
Is there a clear vision and strategy that addresses the changing needs of the population and communities it serves?
CQC wording, mental health care draft, pages 56 to 60.
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:
- Strategy and vision
- Values
- Organisation sustainability
- Addressing social impact
- Environmental sustainability: Staff awareness and practice, carbon reduction practices – e.g. travel and transport, medicines and supply chain, estates and facilities, efficient service delivery with resource optimisation
- Equity‑driven strategy
- Anti‑racism focus
- Neighbourhood/system‑level alignment
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 56 to 60. 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
- There is a clear, compelling and shared vision, strategy and supporting objectives that responds proactively to the changing needs of its population and communities. These are co-produced with staff, people and those close to them, and community partners. The vision, strategy and supporting objectives are well-understood, owned and embedded across the service.
- The strategy delivers measurable improvements in population health, access to care, and people’s experience and outcomes, including demonstrable reductions in health inequalities. Equality, diversity and inclusion are embedded as core strategic priorities, with anti-racism, cultural humility and stigma-awareness integral to long-term care models, workforce strategies and service transformation.
- An inclusive, culturally sensitive and non-discriminatory person-centred approach is engrained in the values of the service and is evident in everyday interactions with staff, people who use the service and the public. People feel respected, listened to and safe, and services are designed around what matters most to communities served.
- Leaders provide visible, values-driven leadership, actively shaping and testing the strategic direction through curiosity, constructive challenge and learning. They analyse data, people’s lived experience, insight from staff and research evidence to ensure that the strategy remains relevant, equitable and impactful.
- Staff are proud of the service and consistently report high levels of engagement, pride and trust in leadership. They report that the service is an inclusive, supportive and empowering place to work. Staff feel alignment and ownership of the service’s culture, vision and values.
- Strategies and plans are fully aligned with those of the wider health and care system and actively shape it, and the service plays a strong role within the system. Through effective collaborative working with system partners, community-led organisations and local stakeholders, the service contributes to shared priorities and continually improving outcomes.
- The strategy and vision are ambitious, challenging and innovative, yet grounded in a clear understanding of risk, capacity and resources.
- Feedback from staff and people using the service includes culturally rooted forms of insight., This is systematically gathered, analysed and used to inform decision making. The service demonstrates how learning from feedback leads to tangible improvement, and shares this transparently in accessible ways with staff, people and communities.
- There is strong collaborative and team-working, with a shared focus on improving the quality, experience and sustainability.
- Environmental sustainability is embedded within strategic decision making, and leaders recognise its role in improving population health, delivering value and ensuring the long-term sustainability of services. Staff understand how sustainability relates to their roles and take pride in initiatives that reduce waste, minimise energy use and support greener models of care.
Good
- Leaders ensure there is a clear shared vision and strategy that responds to the needs of the population and communities served. The vision and values are communicated effectively, and staff across the service understand them and how their role contributes to delivering them.
- The vision, strategy and supporting objectives have been developed through a structured planning process, with meaningful engagement of staff, people and those close to them, communities and external partners. Equality, diversity and inclusion are reflected within the strategy, with anti-racism, cultural humility and stigma-awareness recognised as important strategic principles, although their application may vary across services.
- The strategy is credible and achievable, promoting high-quality, person-centred, culturally sensitive and non-discriminatory care. There is clear intent to reduce health inequalities supported by identified priorities and improvement actions. Progress in outcomes is evident, and further areas of work are allocated to leaders. There are clear plans to deliver further improvements.
- Leaders provide effective oversight of the strategy through regular monitoring of progress against delivery plans, key performance indicators and risks. Leaders use data, insight and research to inform decision making and to understand the needs of the local population.
- The strategy has clear, time-bound equity goals, with resourced plans and key performance indicators.
- Staff and leaders use data, research and information to ensure any risks to delivering the strategy, including relevant local factors, are understood and have an action plan to address them. They monitor and review progress against delivery of the strategy and relevant local plans, and system wide plans, where appropriate.
- Sustainability is actively considered, with actions taken to reduce the impact of care on the environment, to support sustainable practice, reduce waste and minimise energy use.
- Staff are empowered to know how environmental sustainability relates to their role including through planning and delivering care, preventing diseases and good practice in the use of medicines.
- Where appropriate, the vision, strategy and supporting objectives support mental health services to be delivered in trusted, community-based settings that are accessible and culturally relevant to people who use them.
Requires improvement
- The service’s vision, strategy and plans have some significant gaps or weaknesses that undermine their credibility. They are either incomplete, out of date, not sufficiently clear or not well-understood.
- Equality, diversity and inclusion principles, including tackling racism and stigma, are not consistently promoted and they are not necessarily central to the service’s vision, values and strategy.
- The service’s strategy and vision may not have been co-developed with staff, people who use the service and other stakeholders, so there is no feeling of co-ownership among these groups.
- Results of consultations with stakeholders and feedback from staff and people using the service are not always taken into account in developing and evaluating strategies or plans. Culturally rooted feedback is not always gathered, considered and made available in transparent and accessible ways.
- The plan and strategy do not fully reflect the local health and care systemin which the service operates. Use of engagement, data and research to help inform them is limited and not always effective.
- System-wide collaborative working with partnership agencies and community-led organisations is inconsistent, and leaders are not always visible.
- Leaders at all levels are not always held to account for the delivery of the strategy.
- Staff do not always feel actively engaged or empowered. Some staff with protected equality characteristics or from diverse ethnic and cultural backgrounds feel they are treated differently. They do not always feel pride in their service and do not always trust its leadership.
- Sustainability is not a primary consideration at this service.
- Where appropriate, the vision, strategy and supporting objectives do not always enable mental health services to be delivered in trusted, community-based settings that are accessible and culturally relevant to people who use them.
Inadequate
- There is no credible statement of the service’s vision and guiding values. These are either outdated or not underpinned by detailed and realistic plans and objectives.
- Equality, diversity and inclusion principles, including a commitment to anti-racism and cultural humility, are often neglected, if not altogether absent from the service’s strategy and vision.
- Key stakeholders have not been engaged in creating the service’s strategy. Collaborative working and co-production with people and local communities to gather feedback, including culturally rooted forms of feedback, is not happening.
- Staff do not understand the service’s vision and values and do not understand how their role contributes to achieving the strategy.
- Strategies and plans are not aligned with the wider health and care systemin which the service operates.
- There is no effective approach to monitoring, reviewing or providing evidence of progress against delivery of the strategy or plans.
- Leaders at all levels are not held accountable for the delivery of the strategy.
- Staff feel disengaged, disempowered and often feel no pride in their service. Staff with protected equality characteristics or from diverse ethnic and cultural backgrounds are treated differently.
- Sustainability is either completely absent from the service’s strategy and vision, or it is poorly or ineffectively communicated.
- Staff are unaware of their responsibilities or contribution in relation to reducing waste and minimising the use of energy.
- The vision, strategy and supporting objectives do not consider or enable mental health services to be delivered in trusted, community-based settings that are accessible and culturally relevant to people who use them.
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.