The Fourteen CQC Fundamental Standards, and What Each One Asks of You
The Care Quality Commission (CQC) assesses care services against 14 fundamental standards that define the minimum requirements for safe, effective, and person-centred care. Whether you run a care home, supported living service, domiciliary care agency, or any other regulated activity, understanding these standards is essential to achieving and maintaining CQC registration.
This guide explains all 14 fundamental standards, clarifies the confusion around how many there are, shows what CQC inspectors look for, and provides practical steps to demonstrate compliance. Whether you are registering for the first time or preparing for inspection, this guide will help you understand what CQC expects.
What Are the CQC Fundamental Standards?
The fundamental standards are the core regulatory requirements that all care providers must meet. They stem from the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and form the foundation of CQC regulation and inspection.
These standards set out what it means to provide safe, effective, and person-centred care. They apply to all registered providers, from small domiciliary care agencies to large residential homes, and across all sectors including health services, social care, and specialist services. The CQC official guidance on fundamental standards provides the regulatory framework against which all services are assessed.
Why the Confusion About Numbers?
One of the most frequently asked questions is: how many fundamental standards are there? People search for '5 fundamental standards', '11 fundamental standards', '12 fundamental standards', '13 fundamental standards' and '14 fundamental standards', and most of those numbers were correct at some point. CQC's own list now has 14.
14 fundamental standards:
This is CQC's own count and the one to work to. Regulations 9 to 20 plus Regulation 20A give 13. Regulation 9A, inserted on 6 April 2024, makes 14.
13 fundamental standards:
The number almost every other guide still uses. It was right until Regulation 9A arrived, and it is still the number that applies to a service registered only for personal care, because Regulation 9A does not cover personal care.
5 CQC key questions
CQC assesses services against five domains: Safe, Effective, Caring, Responsive, and Well-led. These are not the same as the fundamental standards but relate to how services are assessed.
CQC 5 principles
Some people confuse fundamental standards with CQC's five key principles or values, which is a different framework entirely.
11 or 12 standards
Older regulatory guidance or certain sector-specific frameworks may reference different numbers, which adds to the confusion.
To be clear
CQC lists 14 fundamental standards: Regulations 9 to 20, plus 9A and 20A. Regulation 9A covers care homes, hospitals and hospices, so if you are registered for personal care in someone's own home, 13 of the 14 apply to you and all 13 must be met to keep your registration.
All 14 CQC Fundamental Standards Explained
Regulation 11: Need for Consent
Services must obtain valid consent before providing care or treatment. This includes both written and verbal consent and must be given freely by someone with capacity to consent, or by someone act... Read more
Person-Centred Care
Regulation 9 requires that care and treatment must be appropriate, meet the needs of the person receiving it, and reflect their preferences. In practice that means assessing needs with the person, designing the support around them, and reviewing it as those needs change.
- What CQC looks for: Evidence that care plans are person-centred, involve the individual and their family, and are regularly reviewed and updated.
- Compliance tips: Develop individualised care plans that reflect each person's goals, preferences, and support needs. Involve people and their families in planning.
Visiting and Accompanying
Regulation 9A was inserted by the Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2023 and came into force on 6 April 2024. It requires that people staying in a care home, hospital or hospice can receive visits from the people they want to see, that care home residents are not discouraged from going out to visit others, and that someone attending a hospital or hospice appointment without an overnight stay can be accompanied.
- Who it applies to: Care homes, hospitals and hospices. Regulation 9A(6) excludes the regulated activity of personal care, so a domiciliary care or supported living service registered only for personal care is not held to this standard.
- What CQC looks for: A visiting policy that starts from enabling visits rather than restricting them, decisions recorded against the least restrictive option, and any refusal justified by genuinely exceptional circumstances.
Dignity and Respect
This standard requires that care providers treat people with respect and ensure their dignity is maintained at all times. This includes respecting confidentiality, privacy, and personal autonomy.
- What CQC looks for: Examples of how the service promotes dignity, respects people's privacy, maintains confidentiality, and treats people with respect even in difficult situations.
- Compliance tips: Train staff on dignity and respect. Create policies that protect privacy. Respond promptly to complaints about disrespectful treatment.
Need for Consent
Services must obtain valid consent before providing care or treatment. This includes both written and verbal consent and must be given freely by someone with capacity to consent, or by someone acting with legal authority.
- What CQC looks for: Evidence of consent processes, including capacity assessments, Mental Capacity Act 2005 compliance, DoLS or LPS where relevant.
- Compliance tips: Implement robust consent procedures. Ensure staff understand the Mental Capacity Act 2005. Document all consent decisions.
Safe Care and Treatment
Regulation 12 is one of the most important standards. It requires that care and treatment is provided in a safe way, with systems to identify and manage risks.
- What CQC looks for: Risk assessments, risk management plans, incident reporting systems, learning from incidents, medication management systems, and infection control procedures.
- Compliance tips: Conduct thorough risk assessments for each person. Implement risk management plans that use the least restrictive approach.
Safeguarding Service Users from Abuse and Improper Treatment
Services must have systems in place to safeguard people from abuse, including physical, emotional, and financial abuse, and to respond promptly to any safeguarding concerns.
- What CQC looks for: Safeguarding policies, staff training records, incident logs, evidence of safeguarding referrals made, and evidence of learning from safeguarding concerns.
- Compliance tips: Ensure all staff receive annual safeguarding training. Have a clear policy for reporting concerns.
Meeting Nutritional and Hydration Needs
Services must assess and meet people's nutritional and hydration needs, taking account of any specific dietary requirements or preferences.
- What CQC looks for: Assessment of nutritional needs, menus that reflect people's preferences, monitoring for signs of malnutrition or dehydration.
