Safety is a priority for everyone and leaders embed a culture of openness and collaboration. People are always safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty is protected where this is in their best interests and in line with legislation.​

​Learning culture ​

We expect providers, commissioners and system leaders live up to this statement:

We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

• What this quality statement means

• Safety is a top priority that involves everyone, including staff as well as people using the service. There is a culture of safety and learning. This is based on openness, transparency and learning from events that have either put people and staff at risk of harm, or that have caused them harm.

• Risks are not overlooked or ignored. They are dealt with willingly as an opportunity to put things right, learn and improve.

• People and staff are encouraged and supported to raise concerns, they feel confident that they will be treated with compassion and understanding, and won’t be blamed, or treated negatively if they do so.

• Raising concerns helps to proactively identify and manage risks before safety events happen.

• Incidents and complaints are appropriately investigated and reported.

• Lessons are learned from safety incidents or complaints, resulting in changes that improve care for others.

• I statements

• I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

• I can get information and advice about my health, care and support and how I can be as well as possible - physically, mentally and emotionally.

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Safe systems, pathways and transitions

We expect providers, commissioners and system leaders live up to this statement:

We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

What this quality statement means

• Safety and continuity of care is a priority throughout people’s care journey. This happens through a collaborative, joined-up approach to safety that involves them along with staff and other partners in their care. This includes referrals, admissions and discharge, and where people are moving between services.

• There is a strong awareness of the risks to people across their care journeys. The approach to identifying and managing these risks is proactive and effective. The effectiveness of these processes is monitored and managed to keep people safe.

• Care and support is planned and organised with people, together with partners and communities in ways that ensure continuity.

• The views of people who use services, partners and staff are listened to and taken into account.

• Policies and processes about safety are aligned with other key partners who are involved in people’s care journey to enable shared learning and drive improvement.

I statements

I statements reflect what people have said matters to them.

• I know what to do and who I can contact when I realise that things might be at risk of going wrong or my health condition may be worsening. 

• When I move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place. 

 

Safeguarding 

We expect providers, commissioners and system leaders live up to this statement:

We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We make sure we share concerns quickly and appropriately.

What this quality statement means

• There is a strong understanding of safeguarding and how to take appropriate action.

• People are supported to understand safeguarding, what being safe means to them, and how to raise concerns when they don’t feel safe, or they have concerns about the safety of other people.

• There are effective systems, processes and practices to make sure people are protected from abuse and neglect.

• There is a commitment to taking immediate action to keep people safe from abuse and neglect. This includes working with partners in a collaborative way.

• People are appropriately supported when they feel unsafe or experience abuse or neglect.

• Where applicable, there is a clear understanding of the Deprivation of Liberty Safeguards (DoLS) and this is only used when it is in the best interest of the person.

• Safeguarding systems, processes and practices mean that people’s human rights are upheld and they are protected from discrimination.

• People are supported to understand their rights, including their human rights, rights under the Mental Capacity Act 2005 and their rights under the Equality Act 2010.

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

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Involving people to manage risks

We expect providers, commissioners and system leaders live up to this statement:

We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.

What this quality statement means

• People are informed about any risks and how to keep themselves safe.

• Risks are assessed, and people and staff understand them.

• There is a balanced and proportionate approach to risk that supports people and respects the choices they make about their care.

• Risk assessments about care are person-centred, proportionate, and regularly reviewed with the person, where possible.

• When people communicate their needs, emotions or distress, staff can manage this in a positive way that protects their rights and dignity and maximises learning for the future about the causes of their distress.

• Restraint is only ever used as a last resort. If staff use restraint, it is lawful, for a legitimate purpose, safe and necessary, and staff always follow best practice. Where relevant, equality and human rights legislation is considered. The service always takes a proportionate approach to imposing restrictions on people. People’s care plans reflect any foreseeable risks that may need restrictions.

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

• I know what to do and who I can contact when I realise that things might be at risk of going wrong or my health condition may be worsening.

• If my treatment, including medication, has to change, I know why and am involved in the decision.

• When I move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place.

• I have considerate support delivered by competent people.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

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Safe environments

We expect providers, commissioners and system leaders live up to this statement:

We detect and control potential risks in the care environment. We make sure that the equipment, facilities and technology support the delivery of safe care.

