CQC Is Abolishing Its Inspection Scoring System — And Replacing It With 4 New Frameworks. Consultation Closes June 12.

The Care Quality Commission is scrapping its single assessment framework (SAF) and replacing it with four new sector-specific inspection frameworks. Scoring is being removed. Quality Statements are being replaced by structured key lines of enquiry. The consultation closes on 12 June 2026 — and near-zero CQC-registered providers know this is happening.

If you run a care home, dental practice, GP surgery, mental health service, or independent hospital, the way CQC inspects your service is about to change fundamentally. This is the biggest reform to CQC inspection methodology since the SAF launched in 2023. Here's what we know, what it means for your service, and what you need to do before the consultation closes.

What's Actually Changing

The CQC introduced its single assessment framework in 2023 — a unified approach intended to make inspections more consistent across all registered providers. It used Quality Statements aligned to five key questions (Safe, Effective, Caring, Responsive, Well-led), with scores awarded at each evidence category.

That framework is being abandoned.

The draft replacement involves four sector-specific frameworks, each tailored to a distinct type of registered provider:

Adult social care — care homes, domiciliary care, supported living
Mental health — inpatient and community mental health services
Primary care — GP surgeries, dental practices, community pharmacy
Hospitals — NHS acute trusts, independent hospitals

Each framework is designed to reflect the different contexts, risks, and quality indicators relevant to that sector — rather than forcing all providers through the same lens.

Scoring Is Gone

Under the SAF, CQC awarded numerical scores at the evidence category level. Those are being removed. Under the new frameworks, CQC inspectors will assess key lines of enquiry (KLOEs — a return to a more familiar format) and make a direct quality rating without intermediate scoring.

This is significant. The SAF's scoring system was one of the most criticised elements of the 2023 reform — providers found it opaque, inconsistent, and difficult to map to operational improvements. CQC itself acknowledged the framework had "not yet delivered" its intended benefits.

New: "Workforce Wellbeing and Enablement" Quality Statement

The draft frameworks propose a new quality statement specifically focused on workforce wellbeing and enablement. This would become a standalone inspection focus, reflecting the sector-wide recognition that staff wellbeing directly affects care quality.

For care homes and mental health services in particular, this adds a new dimension to compliance preparation. CQC inspectors will be looking not just at whether you have enough staff, but at how well you support them, how you address concerns, and whether your workforce environment enables safe, effective care.

Timeline: When Does This Take Effect?

Milestone	Date
Draft frameworks published	March 2026
Consultation closes	12 June 2026
Summer piloting begins	Summer 2026
New frameworks go live	Late 2026

You have 73 days from today to respond to the consultation. After that, summer piloting begins with a selected group of providers. Full rollout is expected in late 2026.

Who Is Affected

All 65,000+ CQC-registered providers in England. The scope includes:

Care homes (residential and nursing) — covered under the adult social care framework
Domiciliary care agencies — adult social care framework
Supported living providers — adult social care framework
GP surgeries — primary care framework
Dental practices — primary care framework
Community pharmacies — primary care framework
NHS and independent mental health services — mental health framework
NHS acute trusts — hospitals framework
Independent hospitals and clinics — hospitals framework

If you are registered with CQC, you are affected. The only question is which of the four new frameworks will apply to your service.

Why CQC Is Making This Change

The CQC's own position is that the single assessment framework, while sound in principle, has not worked as intended in practice. Key criticisms that have driven the review:

Operational inconsistency. Providers and commissioners found that inspection teams were applying the SAF inconsistently — similar services receiving different scores for comparable evidence. The lack of sector-specific nuance made this worse.

The Kirkup Report. The 2024 independent review by Dr Bill Kirkup identified serious failings in CQC's regulatory capability and culture. It found the organisation had moved away from the deep sector expertise that had historically made its inspections effective. The sector-specific framework approach is partly a response to Kirkup's recommendation to rebuild that expertise.

Inspection backlog. CQC has a significant backlog of providers not yet rated under the SAF. The transition to new frameworks creates an opportunity to reset the inspection programme with a more workable methodology.

Provider feedback. Sustained criticism from provider bodies including the NHS Confederation, the Care Provider Alliance, and NHS England prompted CQC to accelerate its reform timetable.

What the 4 New Frameworks Mean in Practice

Adult Social Care

Adult social care providers are likely to see the most significant change. The adult social care framework is expected to place greater emphasis on:

Person-centred care planning — how well care plans reflect individual needs and preferences
Workforce wellbeing — the new quality statement means staff experience becomes an explicit inspection focus
Medicines management — a persistent enforcement area, likely to be more explicitly structured
Safeguarding systems — not just whether safeguarding processes exist, but whether they work in practice

For care home operators, the removal of scoring removes some of the ambiguity in the SAF — but it also means you can no longer rely on a numerical score as a proxy for compliance. CQC will be making qualitative judgements about your service against sector-specific criteria.

What to do now: Map your current Quality Statement evidence against the draft adult social care KLOE structure. Identify gaps before inspectors do.

Primary Care (GP and Dental)

GP practices and dental providers often found the SAF framework less intuitive than their previous Fundamental Standards approach. The primary care framework should provide clearer, more contextually relevant lines of enquiry.