- Compliance tips: Carry out nutritional assessments on admission. Involve people in meal planning. Monitor weight regularly.
Duty of Candour in Health and Social Care
Duty of candour is a legal requirement under Regulation 20. Our guide explains what counts as a notifiable safety incident, the steps you must follow, and what happens if you fail to comply.
Premises and Equipment
The service must ensure that premises, facilities, and equipment are safe, clean, secure, and suitable for the purposes for which they are used.
- What CQC looks for: Safe, clean premises; appropriate furniture and equipment; maintenance records; infection control measures; and security arrangements.
- Compliance tips: Conduct regular health and safety checks. Maintain premises well. Keep equipment serviced and safe.
Receiving and Acting on Complaints
Services must have a complaints procedure, receive complaints in a way that is accessible to people, and investigate and respond to complaints promptly.
- What CQC looks for: Accessible complaints procedures, evidence of complaints received, investigation records, responses to complainants.
- Compliance tips: Ensure your complaints procedure is easy to access and understand. Train staff to receive complaints positively.
Good Governance
Regulation 17 requires that systems and processes are established and operated effectively to ensure compliance with all regulations and to ensure good governance of the provider.
- What CQC looks for: Clear management structure, quality governance systems, management of risks to the service, financial management.
- Compliance tips: Establish clear governance arrangements. Hold regular management meetings. Monitor quality metrics.
Staffing
The service must have sufficient numbers of suitably qualified, competent, skilled, and experienced staff to meet the needs of people using the service.
- What CQC looks for: Staffing levels appropriate to the needs of people, evidence of staff recruitment checks, training records, supervision records.
- Compliance tips: Conduct dependency and acuity assessments to determine staffing levels. Implement robust recruitment procedures.
Fit and Proper Persons Employed
The service must ensure that all employees are of good character, have the necessary qualifications and experience, and can meet the demands of the role.
- What CQC looks for: Recruitment procedures, references, DBS clearance, health screening, evidence of qualifications.
- Compliance tips: Implement thorough recruitment procedures. Always take up references. Conduct DBS checks.
Duty of Candour
Regulation 20 requires that services must be honest and open with people when something has gone wrong and act to put matters right.
- What CQC looks for: A duty of candour policy, evidence that people and their families have been informed when things go wrong, apologies offered.
- Compliance tips: Develop a clear duty of candour policy. Train staff to recognise when duty of candour applies.
Requirement as to Display of Performance Assessments
Services must display a copy of their CQC performance assessment rating in a prominent place where people can easily see it.
- What CQC looks for: A current CQC rating document displayed prominently in the main entrance area where visitors can easily see it.
- Compliance tips: Display your CQC rating prominently. Include your website URL for people to view the full report. Update the display if your rating changes.
CQC Registered Manager Requirements
What qualifications, experience, and skills does a CQC Registered Manager need? Our guide covers the fit person requirements, DBS checks, interview preparation, and ongoing responsibilities.
How CQC Assesses the Fundamental Standards
Understanding how CQC inspects against these standards will help you prepare effectively.
Quality Statements
CQC uses 34 quality statements that map to the fundamental standards. Each quality statement defines what excellence looks like. These statements provide more detail and context than the fundamental standards alone.
Evidence Categories
During inspection, inspectors gather evidence across five key categories:
People's Experience
Speaking with people using the service, their families, and advocates about their experience
Feedback
Reviewing survey data, complaints, compliments, and feedback
Processes
Examining policies, procedures, training records, and governance systems
Outcomes
Looking at data on incidents, safeguarding, hospital admissions, and goal achievement
Observation
Watching staff interact with people and observing how the service operates day-to-day
Fundamental Standards vs Quality Statements
It is important to understand the distinction between the two. The 14 fundamental standards are the regulatory minimum requirements set out in legislation. The quality statements are what CQC scores you against when it assesses you, and the two are not the same thing.
The 34 quality statements define what excellence looks like when you meet and exceed those standards.
Fundamental standards
The legal minimum you must meet. Failure to meet a fundamental standard will result in regulatory action.
Quality statements
Guidance on how to achieve excellence. These help services go beyond minimum compliance to provide outstanding care.
To achieve an Outstanding rating, your service must not only meet the fundamental standards but also demonstrate excellence against the quality statements.
How to Demonstrate Compliance
Here are practical steps to help your service demonstrate compliance with all 14 fundamental standards.
Conduct a self-assessment
Use the 14 fundamental standards to audit your current practice. For each standard, identify your strengths and areas for improvement.
Develop individualised policies
Create policies specific to your service that address each fundamental standard. Ensure policies are written in plain language.
Train your staff
Ensure all staff understand the fundamental standards and how they apply to their role.
Create evidence folders
Organise your evidence in a structured way. Create a folder for each fundamental standard.
Maintain records
Keep detailed records of policies, procedures, training, incidents, complaints, safeguarding concerns, and actions taken.
Review and improve continuously
Regularly review your compliance. Use feedback from people using the service, families, and staff to identify improvements.
How Care Sync Experts Can Help
Care Sync Experts specialises in supporting care providers to understand and comply with the fundamental standards. Our services include:
Guidance through the registration process, ensuring you meet all 14 fundamental standards from the start
Comprehensive policy templates that address all 14 fundamental standards, tailored to your service type
Mock inspections
Full or focused mock inspections that test your readiness against the fundamental standards
Compliance audits
Detailed audits that assess your service against all 14 standards and identify gaps
Training
Staff training on the fundamental standards and how to embed compliance into day-to-day practice
Contact Care Sync Experts:
Whether you are registering for the first time, preparing for inspection, or have received a rating you want to improve, contact Care Sync Experts today.
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