What this quality statement means

• People are cared for in safe environments that are designed to meet their needs.

• Facilities, equipment and technology are well-maintained and consistently support staff to deliver safe and effective care.

• There are effective arrangements to monitor the safety and upkeep of the premises.

• Equipment used to deliver care and treatment is suitable for the intended purpose, stored securely and used properly.

• Leaders and staff consider how environments can keep people safe from psychological harm as well as physical harm, for example in relation to sexual safety and in relation to sensory needs.

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

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Safe and effective staffing

We expect providers, commissioners and system leaders live up to this statement:

We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development. They work together effectively to provide safe care that meets people’s individual needs.

What this quality statement means

• There are robust and safe recruitment practices to make sure that all staff, including agency staff and volunteers, are suitably experienced, competent and able to carry out their role.

• Recruitment, disciplinary and capability processes are fair and are reviewed to ensure there is no disadvantage based on any specific protected equality characteristic.

• There are appropriate staffing levels and skill mix to make sure people receive consistently safe, good quality care that meets their needs.

• Staff receive training appropriate and relevant to their role.

• Staff receive the support they need to deliver safe care. This includes supervision, appraisal and support to develop, improve services and where needed, professional revalidation.

• Staff at all levels have opportunities to learn, and poor performance is managed appropriately.

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

• I know what to do and who I can contact when I realise that things might be at risk of going wrong or my health condition may be worsening.

• If my treatment, including medication, has to change, I know why and am involved in the decision.

• I have considerate support delivered by competent people.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

 

 

Infection prevention and control

We expect providers, commissioners and system leaders live up to this statement:

We assess and manage the risk of infection. We detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.

What this quality statement means

• There is an effective approach to assessing and managing the risk of infection, which is in line with current relevant national guidance.

• People are protected as much as possible from the risk of infection because premises and equipment are kept clean and hygienic.

• There are clear roles and responsibilities around infection prevention and control.

• Information about the risk of infection is shared appropriately with relevant partners, including agencies, people using the service and visitors.

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

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Medicines optimisation

We expect providers, commissioners and system leaders live up to this statement:

We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

What this quality statement means

• People are appropriately involved in decisions about their medicines.

• People are involved with assessments and reviews about the level of support they need to manage their medicines safely and to make sure their preferences are included. This is clearly documented in their care plan.

• The approach to medicines reflects current and relevant best practice and professional guidance.

• People’s medicines are appropriately prescribed, supplied and administered in line with the relevant legislation, current national guidance or best available evidence, and in line with the Mental Capacity Act 2005.

• Accurate, up-to-date information about people’s medicines is available, particularly when they move between health and care settings, in line with current national guidance, when transferring between locations or changing levels of care.

• People’s behaviour is not inappropriately controlled by medicines.

• There are appropriate arrangements for the safe management, use and oversight of controlled drugs. 

I statements

I statements reflect what people have said matters to them.

• I feel safe and am supported to understand and manage any risks.

• I know what to do and who I can contact when I realise that things might be at risk of going wrong or my health condition may be worsening.

• If my treatment, including medication, has to change, I know why and am involved in the decision.

• I have considerate support delivered by competent people.

​

Effective

We expect providers, commissioners and system leaders live up to this statement:

People and communities have the best possible outcomes because their needs are assessed. Their care, support and treatment reflects these needs and any protected equality characteristics. Services work in harmony, with people at the centre of their care. Leaders instil a culture of improvement, where understanding current outcomes and exploring best practice is part of everyday work.

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Assessing needs

What this quality statement means

• People are involved in the assessment of their needs, and support is provided where needed to maximise their involvement.

• People are confident that their individual needs have been appropriately assessed and are fully understood.

• People’s communication needs are assessed and met to maximise the effectiveness of their care and treatment.

• People’s needs are assessed using a range of assessment tools to ensure their needs are reflected and understood.

• Assessments consider the person’s health, care, wellbeing, and communication needs, to enable them to receive care or treatment that has the best possible outcomes.

• Assessments are up-to-date and staff understand people’s current needs.

• People’s care needs are routinely reviewed.

• The needs of carers of people using services are also assessed and met. This supports their health and wellbeing in their carer roles and helps them to provide safe and effective care to the people they support.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and goals.

