This page includes prompts for each of the CQC's five assessment framework key questions to support reflection and celebrate your own practice.
This is an opportunity to reflect, not something to worry about. Please take some time to review these prompts individually, discuss them with your team, and speak to your manager if you have any questions.
Safety is a top priority for everyone, and leaders embed a culture of openness and collaboration. People are always safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty is protected where this is in their best interests and in line with legislation.
- Do you know how to raise a concern and how to record safety incidents on our risk management system Radar?
- How is learning from incidents shared across your team?
- What improvements have been made recently to enhance safety?
- How do you ensure risks are not ignored but acted upon?
- Can you explain what Duty of Candour means?
- How do you gather feedback from patients?
- Why are ID labels important and how do you check them?
- How do you involve patients and families in discharge planning?
- Can you describe the MCA (Mental Capacity Act) and DoLS (Deprivation of Liberties Safeguards) processes?
- What would you do if you suspected a safeguarding issue?
- How do you manage risks during daily routines (e.g., safety huddles)?
- How often do you check the resuscitation trolley and what do you look for?
- How do you identify patients at risk of falling?
- What steps do you take to prevent pressure damage?
- What is restrictive practice, and when is it appropriate?
- How do you ensure oxygen and suction equipment is available and working?
- How do you ensure good hand hygiene?
- How do you share infection risk information with patients and visitors?
- How is medicine safely stored?
People and communities have the best possible outcomes because their needs are assessed. Their care, support and treatment reflect these needs and any protected equality characteristics. Services work in harmony, with people at the centre of their care. Leaders instil a culture of improvement, where understanding current outcomes and exploring best practice is part of everyday work.
- How do you ensure care plans are up to date and reflect the patient’s current needs?
- Do you know where ReSPECT decisions are recorded and how they are used in care?
- How are carers and families involved and how is their input documented?
- What is included in your handover documents? How do you keep it current?
- How do staff access and apply guidelines day to day?
- How do you prepare the environment for meal times?
- How often does the multidisciplinary team (MDT) meet and which disciplines attend? How do you document decisions?
- What processes support communication on and off the ward and within teams and services?
- How is information shared when tasks are delegated or referrals made?
- How do you encourage patients to make healthier choices?
- How are risk assessments reviewed and updated?
- How do you ensure patients understand what they’re consenting to?
People are always treated with kindness, empathy and compassion. They understand that they matter and that their experience of how they are treated and supported matters. Their privacy and dignity is respected. Every effort is made to take their wishes into account and respect their choices, to achieve the best possible outcomes for them. This includes supporting people to live as independently as possible.
- How do you maintain privacy and dignity during physical care?
- How do you support patients’ cultural or religious needs?
- How do you use the patient passport for patients with learning disabilities or dementia?
- Can you explain the ReSPECT form and DNACPR process?
- How do you support visiting rights, especially at end of life?
- How do you encourage independence and well-being?
- How do you help patients understand their rights?
- How do you maintain confidentiality during ward, service and team discussions?
- Who is the Freedom to Speak Up Guardian and how would you raise a concern?
People and communities are always at the centre of how care is planned and delivered. The health and care needs of people and communities are understood, and they are actively involved in planning care that meets these needs. Care, support and treatment is easily accessible, including physical access. People can access care in ways that meet their personal circumstances and protected equality characteristics.
- Do care plans reflect physical, mental, emotional and social needs?
- Do you know where protected characteristics are recorded?
- Do care plans show treatment choices and patient preferences?
- Do staff in your team have an awareness of how to provide reasonable adjustments?
- How do you record shared decisions?
- How do you help patients understand their condition and options?
- What’s included in handover communications, and how is it kept current?
- How do you access interpreters?
- Is there clear signage? What’s on the welcome board and is this up to date?
- How do you support patients who don’t speak English, are deaf, or have literacy difficulties?
- How are concerns/complaints listened to and acted on?
- How is feedback shared back to teams?
There is an inclusive and positive culture of continuous learning and improvement. This is based on meeting the needs of people who use services and wider communities, and all leaders and staff share this. Leaders proactively support staff and collaborate with partners to deliver care that is safe, integrated, person-centred and sustainable, and to reduce inequalities.
- How do you use newsletters or briefings to share learning and good practice?
- How are staff survey results shared and acted on within your team?
- What policies and procedures support equality, diversity and inclusion (EDI)?
- What are the current qualities priorities for your service?
- What daily support exists for emotional wellbeing?
- How can staff raise concerns?
- How are you involved in decisions?
- Are breaks protected and taken?
- How do you ensure voices of protected groups are heard?
- What are current staffing levels and skill mix?
- What are your top three risks, and how are these mitigated/escalated?
- Are you involved in any quality improvement (QI) projects?
- Is waste management in your area correct?
If you have any questions about anything in this guide, please talk to your manager or head of service, or email any questions to cqc.queries@wsh.nhs.uk.
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