What are the CQC Fundamental Standards?

The CQC Fundamental Standards are 13 minimum standards all UK health and social care providers must meet by law. They include person-centred care, dignity, consent, safety, safeguarding, nutrition, premises safety, complaints handling, good governance, sufficient staffing, fit and proper staff, duty of candour, and display of ratings.

The Care Quality Commission (CQC) in the UK sets out fundamental standards of care that all health and social care providers must meet. These are the basic requirements – the standards below which care must never fall. They ensure that everyone receiving care is treated safely, with dignity, and in accordance with their needs and rights.

In 2023, the CQC introduced a new Single Assessment Framework for regulation. This updated framework changed how services are evaluated against the fundamental standards, replacing older Key Lines of Enquiry (KLOEs) with new quality statements and

evidence categories. The goal was to streamline assessments across all sectors and put greater emphasis on people’s actual experiences of care.

At DKJ Support Services, we know from real-world experience that navigating CQC compliance can be challenging. That’s why we provide CQC registration support for private clinics, GP practices, and healthcare providers. What are practise privileges? How does an inspection work? We’ll give you the knowledge and tools needed to meet and exceed these standards, lightening your workload so you can focus on delivering exceptional care.

In this article, we provide a comprehensive overview of the CQC fundamental standards and their role in regulation and compliance. We’ll also cover how you can demonstrate compliance, whether you’re already running an established service or just starting out.

The CQC Fundamental Standards

The fundamental standards are a set of core requirements that every CQC-registered service must meet by law. They are essentially the minimum standards of quality and safety as defined in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (and subsequent amendments).

Any breach of these standards can result in CQC enforcement action, including warnings, fines, or even closure of the service.

List of Fundamental Standards

1. Person-Centred Care – Care and treatment must be tailored to each individual’s needs and preferences.
   
2. Visiting and Accompanying – People in care homes, hospitals, or hospices must be enabled to have visitors, and to be accompanied on appointments if they wish.
   
3. Dignity and Respect – People must be treated with dignity and respect at all times. This means privacy must be provided when needed, everyone should be treated equally, and individuals should get support to remain independent and involved in their community.
4. Consent – Care or treatment must only be given with the consent of the person (or their lawful representative).
   
5. Safety – People must not receive unsafe care or be put at avoidable risk of harm. Providers must assess risks and have competent, skilled staff to keep people safe.
   
6. Safeguarding from Abuse – People must not suffer any form of abuse or improper treatment while in care. This includes protection from neglect, degrading treatment, unnecessary restraint, or restrictions on freedom.
   
7. Food and Drink (Nutrition) – People must have enough to eat and drink to keep them in good health while receiving care or treatment.
   
8. Premises and Equipment – The places where care is provided, and the equipment used, must be clean, secure, suitable, and properly maintained.
   
9. Complaints – People must be able to complain about their care, and providers must have a system to handle and respond to complaints thoroughly. If problems are identified, the provider should investigate and take appropriate action.
   
10. Good Governance – The service must have effective governance, management, and oversight systems to continually check and improve the quality and safety of care. Providers need plans and audits in place to ensure they can meet all the standards and reduce risks to health, safety, and welfare.
    
11. Staffing – Services must have enough staff who are suitably qualified, competent, and experienced to meet people’s needs. Staff must receive appropriate training, support, and supervision to do their jobs effectively.
    
12. Fit and Proper Staff – Providers must only employ people who are fit for their roles. This means robust recruitment procedures, including background and criminal record checks, to prevent unsuitable staff from being hired.
    
13. Duty of Candour – Providers must be open and transparent with people about their care and treatment. If something goes wrong, the provider must inform the person (and/or their family), apologise, explain what happened, and offer support.
    
14. Display of Ratings – After a CQC assessment, a provider must display its CQC rating where people can see it (for example, in a reception area and on the provider’s website). The latest inspection report should also be accessible to the public. 

Each of these fundamental standards is a rule that underpins high-quality care. They cover the full range of expectations from the perspective of the person receiving care (for instance, “I get enough to eat and drink” or “I am treated with respect”) and the responsibilities of the provider (e.g. “We ensure we have sufficient, trained staff”). 

In the next sections, we’ll see how CQC’s 2023 Single Assessment Framework incorporates these standards into its new way of assessing services.

How the CQC Assesses Compliance With Fundamental Standards

In 2023, the CQC introduced the Single Assessment Framework to replace the older Key Lines of Enquiry (KLOEs). The new framework provides a consistent method of assessment across all health and social care services. While the five key questions—Safe, Effective, Caring, Responsive, and Well-Led—remain, the way services are assessed has evolved.

Services are now assessed against a series of Quality Statements, which clearly define what good care looks like under each of the five questions. These statements are mapped directly to the fundamental standards.

In addition, the CQC collects evidence under six categories. This holistic approach ensures that compliance is not just about having the right policies but about demonstrating real, tangible outcomes for people who use services. The six categories are:

1. People’s Experience

This refers to what people who use the service (and their families or carers) say about their care. It includes direct feedback, interviews, surveys, compliments and complaints, and any other evidence of the lived experience of people receiving the care.

CQC places a strong emphasis on hearing the voices of service users – for example, inspectors might review satisfaction survey results, talk to patients or residents during an inspection, or consider feedback given through CQC’s online feedback forms.

Under the new framework, people’s experience is often front and centre, as it reflects whether fundamental standards like person-centred care, dignity, and respect are truly being met from the service user’s perspective.