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Delivering evidence-based care and treatment

We expect providers, commissioners and system leaders live up to this statement:

We plan and deliver people’s care and treatment with them, including what is important and matters to them. We do this in line with legislation and current evidence-based good practice and standards.

What this quality statement means

• People receive care, treatment and support that is evidence-based and in line with good practice standards.

• The provider’s systems ensure that staff are up-to-date with national legislation, evidence-based good practice and required standards.

• People are told about current good practice that is relevant to their care and are involved in how this is reflected in their care plan.

• People’s nutrition and hydration needs are met in line with current guidance.

• Staff and leaders are encouraged to learn about new and innovative approaches that evidence shows can improve the way their service delivers care.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and goals.

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How staff, teams and services work together

We expect providers, commissioners and system leaders live up to this statement:

We work effectively across teams and services to support people. We make sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

What this quality statement means

• Staff have access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support.

• Plans for transition, referral and discharge consider people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.

• When people are due to move between services, all necessary staff, teams and services are involved in assessing their needs to maintain continuity of care.

• Information is shared between teams and services to ensure continuity of care, for example when clinical tasks are delegated or when people are referred between services.

• When people receive care from a range of different staff, teams or services, it is co-ordinated effectively. All relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

• I have care and support that is co-ordinated, and everyone works well together and with me.

​

How staff, teams and services work together

We expect providers, commissioners and system leaders live up to this statement:

We work effectively across teams and services to support people. We make sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

What this quality statement means

• Staff have access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support.

• Plans for transition, referral and discharge consider people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.

• When people are due to move between services, all necessary staff, teams and services are involved in assessing their needs to maintain continuity of care.

• Information is shared between teams and services to ensure continuity of care, for example when clinical tasks are delegated or when people are referred between services.

• When people receive care from a range of different staff, teams or services, it is co-ordinated effectively. All relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

• I have care and support that is co-ordinated, and everyone works well together and with me.

​

​

Supporting people to live healthier lives

We expect providers, commissioners and system leaders live up to this statement:

We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce their future needs for care and support.

What this quality statement means

• People are empowered and supported to manage their own health, care and wellbeing needs by staff who understand their needs and preferences.

• People are involved in regularly reviewing their health and wellbeing needs where appropriate and necessary.

• People are encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing.

• Services focus on identifying risks to people’s health and wellbeing early and on how to support people to prevent deterioration.

• People are involved in regularly monitoring their health, including health assessments and checks where appropriate and necessary with health and care professionals. 

I statements

I statements reflect what people have said matters to them.

• I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and goals.

​

Monitoring and improving outcomes

We expect providers, commissioners and system leaders live up to this statement:

We routinely monitor people’s care and treatment to continuously improve it. We ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

What this quality statement means

• People who use the service consistently experience positive outcomes. These meet agreed expectations as set out in legislation, standards and evidence-based clinical guidance.

• There are effective approaches to monitor people’s care and treatment and their outcomes.

• This means that continuous improvements are made to people’s care and treatment.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and goals.

​

Consent to care and treatment

We expect providers, commissioners and system leaders live up to this statement:

We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

What this quality statement means

• People understand their rights around consent to the care and treatment they are offered.

• People’s views and wishes are taken into account when their care is planned.

• There are systems and practices to ensure that people understand the care and treatment being offered or recommended. This helps them make an informed decision.

• People receive information about care and treatment in a way they can understand and have appropriate support and time to make decisions.

• Staff understand the importance of ensuring that people fully understand what they are consenting to and the importance of obtaining consent before they deliver care or treatment.

• Where necessary, people with legal authority or responsibility can make decisions within the requirements of the Mental Capacity Act 2005.This includes the duty to consult others such as carers, families and/or advocates, where appropriate.

• People's capacity and ability to consent is taken into account, and they, or a person lawfully acting on their behalf, are involved in planning, managing and reviewing their care and treatment.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

​

​

Caring

People are always treated with kindness, empathy and compassion. They understand that they matter and that their experience of how they are treated and supported matters. Their privacy and dignity is respected. Every effort is made to take their wishes into account and respect their choices, to achieve the best possible outcomes for them. This includes supporting people to live as independently as possible.

Kindness, compassion and dignity

We expect providers, commissioners and system leaders live up to this statement:

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

What this quality statement means

• People feel they are treated with kindness, compassion and dignity in their day-to-day care and support.

