What Are the CQC Fundamental Standards?
Updated: 5 days ago
The CQC Fundamental Standards are the minimum standards below which care and treatment must never fall. When the Care Quality Commission registers a healthcare service, it assesses whether the provider is likely to meet these standards.
As of March 2026, CQC lists 14 Fundamental Standards. These are principally linked to Regulations 9 to 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The standards apply differently depending on the type of service, the regulated activities being delivered and whether the provider has received a CQC rating. GP practices, dental practices and independent healthcare providers should therefore understand both the general standards and the detailed regulations relevant to their services.
How many CQC Fundamental Standards are there?
CQC currently lists the following 14 Fundamental Standards:
Person-centred care
Visiting and accompanying
Dignity and respect
Consent
Safety
Safeguarding from abuse
Food and drink
Premises and equipment
Complaints
Good governance
Staffing
Fit and proper staff
Duty of candour
Display of ratings
Visiting and accompanying is a relatively recent addition. This means older articles referring to 13 Fundamental Standards are no longer consistent with CQC’s current published list.
The 14 CQC Fundamental Standards explained
1. Person-centred care
Regulation 9 requires care and treatment to be appropriate, meet the person’s needs and reflect their preferences.
Providers should carry out appropriate assessments and design care or treatment around the individual. Patients should be involved in decisions about their care, and providers should consider their preferences and relevant protected characteristics.
Healthcare providers should be able to demonstrate that treatment is based on an appropriate assessment rather than automatically following a standardised pathway without considering the individual patient.
2. Visiting and accompanying
Regulation 9A concerns visiting and accompanying in care homes, hospitals and hospices.
It requires providers, unless there are exceptional circumstances, to:
Facilitate visits for people staying in a care home, hospital or hospice
Avoid discouraging care home residents from taking visits outside the home
Allow people attending hospital or hospice appointments to be accompanied
Restrictions must be necessary, proportionate and based on individual circumstances.
This regulation does not generally apply to ordinary GP practices, dental practices or independent clinics unless the service falls within the relevant legal definition of a hospital or hospice and carries on an activity covered by Regulation 9A.
Providers should not imply that Regulation 9A applies universally across all primary care services.
3. Dignity and respect
Regulation 10 requires patients to be treated with dignity and respect while receiving care and treatment.
This includes:
Respecting personal preferences and protected characteristics
Providing privacy when patients need or want it
Supporting autonomy and independence
Using appropriate and respectful forms of communication
For GP practices, dental practices and clinics, this may be demonstrated through private consultation areas, appropriate chaperone arrangements, confidential communication and reasonable adjustments.
4. Consent
Regulation 11 requires care and treatment to be provided only with the consent of the relevant person.
Providers must follow applicable law and guidance concerning consent, including the Mental Capacity Act 2005 where a person aged 16 or over may lack capacity to make a particular decision.
Consent must be informed, voluntary and obtained from someone with the authority and capacity to provide it. Where a person lacks capacity, decisions must be made in accordance with the relevant legal framework.
Records should demonstrate how consent was obtained where this is appropriate to the care or treatment provided.
5. Safety
Regulation 12 requires care and treatment to be provided safely.
Providers must assess risks to patients’ health and safety and take appropriate action to mitigate those risks. They must also ensure that staff have the qualifications, competence, skills and experience necessary to provide safe care and treatment.
Depending on the service, this may include:
Infection prevention and control
Medicines management
Equipment safety
Emergency procedures
Safe clinical referrals
Test-result management
Patient identification
Clinical risk assessment
The specific systems required will depend on the regulated activities and treatments being provided.
6. Safeguarding from abuse
Regulation 13 protects people from abuse and improper treatment.
CQC’s description includes protection from:
Neglect
Degrading treatment
Unnecessary or disproportionate restraint
Inappropriate restrictions on a person’s freedom
Providers should have effective safeguarding systems and ensure staff understand how to identify, report and escalate concerns.
Safeguarding arrangements should reflect the patient groups using the service and include appropriate local referral pathways.
7. Food and drink
Regulation 14 concerns meeting people’s nutritional and hydration needs.
The regulation applies where:
Care or treatment includes accommodation provided by the service
Care or treatment involves an overnight stay on the service’s premises
Meeting nutritional or hydration needs forms part of the provider’s arrangements for care or treatment
Where it applies, providers must assess and meet people’s nutritional and hydration needs, including reasonable requirements arising from their preferences, religion or cultural background.
Regulation 14 will therefore have limited application to many consultation-only GP practices, dental practices and independent clinics. Providing sedation or post-treatment monitoring does not, by itself, automatically mean the full regulation applies.
8. Premises and equipment
Regulation 15 requires premises and equipment to be clean, secure, suitable for their intended purpose, properly used and appropriately maintained.
