What Are the CQC Fundamental Standards?

The CQC Fundamental Standards are a legally defined set of minimum requirements designed to ensure that health and social care services in England provide safe, high-quality, and compassionate care. These standards exist to protect the wellbeing, safety, and dignity of individuals using care services. The Care Quality Commission (CQC), an independent regulatory body, enforces these standards under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which came into effect in April 2015.

The standards are designed to cover every aspect of care, ranging from how people are treated to the quality of facilities and the responsibility of staff. They apply to all registered care providers, such as hospitals, care homes, GP surgeries, and community-based services. Failing to meet these standards can result in regulatory action, including fines, suspension of services, or closure.

Person-Centred Care

Person-centred care places the individual at the heart of all decisions about their care and treatment. This standard ensures that care and services are not delivered as a “one-size-fits-all” approach, but instead are tailored to meet each individual’s specific needs, wants, and preferences.

Key requirements include:

• Actively involving individuals in discussions about their care.
• Including family members or loved ones in conversations, if appropriate.
• Adapting care to reflect changes in an individual’s preferences or health over time.

Under this standard, people should feel empowered to express their choices and have their voices heard. For example, a person with mobility issues should be consulted about how best to help them manage daily activities, rather than having pre-determined solutions imposed on them. It also considers cultural or religious beliefs, ensuring these are respected during care.

Dignity and Respect

Treating individuals with dignity and respect is fundamental in health and social care. This means making people feel valued, heard, and supported throughout their experiences.

Care providers must:

• Preserve a person’s privacy during treatments or personal activities, such as bathing or dressing, by ensuring proper boundaries are maintained.
• Use appropriate language and behaviour, avoiding patronising or dismissive attitudes.
• Promote independence rather than assuming individuals are incapable of making decisions.

For instance, a carer assisting someone with personal hygiene should provide privacy and explain what they are doing before starting. By maintaining an individual’s dignity, care providers contribute to their emotional and psychological wellbeing.

Consent

Consent is the process by which individuals agree to treatment or care after being fully informed about what it involves. This is a legal and ethical obligation that ensures individuals have control over what happens to them.

Providers must:

• Fully explain the pros, cons, and risks of treatments or care plans in a way that the individual can understand.
• Respect the decision of those who refuse treatment, even if it conflicts with the provider’s opinion.
• Follow the rules laid out in the Mental Capacity Act 2005 when a person lacks the capacity to make decisions, which includes consulting with family members and considering what is in the best interest of the individual.

For example, before administering medication, staff should inform the person of its purpose and seek their agreement. This gives individuals autonomy over their own care.

Safety

Safety is a priority in every aspect of care. This standard ensures all actions and decisions taken by care providers minimise risks and avoid harm.

This includes:

• Maintaining a hazard-free environment, whether this means clear walkways or well-lit areas.
• Storing and administering medications correctly to prevent errors.
• Monitoring individuals who may be at risk of falling or experiencing other accidents.

An example of meeting this standard would be conducting regular risk assessments in a care home to identify any potential dangers and implementing measures to address these issues quickly. A safe environment builds trust for those receiving support.

Safeguarding from Abuse

Safeguarding protects individuals from abuse, neglect, exploitation, or harm. Everyone, regardless of age, health, or ability, has the right to feel safe in their care setting.

Care providers must:

• Train staff to recognise and respond to any signs of abuse, such as physical injuries, changes in behaviour, or financial irregularities.
• Have clear procedures for reporting and dealing with safeguarding concerns.
• Ensure the care environment is free from bullying, harassment, or mistreatment.

For example, if a carer notices unexplained bruising or a person showing fear around certain individuals, they must raise the concern with safeguarding leads immediately. Reporting safeguarding concerns is a duty, not a choice, for care providers.

Food and Drink

Proper nutrition and hydration are crucial for maintaining physical and mental health. This standard ensures individuals receive suitable food and drink to meet their dietary and cultural needs.