• People feel that staff listen to them and communicate with them appropriately, in a way they can understand.

• People feel that staff know and understand them, including their preferences, wishes, personal histories, backgrounds and potential.

• People believe that staff will respond to their needs quickly and efficiently, especially if they are in pain, discomfort, or distress.

• People’s privacy and dignity is respected and upheld at all times.

• People are assured that information about them is treated confidentially and they know that staff respect their privacy.

• There is a culture of kindness and respect between colleagues from other organisations.

• Young adults feel they have control over their own privacy and the amount of parental involvement in managing their care and support.

I statements

I statements reflect what people have said matters to them.

• I am treated with respect and dignity.

​

Treating people as individuals

We expect providers, commissioners and system leaders live up to this statement:

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences. We take account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

What this quality statement means

• People’s individual needs and preferences are understood and these are reflected in their care, treatment and support.

• People’s personal, cultural, social and religious needs are understood and met.

• Staff treat people as individuals, considering any relevant protected equality characteristics.

• People’s communication needs are met to enable them to engage in their care, treatment and support to maximise their experience and outcomes.

I statements

I statements reflect what people have said matters to them.

• I am treated with respect and dignity.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and personal goals.

• I am supported to manage my health in a way that makes sense to me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I can keep in touch and meet up with people who are important to me, including family, friends and people who share my interests, identity and culture.

​

Independence, choice and control

Quality statement

We expect providers, commissioners and system leaders live up to this statement:

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing.

What this quality statement means

• People are supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing.

• People are supported to understand their rights by using different ways to communicate. Their understanding is reviewed throughout their care and treatment.

• People are supported to maintain relationships and networks that are important to them.

• People have access to their friends and family while they are using a service.

• People have access to activities and the local community to promote and support their independence, health and wellbeing.

• There is a range of appropriate equipment to support and maximise people’s independence and outcomes from care and treatment.

I statements

I statements reflect what people have said matters to them.

• I am treated with respect and dignity.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and personal goals.

• I am supported to manage my health in a way that makes sense to me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I can keep in touch and meet up with people who are important to me, including family, friends and people who share my interests, identity and culture.

​

​

Responding to people's immediate needs

Quality statement

We expect providers, commissioners and system leaders live up to this statement:

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

What this quality statement means

• People’s needs, views, wishes and comfort are a priority and staff quickly anticipate these to avoid any preventable discomfort, concern or distress.

• Staff are alert to people’s needs and take time to observe, communicate and engage people in discussions about their immediate needs. They find out how to respond in the most appropriate way to respect their wishes.

• Staff can quickly recognise when people need urgent help or support and use appropriate tools and technology to assist.

I statements

I statements reflect what people have said matters to them.

• I am treated with respect and dignity

• I am supported to manage my health in a way that makes sense to me.

​

​

Workforce wellbeing and enablement

We expect providers, commissioners and system leaders live up to this statement:

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

What this quality statement means

• People receive safe, effective and person-centred care as the provider recognises and meets the wellbeing needs of staff. These include the necessary resource and facilities for safe working, such as regular breaks and rest areas.

• People benefit from staff who have regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. If necessary, leaders provide a timely and considered response.

• People’s experience of a service is driven by a culture that normalises good wellbeing through inclusivity, active listening, and open conversations. This enables staff to do their job well and to be well.

• Staff are supported if they are struggling at work. This has a positive impact on the care they deliver to people.

• Staff have easy access to personalised support that recognises the diversity of a workforce with proactive and reactive measures.

• People are supported by staff who feel valued by their leaders and their colleagues. They have a sense of belonging and the ability to contribute to decision making.

I statements

I statements reflect what people have said matters to them.

• I have care and support that enables me to live as I want to, seeing me as a unique person with skills, strengths and personal goals.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

​

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Responsive

People and communities are always at the centre of how care is planned and delivered. The health and care needs of people and communities are understood and they are actively involved in planning care that meets these needs. Care, support and treatment is easily accessible, including physical access. People can access care in ways that meet their personal circumstances and protected equality characteristics.

​

Person-centred care

We expect providers, commissioners and system leaders live up to this statement:

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

What this quality statement means

• People’s care plans fully reflect their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act.

