How do we show our everyday care against the CQC quality statements?

What are the quality statements, in plain English?

CQC's assessment framework is made up of 5 key questions, and under each one sits a set of quality statements. In CQC's words, they are the commitments that providers, commissioners and system leaders should live up to. CQC expresses them as we statements, showing what is needed to deliver high quality, person centred care, and they relate to the regulations CQC considers in its judgements.

Each quality statement also has I statements linked to it. CQC's page on I statements says they are part of the framework and that they reflect what people have said matters to them. In plain English, the we statement says what the service commits to, and the I statements say how that commitment should feel to the person receiving care.

That pairing is the most useful thing to understand about evidence. If the we statement is true in your service, the person can say the I statement in their own words. So the best evidence often comes from the person rather than from a form you filled in about them.

Are the quality statements about to change?

Yes. Know where things stand before you rebuild anything. In its March update, CQC said it is moving away from a single assessment framework to separate frameworks for each sector, and adult social care is one of its draft frameworks. Its 5 key questions remain. In the draft frameworks, the quality statements are replaced by structured questions describing what CQC will look for, alongside rating characteristics for each sector.

CQC's August update says it continued testing and piloting the draft frameworks across all sectors through the summer, with more engagement with each sector planned for the autumn. CQC's August update was its latest at the time I wrote this, and the adult social care framework was still being developed.

My advice is the same as it would be under any framework. Do not build a new evidence system around wording that CQC plans to replace. The habits in this post should hold up whatever the final questions say, because they rest on the 5 key questions, which CQC says remain, the regulations you already work to, and what people tell you about their own care.

Why does good care so often go unseen?

Often the care is fine and the evidence is in the wrong place.

The first mistake is building an evidence folder that sits apart from the work. Someone spends weeks matching documents to every quality statement, and the folder goes out of date the week after it is finished. Meanwhile the real evidence, in daily notes, handovers and conversations, is never connected to anything.

The second mistake is assuming that having a process proves it works. CQC's page on the processes evidence category says its assessments focus on how effective processes are to the relevant quality statement, and that it looks at sources that measure how well they work. A falls policy is a document. A falls audit that shows fewer falls, and a person who still walks to the garden every afternoon, is evidence of the process working.

Then there are the people themselves, who often get left out. CQC's page on the importance of people's experience says people using services, their families, friends and advocates are the best sources of evidence about lived experience of care. It says CQC weights their experience equally with the other evidence categories. Elsewhere it groups evidence into 6 categories, and people's experience is one of them, not an extra.

What does one quality statement look like in daily practice?

Take the quality statement on involving people to manage risks, under the safe key question. CQC's we statement commits the service to working with people to understand and manage risks, so that care is safe and supportive and lets them do the things that matter to them. CQC's explanation adds that risk assessments about care should be person centred, proportionate and regularly reviewed with the person, where possible. The page links the statement to Regulation 9 on person centred care, Regulation 11 on need for consent and Regulation 12 on safe care and treatment, and asks you to also consider Regulation 10 on dignity and respect.

The I statements make it personal. One reads: "I feel safe and am supported to understand and manage any risks." Another reads: "If my treatment, including medication, has to change, I know why and am involved in the decision."

Most services already do this work every day. The table shows where it tends to show up, and how to catch it without adding a form.

What the statement asks	Where it already happens	How to capture it as you go
People understand their own risks	A carer talks through why someone uses a frame at night	Write the person's own words about the risk in their care notes
A balanced approach that respects choice	Someone chooses to keep walking to the shop alone	Record the conversation, what they chose, and what you agreed together
Risk assessments reviewed with the person	A monthly review after a change in mobility	Note who was in the room and what the person said, not just the new score
People involved when medication changes	The GP changes a prescription after a review	Record that the change was explained, and how the person responded
Staff understand the risks	Handover between the day and night shift	Ask one carer each week to explain one person's plan in their own words

None of those needs a new system. It needs the person's voice written down where it happens, and a manager who knows where to find it.

How do I turn everyday practice into evidence without extra paperwork?

Start with the notes you already write. Daily records that say "personal care given, settled" tell an inspector very little. A line that says what the person chose, and what they said about it, tells them a great deal, and it takes no longer to write. This is the change I would make first. A short session with your team on writing notes this way will do more for your evidence than a new template.

Then use the meetings you already hold. Supervision, team meetings and residents' meetings are full of evidence about leadership, learning and involvement. Add one standing question to each: what did we change this month because someone told us to? Write the answer down. Over a few months, that record shows feedback being acted on, which usually carries more weight than a pile of completed surveys.

Next, look at your audits differently. When an audit finds something, follow it to the person. A care plan audit that says "reviewed on time" is a process. A care plan audit that says "reviewed with the person, who asked to move her bath to the evening, and now has it then" shows the process working for someone.

Finally, keep a short index rather than a folder. One page per key question is enough, listing where the evidence lives: which notes, which meeting records, which feedback. CQC says its lists of evidence categories for each sector are a guide, not a checklist. You are not building a box for every category. You are trying to know where to look when someone asks.

When is this not the answer?

If the care itself is not right, better evidence will not help. If people tell you they do not feel involved in decisions about risk, the job is to change practice, then record the change. Writing it down more neatly only moves the gap somewhere harder to see.

If you have open concerns about someone's safety, staffing you cannot cover, or enforcement action under way, deal with those first. Evidence work is for a service that is broadly stable.

And if your records already carry people's voices, your team can explain their work in their own words, and your audits follow findings through to the person, you may not need to change much at all. Tidy your index and carry on.

Where should I start?

Pick one quality statement this month. Involving people to manage risks is a good one, because almost every service does this work daily. Read the I statements with your team, then look at five care notes and see whether the person's voice is in them. That one exercise will often tell you more about your evidence than any folder.

If you would like a second pair of eyes, my inspection preparation work looks at whether your everyday records show the care you give, and my quality assurance audits test whether your own checks follow through to people. My earlier post on knowing whether your service is ready for an assessment covers readiness more broadly. When you are ready, book some time with me and we can look at one quality statement together.