Meeting this standard involves:

• Preparing balanced, nutritious meals that cater to individual requirements, such as low-sodium meals for those with high blood pressure or allergen-free foods.
• Assisting individuals who have difficulty eating or drinking, such as providing adapted cutlery for someone with arthritis.
• Monitoring food and fluid intake for people at risk of malnutrition or dehydration.

For example, a care provider may create a personalised meal plan for a diabetic resident, ensuring their blood sugar levels remain stable.

Premises and Equipment

Care settings, as well as the equipment used within them, must be safe, clean, and fit for purpose. This standard ensures individuals are treated in environments where they will not be put at risk.

To meet this standard, providers must:

• Regularly maintain and service medical or mobility equipment, like wheelchairs or hoists.
• Thoroughly clean facilities to reduce the risk of infections.
• Carry out health and safety compliance checks on the premises, such as fire safety inspections.

For instance, ensuring hospital beds are in good working condition and that patient rooms are sanitised supports safe and hygienic care delivery.

Complaints

People have the right to voice concerns if they are unhappy with their care. Providers are required to have effective procedures in place for managing complaints.

This standard involves:

• Providing clear and accessible ways for individuals to raise concerns, such as through written feedback forms or conversations with staff.
• Acknowledging complaints promptly and addressing them fairly.
• Using complaints as opportunities to improve services.

For example, a care home might implement changes to its meal scheduling after receiving complaints about late meal delivery.

Good Governance

Good governance refers to having strong systems in place to maintain high standards of care and accountability. Proper management ensures organisations operate effectively and identify areas that need improvement.

Providers must:

• Regularly review care delivery and collect feedback from staff and service users.
• Keep accurate care records and ensure data systems are secure.
• Monitor staff training and performance to ensure roles are performed correctly.

For example, a GP surgery might implement feedback systems to identify patient satisfaction issues and make service improvements.

Staffing

The quality of care is closely linked to the number and ability of staff members within a service. Having enough skilled staff ensures care is delivered safely and effectively.

Under this standard, providers must:

• Recruit staff with the right qualifications, experience, and character for care roles.
• Provide training and professional development opportunities.
• Employ enough staff to meet the needs of all individuals using the service.

For instance, a care home with residents who need 24-hour support should hire an adequate number of care workers to prevent staff burnout and ensure residents receive attentive care.

Fit and Proper Persons

This standard focuses on the suitability of leaders within the care organisation. Those in senior roles must demonstrate both competence and good character.

Requirements include:

• Passing criminal record checks and identity verification.
• Demonstrating a clear understanding of regulatory frameworks and best practices in care.
• Leading in a way that supports the wellbeing of staff and individuals receiving care.

For example, a director in a care home must show they have the skills to make financial, managerial, and operational decisions that benefit residents.

Duty of Candour

The Duty of Candour standard ensures transparency when mistakes occur. If something goes wrong and a person suffers harm, providers must acknowledge this and apologise.

Obligations include:

• Informing the person affected or their family promptly.
• Explaining what happened and what steps will be taken to prevent future incidents.
• Offering support during and after the incident.

For instance, a hospital that administers the incorrect medication must promptly inform the patient or their family, explain the error, and address any harm caused.

Display of Ratings

To help individuals make informed choices, providers must visibly display their CQC ratings. This promotes transparency and holds organisations accountable.

Providers must:

• Clearly display the rating at their premises, such as a poster in the reception area.
• Update their websites with the latest inspection outcomes.

For example, a GP practice rated as “Good” might place this rating on their noticeboard or website homepage to inform patients.

Final Thoughts

The CQC Fundamental Standards form the backbone of safe, compassionate, and effective care. By holding care providers accountable to these standards, the CQC ensures individuals can trust that their needs and rights will be respected in every aspect of care. Meeting these standards is not optional but an essential requirement for delivering responsible and respectful care across England.