CQC inspection checklist & how to prepare
A practical checklist and readiness guide for CQC-registered providers — what inspectors look for under the five key questions, what's changing in 2026, how to prepare, and how to run a mock inspection. Plus how to stop the pre-inspection scramble for good.
What CQC looks for: the five key questions
Every service CQC regulates is assessed against the same five key questions — is it safe, effective, caring, responsive and well-led? An inspection (now usually called an “assessment”) is, at heart, a request for evidence against each one. Get familiar with what sits behind each question, because that is the lens the inspector uses.
If you are preparing for a first inspection, it is worth reading what the CQC is and what it looks for alongside this checklist.
Inspectors also check whether you have notified them of what you were required to — see CQC notifications: what you must report and when.
Below we break down each question in turn — what good looks like, the evidence to have ready, and the mistake that most often costs providers a rating. The definitive source is CQC’s own guidance: the five key questions and the assessment framework on cqc.org.uk.
The five key questions, one by one
1. Safe
What good looks like: people are protected from avoidable harm, and risk is managed without needlessly restricting anyone’s freedom.
Evidence to have ready: safeguarding referrals with their outcomes; a complete incident log that shows action and learning; current, individual risk assessments; complete MAR charts with medicines safely stored, stocked and audited; infection prevention and control; and staffing that matches the dependency of the people you support.
Most common finding: medicines. Gaps in MAR charts, storage or stock problems, and dosage errors — and inspectors judge the outcome, not the tidiness of the medicines policy.
2. Effective
What good looks like: care achieves good outcomes, follows current best practice, and consent is properly obtained.
Evidence to have ready: care and treatment in line with current guidance; Mental Capacity Act assessments and Deprivation of Liberty Safeguards applications where needed; nutrition and hydration; staff competence, supervision and training that demonstrably reaches the floor; and effective multi-disciplinary working.
Most common finding: consent. MCA assessments missing, generic, or not decision-specific, and DoLS not applied for when they should be.
3. Caring
What good looks like: people are treated with dignity, compassion and respect, and are genuinely involved in decisions about their own care.
Evidence to have ready: what an inspector observes directly, what people and families say, and records showing that privacy, independence and personal preferences are respected.
Most common finding: this is the hardest question to stage, because it is judged heavily on observation and the voice of people using the service. A caring culture has to be real, not documented.
4. Responsive
What good looks like: care is person-centred, adapts as needs change, and complaints are welcomed and used to improve.
Evidence to have ready: personalised, current care plans that read like the individual; a complaints log with responses and demonstrable learning; accessible information; and, where relevant, sensitive end-of-life care.
Most common finding: template care plans that could belong to anyone, and complaints that are logged but never learned from.
5. Well-led
What good looks like: leadership is visible and accountable, the culture is open and learning, and governance and quality assurance actually work.
Evidence to have ready: a governance framework with clear roles; an audit cycle whose findings reach leadership and close; an honest self-assessment; a registered manager in post; duty-of-candour records; and staff who feel able to raise concerns.
Most common finding: a governance story that lives in people’s heads rather than the record, and quality assurance that never reaches the board. This is where good services most often win or lose the overall rating.
What’s changing in 2026
The framework is being reformed — and if you’re preparing this year, you should know where it’s heading so you don’t build your evidence around something that’s about to move.
Three changes are landing together. CQC is replacing the 34 quality statements with key lines of enquiry framed as structured questions — closer in style to the pre-2023 KLOEs — splitting the single merged framework into four sector-specific frameworks, and removing scoring altogether in favour of rating judgements made directly at key question level against published rating characteristics. CQC set all three out in its March 2026 update. Feedback on the drafts closed on 12 June 2026, the frameworks are being piloted over the summer, and implementation is expected at the end of the year.
What isn’t changing — and why it matters. The five key questions stay exactly as they are, and so does the four-point rating scale (Outstanding, Good, Requires improvement, Inadequate). That’s the anchor. If you organise your evidence around Safe, Effective, Caring, Responsive and Well-led, your preparation survives the reform regardless of how the supporting questions are re-worded. Build around the five questions, not around the wording of a statement that may change.