• People who use services and those close to them (including carers and dependants) are regularly involved in planning and making shared decisions about their care and treatment, so it is centred around them and their needs.

• People understand their condition, care and treatment options (including any associated risks and benefits) and any advice provided.

• People can receive the most appropriate care and treatment for them as the service makes reasonable adjustments where necessary.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I am supported to plan ahead for important changes in my life that I can anticipate.

• I know how to access my health and care records and decide which personal information can be shared with other people, including my family, care staff, school or college.

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Care provision, integration, and continuity

We expect providers, commissioners and system leaders live up to this statement:

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

What this quality statement means

• People receive care and treatment from services that understand the diverse health and social care needs of their local communities.

• There is continuity in people’s care and treatment because services are flexible and joined-up.

• People’s care and treatment is delivered in a way that meets their assessed needs from services that are co-ordinated and responsive.

• Delivering and co-ordinating services considers the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

​

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Providing information

We expect providers, commissioners and system leaders live up to this statement:

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

What this quality statement means

• People can get information and advice that is accurate, up-to-date and provided in a way that they can understand and which meets their communication needs.

• People who use the service, their family, friends, and carers are provided with information that it is accessible, safe and secure and supports their rights and choices.

• People’s individual needs to have information in an accessible way are identified, recorded, highlighted and shared. These needs are met and reviewed to support their care and treatment in line with the Accessible Information Standard.

• People can expect information to be tailored to individual needs. This includes making reasonable adjustments for disabled people, interpreting and translation for people who don’t speak English as a first language and for d/Deaf people who use British Sign Language. People who have difficulty with reading, writing or using digital services are supported with accessible information.

• People know how to access their health and care records and decide which personal information can be shared with other people, including their family, care staff, school or college.

• Information about people that is collected and shared meets data protection legislation requirements.

• People are provided with clear and transparent information that follows consumer rights best practice, including contracts and charges.

• People receive information in a timely way that meets best practice standards, legal requirements and is tailored to individual need.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice that is accurate, up to date and provided in a way that I can understand.

• I am encouraged and enabled to feedback about my care in ways that work for me and I know how it was acted on.

• I know how to access my health and care records and decide which personal information can be shared with other people, including my family, care staff, school or college.

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Listening to and involving people

We expect providers, commissioners and system leaders live up to this statement:

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

What this quality statement means

• People know how to give feedback about their experiences of care and support including how to raise any concerns or issues and can do so in a range of accessible ways.

• People, their family, friends and other carers feel confident that if they complain, they will be taken seriously and treated compassionately.

• People feel that their complaint or concern will be explored thoroughly and they will receive a response in good time because complaints are dealt with in an open and transparent way, with no repercussions.

• People are kept informed about how their feedback was acted on. Where improvements are required as a result, people have the opportunity to be involved in shaping the solutions and measuring the impact.

• Learning from complaints and concerns is seen as an opportunity for improvement and staff can give examples of how they incorporated learning into daily practice.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I am encouraged and enabled to feedback about my care in ways that work for me and I know how it was acted on.

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Equity in access

We expect providers, commissioners and system leaders live up to this statement:

We make sure that everyone can access the care, support and treatment they need when they need it.

What this quality statement means

• People can access care, treatment and support when they need to and in a way that works for them, which promotes equality, removes barriers or delays and protects their rights.

• People can expect their care, treatment and support to be accessible, timely and in line with best practice, quality standards and legal requirements, including those on equality and human rights. This includes making reasonable adjustments for disabled people, addressing communication barriers and having accessible premises.

• People can access services when they need to, without physical or digital barriers, including out of normal hours and in an emergency. Physical premises and equipment are accessible. People are given support to overcome barriers to ensure equal access.

• Leaders and staff are alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support, whether this is from wider society, within organisational processes and culture or from individuals.

• Providers use people’s feedback and other evidence to actively seek to improve access for people more likely to experience barriers or delays in accessing their care.

• Services are designed to make them accessible and timely for people who are most likely to have difficulty accessing care. When there are barriers, they are removed.

• When services change, equity of access is considered.

• People have equal access to care, treatment and support because the provider complies with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.

• The provider prioritises, allocates resources and opportunities as needed to tackle inequalities and achieve equity of access.