2. Feedback from Staff and Leaders

CQC also considers what the staff and management of the service say. This includes staff surveys, one-to-one conversations or interviews with staff members during inspection, and feedback from leaders or managers about how the service operates.

The purpose is to gauge the culture and internal perspectives – for instance, do staff feel supported and trained (linking to the Staffing standard)? Are they aware of and following the service’s policies on safety and consent? Do leaders demonstrate openness and commitment to the fundamental standards? Feedback from staff can reveal strengths or issues like morale, training adequacy, and whether there is a culture of candour and learning within the team.

3. Feedback from Partners

Many services work in partnership with other entities in health and social care. For example, a small private clinic might work with NHS commissioners, GPs, local hospitals, or professional bodies.

CQC may gather input from these external partners – such as commissioners, local authority contract managers, other providers in the care network, or community organisations. This category might include reference to any external reviews or accreditation, or feedback from professionals who refer patients to the service.

The idea is to see how the service is viewed by its peers and partners, and whether it collaborates appropriately. For instance, if a care home has a history of poor communication with the local safeguarding authority, that might emerge through partner feedback and indicate a problem with meeting safeguarding standards or good governance. On the other hand, positive partner feedback (e.g. a commissioner noting the provider proactively engages to improve care quality) can be evidence of a well-led and responsive service.

4. Observation

Direct observations by inspectors remain a vital evidence source. This includes what inspectors see and hear during on-site visits: the interactions between staff and people using the service, the cleanliness and safety of the environment, how care is delivered in real time, and more.

Observation is particularly relevant to standards of dignity (e.g. inspectors will watch if people are treated respectfully), safety (noting if proper infection control measures are followed, or if equipment is used safely), and general care practices. Inspectors might do things like observe a mealtime in a care home to see if people are getting adequate nutrition in a dignified manner, or observe how medications are administered.

They will also look at the premises and equipment – checking, for example, if emergency exits are clear, if cleaning schedules are in place, and if the overall atmosphere is caring and inclusive. What they observe is then matched against what the service claims it does, serving as a real-world check on the fundamental standards being met.

5. Processes

This category covers the systems, policies, and records that the service has in place. It encompasses all the documentation and procedural evidence of how the service runs.

During an assessment, CQC will examine things like care plans, risk assessments, training records, incident logs, complaint records, audit reports, policies (e.g. for infection control, safeguarding, consent), and meeting minutes. These documents show whether the provider has the proper processes to meet the fundamental standards.

Essentially, the “Processes” evidence shows the backbone behind the care—that there are organised, effective systems to ensure standards are consistently met.

Notably, for new providers or those yet to have many service users, this category is very important. At registration, you may have to rely on showing your policies and procedures as evidence that you will meet the standards, given you have little track record yet. Part of our expertise at DKJ Support Services involves knowing how best to organise and demonstrate these processes.

6. Outcomes

Finally, CQC looks at a service’s outcomes – the measurable results of care and performance indicators. This can include clinical outcomes (like recovery rates, infection rates, health improvements), safety outcomes (like number of falls or medication errors), and other forms of evidence that reflect the quality of care.

Outcomes also cover things like response times for a service or results of external quality assessments. Inspectors will review any available data: for instance, in a clinic, they might review patient outcome data or treatment success rates; in a care home, they might look at trends in weight gain or loss of residents, or incidents of pressure ulcers.

CQC also increasingly expects providers to be using data to drive improvement, so demonstrating good outcomes and explaining how you use outcome data is a way to show compliance with standards.

How DKJ Support Services Can Help You Meet Fundamental Standards

At DKJ Support Services, we recognise that while the CQC provides guidance, applying it in practice can be complex, especially when you are setting up a new clinic or managing multiple services.

We offer:

• CQC registration support, from writing your Statement of Purpose and preparing governance documents to developing policies in accordance with the fundamental standards.
  
• Compliance audits assessing your service against the fundamental standards before CQC inspections.
  
• CQC training courses for staff and managers on compliance, safeguarding, and governance.
  
• Mock inspections by the experts, providing a simulated inspection experience to identify gaps.
  
• Bid management services, supporting healthcare providers to secure tenders and contracts, particularly in regulated spaces.

Our support is not generic. We tailor our consultancy to your specific service, whether you are a GP practice or an aesthetic clinic. With our background in NHS, primary care, and private clinical services, we bring expert insight that is both practical and rooted in real experience.

Final Thoughts

The CQC’s fundamental standards set the baseline of care quality and safety that must be provided in every health and social care service in England. The Single Assessment Framework (as of 2023) did not change those underlying standards, but it did change how regulators evaluate services against them.

For clinic owners, managers, and care sector entrepreneurs, the message is clear: understanding and embedding the fundamental standards in your service is essential for both compliance and good care. Services that embrace this will find that compliance becomes a natural part of their operations, and they can approach CQC assessments (whether an on-site inspection or an ongoing monitoring activity) with confidence and pride in the care they deliver.

At DKJ Support Services, we use our expert experience in primary care and private clinical practices to guide healthcare providers through CQC compliance and bid management processes. We are not your typical consultants—we are experts from experience, having worked directly within the healthcare system. Whether you are preparing for your first CQC registration, managing ongoing compliance, or seeking to improve your inspection rating, DKJ is here to support you every step of the way.

Get in touch with us today to find out how we can help you not just meet these standards, but exceed them.

Sources:

• The fundamental standards – Care Quality Commission
• Regulations for service providers and managers – Care Quality Commission
• 6. The single assessment framework – Care Quality Commission
• Assessment – Care Quality Commission