Revised Quality Statements and Regulation 9A: What Care Providers Must Know

The Care Quality Commission (CQC) has implemented significant changes to its inspection and assessment model. Two key developments are central to this shift: the introduction of Quality Statements within the Single Assessment Framework (SAF) and the implementation of Regulation 9A: Visiting and Accompaniment. Both developments alter how providers must evidence compliance and safeguard the rights and experiences of people who use services.

From KLOEs to Quality Statements

Historically, CQC inspections were structured around Key Lines of Enquiry (KLOEs) supported by a large number of prompts. This system was often considered complex and inconsistent across different types of services.

In November 2023, the CQC began rolling out the Single Assessment Framework, which was fully implemented by March 2024. This framework replaced the KLOE model with 34 concise Quality Statements, organised under the five key questions: Safe, Effective, Caring, Responsive, and Well-led.

Each Quality Statement begins with the word “We” to define provider responsibilities. These are paired with “I statements” that describe what people using services should expect to experience. Examples include:

• Safe: “We assess and manage risks to people’s health, safety and wellbeing.”

• Well-led: “We have clear roles and accountabilities, and our leaders model a culture of openness and learning.”

  
  

The assessment model requires providers to demonstrate compliance through multiple sources of evidence. This includes service-user feedback, staff feedback, documented processes, and measurable outcomes. The focus of inspection has shifted from reviewing policies and procedures in isolation to evaluating the actual impact and lived experiences of people receiving care.

Regulation 9A: The Right to Visiting and Accompaniment

Since 6 April 2024, Regulation 9A has been recognised as a fundamental standard of care. This regulation establishes clear rights relating to visiting and accompaniment:

• People living in care homes, staying in hospices, or admitted to hospitals have the right to receive visitors of their choosing.

• People attending health appointments without overnight stays have the right to be accompanied.

  
  

Restrictions may only be applied in exceptional circumstances. Any such restrictions must be necessary, proportionate, clearly documented, and subject to regular review. Decisions that affect individuals who lack capacity must comply with the Mental Capacity Act 2005. This includes involving appropriate advocates or family members and ensuring that human rights principles are upheld.

Regulation 9A was introduced in response to the restrictions seen during the COVID-19 pandemic. It is intended to prevent blanket visiting bans and reduce the risk of people experiencing harmful isolation.

What Care Providers Should Do Now

To comply with the revised regulatory framework, providers should:

1. Review and update policies: Ensure policies are aligned with the 34 Quality Statements and incorporate requirements set out in Regulation 9A.

   
   

2. Train staff: Make certain that staff at all levels understand their responsibilities in evidencing compliance and upholding visiting and accompaniment rights.

   
   

3. Audit and document decisions: Maintain clear records of visiting restrictions, risk assessments, and review processes to demonstrate regulatory compliance.

   
   

4. Communicate clearly: Provide residents, patients, and families with accessible information on their rights, including easy-read formats where required.

   
   

5. Monitor impact: Collect evidence of compliance not only through policies but also through the lived experiences of people using services.

   
   

Challenges Ahead

Providers are likely to encounter challenges in meeting these new expectations. Key issues include:

• The administrative burden of collecting and managing evidence across multiple categories.

• Balancing infection control with the rights of individuals to maintain family and social contact.

• Ensuring consistent staff understanding in environments with high turnover and workforce pressures.

Despite these challenges, providers who adopt a proactive approach and embed a culture of rights, transparency, and safety will be better positioned to deliver high-quality care.

How CareLearner and ADAM AI Can Help

CareLearner has developed an integrated quality management system designed to support providers during regulatory changes. The ADAM AI platform offers:

• Automated generation and updating of policies aligned to Quality Statements and Regulation 9A.

• Mobile access for staff, ensuring that the most up-to-date policies are available in real time.

• Version control and audit trails, enabling providers to evidence changes effectively during inspections.

• Training modules that help staff understand their responsibilities relating to visiting rights, risk management, and safeguarding.

• Tools for feedback collection, incident reporting, and compliance auditing to demonstrate how policies are embedded in practice.

This system allows providers to move beyond compliance as a process of documentation and instead establish a sustainable culture of learning, safety, and accountability.

Conclusion

The introduction of the revised Quality Statements and Regulation 9A reflects a wider regulatory shift towards safeguarding rights, promoting transparency, and prioritising the experiences of people using services. Providers that align their systems and practices with these expectations will be well-positioned not only to achieve compliance but also to deliver safer and more compassionate care.