1.4 Summarise the different types of inspection and key themes of the inspection process

This guide will help you answer 1.4 Summarise the different types of inspection and key themes of the inspection process.

Adult social care services are regularly checked for safety and quality through inspections led by the Care Quality Commission (CQC). Understanding the different types of inspection and their key themes helps you prepare, lead your team, and maintain high standards.

There are several kinds of inspection, each with a different purpose and process. Inspections focus on a consistent set of themes across all regulated services.

Main Types of Inspection

Comprehensive (Focused) Inspections

A comprehensive inspection is the standard, full review of a service. Inspectors look at every aspect of the service using the five Key Questions. They talk to residents, staff, and families, review records, and observe practice.

These inspections usually:

• Take place routinely, often every one to three years depending on the last rating
• Happen more frequently if concerns are raised or a service requires improvement
• Lead to an overall rating and a detailed report

Targeted (Themed) Inspections

A targeted inspection usually concentrates on particular aspects of care. CQC may decide to carry out a targeted inspection if:

• There are specific concerns about safety or quality
• There’s been a significant event, such as a safeguarding alert or a serious incident
• The CQC wants to check specific improvements have been made since last time

The focus might only be on safe care, medicines management, or the effectiveness of leadership. Only relevant Key Questions are assessed.

Follow-Up Inspections

Follow-up inspections take place after a previous inspection where issues were identified. The main aim is to:

• Check if the service has fixed problems
• Confirm that improvements are being sustained

These are usually shorter and more focused than a comprehensive inspection.

Themed Inspections

Themed inspections look at cross-cutting issues across multiple providers. The CQC may launch themed inspections to investigate:

• Sector-wide issues, such as infection prevention
• How services support certain groups (e.g. people with dementia, people with complex needs)
• National priorities, like integrated working between health and social care

A themed inspection usually follows a common framework in many services at the same time.

Responsive (Unannounced) Inspections

Responsive inspections are carried out in response to:

• Concerns or complaints from the public, staff, local authorities, or other professionals
• Serious incidents, safeguarding alerts, or whistleblowing

Responsive inspections are usually unannounced and can focus on any area where risks have been identified.

Key Themes of the Inspection Process

During every inspection, the CQC uses standard themes to assess quality, safety, and compliance. These are presented as the five Key Questions, and further broken down into Key Lines of Enquiry (KLOEs).

The Five Key Questions

Every service is inspected against the same five Key Questions, which guide the whole process:

• Safe: Are people protected from abuse and avoidable harm?
• Effective: Does care, treatment, and support achieve good outcomes and enhance quality of life?
• Caring: Do staff involve and treat people with compassion, kindness, dignity, and respect?
• Responsive: Is the service organised so that it meets people’s needs?
• Well-led: Does the leadership, management, and governance ensure high quality, person-centred care, encourage learning and innovation, and promote an open and fair culture?

Inspectors look for evidence in each of these areas.

Key Lines of Enquiry (KLOEs)

Each Key Question is supported by Key Lines of Enquiry. KLOEs are more detailed questions or prompts that help inspectors look at specific aspects of care under each theme. For example:

• Safe: How are medicines managed? How does the service learn from incidents?
• Effective: Do staff have the right training and skills?
• Caring: How do staff promote independence?
• Responsive: How are people’s views collected and acted upon?
• Well-led: How do leaders drive improvement?

KLOEs help create a structured, consistent approach to collecting and judging evidence.

Person-Centred Care

A key theme throughout inspection is person-centred care. The CQC expects that:

• People are treated as individuals
• Care plans reflect personal needs, wishes, and preferences
• People are involved in decisions about their own support

Inspectors check records, observe practice, and speak with people to see if true person-centred care is being provided.

Safeguarding and Safety

Inspectors always focus on how the service protects people from abuse, neglect, and avoidable harm. This includes:

• Staff recruitment and vetting
• Training on safeguarding adults
• Safe management of medication
• Effective risk assessments
• Procedures for reporting concerns

Dignity and Respect

Inspectors look for:

• How staff support privacy and dignity
• Whether the environment is respectful
• Staff attitudes and relationships with people in their care

Good Governance and Leadership

This theme examines the effectiveness of leadership and management. Inspectors explore:

• Staff support, training, and supervision
• How feedback is gathered and used
• Openness and honesty (duty of candour)
• Status and implementation of policies and audits

Equality, Diversity, and Accessibility

CQC checks that care is accessible and non-discriminatory. Services need to show compliance with the Equality Act and attention to individual differences.

Learning and Continuous Improvement

Inspectors seek evidence that leaders:

• Learn from mistakes, complaints, and incidents
• Share and embed best practice
• Adapt when regulations or guidance change

Inspection Ratings

Following inspection, the CQC issues a rating for each Key Question and an overall rating for the service:

• Outstanding
• Good
• Requires improvement
• Inadequate

The rating is published, along with a report describing evidence, strengths, and any required actions.

What to Expect During Inspection

During an inspection, you and your staff will likely experience:

• An analysis of policies and procedures
• Review of care records, medicines management, and staff files
• Observations of care interactions
• Private conversations with people who use the service and their families
• A look at complaints records, safeguarding alerts, and audit trails
• Assessment of leadership skills and service culture

Final Thoughts

There are several types of inspection in adult social care, including comprehensive, targeted, follow-up, themed, and responsive inspections. Every inspection revolves around the five Key Questions: Safe, Effective, Caring, Responsive, and Well-led. Key themes include person-centred care, safety, dignity, leadership, equality, and learning. Understanding inspection types and themes helps managers prepare, promote quality, and maintain compliance with legal and regulatory expectations.