Providers should consider:
Cleanliness and infection prevention
Equipment servicing
Safe storage
Security
Accessibility
Premises maintenance
Environmental risks
Suitability of clinical rooms
The premises and equipment must be appropriate for the regulated activities delivered at the location.
9. Complaints
Regulation 16 requires providers to establish and operate an effective system for receiving, recording, handling and responding to complaints.
Complaints must be investigated properly, and providers must take necessary and proportionate action in response to any failures identified.
Patients should receive accessible information explaining how to complain. Providers should also monitor complaints for themes and use learning to improve the service.
10. Good governance
Regulation 17 requires providers to operate effective systems and processes that assess, monitor and improve the quality and safety of services.
Providers must also assess, monitor and mitigate risks to patients and others. They must maintain securely an accurate, complete and contemporaneous record for each patient, together with other records relating to the management of the regulated activity.
Governance evidence may include:
Clinical and non-clinical audits
Risk assessments
Incident monitoring
Complaints analysis
Patient feedback
Accurate patient records
Improvement plans
Recorded management oversight
The regulations do not prescribe one universal audit schedule or governance template. Systems should be proportionate to the nature, size and complexity of the service.
11. Staffing
Regulation 18 requires providers to have enough suitably qualified, competent, skilled and experienced staff to meet the requirements of the regulations.
Staff must receive appropriate:
Support
Training
Professional development
Supervision
Appraisal
The necessary staffing levels and training requirements should be based on the needs of patients, the service’s regulated activities and the risks associated with the care or treatment provided.
There is no single universal CQC mandatory training list that applies identically to every provider.
12. Fit and proper staff
Regulation 19 is formally titled “Fit and proper persons employed.”
It requires people employed for the purposes of carrying on a regulated activity to:
Be of good character
Have the necessary qualifications, competence, skills and experience
Be able, after reasonable adjustments, to perform tasks intrinsic to their work
Providers must operate effective recruitment procedures, obtain the information required by Schedule 3 and check professional registration where registration is legally required.
The meaning of employment is broad and can include volunteers, contractors, agency workers and bank staff.
Providers must also monitor staff suitability after recruitment and take appropriate action when someone no longer meets the required criteria.
13. Duty of candour
Regulation 20 requires registered providers to act openly and transparently with patients in relation to care and treatment.
Where a notifiable safety incident occurs, the provider must follow the specific statutory duty of candour process. This includes notifying the relevant person, providing a truthful account of what is known, offering an apology and giving appropriate support.
The provider must also supply written information and maintain a secure written record of the notification.
Not every incident meets the legal definition of a notifiable safety incident. Providers must understand the relevant thresholds while maintaining a wider culture of openness.
14. Display of ratings
Regulation 20A applies when a provider has received a CQC rating.
The provider must display its most recent rating conspicuously and legibly:
At each relevant location delivering regulated activities
At its principal place of business where applicable
On every website maintained by or on behalf of the provider
The website must also show CQC’s website address and where the provider’s most recent assessment can be accessed. The displayed information must make clear which rating relates to which premises or activities and include the date the rating was given.
CQC provides posters and digital products to help providers display the required information correctly.
Are the Fundamental Standards the same as the five CQC key questions?
No. The Fundamental Standards and the five key questions are connected, but they are not interchangeable.
The Fundamental Standards reflect legal requirements. CQC’s five key questions are used to structure its assessment of whether a service is:
Safe
Effective
Caring
Responsive
Well-led
Evidence relating to one regulation may affect more than one key question. For example, poor recruitment procedures may raise concerns about safety, effectiveness and leadership.
How can healthcare providers demonstrate compliance?
Having a policy is not sufficient if the policy is not implemented.
Providers should be able to demonstrate:
Staff understand their responsibilities
Risks are identified and acted upon
Required checks are completed
Records are accurate and current
Audits lead to improvement
Complaints and incidents result in learning
Leadership maintains effective oversight
Patients are involved in decisions about their care
The evidence required should be proportionate to the provider’s regulated activities, patient groups, treatments and organisational structure.
Preparing your service for CQC
Providers should review their compliance with the CQC Fundamental Standards routinely rather than waiting for an inspection or assessment.
A structured review should consider:
Regulated activities
Conditions of registration
Statement of Purpose
Governance arrangements
Policies and procedures
Risk assessments
Recruitment records
Staff training and competency
Audits
Complaints and incidents
Patient feedback
Evidence of improvement
New providers should begin developing these systems before submitting their CQC registration application.
Want an expert to check your compliance? See my CQC mock inspection service.
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If you are unsure which Fundamental Standards apply to your service or whether your current evidence demonstrates compliance, a structured review can identify gaps and establish a practical improvement plan.
This article provides general information and does not constitute legal advice. Providers should refer to the legislation, current CQC guidance and the circumstances of their individual service.
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