Quick reference

• CQC assessment is continuous: notifications, feedback and data feed the picture between visits, so "getting ready for the inspection" should really mean "running a good service".
• Have your core evidence retrievable within minutes: safe recruitment files, training matrix, supervision records, audits with closed actions, care plans and daily notes.
• Staff conversations carry real weight — support everyone to describe safeguarding, whistleblowing, capacity and the people they support with confidence.
• Check your statutory notifications history: gaps between what happened and what was notified are found quickly.
• After a draft report, use the factual accuracy process — it exists to correct errors, with deadlines.
• CQC's framework is changing during 2026; confirm which framework applies to your assessment on cqc.org.uk.

Full topic page

• The fundamental standards are regulations 9 to 20A of the 2014 Regulations — the level below which care must never fall.
• The ones to know cold: Reg 9 person-centred care, Reg 10 dignity, Reg 11 consent, Reg 12 safe care, Reg 13 safeguarding, Reg 17 good governance, Reg 18 staffing, Reg 20 duty of candour.
• Statutory notifications (deaths, serious injuries, abuse allegations, events stopping safe service) must reach CQC without delay — they come from the 2009 Registration Regulations.
• CQC currently assesses against five key questions (safe, effective, caring, responsive, well-led) with ratings from Outstanding to Inadequate.
• Big change is under way in 2026: CQC consulted on new sector-specific frameworks and rating characteristics, expected to start replacing the current approach from late 2026 — check cqc.org.uk for the current position.
• Breaching some fundamental standards (for example Reg 12 or 13 causing avoidable harm) can be a criminal offence for the provider.

Full topic page

• The Care Act 2014 is the backbone of adult social care in England: wellbeing, assessments, eligibility, safeguarding and market shaping all flow from it.
• The Health and Social Care Act 2008 and its 2014 Regulations create CQC registration and the fundamental standards every provider must meet.
• The Mental Capacity Act 2005 governs decision-making for people who may lack capacity; the Deprivation of Liberty Safeguards still apply in 2026.
• The Health and Safety at Work etc. Act 1974 and its regulations protect staff and everyone affected by the work, including people receiving care.
• The Equality Act 2010 and Human Rights Act 1998 underpin dignity, fairness and non-discrimination in every care setting.
• Reform is live: the Casey Commission is reporting from 2026 and the Liberty Protection Safeguards remain planned but not yet in force — always check current guidance.

Full topic page

• The assessor is usually the person proposing the decision or care — for everyday decisions, that often means care staff, not a doctor.
• Assess one decision at a time: the question is always "capacity to decide X, now".
• Stage 1: an impairment or disturbance of the mind or brain. Stage 2: because of it, unable to understand, retain, use/weigh, or communicate.
• The inability must be caused by the impairment — communication barriers and poor explanations don't count as incapacity.
• Fluctuating capacity means assess at the right time and, where possible, delay decisions until capacity returns.
• A capacity assessment that isn't recorded may as well not have happened — record what you asked, what they said, and your reasoning.

Full topic page

• Valid consent is informed, voluntary, and given by someone with capacity for that decision — and it can be withdrawn at any moment.
• Consent is a continuous conversation, not a signature: ask, explain, and check every time, every visit.
• A capacitous refusal must be respected, even when the consequences worry you — record it, keep offering, keep the relationship.
• Nobody consents "on behalf of" an adult unless they hold legal authority (health and welfare LPA or deputyship) — and even then, only within its scope and in the person's best interests.
• Where the person lacks capacity, care proceeds under MCA best interests (section 5), not under a relative's signature.
• Watch for coerced or exhausted compliance — going along with something is not the same as agreeing to it.

Full topic page

• DoLS remain the law in 2026. The Liberty Protection Safeguards are not yet in force — implementation is not expected before 2027 at the earliest.
• In June 2026 the Supreme Court replaced the Cheshire West "acid test" with a multifactorial assessment — follow the new official guidance and your local authority's advice.
• DoLS apply in care homes and hospitals to people 18+ who lack capacity to consent to arrangements amounting to a deprivation of liberty.
• Care home managers apply to the local authority (supervisory body) for standard authorisations; urgent authorisations cover genuine emergencies for up to 7 days.
• Every authorisation needs a Relevant Person's Representative, and conditions attached must actually be met.
• Deprivations outside care homes and hospitals (e.g. supported living) still need Court of Protection authorisation.

