Improvement, innovation and learning
Does the service enable and embed continuous improvement, innovation and learning, using evidence and lived experience?
In brief
Improvement, innovation and learning is key line of enquiry 6 under the Well-led key question in the Care Quality Commission (CQC) draft adult social care assessment framework (v9, 19 March 2026), currently published for consultation. It covers innovation, learning and improvement, research. 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
- Well-led
- Line of enquiry
- KLOE 6 of 6 under Well-led
- 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. 62–64 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:
- Innovation
- Learning and improvement
- Research
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.
- There is a fully embedded and systematic approach to quality improvement, which leaders understand is key to delivering high-quality care.
- Rigorous and constructive challenge from people who use services and stakeholders is welcomed and seen as a vital way of holding the service to account. Leaders actively seek feedback, respond transparently, and use challenge to drive improvement and innovation.
- Learning is a continuous process, embedded through reflection, collective problem-solving, and sharing mistakes as well as good practice. Learning is systemically shared internally and with others to support improvement in the system and innovation in the sector.
- Leaders foster an open culture of trust, which is honest about challenges and mistakes, and uses these as opportunities for learning. Leaders actively listen to staff and encourage collective problem-solving and innovation.
- The service invests in its people to ensure quality improvement is embedded in the way all staff work. There is a clear strategy for how to develop staff capabilities and staff feel empowered to lead and deliver change.
- There are strong external relationships that support research, improvement and innovation. Staff and leaders regularly engage with external partners, including those in research, and embed evidence-based good practice into the service.
- Innovation is contextual, purposeful, and enables better outcomes for staff and people who use the service.
- Leaders actively seek opportunities and contribute to safe, ethical and effective research.
Good
In plain terms: The service meets the expected standard.
- Staff and leaders understand how to drive improvement through consistent approaches that enable the right environment for improvement, measuring outcomes and impact.
- Staff are supported to prioritise time to develop their skills around improvement and innovation. There is a clear strategy for how to develop these capabilities. Staff are consistently encouraged to contribute to improvement and innovation initiatives.
- Leaders foster a culture of trust by encouraging staff to speak up with ideas for improvement and innovation, and by actively investing time to listen and engage.
- Staff and leaders engage with external work, including research, and embed evidence-based good practice in the service.
- Leaders encourage collective problem-solving and innovation to achieve consistency in the quality of care.
- Learning is a continuous part of improvement and innovation, including good and poor outcomes for people and the impact. Learning is used to inform future processes.
Requires improvement
In plain terms: The service is not yet Good and has areas that must improve.
- Approaches to driving improvement are inconsistent and do not measure and evaluate outcomes and impacts effectively.
- Improvement and innovation are not consistently valued, and people and staff are not routinely encouraged or supported to contribute ideas.
- Opportunities to learn from others may be missed or not fully applied or embedded.
- Leaders do not consistently seek to understand other people’s perspectives, especially those from marginalised or under-represented groups.
- Staff feel their ideas are not fully discussed or considered, or senior voices tend to be listened to more.
- The service does not proactively seek out or keep up-to-date with evidence-based good practice that is relevant for the service and supports improvement.
- The service does not consider innovative or new approaches or discourages this because of a fear of making mistakes or reputational damage. Risk-taking is punished rather than supported, and existing practices are favoured even when ineffective.
- Leaders do not routinely take action where there is an opportunity to improve using evidence of poor care or outcomes.
Inadequate
In plain terms: Performance is well below the expected standard; enforcement may follow.
- There is little or no evidence of effective learning, innovation or service improvement.
- Staff are not involved or do not feel safe to highlight areas that could be improved and how this could be done.
- Leaders do not work with staff to improve the service. There is minimal investment or insufficient time to develop staff skillsaround quality improvem ent and innovation.
- Ideas and suggestions are routinely ignored, or only senior voices are listened to, missing opportunities to learn from others.
- There is little or no engagement with external partners to improve the service or innovate..
- Innovation cannot be identified or implemented because the approach to improvement is generally poor. Where the service does try to introduce innovation, it is not evidence-based or meaningful to the staff or people using the service.
Reading these against your own evidence is where most providers get stuck. We can walk it through with you.