The practical takeaway for 2026: keep your evidence current and well-organised against the five questions, watch for your sector’s final framework when CQC publishes it, and don’t invest heavily in memorising the 34 quality statements when a slimmer set is on the way. For the full breakdown — dates, sector frameworks and what to do now — see our guide to CQC’s new assessment frameworks.
How a CQC inspection actually works
Notice — often none. Comprehensive on-site assessments are frequently unannounced. Where notice is given, residential adult social care providers typically get around two working days, and domiciliary services usually a little more so people using the service can be contacted. The safe assumption is that you may get very little warning — which is exactly why “ready every day” beats “ready on the day.”
It’s evidence-led. CQC gathers evidence from multiple sources — records you provide, direct observation, and conversations with people using the service, families and staff — and weighs it against the five key questions before reaching a rating. Increasingly this runs alongside ongoing, off-site monitoring rather than a single visit on a fixed cycle, so there is no reliable “inspection is due” date to prepare against.
It ends in a rating. Each key question is scored and a service is rated Outstanding, Good, Requires improvement or Inadequate. The rating is published, and a poor one carries real commercial and regulatory weight — from local-authority and ICB confidence to, in serious cases, enforcement action. We explain the scoring in CQC ratings explained.
Does it differ by sector?
The five key questions are universal, but the emphasis — and the evidence that matters most — shifts by service type. From 2026, CQC is making this explicit with four sector-specific frameworks. In broad terms:
Care homes (residential & nursing)
Expect close attention to medicines, falls and pressure-area management, safeguarding, DoLS, personalised care plans, and staffing matched to the dependency of residents.
Domiciliary & home care
The focus moves to missed and late calls, lone-working safety, medication support in people’s own homes, and the scheduling and travel that make visits reliable — often tested through spot checks and the feedback of people and their families.
GP practices
Prescribing and medicines management, a named safeguarding lead, significant-event analysis, infection prevention and control, and safe recruitment checks tend to dominate.
Dental practices
Decontamination and infection control, radiography assurance, medical-emergency and resuscitation readiness, safeguarding and complaints handling are the usual pressure points.
Whatever your sector, the underlying task is identical: organise your evidence around the five key questions and be able to produce it on demand.
The CQC inspection checklist
The evidence inspectors most commonly ask for. If you can produce each of these — current, complete and showing you acted on what you found — you’re in strong shape.
Policies & procedures
- Statement of purpose current and accurate
- Policies in date and reviewed
- Staff have read & understood them (evidence of acknowledgement)
Staff files & training
- DBS, right-to-work, references, induction on file
- Mandatory training up to date, with evidence of competence
- Supervisions and appraisals current
Incidents & safeguarding
- Incident log complete, with duty-of-candour records
- Safeguarding referrals and outcomes documented
- Evidence you learned and changed practice — not just logged
Risk & audits
- Risk assessments and register current, actions tracked
- Recent audits (medicines, infection control, care plans) with findings actioned
- A quality-assurance cycle the board can see
Care records & medicines
- Person-centred, current care plans with consent (MCA/DoLS)
- MAR charts complete; medicines stored and audited
Governance & feedback
- Complaints log with responses and learning
- Feedback from people, families and staff, acted on
- A clear golden thread: issue → action → improvement → evidence
Run a mock inspection
A mock inspection is a dry run of the real thing: someone independent walks the service against the five key questions, asks the questions an inspector would, and pulls the evidence to see if it’s really there. Do one a few weeks before you expect to be assessed — it surfaces gaps while you can still fix them, and it takes the fear out of the day. The most common finding isn’t that the care is poor; it’s that the evidence of good care is scattered and hard to produce on demand.
Because you may get little or no notice of the real thing, treat the mock as the moment you’d normally use to prepare — the point is to already be ready. Here’s a structure that works (and our full guide to running a CQC mock inspection goes deeper):
- Pick an independent assessor. A senior person who doesn’t run the unit being reviewed, or an external consultant. Fresh eyes catch what familiarity hides.
- Assess against the five key questions. Use CQC’s own framework as your script, so the mock mirrors the lens a real inspector uses.
- Test evidence retrieval, on the clock. Can you produce a named person’s current care plan, a MAR chart, the training matrix and the learning from a recent incident within minutes? If it takes an afternoon, that’s your finding.
- Talk to staff. Can they explain safeguarding, whistleblowing, and how they’d support a specific person? Inspectors ask the frontline, not just the manager.