Full topic page

• The Equality Act 2010 protects nine characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.
• Discrimination can be direct, indirect, by association or by perception — and includes harassment and victimisation.
• Service providers owe an anticipatory duty of reasonable adjustments for disabled people: plan for access needs before someone has to ask.
• The Accessible Information Standard requires health and care services to identify, record, flag and meet communication needs.
• Person-centred care and equality are the same discipline: know the person, not the stereotype.
• Staff are protected too — a respectful workplace is part of safe care.

Full topic page

• Principle 1: assume capacity. It is for others to prove someone lacks it, never for the person to prove they have it.
• Support people to decide before deciding for them: right time, right place, right words, right format.
• An unwise decision is not the same as an incapacitous one — adults may make choices others disagree with.
• Capacity is decision-specific and time-specific: "lacks capacity" without saying for what and when is meaningless.
• Anything done for a person who lacks capacity must be in their best interests and the least restrictive option.
• Check for LPAs, deputies and advance decisions before best-interests decisions; involve an IMCA when there is no one to consult for serious decisions.

Full topic page

• Restrictions sit on a spectrum; at some point their type, duration, intensity and effect add up to a deprivation of liberty that needs legal authorisation.
• Since June 2026 there is no single "acid test": courts weigh multiple factors, including — importantly — the person's own wishes and feelings about the arrangements.
• A person who is content, understands their situation at a basic level, and accepts it may be validly consenting; genuine, consistent objection points the other way.
• Restraint must always be necessary, proportionate and the least restrictive option, whatever the legal label.
• Blanket rules (all doors locked, everyone supervised) are the fastest route to unlawful restriction — assess individually.
• If in doubt, treat it as potentially a deprivation: ask, record, and let the DoLS team or commissioner advise.

Full topic page

• Safeguarding is everyone's job: if you see it, hear it or suspect it, you report it — you never investigate it yourself.
• The Care Act three-part test: care and support needs + experiencing or at risk of abuse or neglect + unable to protect themselves because of those needs.
• Ten recognised types of abuse include physical, sexual, psychological, financial, neglect, self-neglect, domestic, discriminatory, organisational abuse and modern slavery.
• Report to your manager or safeguarding lead the same day; anyone can also raise a concern directly with the local authority.
• Never promise secrecy, never ask leading questions, record the person's exact words, and preserve evidence.
• Making Safeguarding Personal means the person's own wishes shape what happens next wherever possible.

Full topic page

• Whistleblowing is raising a concern about wrongdoing that affects others — unsafe care, abuse, fraud, cover-ups — not a personal grievance.
• The Public Interest Disclosure Act 1998 protects workers (including agency and bank staff) from dismissal or detriment for protected disclosures.
• Start internally where safe: manager, senior manager, or the organisation's speak-up route. You can go straight to a prescribed body when internal routes fail or are part of the problem.
• CQC is a prescribed body for care workers: 03000 616161. Safeguarding concerns about individuals also go to the local authority — and 999 in emergencies.
• Keep dated, factual notes of what you saw and what you reported. Anonymous concerns are acted on where possible, but named ones are easier to investigate — and your name is handled carefully.
• Never be silenced by a confidentiality clause: the law protects public interest disclosures regardless.

Full topic page

• A care plan answers three questions for a stranger walking in: what matters to this person, what support do they need, and exactly how do they want it done.
• Plan around outcomes the person wants ("get back to church on Sundays"), not just tasks ("2x daily personal care").
• The person — and, where they wish, family — co-writes the plan; involvement is a legal requirement, not a signature at the end.
• Plans must change when the person changes: review after every incident, hospital stay, or new need, and routinely at agreed intervals.
• Daily notes should evidence the plan being delivered — when notes and plan tell different stories, both lose credibility.
• Risk plans belong inside care plans: enabling risk safely, not banning life.

Full topic page

• Dementia is an umbrella of conditions (Alzheimer's, vascular, Lewy body, frontotemporal and more) — each changes abilities differently.
• Behaviour is communication: "challenging behaviour" almost always decodes as pain, fear, boredom, need, or an environment that makes no sense.
• Enter the person's reality rather than correcting it — winning an argument with dementia is losing the person.
• Life story is clinical information: what someone did at 30 explains what they do at 85.
• Antipsychotics are a last resort for severe distress or risk, reviewed relentlessly — not a management tool.
• People with dementia keep their rights: capacity is decision-specific, and a diagnosis authorises nothing by itself.

