Safe · KLOE 2
Managing risks during care and treatment
Are risks to each person monitored and managed so that their care and treatment is safe and supportive?
In brief
Managing risks during care and treatment is key line of enquiry 2 under the Safe key question in the Care Quality Commission (CQC) draft adult social care assessment framework (v9, 19 March 2026), currently published for consultation. It covers managing risk, deterioration and emergencies, positive risk taking, people who are communicating a need, expressing feelings or an emotional reaction, restrictive practice. 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
- Safe
- Line of enquiry
- KLOE 2 of 7 under Safe
- 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. 5–8 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:
- Managing risk, deterioration and emergencies
- Positive risk taking
- People who are communicating a need, expressing feelings or an emotional reaction
- Restrictive practice
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 dedicates time to keep up-to-date with new methods and emerging good practice in managing risks during care, support and treatment. These are used to drive improvements, shown by positive outcomes for people.
- Staff and leaders proactively seek, identify and act on all available opportunities to maximise people’s involvement, choice and independence while managing risks and supporting them to stay safe. This has a demonstrable impact on people’s care, outcomes and/or quality of life.
- People, those close to them and staff work in collaboration to review and improve the management of risks around care, support and treatment. There is a strong focus on equity and inclusion as part of this.
- A rights-respecting culture is embedded in the service and reducing restrictive practices is a shared priority, which is reflected in decision-making about managing risks.
- Improvements to risk management are implemented promptly and sustained, and learning is identified, acted on and shared internally and externally.
Good
In plain terms: The service meets the expected standard.
- People’s care plans reflect any foreseeable risks and how they should be managed. Deterioration, emergencies and clinical risks are anticipated where possible and managed to reduce the potential for harm.
- There is a balanced and proportionate approach to risk. People’s rights and choices about their care and their lives are respected. People are supported to take carefully managed risks to live fulfilling lives.
- People are respected and protected from avoidable harm because care is provided in line with recognised good practice guidance.
- Care, support and treatment are discussed with people so they understand the potential risks and side effects. Where appropriate, people and those close to them are actively involved in managing their own risks.
- When people communicate their needs, emotions or distress, they are consistently supported and listened to. Staff can manage this in a positive way that protects people’s rights and safety.
- Staff anticipate and proactively seek to identify what is causing people’s distress, and always take a least restrictive approach.
- The service has a process to ensure that any restrictions on people’s freedom, choice and control are necessary, proportionate and safe. This particularly includes where people lack mental capacity.
- Restraint is only ever used as a last resort and there is a clear commitment from all staff to minimising the use of restrictive interventions in the service. If staff use restraint, it is lawful, for a legitimate purpose, safe and necessary, and staff follow good practice.
- Staff can identify inappropriate and unlawful restrictive practices and use de-escalation techniques where necessary.
- Any use of seclusion or segregation is appropriate, regularly reviewed, and actively reduced.
Requires improvement
In plain terms: The service is not yet Good and has areas that must improve.
- Individual safety risks are not consistently assessed, understood or monitored, or this is not done comprehensively.
- Deterioration, emergencies or clinical risks are not identified in time. Opportunities to anticipate risks are missed.
- Risk management does not consistently take a holistic view of people’s needs or choices. The culture may be risk-averse and focused narrowly on clinical or physical risks.
- Care plans do not consistently reflect current risks or required actions or are not routinely kept up to date. Information is not adequately shared with staff who need it.
- The service does not consistently discuss people’s care, support and treatment with them and those close to them. As a consequence, people may not understand potential risks or side effects, or they don’t have the opportunity to be sufficiently involved in making decisions about risks.
- Least restrictive options are not always considered, meaning unnecessary restrictions can be placed on people, limiting their lifestyle and independence.
- The service does not appropriately explore all options before using restraint. Staff do not consistently use de-escalation techniques.
- The service cannot demonstrate that restraint is used in accordance with good practice and that it always meets legal requirements.
- Seclusion or segregation may be used inappropriately, without clear plans to reduce or stop using it. Arrangements are not kept under review appropriately.
Inadequate
In plain terms: Performance is well below the expected standard; enforcement may follow.
- The service does not understand the risks to the people it supports.
- Practices place people at risk of harm or do not protect them from actual harm.
- Where action is taken to address risks, plans are not clear or co-ordinated. People are not assured that they will be safe and sometimes do not feel safe.
- Information about risks to people is not shared with those who need it.
- People are not involved in managing risks that affect their safety.
- Risk management includes unjustifiable or unlawful restrictions on people, which significantly limit their control over their lives and their independence.
- Restraint is used inappropriately and disproportionately, and there is no clear approach to preventing situations from escalating.
- People are inappropriately segregated. There is a lack of appropriate justification or plan to review, reduce or end segregation.
Reading these against your own evidence is where most providers get stuck. We can walk it through with you.