- Walk the environment as a visitor. Look at safety, cleanliness, dignity and the “homely” feel through the eyes of someone arriving for the first time.
- Score, assign, and re-check. Write findings against each question, give every gap an owner and a deadline, then re-test before the deadline passes. A mock that doesn’t close its actions is just a to-do list.
Why providers get “Requires improvement”
Rarely because they don’t care. Usually because they can’t prove they do. The same handful of gaps come up again and again:
- Medicines that don’t hold up. Gaps in MAR charts, dosage errors, and storage or stock issues. Inspectors judge the outcome, not the medicines policy.
- Generic care plans. Plans that read like templates rather than reflecting the individual’s needs, preferences and risks. Personalisation is checked directly against the person.
- Training records that don’t match reality. A matrix that says “complete” while competence on the floor tells a different story.
- Incidents logged, but no learning. A full incident log with no evidence that anything changed as a result — no action, no follow-up, no closed loop.
- Audits without follow-through. Audits carried out but findings never actioned or closed, so the same issue recurs.
- Governance in people’s heads. A quality story the registered manager can tell but can’t show — nothing in the record that a board or an inspector can follow.
Every one of these is an evidence-and-consistency problem, not a care problem — which is exactly the kind a connected system removes.
Or stop preparing for inspections altogether.
Keeping all of the above current by hand is the scramble. CompliantCare keeps it done — so when the inspector calls, the checklist is already complete and the evidence is one click away.
- Policies drafted, in date, and proven read by every member of staff
- Incidents actioned, with learning documented — not just logged
- Audits, risk and training connected, findings tracked to closure
- A one-click evidence pack for every one of the five key questions
Free tool: the care home audit tool turns this checklist into a working spreadsheet — all 34 quality statements, what to check for each, and columns for your finding, owner and closure date.
Last reviewed: 30 July 2026. We review the CQC guides monthly against CQC’s published guidance; where ours differs from theirs, theirs is correct.
Common questions
What do CQC look for in an inspection?
Evidence against the five key questions — Safe, Effective, Caring, Responsive and Well-led. Inspectors look for current records, consistent practice, and proof that you learn from what goes wrong and act on it. They weigh what they read against what they observe and what people, families and staff tell them.
How much notice does CQC give before an inspection?
Often none — comprehensive on-site assessments are frequently unannounced. Where notice is given, residential adult social care providers typically get around two working days, and domiciliary services a little more so people can be contacted. Assume little warning, and stay ready year-round rather than preparing for a date.
What is changing with the CQC framework in 2026?
CQC is replacing the 34 quality statements with key lines of enquiry framed as structured questions, splitting the single framework into four sector-specific frameworks, and removing scoring from its assessment methodology in favour of rating judgements made directly at key question level. Drafts were published in March 2026, feedback closed on 12 June, pilots run over the summer and implementation is expected at the end of 2026. The five key questions and the four rating levels stay the same, so preparing around the five questions remains the safe approach.
What is a mock CQC inspection?
A rehearsal of a real inspection — an independent walk-through against the five key questions, testing whether your evidence is complete and easy to produce, and whether staff can speak to safeguarding and a person's care. It's the fastest way to find and fix gaps before the real assessment.
How are CQC ratings decided?
Each of the five key questions is scored, and the service is rated Outstanding, Good, Requires improvement or Inadequate. The rating is published and carries real weight with commissioners, local authorities and, in serious cases, enforcement.
How long does it take to prepare for a CQC inspection?
If your evidence is scattered, prep can consume weeks. If your policies, incidents, audits and training are already current and connected, there's very little to do — which is the whole point of a system like CompliantCare.
Does CompliantCare help with CQC compliance?
Yes — it keeps policies acknowledged, incidents actioned with learning, audits and risk connected, and generates inspection-ready evidence packs on demand, so you're ready every day rather than scrambling before a visit.
References
- Care Quality Commission — The five key questions we ask
- Care Quality Commission — Assessment framework
- Care Quality Commission — Assessing quality and performance
- Care Quality Commission — Our March 2026 update
For general information only and reflects our understanding of CQC's approach as of July 2026. The framework is changing during 2026 — always check cqc.org.uk for the current framework for your sector. Reviewed by the CompliantCare clinical team.