Responsive · KLOE 4

Equity in experiences

Does the service tailor people's care, support and treatment effectively, to ensure equity in experiences?

In brief

Equity in experiences is key line of enquiry 4 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 barriers experienced during care, support and treatment, inequalities in experience, reasonable adjustments and communication needs, equality and human rights duties and obligations in relation to service design and delivery, experiences of people and communities whose voices are seldom heard, accessibility, transparency and communication, translation and interpreting services. 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 4 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. 47–50 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:

Barriers experienced during care, support and treatment
Inequalities in experience
Reasonable adjustments and communication needs
Equality and human rights duties and obligations in relation to service design and delivery
Experiences of people and communities whose voices are seldom heard
Accessibility, transparency and communication
Translation and interpreting services

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.

People are active partners in shaping their care. They co-design their care, receive tailored advocacy support, and are confident about their rights to experience good care, support and treatment.
Learning from concerns about poor experiences leads to transparent, systemic changes that have a positive impact, particularly for people more likely to have poorer experiences and outcomes from their care.
The service anticipates and prevents inequity using data, lived experience, and proactive strategies. Regular equity audits show measurable progress.
People’s experiences of their care, support and treatment are exceptional, and the service has evidence of identifying and closing gaps in health and care inequalities.
Advocacy of tailored and inclusive care and support is embedded in the design and delivery of the service. Staff at all levels champion inclusion.
A culture of shared learning, mentoring, and specialist support enables staff to embed and lead inclusive and innovative communication practices, continuously improving equity in people’s experiences.
Staff are highly skilled advocates, trained through learning co-produced with people using services. Staff challenge systemic inequalities and innovate solutions.

Good

In plain terms: The service meets the expected standard.

Leaders and staff work collaboratively to achieve equity. They do this by recognising barriers, collecting and acting on evidence, including people’s experiences, and allocating resources to reduce barriers and improve this.
If people have raised issues about discrimination and inequality they are listened to and understood, and the service has taken appropriate action in response to their concerns.
Staff demonstrate confidence in their understanding of people's equality-related needs and are able to meet them.
There is a culture where staff challenge inequalities and seek to find solutions to the barriers that people face. Staff advocate for people to ensure they are not discriminated against in the wider health and care system.
The service complies with legal, equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected equality characteristics and making reasonable adjustments to support equity in experience and outcomes.
The service appropriately identifies people’s individual communication needs to make sure up-to-date information is routinely provided in an accessible way.
Interpreting and translation are provided or accessed for people who don’t speak English as a first language and for people who use British Sign Language.
People who have difficulty with reading, writing or using digital services are supported to access information.
The service identifies and meets the information and communication needs of people with a disability, impairment or sensory loss. These needs are recorded, flagged, shared and reviewed appropriately. Where applicable, the requirements of the Accessible Information Standard are met.
Staff are supported to develop the skills they need to remove barriers to effective communication with the people they support.

Requires improvement

In plain terms: The service is not yet Good and has areas that must improve.

People do not consistently feel that the concerns they have raised about discrimination and inequality have been listened to, adequately understood or appropriately addressed.
Staff and leaders do not have a good understanding of the impact on people who face or experience inequality. They do not understand how their approach to delivering care can either minimise or prevent this or add to this inequality.
Staff lack confidence in understanding people’s equality-related needs and do not always understand how to meet them. Staff are not routinely equipped or supported to challenge inequality and discrimination or work with people to find solutions that work for them.
There have been instances where the service had not complied with legal, equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected equality characteristics and making reasonable adjustments to support equity in experience and outcomes for relevant groups of people.
The service does not routinely identify or meet people’s information and communication needs. For people who don’t speak English as a first language or who use British Sign language, information is not consistently presented or available in their preferred language. When applicable, the requirements of the Accessible Information Standard are not consistently met.
People who have difficulty reading, writing or using digital services are not adequately supported to access information.
The information and communication needs of people with a disability, impairment or sensory loss are not routinely met.
Staff are not adequately supported to develop the skills they need to remove barriers to effective communication with all the people they support.

Inadequate

In plain terms: Performance is well below the expected standard; enforcement may follow.

People are not enabled to give their views, and they feel their rights are not respected. Many feel disempowered and ignored, particularly where they experience inequitable treatment based on protected equality characteristics.
Concerns about discrimination or inequality are dismissed, ignored, or inadequately addressed. People feel unsafe or unsupported when raising issues.
Staff and leaders show little or no understanding of the impact of inequality on people. Care delivery contributes to or worsens inequities, with no recognition of the service’s role in preventing harm.
Staff lack the knowledge and confidence to meet equality-related needs. They are not supported to challenge discrimination or work with people to find solutions. Inequality and discriminatory practices routinely go unchallenged.
The service does not meet equality and human rights requirements, including failing to avoid discrimination, disregarding the needs of people with different protected equality characteristics, and not making reasonable adjustments.
People’s communication needs are ignored or overlooked, and information is often inaccessible, leaving people unable to understand or manage their care. As a result, people have poor experiences, or their care, support and treatment are not in line with preferences. When applicable, the service does not meet the Accessible Information Standard.
Staff receive little or no training or support to remove communication barriers. This results in persistent failures to engage effectively with people who have diverse needs.

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