CQC inspection is changing in 2026 – Unique Training Solutions

CQC inspection is changing in 2026: what health and social care leaders need to know, and why capacity and liberty are now centre stage

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For two years, services across health and social care have organised their evidence around the Single Assessment Framework and its 34 quality statements. That is coming to an end. In 2026 the CQC is moving to sector-specific frameworks and bringing back Key Lines of Enquiry, and it is doing so in the busiest inspection year the sector has seen in a long time.

Whether you run a care home, a home care service, a hospital ward, a GP practice or a community service, the change is worth understanding now, not in the autumn. Here is what is actually changing, when, and why the Mental Capacity Act and the Deprivation of Liberty Safeguards have quietly moved to the front of the queue.

What is actually changing

On 24/03/2026 the CQC published four draft sector-specific assessment frameworks: one for adult social care, one for hospitals covering secondary and specialist care, one for primary care and community services, and one for mental health. This undoes the one-size-fits-all approach of the Single Assessment Framework, where a care home, a GP practice and an acute hospital were all judged against the same set of statements.

Three things stand out in the draft:

The 34 quality statements are replaced by Key Lines of Enquiry, written as direct questions an inspector will put to your service. For adult social care, the draft sets out 24 of them; the healthcare frameworks have their own sets. Either way, instead of asking you to demonstrate a statement, an inspector asks you how you do something, and expects you to answer.

The numerical scoring system is going, and plain-English descriptions of what each rating level looks like are coming back. If you worked through the old Key Lines of Enquiry era, the shape will feel familiar.

The five key questions do not change. Safe, Effective, Caring, Responsive and Well-led remain the backbone across every sector. Everything you have built against those five still counts.

The timeline that matters

Two dates are worth putting in the diary.

By 30/09/2026, the CQC has set itself a target of publishing 9,000 assessments across all the sectors it regulates, and inspection activity is running around 50% higher than the previous year. If your rating is more than two years old, there is a real chance you will be assessed during 2026, and it will be under the current framework, which already tests consent, capacity and DoLS.

Towards the end of 2026, the new frameworks go live. The final versions are expected in summer 2026 following the consultation, which closed on 12/06/2026, with piloting over the summer. Until they land, the Single Assessment Framework remains in force, so this is a year of being inspected under one framework while preparing for the next.

There is also a quieter shift underneath all this. The CQC now assesses services throughout the year using data signals, not just on the day someone visits. Readiness is no longer an event you prepare for; it is a state you stay in.

Why capacity and liberty are now centre stage

Read across the draft frameworks and a pattern appears. Choice, consent and the least restrictive option run through the Caring, Effective and Responsive questions. Governance and accountability sit in Well-led. Safeguarding and risk sit in Safe. A large share of these questions turn on the same ground: consent, mental capacity, best interests and the least restrictive option. In other words, the Mental Capacity Act and the Deprivation of Liberty Safeguards.

The link to safeguarding is the sharpest part. If someone is deprived of their liberty without the right authorisation, the direction of travel is to treat that as a safeguarding matter. Weak or missing capacity records are exactly the kind of thing a question-led inspection surfaces quickly, because an inspector is no longer reading a folder; they are asking a manager or clinical leader to explain, out loud, how a decision was made.

Why DoLS is under real pressure right now

This matters more in 2026 than it might have a few years ago. The Liberty Protection Safeguards, the intended replacement for DoLS, are still on hold, so DoLS remains the law. The national waiting list for DoLS applications has sat above 100,000 for years.

In a care home or a hospital, someone who lacks capacity, is kept under continuous supervision and is not free to leave needs a DoLS authorisation. In settings DoLS does not cover, such as supported living, home care and other community services, the route is the Court of Protection. Getting this right protects the person’s rights first, and the service’s rating second. Getting it wrong is now more visible than ever.

What health and social care leaders can do now

The practical work does not wait for the final framework. A few things hold their value whatever the final wording says:

Keep working to the current Single Assessment Framework, because it is what you are inspected under today. Audit your evidence against the five key questions, since those are not changing. Make sure capacity assessments are decision and time specific and properly recorded, rather than treated as a blanket judgement. Check that DoLS authorisations and Court of Protection referrals are being made and tracked. And give your managers and clinical leaders the confidence to explain their evidence in conversation, with the same clear answer coming from each of them.

Most of all, treat readiness as continuous. The service that can answer an inspector’s questions in October is the one that has been practising the answers since spring.

A note on getting your team ready

Preparing for the new frameworks is partly about knowledge and partly about leadership, so it helps to think about both. At Unique Training Solutions we run a set of live, tutor-led courses, delivered privately for a single organisation’s team, that line up with the parts of inspection this article has covered.

For the capacity and liberty questions at the heart of the change, MCA and DoLS for Managers works through capacity assessment, best interests and the least restrictive option, and every learner leaves with a work-in-progress quality improvement plan that maps their own service’s evidence against the new Key Lines of Enquiry.

Because the draft frameworks treat an unauthorised deprivation of liberty as a safeguarding matter, Safeguarding Adults at Risk for Managers sits naturally alongside it. Built for health, social care and housing managers, it covers professional accountability, the Care Act 2014 in practice, referral procedures, and how to strengthen the systems and staff practice that keep people safe.

For the leadership and governance side, the ground inspectors probe hardest under Well-led, two Skills for Care approved programmes go deeper. Well Led, delivered over four days, focuses on the difference between quality assurance and quality improvement, benchmarking and gap analysis to drive service ratings, and leading improvement plans with real impact. Lead to Succeed, over five days, develops leadership styles and workplace culture and includes a full day on managing quality: using data and audits, setting action plans and delivering improvements that can be measured. Both are built around the language the new frameworks use: quality, evidence, action planning, and being ready all year round rather than on inspection day alone.

A note for adult social care providers in England: some of this training may be eligible for funding through the Learning and Development Support Scheme (LDSS). Funded by the Department of Health and Social Care and administered by the NHS Business Services Authority, the scheme reimburses eligible employers towards the cost of approved courses and qualifications for their workforce, including deputy and CQC-registered managers, and it has been confirmed to continue into the 2026 to 2027 financial year. Claims are made through the online service, and your organisation needs an up-to-date Adult Social Care Workforce Data Set (ASC-WDS) account; the funding pot is limited and works on a first-come basis, so it is worth acting early. Ask us which of our courses you may be able to claim for.

If any of these would help your registered managers, senior clinical leaders and quality leads across health and social care, get in touch at emma@uniquetrainingsolutions.co.uk.

Please note: The new frameworks are in draft at the time of writing and may change following consultation and piloting; the final versions are expected in summer 2026. Services remain inspected under the Single Assessment Framework until the new frameworks go live, which is expected towards the end of 2026.