CQC 2026 KLOEs Explained: The 24 Draft Key Lines of Enquiry for Adult Social Care

What Are KLOEs?

Key Lines of Enquiry (KLOEs) are structured questions that CQC inspectors use to assess the quality of care services. They form the foundation of CQC inspections and are designed to be:

• Specific: Focused on a clear aspect of care quality
• Measurable: Supported by prompts and evidence sources
• Observable: Grounded in what inspectors can see, read, and hear
• Consistent: Applied uniformly across all similar services

KLOEs are grouped under five key questions: Is the service Safe, Effective, Caring, Responsive, and Well-led? These five domains have remained central to CQC regulation since 2015.

From SAF Back to KLOEs: Why the Change?

In 2024, the CQC introduced the Single Assessment Framework (SAF) as a unified approach across all health and social care sectors. The framework used broad "Quality Statements" rather than specific KLOEs. Early feedback revealed significant limitations:

• Quality Statements were too vague, leading to inconsistent interpretation
• Providers struggled to understand what evidence would be assessed
• Inspectors had insufficient guidance on what to look for
• The one-size-fits-all approach didn't account for sector-specific differences

In response, the CQC announced in early 2026 that it would return to sector-specific assessment frameworks built around KLOEs. This shift signals a move from descriptive compliance toward evaluative judgement — inspectors will assess not just whether documentation exists, but whether it answers specific questions clearly and consistently.

The 2026 Framework: Four Sector-Specific Approaches

The new CQC framework introduces separate assessment frameworks for:

• Adult Social Care (ASC): Care homes, domiciliary care, supported living, day services
• Mental Health: Mental health services and crisis support
• Primary Care: GP practices and primary care networks
• Hospitals: NHS hospital trusts

Adult Social Care is leading this transition. The draft ASC framework includes 24 Key Lines of Enquiry, grouped under the five key questions. This represents a significant increase in specificity compared to the previous SAF approach.

The 24 Draft KLOEs for Adult Social Care

The proposed 24 KLOEs are structured under the five key questions. Here is the draft framework:

Note: These KLOEs are in draft form and are subject to refinement following CQC consultation. The final framework may include adjustments based on stakeholder feedback.

Rating Characteristics: Outstanding, Good, Requires Improvement, Inadequate

A key feature of the new framework is the return of rating characteristics — clear definitions of what each rating level means for each KLOE. This replaces the more subjective scoring system used under SAF.

These rating characteristics provide clarity and defensibility — both inspectors and providers know what evidence and standards correspond to each rating level.

Professional Judgement in the Round

A significant shift in the new framework is the emphasis on "professional judgement in the round." This means:

• Inspectors will assess the totality of evidence, not just tick boxes
• Context matters — e.g., a single medication error doesn't automatically mean "Inadequate" if systems are robust and learning has occurred
• Narrative evidence is valued equally with documentary evidence
• Multiple sources of data are triangulated (observations, interviews, records, outcome measures)

This represents a departure from mechanistic scoring systems. The implication: providers need a sophisticated approach to evidence gathering and narration.

What This Means for Providers: The Inspection Readiness Imperative

1. Evidence Must Answer the KLOE Question Directly

Under the new framework, every piece of evidence must be traceable to a specific KLOE. Providers should:

• Map policies and procedures to each KLOE
• Ensure care records directly address the concerns raised in KLOEs
• Maintain audit trails showing how decisions are made
• Document reasoning and not just actions

2. Digital Records Are Essential

The CQC is increasingly expecting Digital Social Care Records (DSCR) that are:

• Real-time and contemporaneous (not retrospectively completed)
• Audit-traceable (timestamps, versioning, who made changes)
• Accessible to inspectors without manual file pulling
• Integrated with outcome measurement systems

Providers still using paper or fragmented systems will struggle under the new inspection regime.

3. Leadership and Governance Must Be Demonstrable

The expanded "Well-led" domain (5 KLOEs) signals increased scrutiny of governance. Providers should ensure:

• Registered Manager has clear governance role and authority
• Board/ownership has documented oversight of KLOEs
• Risk registers specifically address KLOE-aligned risks
• Quality assurance processes are audit-visible

4. Outcome Measurement Will Be Central

The framework emphasizes outcomes for people. Providers should:

• Use validated outcome measures for each KLOE domain
• Track outcomes longitudinally (not just snapshots)
• Be able to show correlation between care quality and outcomes
• Respond systematically when outcomes decline

Strategic Implications for the Sector

Increased Inspection Volume

The CQC has indicated an inspection target of 9,000 assessments across adult social care annually (up from approximately 5,000-6,000 historically). This reflects a significant intensification of regulatory presence and a shortened cycle between inspections.

The Emerging Readiness Sector

The complexity of the new framework is creating demand for:

• Mock inspections: Services that simulate CQC inspection using the draft KLOEs
• Compliance consultancy: Advice on mapping services to KLOEs and preparing evidence
• Digital systems: Software that automates KLOE-aligned documentation and audit trails
• Quality assurance tools: Systems that mirror CQC assessment methodology

Consolidation Incentives

The increased complexity and cost of compliance is likely to accelerate consolidation in the sector. Smaller, independent providers may struggle to afford the systems, consultancy, and staffing required to meet the new standards. Larger operators with centralised compliance functions will have advantages.

Key Takeaways for Providers

• KLOEs are specific questions, not vague domains. Evidence must directly address each KLOE.
• Rating characteristics are fixed. Know what "Good" and "Outstanding" mean for each KLOE.
• Professional judgement is holistic. Context and triangulated evidence matter more than single incidents.
• Digital records are non-negotiable. Manual systems will not satisfy the new inspection expectations.
• Outcomes are central. Services must demonstrate they improve people's lives, not just provide activities.
• Leadership visibility is critical. The Well-led domain now comprises 5 KLOEs, up from historical emphasis.
• Preparation starts now. The 2026 framework begins rolling inspections imminently. Services not preparing will be caught unprepared.