Care provision, integration and continuity
Is care co-ordinated and delivered in a flexible, joined-up way that reflects diverse needs and promotes choice and continuity?
In brief
Care provision, integration and continuity is key line of enquiry 1 under the Responsive key question in the Care Quality Commission (CQC) draft adult social care assessment framework (v9, 19 March 2026), currently published for consultation. It covers collaborative, coordinated and flexible working, provision of services, continuity of care, support and treatment. 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
- Responsive
- Line of enquiry
- KLOE 1 of 4 under Responsive
- 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. 42–43 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:
- Collaborative, coordinated and flexible working
- Provision of services
- Continuity of care, support and treatment
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.
- The service actively embraces inclusion, ensuring choice, continuity and responsiveness that is equitable. It actively identifies and responds to those most at risk of experiencing poorer care or facing barriers to accessing care.
- The service proactively identifies and responds to challenges that could impact joint working across services.
- Services work in partnership with people and demonstrate a deep commitment to challenging themselves to tackle health inequalities
Good
In plain terms: The service meets the expected standard.
- The service understands the diverse needs of the people who use it and tailors their support accordingly. This includes recognising and responding to the needs of people with protected equality characteristics and those most at risk of experiencing poorer care or facing barriers to accessing care.
- The service works collaboratively and flexibly with others. People experience continuity of care, support and treatment; this includes working with commissioners to manage continuity of care.
- Where support is provided by more than one service, or by unpaid carers, staff work in a planned, coordinated and flexible way to make sure care is joined up and meets people’s needs.
- Staff can identify and take appropriate action when there is a gap in care provision. This includes identifying and taking appropriate action where people are eligible to receive more care or support.
- People receive the care, support and treatment they are entitled to from the service, which has been arranged and/or funded for them.
Requires improvement
In plain terms: The service is not yet Good and has areas that must improve.
- The service does not fully understand the diverse needs of the people who use it, including people with protected equality characteristics and those most at risk of experiencing poorer care or facing barriers to accessing care. Care is not routinely tailored to meet their needs.
- People’s care, support and treatment is not always sufficiently co-ordinated or responsive. Care is not routinely delivered in a way that fully meets assessed needs or reasonably supports the choices of everyone using the service.
- Where a person is supported by more than one service or by unpaid carers, the service misses opportunities to make sure care is sufficiently co-ordinated, flexible and joined up.
- The service does not consistently take appropriate action or escalate issues where there are identified gaps in care provision, for example to commissioners.
- The service does not consistently deliver the full package of care, support or treatment that has been agreed and arranged.
Inadequate
In plain terms: Performance is well below the expected standard; enforcement may follow.
- The service does not adequately understand the needs of all the people it supports. Support is not adequately tailored to meet a diverse range of needs which results in poor outcomes of care for people. This has a significant impact on people with protected equality characteristics and those most at risk of experiencing poorer care or facing barriers to accessing care.
- The service does not work in a co-ordinated or collaborative way with other providers or unpaid carers, who are involved in people’s care.
- There are significant shortfalls in meeting people’s assessed needs, including taking into account their choice of how care is delivered.
- The service fails to act or escalate issues where there are identified gaps in care provision, for example to commissioners.
Reading these against your own evidence is where most providers get stuck. We can walk it through with you.