Full topic page

• Plan early, while the person can shape it: wishes, place of care, who matters, DNACPR/ReSPECT conversations led by clinicians and recorded clearly.
• The five priorities of care for the dying person: recognise, communicate sensitively, involve the person and those close to them, support families, and plan and deliver individual care.
• DNACPR decisions apply to CPR only — every other element of care and comfort continues.
• Anticipatory (just-in-case) medicines should be in place before the crisis, with clear access to community nursing 24/7.
• Comfort is the constant work: mouth care, positioning, pain watched for and reported, hearing assumed present to the end.
• After death: verification per local policy, dignity in last offices, notifications completed, and genuine support for family and staff.

Full topic page

• Falls are the top cause of injury in older people — and mostly multi-causal, so single fixes rarely work.
• NICE NG249 (2025) replaced the old falls guideline: multifactorial assessment for over-65s at risk, and for 50–64s with risk conditions.
• The big modifiables: medicines (especially sedatives and blood-pressure drugs), postural hypotension, strength and balance, vision, footwear, continence, environment.
• Strength and balance exercise is the best-evidenced single intervention — movement prevents falls; immobility guarantees decline.
• Every fall gets a post-fall check before moving the person, a review of causes, and a plan update — including unwitnessed falls with head-injury vigilance.
• Falls prevention is not stopping people moving: restraint and restriction increase harm.

Full topic page

• The six rights every time: right person, right medicine, right dose, right route, right time — and the right to refuse.
• Record on the MAR immediately after administration, never before, and never for someone else's round.
• Only trained, competency-assessed staff administer medicines; competency is observed practice, not just a certificate.
• "When required" (PRN) medicines need a protocol: what it's for, signs to look for, dose, gap, maximum in 24 hours, and what to try first.
• Covert medication is a last resort requiring an MCA best-interests decision with prescriber and pharmacist involvement — documented.
• Errors and near misses: make the person safe, seek medical advice, be honest, record, report — and learn without blame.

Full topic page

• Meeting nutrition and hydration needs is a fundamental standard (Regulation 14) — and malnutrition in care is mostly preventable.
• Screen with MUST on admission and monthly (or on change), and act on the score with a clear care plan.
• Dysphagia kills: follow SALT recommendations exactly, using IDDSI levels for food texture and drink thickness.
• Watch intake, not just menus: what reached the plate matters less than what reached the person.
• Small, frequent, fortified beats three big untouched meals; finger food keeps people with dementia eating.
• Dehydration hides behind confusion, UTIs, falls and constipation — offer drinks the person actually likes, every contact.

Full topic page

• Person-centred care means the person shapes the care — not the rota, the task list, or "how we do things here".
• It is a legal requirement (Regulation 9 and the Care Act wellbeing principle), not a nice-to-have.
• Know the person: history, routines, relationships, likes, dislikes, and what a good day looks like to them.
• Offer real choices constantly, in ways the person can use — words, objects, showing rather than telling.
• Focus on strengths and what the person can do; doing things for people that they could do themselves takes ability away.
• If a care plan could belong to anyone, it belongs to no one — the detail is the care.

Full topic page

• Most pressure ulcers are preventable — and serious ones in care settings trigger safeguarding scrutiny for that reason.
• Assess risk on admission and after any change, using a recognised tool (Waterlow, Braden, PURPOSE T) plus clinical judgement.
• The aSSKINg bundle: assess risk, Skin checks, Surface, Keep moving, Incontinence and moisture, Nutrition and hydration, Giving information.
• Skin checks at every episode of personal care — heels, sacrum, buttocks, elbows, ears, and under devices.
• Non-blanching redness (Category 1) is damage already happening: act the same day — pressure off, plan changed, nurse involved.
• Equipment helps only when set correctly: mattress on the right setting for weight, cushions in use, heels floated.

Full topic page

• Reablement is "doing with, not doing for": time-limited support (typically up to 6 weeks) aimed at regaining independence.
• It is one form of intermediate care, alongside home-based rehab, bed-based care and crisis response.
• Discharge to assess / Home First: people leave hospital when medically fit and are assessed for long-term needs at home, not on a ward.
• Every visit works towards the person's own goals — make the tea alongside them today so they make it alone on Friday.
• Progress is reviewed constantly; support steps down as ability returns, and long-term assessment happens near the end, when the person is at their best.
• Reablement must be free for up to 6 weeks where provided as intermediate care.

