Safe · KLOE 5

Safe environments and infection prevention and control

Are potential risks within the care environment detected and managed appropriately to enable safe delivery of care for people and staff?

In brief

Safe environments and infection prevention and control is key line of enquiry 5 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 premises (including gas, electrical and fire safety), equipment, infection prevention and control, environmental risks (including adverse weather such as heatwaves and flooding), digital systems/technology assurance. 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 5 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. 13–16 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:

Premises (including gas, electrical and fire safety)
Equipment
Infection prevention and control
Environmental risks (including adverse weather such as heatwaves and flooding)
Digital systems/technology assurance

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.

Spaces in the service actively promote dignity, autonomy, and wellbeing, adapting flexibly to changing needs.
There are comprehensive systems to proactively manage the safety, maintenance and repair of facilities, premises and equipment. Approaches are innovative and mitigate risk creatively to maximise people’s autonomy and independence.
There is a culture of shared ownership for the safety of the care environment where everyone is empowered to identify and act on risks, and improvements are celebrated and shared across the system.
Human rights and technology bias are the primary consideration of any use of technology, to prevent discrimination.
The service actively considers new ways to ensure that facilities, premises and equipment support the provision of innovative, safe and effective care, for example by drawing on ergonomics expertise.
The service uses innovative ways to co-design the environment with people. This helps mitigate risks and supports people to be as independent as possible.
Psychological safety is embedded in the environmental design. Trauma-informed design principles are applied, and staff are highly skilled and confident in recognising and responding to emotional and sensory needs as part of the care environment.
There are effective approaches to infection prevention and control, and inclusive design. These reduce risk while maintaining a welcoming environment.
People are engaged as partners in infection prevention and control. They are involved in identifying and managing risks.
Infection prevention and control roles for staff are clear and celebrated. Continuous learning and peer support are embedded. Staff are highly skilled, confident and accountable, and performance is transparently shared and improved.
Where the service involves people in preparing food, staff promote their independence and autonomy by supporting them to understand and follow good food hygiene practice.

Good

In plain terms: The service meets the expected standard.

Environments are safe and adapted to meet people’s needs, in line with legislation and good practice.
Where the provider is responsible, there is a comprehensive system to proactively manage the safety and upkeep of the premises (including communal and personal spaces) and equipment, and risks are assessed and controlled. Professionally qualified and competent people complete the necessary environmental and equipment checks and maintenance.
Where the provider is not responsible for the premises, it takes reasonable action to appropriately escalate concerns and mitigate known risks, working in partnership with people.
Facilities, equipment (including special or adaptive equipment) and technology that are the responsibility of the service are maintained, stored and used in line with good practice and guidance.
The service monitors and acts on equipment alerts, recalls and safety information.
Signage, decoration and adaptations to the premises help to meet people’s needs and keep them safe.
Leaders and staff consider how environments support psychological safety.
The service manages the control and prevention of infection well. Infection prevention and control roles are clear. The risk of infection is minimised because premises and equipment are kept clean and hygienic.
Information about the risk of infection is shared appropriately with relevant partners, people using the service and visitors.
Fire safety procedures are effective. Concerns are escalated appropriately where the service is not directly responsible for the premises.
Staff understand the importance of food safety, including hygiene, when preparing or handling food. They follow required standards and good practice.

Requires improvement

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

People are cared for in environments that are not sufficiently safe or adapted to meet their needs.
Risk assessment and management of environmental and equipment risks are partial or inconsistent.
Roles and responsibilities in relation to safely managing the environment or equipment are unclear.
Where the service is responsible, people are at risk of harm because equipment is not appropriately maintained or serviced by qualified or competent people.
Specialist or adaptive equipment is not consistently available or used correctly, placing people at risk.
Policies and procedures relating to equipment and the environment, including infection control, are not routinely kept up to date or not consistently understood by staff.
The service does not consistently meet current national guidance and standards in relation to infection control.
Not all staff fully understand their responsibilities in relation to hygiene and infection control or consistently apply good infection control practices.
External partners are sometimes not informed of concerns about infection or hygiene risks when they should be.
Access to personal protective equipment for staff is unreliable.
Fire safety procedures are in place but not consistently applied, or concerns are not appropriately escalated.
Where relevant, not all staff have undertaken food hygiene training and there are no plans to address this.

Inadequate

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

The environment in which people are cared for is not safe or adapted to meet their needs. It does not comply with legislative requirements to keep people safe.
The service does not properly assess or manage environmental and equipment-related risks.
Where the service is responsible, people may have been harmed or are at significant risk of harm because equipment is not appropriately maintained or serviced by qualified or competent people.
Specialist or adaptive equipment is not available where needed. The benefits of using technology to improve the outcomes for people are not recognised.
The service does not follow or meet national guidance in relation to infection control. Staff do not understand related responsibilities.
People are at risk because prevention and control of infection is poor. Staff do not routinely have access to personal protective equipment.
Policies and procedures are absent, not up-to-date or not followed.
Concerns and risks relating to infection or hygiene are not referred to appropriate agencies.
Fire safety procedures are not followed, or they may be ineffective or absent. Concerns are not identified and escalated.
Where relevant, food hygiene practices are often not understood or followed, risking people’s health.

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