I statements

I statements reflect what people have said matters to them.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

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Equity in experiences and outcomes

We expect providers, commissioners and system leaders live up to this statement:

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

What this quality statement means

• People’s care, treatment and support promotes equality, removes barriers or delays and protects their rights.

• People feel empowered by providers and staff to give their views and understand their rights, including their rights to equality and their human rights.

• People feel that their experiences of discrimination and inequality are listened to and acted on to improve care.

• Leaders and staff are alert to discrimination and inequality that could disadvantage different groups of people using their services, whether from wider society, organisational processes and culture or from individuals. They proactively seek out ways to address these barriers to improve people’s experience, act on information about people's experiences and outcomes and allocate resources and opportunities to achieve equity.

• The provider complies with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes.

I statements

I statements reflect what people have said matters to them.

• I have care and support that is co-ordinated, and everyone works well together and with me.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I am encouraged and enabled to feedback about my care in ways that work for me and I know how it was acted on.

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Planning for the future

We expect providers, commissioners and system leaders live up to this statement:

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

What this quality statement means

• People are supported to make informed choices about their care and plan their future care while they have the capacity to do so.

• People who may be approaching the end of their life are identified (including those with protected characteristics under the Equality Act and people whose circumstances may make them vulnerable). This information is shared with other services and staff.

• People’s decisions and what matters to them are delivered through personalised care plans that are shared with others who may need to be informed.

• When people want to express their wishes about cardiopulmonary resuscitation, they are supported to do so and are able to change their mind if they wish.

• When any treatment is changed or withdrawn, professionals communicate and manage this openly and sensitively so that people have a comfortable and dignified death.

• When people’s future care preferences are for greater independence and fewer care interventions that are likely to benefit them, professionals work together to support them to achieve their goals.

I statements

I statements reflect what people have said matters to them.

• I can get information and advice that is accurate, up to date and provided in a way that I can understand.

• I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.

• I am supported to plan ahead for important changes in my life that I can anticipate.

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Well-led

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There is an inclusive and positive culture of continuous learning and improvement. This is based on meeting the needs of people who use services and wider communities, and all leaders and staff share this. Leaders proactively support staff and collaborate with partners to deliver care that is safe, integrated, person-centred and sustainable, and to reduce inequalities.

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Shared direction and culture

We have a shared vision, strategy and culture. This is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and our communities in order to meet these.

What this quality statement means

• Leaders ensure there is a shared vision and strategy and that staff in all areas know, understand and support the vision, values and strategic goals and how their role helps in achieving them.

• Staff and leaders ensure that the vision, values and strategy have been developed through a structured planning process in collaboration with people who use the service, staff and external partners.

• Staff and leaders demonstrate a positive, compassionate, listening culture that promotes trust and understanding between them and people using the service and is focused on learning and improvement.

• Staff at all levels have a well-developed understanding of equality, diversity and human rights, and they prioritise safe, high-quality, compassionate care.

• Equality and diversity are actively promoted, and the causes of any workforce inequality are identified and action is taken to address these.

• Staff and leaders ensure any risks to delivering the strategy, including relevant local factors, are understood and have an action plan to address them. They monitor and review progress against delivery of the strategy and relevant local plans.

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Capable, compassionate and inclusive leaders

We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively. They do so with integrity, openness and honesty.

What this quality statement means

• Leaders have the experience, capacity, capability and integrity to ensure that the organisational vision can be delivered and risks are well managed.

• Leaders at every level are visible and lead by example, modelling inclusive behaviours.

• High-quality leadership is sustained through safe, effective and inclusive recruitment and succession planning.

• Leaders are knowledgeable about issues and priorities for the quality of services and can access appropriate support and development in their role.

• Leaders are alert to any examples of poor culture that may affect the quality of people’s care and have a detrimental impact on staff. They address this quickly.

Freedom to speak up

We foster a positive culture where people feel that they can speak up and that their voice will be heard.

What this quality statement means

• Staff and leaders act with openness, honesty and transparency.

• Staff and leaders actively promote staff empowerment to drive improvement. They encourage staff to raise concerns and promote the value of doing so. All staff are confident that their voices will be heard.

• There is a culture of speaking up where staff actively raise concerns and those who do (including external whistleblowers) are supported, without fear of detriment. When concerns are raised, leaders investigate sensitively and confidentially, and lessons are shared and acted on.

