Most care home managers can name the CQC's five key questions in their sleep, Safe, Effective, Caring, Responsive, Well-led. The 2024 Single Assessment Framework (SAF) replaced the old KLOEs with 34 Quality Statements, and the change matters less for what it asks and more for how it asks: continuous evidence, not point-in-time scoring.
This article is the working checklist we run with pilot homes. It's organised by key question, with the documents inspectors expect, the outcomes that need to be visible behind those documents, and the operational habit that keeps each item current. Treat it as a starting point, not a finishing line.
Safe
What inspectors look for
- Safeguarding policy, version-controlled, with named lead and dated reviews
- Risk assessments per resident, falls, choking, skin integrity, behaviours of concern, reviewed at the cadence the care plan specifies
- Incident, accident and near-miss log with trend analysis
- Medication: eMAR or paper MAR with witnessing, PRN protocols, refusal log, controlled drug register, stock checks
- Infection prevention & control, cleaning logs, outbreak escalation, PPE stock, isolation status records
- Premises & equipment, fire drills monthly, PAT testing, LOLER, water temp checks
- Staffing levels evidenced against dependency, not against budget
Operational habit
Daily: medication round witnessed and signed. Weekly: infection control walkround. Monthly: incident trend review and fire drill. Quarterly: risk assessment audit. If any of these slip, ServPatch's open-actions list surfaces them before the manager notices on a CQC questionnaire.
An inspector once told one of our pilot homes: "I don't need you to show me policies. I need you to show me what you did when the policy was tested." That sentence is the SAF in 22 words.
Effective
What inspectors look for
- Person-centred care plans co-produced with the resident and/or family
- Mental Capacity Act assessments with best-interest decisions documented
- DoLS authorisations current; conditions met and evidenced
- Nutrition and hydration monitoring, MUST scores, weight charts, fluid balance
- Training matrix, mandatory courses current, plus role-specific (dementia, end-of-life, autism)
- Supervision, appraisal and competency assessment records
- Wound care, pressure area and tissue viability monitoring with photographic evidence
Operational habit
A 6-monthly care-plan review is the floor, not the ceiling. The strongest homes review on change, admission, hospital return, condition change, end-of-life decision, and let the system show the audit trail.
Caring
What inspectors look for
- Daily notes that show person-centred care, not task completion
- Resident voice, meeting minutes, complaints, compliments, survey results
- End-of-life wishes recorded and respected, RESPECT/ReSPECT forms current
- Cultural, spiritual and dietary preferences captured and acted on
- Activities programme that responds to individuals, not the average
Operational habit
Read three random daily notes per resident per week and ask: does this sound like a person, or like a checklist? If it sounds like a checklist, the documentation pattern needs work, not the carer.
Responsive
What inspectors look for
- Care plans adjusted to need, including communication, sensory and cognitive needs
- Complaints procedure visible, accessible, and actioned within published timescales
- Admission, transfer and discharge processes with clinical handover evidence
- Equality, diversity and inclusion in practice, not just policy
- Family communication log
Well-led
What inspectors look for
- Registered manager visible, named, with current DBS and qualifications
- Governance framework, quality assurance audits, action logs, board / owner oversight
- Notifications to CQC made within statutory timescales
- Whistleblowing and Freedom to Speak Up route in practice
- Learning culture, lessons logged after incidents, complaints and audits, with closed-loop actions
- Workforce wellbeing measured and acted on
Operational habit
A monthly governance pack, incidents, complaints, audits, training compliance, staffing, safeguarding, read by a non-operational owner or board member. The pack itself is your Well-led evidence. ServPatch generates this in one click.
The thirty-minute Sunday habit
Every successful pilot home we've worked with does the same Sunday-evening discipline: thirty minutes to skim the week. Open actions, overdue audits, incidents not yet reviewed, training expiring within thirty days, family contact log. The system surfaces the list. The manager closes loops, then moves on with the weekend. Inspection prep stops being a project and starts being a posture.