CQC Effective Key Question: A Practical Preparation Guide

The Effective key question asks whether care, treatment and support achieve good outcomes, promote quality of life and are based on the best available evidence. Providers need to connect individual assessments and care plans to competent practice and measurable outcomes.

Good evidence shows more than tasks completed. It demonstrates that staff understand each person's needs, work effectively with others, obtain lawful consent and adjust support when it is not producing the intended result.

Understand the current Effective quality statements

CQC's published assessment framework places six quality statements under Effective. The exact evidence considered depends on the service and assessment scope.

• Assessing needs.
• Delivering evidence-based care and treatment.
• How staff, teams and services work together.
• Supporting people to live healthier lives.
• Monitoring and improving outcomes.
• Consent to care and treatment.

Assess and review the whole person

Assessment should involve the person and cover their physical health, mental health, care, wellbeing, communication, culture, strengths, goals and preferences. It should also identify relevant risks and the support needed to make decisions.

• Complete assessments before care begins and review them at agreed intervals.
• Update plans promptly after changes, incidents, hospital admissions or professional advice.
• Use suitable assessment tools without allowing templates to replace professional judgement.
• Record desired outcomes in the person's own terms wherever possible.
• Make current plans available to the staff responsible for delivering care.
• Consider the needs of unpaid carers where relevant to safe and effective support.

Turn evidence and guidance into competent practice

• Identify current legislation, professional guidance and recognised good practice relevant to the service.
• Convert guidance into clear procedures, care plans, training and competency checks.
• Give staff role-specific learning rather than relying only on generic online certificates.
• Observe practice and reassess competency after errors, long absences or changing responsibilities.
• Keep clinical or specialist advice current and accessible.
• Record the rationale when an individual need requires a different approach.

Coordinate care and support healthier lives

• Define responsibilities between the service, GPs, nurses, pharmacies, therapists and commissioners.
• Escalate deterioration and obtain timely professional advice.
• Share accurate information lawfully during referrals, reviews and transitions.
• Support nutrition, hydration, oral health, mobility and emotional wellbeing as relevant.
• Help people access screening, appointments and health-promotion information.
• Follow up recommendations and record their effect on the person's wellbeing.

Show outcomes, consent and continual review

1. 1Agree meaningful goals and decide how progress will be recognised.
2. 2Record consent for the specific care or decision rather than treating it as a one-off signature.
3. 3Support people to decide and presume capacity unless established otherwise.
4. 4Use lawful best-interest decision-making where a person lacks capacity for that decision.
5. 5Review outcome information, feedback, incidents and audits together.
6. 6Change the plan when evidence shows the intended outcome is not being achieved.