• When something goes wrong, people receive a sincere and timely apology and are told about any actions being taken to prevent the same happening again.

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Workforce equality, diversity and inclusion

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

What this quality statement means

• Leaders take action to continually review and improve the culture of the organisation in the context of equality, diversity and inclusion.

• Leaders take action to improve where there are any disparities in the experience of staff with protected equality characteristics, or those from excluded and marginalised groups. Any interventions are monitored to evaluate their impact.

• Leaders take steps to remove bias from practices to ensure equality of opportunity and experience for the workforce within their place of work, and throughout their employment. Checking accountability includes ongoing review of policies and procedures to tackle structural and institutional discrimination and bias to achieve a fair culture for all.

• Leaders take action to prevent and address bullying and harassment at all levels and for all staff, with a clear focus on those with protected characteristics under the Equality Act and those from excluded and marginalised groups.

• Leaders make reasonable adjustments to support disabled staff to carry out their roles well.

• Leaders take active steps to ensure staff and leaders are representative of the population of people using the service.

• Leaders ensure there are effective and proactive ways to engage with and involve staff, with a focus on hearing the voices of staff with protected equality characteristics and those who are excluded or marginalised, or who may be least heard within their service. Staff feel empowered and are confident that their concerns and ideas result in positive change to shape services and create a more equitable and inclusive organisation.

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Governance, management and sustainability

We have clear responsibilities, roles, systems of accountability and good governance. We use these to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

What this quality statement means

• There are clear and effective governance, management and accountability arrangements. Staff understand their role and responsibilities. Managers can account for the actions, behaviours and performance of staff.

• The systems to manage current and future performance and risks to the quality of the service take a proportionate approach to managing risk that allows new and innovative ideas to be tested within the service.

• Data or notifications are consistently submitted to external organisations as required.

• There are robust arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information is used effectively to monitor and improve the quality of care.

• Leaders implement relevant or mandatory quality frameworks, recognised standards, best practices or equivalents to improve equity in experience and outcomes for people using services and tackle known inequalities.

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Partnerships and communities

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

What this quality statement means

• Staff and leaders are open and transparent, and they collaborate with all relevant external stakeholders and agencies.

• Staff and leaders work in partnership with key organisations to support care provision, service development and joined-up care.

• Staff and leaders engage with people, communities and partners to share learning with each other that results in continuous improvements to the service. They use these networks to identify new or innovative ideas that can lead to better outcomes for people.

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Learning, improvement and innovation

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research

What this quality statement means

• Staff and leaders have a good understanding of how to make improvement happen. The approach is consistent and includes measuring outcomes and impact.

• Staff and leaders ensure that people using the service, their families and carers are involved in developing and evaluating improvement and innovation initiatives.

• There are processes to ensure that learning happens when things go wrong, and from examples of good practice. Leaders encourage reflection and collective problem-solving.

• Staff are supported to prioritise time to develop their skills around improvement and innovation. There is a clear strategy for how to develop these capabilities and staff are consistently encouraged to contribute to improvement initiatives.

• Leaders encourage staff to speak up with ideas for improvement and innovation and actively invest time to listen and engage. There is a strong sense of trust between leadership and staff.

• The service has strong external relationships that support improvement and innovation. Staff and leaders engage with external work, including research, and embed evidence-based practice in the organisation.

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Environmental sustainability – sustainable development

We understand any negative impact of our activities on the environment and we strive to make a positive contribution in reducing it and support people to do the same.

What this quality statement means

• Staff and leaders understand that climate change is a significant threat to the health of people who use services, their staff, and the wider population. 

• Staff and leaders empower their staff to understand sustainable healthcare and how to reduce the environmental impact of healthcare activity. 

• Staff and leaders encourage a shared goal of preventative, high quality, low carbon care which has health benefits for staff and the population the providers serve, for example, how a reduction in air pollution will lead to significant reductions in coronary heart disease, stroke, and lung cancer, among others. 

• Staff and leaders have Green Plans and take action to ensure the settings in which they provide care are as low carbon as possible, ensure energy efficiency, and use renewable energy sources where possible. 

• Staff and leaders take active steps towards ensuring the principles of net zero care are embedded in planning and delivery of care. Low carbon care is resource efficient and supports care to be delivered in the right place at the right time.

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The above is taken from CQC's website and more information can be found there.