We responded to the CQC’s assessment framework consultation
At the end of last year, the English regulator, the Care Quality Commission (CQC) ran a consultation on their assessment frameworks. Assessment frameworks are used to inspect and rate health and care providers, based on their performance related to key characteristics. We responded to the consultation, representing older people receiving care.
Our key feedback
We welcome the review of the assessment framework, as the people we support have struggled for too long with inadequate regulation under the Single Assessment Framework. There are some positive recommendations that we support, and we have shared feedback where we are concerned more needs to be done to protect peoples’ rights.
Sector-specific frameworks are welcome
We supported the reintroduction of clear rating characteristics and sector-specific frameworks, particularly for adult social care. Care homes are not clinical services – they are people’s homes. Residents are often isolated or unable to raise concerns safely or independently.
We warned that the Single Assessment Framework failed to account for these realities and contributed to a decline in reliable, on-the-ground inspections. New frameworks must start with key legislation such as the Care Act, measuring how well services promote wellbeing, dignity and outcomes, not just whether tasks are completed.
Lived experience must be prioritised
Drawing on our adviceline and feedback from our Lived Experience Group, we stressed that inspections must speak directly to people using services and their representatives – safely, privately and without fear of reprisals. We also called for the checking of care plans against people’s actual experiences.
We highlighted persistent issues such as poor dementia care, inappropriate staffing levels, lack of meaningful activities, and failures to involve attorneys or representatives – all of which are often missed without robust inspection.
Light touch regulation puts people at risk
We raised serious concerns about the CQC’s proposed move to infrequent, incomplete inspections. People living in care often have no external visitors, no advocates and no safe route to complain. Relying on intelligence alone is dangerous when our research found that 56% of people who witness poor care do not report it.
We were clear that inspections taking place every 3-5 years would put people at serious risk of poor care going unchecked, especially in closed cultures. We also called for re-inspection triggered by changes in management, a known risk point for declining care.
Professional judgement must be fostered and evidence-led
While we agreed that the previous scoring system was overly complex, we warned that increased reliance on professional judgement must be supported by measurable rating characteristics and training in adult social care, human rights and equality law.
There must be consistent, transparent narrative reports that people using services and their loved ones can actually understand. Ratings must be based on demonstrable adherence to legislation, not values-based statements or unverified provider claims.
Human rights and equality must be upheld
We highlighted that older people, disabled people and those living with dementia are at heightened risk of harm in closed care settings. New frameworks must actively prevent bias, poor assumptions and institutional neglect.
We pushed for dementia-specific assessment criteria for dementia specialist providers and adjustments to ensure equity, not “one-size-fits-all” care.
Regulation is essential for protecting the rights of older people receiving care. Find out more about our experience supporting people with poor regulation, and our recommendations to improve it in Our Vision for Social Care.