Specific areas to watch in the draft:

Access and continuity — a long-running pressure point for GP services
Infection prevention and control — elevated post-pandemic, remains a priority area for dental
Clinical governance — learning from incidents, clinical audit cycles, prescribing governance

What to do now: Review the draft primary care framework against your current governance documentation. Check your last inspection report and map any previous concerns to the new structure.

Mental Health

Mental health services face some of the most complex inspection criteria in the CQC portfolio. The new framework is expected to provide clearer, more consistent lines of enquiry for both inpatient and community settings.

Priority areas in the draft include:

Restrictive practice — use of restraint, seclusion, and long-term segregation
Ligature risk management — a perennial enforcement focus for inpatient services
Care planning and CPA — alignment of care plans to Care Programme Approach requirements
Patient rights — rights to second opinion, advocacy, and appeal under the Mental Health Act

What to do now: If you run inpatient services, audit your restrictive practice data and ensure your governance reporting reflects the frequency and circumstances of use.

Hospitals

NHS acute trusts and independent hospitals will move to a framework that better reflects hospital-specific risks and quality indicators. Expect greater focus on:

Surgical and procedural safety — WHO surgical checklist compliance, never events
Sepsis and deterioration protocols — National Early Warning Score compliance
Waiting times and access — RTT performance, 12-hour trolley waits
Staffing and rostering — safe staffing levels, skill mix

What to do now: Independent hospital operators should review their clinical governance structures ahead of the pilot phase. CQC has indicated pilots will prioritise services that have not been inspected recently.

The 5 Care Homes in Special Measures in March 2026

CQC enforcement is already accelerating under the existing framework. In March 2026 alone, five care providers were rated Inadequate or placed in special measures:

Finch Manor Nursing Home, Liverpool (27 March) — Inadequate
FiNN Homecare, Wantage, Oxfordshire (27 March) — Inadequate
St Elizabeth Care Home, Southampton (19 March) — remains Inadequate
Ashley Court Care Home, Wolverhampton (6 March) — downgraded
Brierley Hill, West Midlands (20 March) — systemic failure following fraud investigation

Five in a single month. CQC is not waiting for the new frameworks to enforce.

An Inadequate rating is public, permanent, and affects referrals, contracts, and your ability to recruit. Under the new frameworks, that enforcement trajectory is not going away — it's being operationalised more clearly.

How to Respond to the Consultation

The consultation is open to all CQC-registered providers, professional bodies, and interested parties. CQC has published the draft frameworks and is seeking specific feedback on:

Whether the sector-specific approach better reflects your service context
Whether the draft KLOEs are relevant and measurable
Whether the workforce wellbeing quality statement is appropriately framed
Whether the transition timeline is workable for providers

How to respond: CQC is accepting submissions via its online consultation portal at cqc.org.uk. Individual providers, provider networks, and sector bodies can all respond.

Our recommendation: Respond. The frameworks that emerge from this consultation will govern how you are inspected for the next several years. If the draft KLOEs don't reflect the reality of your service, say so. CQC has explicitly invited provider feedback — the Kirkup report made clear that CQC needs to rebuild trust with the sector, and the consultation is part of that.

Not sure which new framework applies to your service — or want to know when the final frameworks are published? ComplianceAlert monitors CQC regulatory changes and sends you plain-English alerts when anything affecting your service is confirmed. Start your free 7-day trial → — no credit card required.

What This Means for Your Compliance Preparation

The transition period — from now until the new frameworks go live in late 2026 — is the window to prepare. What that preparation looks like depends on your service, but some principles apply across all sectors:

1. Don't wait for the final frameworks. The draft KLOEs published in March 2026 are unlikely to change substantially. Start mapping your current evidence and governance documentation to the new structure now.

2. Take the workforce wellbeing statement seriously. This is new territory for many providers. Staff survey data, concerns-log analysis, and evidence of responsive management culture will all be relevant evidence.

3. Review your last inspection report. Under the new frameworks, evidence gathered in previous inspections will still be in scope. Anything CQC flagged previously is more likely, not less, to be scrutinised again.

4. Watch the pilot outcomes. Summer 2026 pilots will generate real inspection reports under the new frameworks. Those reports will be publicly available and will give you the clearest indication of what inspectors are actually looking for.

Key Dates Summary

12 June 2026 — Consultation closes. Respond before this date.
Summer 2026 — Pilot inspections begin under new frameworks
Late 2026 — Full rollout to all registered providers

TL;DR

CQC is scrapping the single assessment framework (SAF) and replacing it with four new sector-specific inspection frameworks
Frameworks cover: adult social care, mental health, primary care, and hospitals
Scoring is being removed; quality ratings will be made directly against key lines of enquiry
A new "Workforce Wellbeing and Enablement" quality statement is proposed
Consultation closes 12 June 2026 — all 65,000+ registered providers should respond
New frameworks go live late 2026 after summer piloting
CQC enforcement is accelerating now — 5 providers in special measures in March alone

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CQC Is Abolishing Its Inspection Scoring System — And Replacing It With 4 New Frameworks