Assessing needs
Are people’s needs holistically assessed and reviewed with them to maximise the effectiveness of their care, support and treatment?
In brief
Assessing needs is key line of enquiry 1 under the Effective key question in the Care Quality Commission (CQC) draft adult social care assessment framework (v9, 19 March 2026), currently published for consultation. It covers assessing people’s needs (including accessibility and communication needs), person-centred approach, care planning, assessment tools. CQC describes performance against it at four rating levels: Outstanding, Good, Requires improvement and Inadequate. Each statement and rating characteristic quoted here is reproduced verbatim from CQC's draft; plain-English summaries are HLTH's own.
- Key question
- Effective
- Line of enquiry
- KLOE 1 of 4 under Effective
- Rating levels
- Outstanding, Good, Requires improvement, Inadequate
- Source
- Adult social care assessment framework, v9 (19 March 2026)
- Status
- Draft, published by CQC for consultation
- Reference
- pp. 22–24 of the CQC draft
Scope and topic areas
What this line of enquiry covers
Scope of this key line of enquiry and topic areas include:
- Assessing people’s needs (including accessibility and communication needs)
- Person-centred approach
- Care planning
- Assessment tools
Rating characteristics
How CQC describes each rating
The four characteristic sets for this KLOE, best to worst. Every point is CQC's wording, reproduced exactly.
Outstanding
In plain terms: Care is exceptional and consistently better than the Good standard.
- A consistent, holistic approach to assessing, planning and delivering care means that people’s quality of life, outcomes and independence are maximised and often exceed expectations.
- There is a culture in which everyone is empowered to develop a deep understanding of people’s needs. This is driven by curiosity to understand individuals, explore new ideas and approaches, and find ways to maximise outcomes, putting people first.
- Assessments proactively address inequalities and personal circumstances that could result in exclusion, with staff at all levels demonstrating a strong understanding and deeply embedded commitment to equity and inclusion.
- The service continually seeks new and innovative ways to assess people’s needs, using or developing new practices, technologies, and tools. It shares the learning from these, both internally and externally with other services.
Good
In plain terms: The service meets the expected standard.
- People’s needs are comprehensively assessed, and reflect their wishes and physical, mental, emotional, sensory, social and communication needs, including those related to protected equality characteristics.
- People’s communication needs are assessed and met to maximise the effectiveness of care, support and treatment.
- Assessments inform care plans, enabling people to receive care, support and treatment that have the best possible outcomes.
- Assessments focus on people’s strengths, and there is a trauma-informed approach to understanding people’s needs.
- People are involved as much as possible in their needs assessment and their needs are fully identified and understood. Where people need support to be involved, this is provided.
- Where appropriate, others close to the person, advocates, professionals and other stakeholders are meaningfully involved in the assessment of people’s needs and reviews.
- People’s needs, emotions and level of distress are assessed using a range of assessment tools to ensure they are reflected and understood.
- Risk assessments about care are person-centred, proportionate, and regularly reviewed with the person, where possible. As a result, people are well-informed of risks and this supports them to keep themselves safe.
- Assessments are regularly reviewed and updated to make sure staff have current information, so that care, support and treatment is meeting people’s needs and individual outcomes as expected.
Requires improvement
In plain terms: The service is not yet Good and has areas that must improve.
- Assessments do not routinely consider the full range of people’s diverse needs, including those related to protected equality characteristics.
- Needs assessments and care plans are not consistently aligned meaning care, support and treatment are not sufficiently effective.
- People are not always sufficiently involved in their assessments or supported to be involved in meaningful ways where this is possible for them.
- The service does not appropriately or meaningfully involve others close to the person, advocates, professionals and other stakeholders in assessments and reviews, where it is possible for them to be involved.
- Assessments are not consistently up-to-date or reviewed to make sure people’s current needs are understood and reflected in their care and support.
- Risk assessments about care are not consistently person-centred and proportionate. They may not be regularly reviewed, or they are not reviewed with the person where this is possible.
- The service does not routinely or consistently use nationally recognised and accepted tools where this would be reasonably expected to support effective needs assessments.
Inadequate
In plain terms: Performance is well below the expected standard; enforcement may follow.
- People’s needs are not adequately assessed, which means care and support is not or is unlikely to be effective in meeting their needs.
- Care, support and treatment are based on uninformed or discriminatory decisions rather than full, accurate assessments of people’s needs.
- Staff do not recognise people’s changing needs or they do not take steps to meet these needs.
- People are not involved in assessing their own care and support needs or planning their care when they could be. This includes where support could enable people to be actively involved.
- Risk assessments about care are not person-centred and proportionate, or do not accurately identify individual risks.
- The service makes no reasonable attempt to involve others close to the person, advocates, professionals or other stakeholders in assessments and reviews.
Reading these against your own evidence is where most providers get stuck. We can walk it through with you.