During 2024, the Care Quality Commission (CQC) rolled out their Single Assessment Framework (SAF). It is extremely important that you, as a care provider, understand this new way of assessing health and social care services throughout England to ensure that your service remains compliant.
In this article we’ll cover the following:
- What is the Single Assessment Framework?
- Why was the new framework introduced?
- What’s changed with the introduction of the SAF?
- Who does the framework apply to?
- Evidence Categories
- What are the quality statements?
- How can Delphi Care help?
What is the Single Assessment Framework?
The Single Assessment Framework is the latest method the CQC (regulator for care providers in England) uses to assess providers. It was first introduced in November 2023 and has suffered problems and bad press. However, it is not set to go anywhere.
With this new assessment framework, the CQC aims to provide care services with clearer expectations in relation to the standard of care and processes.
Why was the new framework introduced?
While the introduction of the new framework has been fraught with issues, the reasons why the CQC implemented it are clear. The Single Assessment Framework was introduced to:
- Make the process simpler so that care providers can focus more on what matters most to people.
- Better reflect how care is actually delivered to patients by different types of services.
- Create a framework that better connects registration activity to assessments of quality.
What’s changed with the introduction of the SAF?
Although it is new, the 5 Key Lines of Enquiries (KLOEs) still exist. However, they have been renamed the key questions. The key questions create the framework that the CQC uses to build a report on providers.
These measure care providers on being:
- Safe
- Effective
- Caring
- Responsive
- and Well-led
However, the new framework places a greater emphasis on external best practices and is evidenced via the CQC quality statements. This has been around for a while under the terminology ‘person centred care’ and all care providers claim to do it. But CQC now wants more evidence of a truly person centred experience.
Using these quality statements, the CQC aim to reduce the level of duplication that occurred across the four separate assessment frameworks that existed before the introduction of the new SAF. This will allow care providers to focus on a specific topic in a specific area which will link to the relevant regulations to make it easier for providers to understand what the CQC are looking for.
All assessments of quality that the CQC complete will be based on the Single Assessment Framework for all types of care service. This should create a more linear and easy to follow process when it comes to evidencing compliance in care.
Who does the framework apply to?
The new Single Assessment Framework applies to all types of service, including; Care Providers, Local Authorities, and Integrated Care Systems.
Evidence Categories
The types of evidence that the CQC look for as part of the new framework have been grouped into 6 different categories. These categories have been designed to help inspectors understand the quality of care being provided and the performance of the service against each of the quality statements.
However, the number of evidence categories they consider and their sources depend on a number of factors such as:
- The type of service.
- The level of assessment, such as Local Authority, Provider, Service, or Integrated Care System.
- Whether the assessment is for an existing service or for a new registration.
The evidence that they collect may consist of information that the CQC either already possesses or actively looks for, obtained through a combination of on-site and off-site activities. The CQC may also conduct unannounced site visits to gather evidence, particularly when addressing a specific concern.
The six evidence categories that the CQC uses as part of the new SAF are:
- People’s Experiences – This category focuses on how people experience the care provided firsthand.
- Feedback from Staff & Leaders – Evidence from this category includes evaluations and insights from those who deliver and oversee the provided care.
- Observations of Care – This includes direct observations of care practices and interactions within the service itself.
- Feedback from Partners – Here the CQC will gather perspectives from other organisations and entities who are involved in delivering care.
- Processes – Here the systems and procedures in place to deliver care are assessed.
- Outcomes of Care – As part of this evidence category the CQC assess the results and impacts of the provided care.
What are the quality statements?
In conjunction with the five key questions that the CQC ask when assessing a service, they will also use quality statements to determine a service’s provision of care is Safe, Effective, Caring, Responsive, and Well-led.
These statements are defined by the CQC as “the commitments that providers, commissioners and system leaders should live up to”. The statements are expressed as expressed as “we” and “I” statements with the latter reflecting what people have said matters most to them when it comes to the process and quality of care provision.
The five key questions (Safe, Effective, Caring, Responsive, and Well-led) will be divided into quality statements that reflect various aspects of these questions;
Safe
The quality statements for the “Safe” key question are:
- Learning culture
- Safe systems, pathways, and transitions
- Safeguarding
- Involving people to manage risk
- Safe environments
- Safe and effective staffing
- Infection prevention and control
- Medicines optimisation
“We” Statement Example
“We foster a proactive and positive safety culture grounded in openness and honesty, where safety concerns are heard, incidents are thoroughly investigated and reported, and lessons are continuously learned to identify and implement best practices.”
“I” Statement Examples
- “I feel safe and I am supported in understanding and managing any risks.”
- “I can get information and advice about my health, care, and support.”
Effective
The quality statements for the “Effective” key question are:
- Assessing needs
- Delivering evidence-based care treatment
- How staff, teams, and services work together
- Supporting people to live healthier lives
- Monitoring and improving outcomes
- Consent to care and treatment
“We” Statement Example
“We consistently monitor the care and treatment provided to ensure continuous improvement. Our focus is on achieving positive, consistent outcomes that align with both clinical standards and the expectations of the individuals we provide care to.”
“I” Statement Examples
- “I have care and support that is coordinated, and everyone works well together and with me.”
- “I am empowered to get the care, support, and treatment that I need and want.”
Caring
The quality statements for the “Caring” key question are:
- Kindness, compassion, and dignity
- Treating people as individuals
- Independence, choice, and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
“We” Statement Example
“We empower individuals to maintain their independence by ensuring they understand their rights and have choice and control over their care, treatment, and overall wellbeing.”
“I” Statement Examples
- “I am treated with respect and dignity.”
- “I am supported in managing my health in a way that makes sense to me.”
- “I can keep in touch and meet up with people who are important to me.”
Responsive
The quality statements for the “Responsive” key question are:
- Person-centred care
- Care provision, integration, and continuity
- Providing information
- Listening to and involving people
- Equity in access
- Equity in experiences and outcomes
- Planning for the future
“We” Statement Example
“We ensure that individuals are at the heart of their own care and treatment decisions, working collaboratively with them to determine the best responses to any changes in their needs.”
“I” Statement Examples
- “I am supported to plan ahead for important changes in my life that I can anticipate.”
- “I know how to access my health and care records and decide which personal information can be shared with other people.”
Well-led
The quality statements for the “Responsive” key question are:
- Shared direction and culture
- Capable, compassionate, and inclusive leaders
- Freedom to speak up
- Workforce equality, diversity, and inclusion
- Governance, management, and sustainability
- Partnerships and communities
- Learning, improvement, and innovation
- Environmental sustainability – sustainable
“We” Statement Example
“We maintain clear responsibilities, defined roles, robust accountability systems, and effective governance to ensure the delivery of high-quality, sustainable care, treatment, and support. We base our actions on the best available information regarding risks, performance, and outcomes, sharing this data securely with others when appropriate.”
“I” Statement Examples
- “I have the freedom to speak-up when there is something that I am concerned about with my health or the care being provided to me.”
- “I feel that the people undertaking my care are compassionate to my needs and are capable of ensuring that I maintain a good level of health.”
How can Delphi Care help?
Here at Delphi Care we have to knowledge and expertise to ensure that your service meets the standards for ‘Outstanding’ care. Our team is made up of former CQC inspectors and ex registered managers, with over 200 collective years’ experience of working in the health and social care sector.
Whether you require our consultancy services, mock inspections, or crisis management and turnaround, we’re here to help! Simply contact us today on 0330 133 3002 or email us at customer-care@delphi.care.
If you would like to chat with one of our consultants, then why not book a meeting now.
We look forward to hearing from you!
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