Full topic page

• The Regulatory Reform (Fire Safety) Order 2005 makes a named "responsible person" accountable, with a written, current fire risk assessment.
• Every person needs a PEEP — a Personal Emergency Evacuation Plan matching their real mobility, hearing, cognition and night-time state.
• Care homes typically use progressive horizontal evacuation and delayed/phased strategies — staff must know theirs cold, on nights above all.
• Fire doors save lives only when closed: never wedge them; report damaged closers and gaps.
• Emollient creams soak into fabric and make it fiercely flammable — assess smokers using them, wash bedding properly.
• Drills at realistic times (including night simulation), recorded, with lessons acted on.

Full topic page

• Care settings feed some of the country's most vulnerable stomachs: listeria, salmonella and E. coli can be fatal where a healthy adult gets a bad weekend.
• Registered kitchens follow a documented food safety management system — most commonly Safer Food, Better Business (SFBB) for care homes.
• The 4 Cs: cleaning, cooking, chilling, cross-contamination — most outbreaks trace to one of them failing.
• Fridges at 5°C or below, freezers -18°C, cook to 75°C core (or equivalent), cool quickly, reheat once, thoroughly.
• Allergens: 14 must be identifiable for every dish; individual allergy and dysphagia needs must be visible to whoever plates and serves.
• Home care workers handling food follow the same principles at domestic scale — hands, surfaces, dates, and the fridge audit nobody asked for.

Full topic page

• Employers must protect staff and anyone affected by the work "so far as is reasonably practicable"; employees must take reasonable care and follow training.
• Five or more staff means written risk assessments and a written health and safety policy.
• COSHH covers cleaning chemicals, medicines-as-hazards and biological agents: know the product, the risk, the controls, and never decant into unmarked bottles.
• Lone working (most of home care) needs its own arrangements: check-ins, escalation, environment awareness.
• Report hazards the day you spot them — a logged, fixed hazard is a system working; a known, tolerated one is evidence.
• In England, safety of people receiving care from registered providers is CQC territory; staff and visitor safety is HSE/local authority territory.

Full topic page

• One incident can trigger several duties at once: internal report, RIDDOR to HSE, CQC notification, safeguarding referral, duty of candour — check each, every time.
• RIDDOR (workers and members of the public): deaths and specified injuries reported without delay (form within 10 days); over-7-day incapacitation within 15 days; listed occupational diseases and dangerous occurrences also count.
• In England, deaths and serious injuries to people receiving care from CQC-registered providers are generally notified to CQC, not reported under RIDDOR.
• Near misses are free lessons — report them with the same energy as accidents.
• Record facts at the time: what, when, where, who, injuries, actions taken — opinions and speculation belong nowhere in an incident report.
• The point of reporting is learning: trends reviewed, causes fixed, staff thanked rather than blamed for honesty.

Full topic page

• Hand hygiene is the single most effective measure: soap and water for visibly dirty hands and after diarrhoeal illness; sanitiser otherwise; the five moments always.
• Standard precautions apply to everyone, every time — you cannot tell by looking who carries what.
• PPE protects only when donned, used and doffed correctly — removal is where most self-contamination happens.
• The Code of Practice under the Health and Social Care Act 2008 (the "Hygiene Code") sets the compliance framework CQC assesses against.
• Suspected outbreaks (two or more linked cases) mean early escalation to the UKHSA health protection team and the local authority.
• Bare below the elbows, cover cuts, stay off work when symptomatic with D&V until 48 hours clear.

Full topic page

• Avoid hazardous manual handling where reasonably practicable; assess what cannot be avoided; reduce the risk — that is the legal order of operations.
• Every person has an individual moving and handling assessment: how they transfer, equipment, sling type and size, number of staff.
• Hoists and slings are lifting equipment: LOLER thorough examination every 6 months, pre-use checks every time.
• Never drag-lift, underarm-lift or catch a falling person — these injure people and staff, and no care plan should require them.
• Encourage the person to do what they can: the safest transfer is often the most enabling one.
• Training is practical and refreshed regularly — techniques decay into habits without it.

Full topic page

• A risk assessment answers four questions: what could cause harm, to whom, how likely and severe, and what are we doing about it.
• Care services run two kinds: workplace assessments (environments, tasks, substances) and individual assessments (this person, this activity).
• Positive risk taking is the professional standard: the question is "how can this happen safely?", not "how do we stop this?".
• A person with capacity can choose risks others dislike — your job is to inform, reduce what they'll accept, and record.
• Dynamic risk assessment is the thinking you do in the moment when reality differs from the paperwork — and it should be recorded afterwards.
• Review on change, incident, or schedule — an out-of-date risk assessment is a false comfort.

Full topic page

• Care information is special category data — the law's most protected tier — and confidentiality is also a professional and human obligation.
• Share on a need-to-know basis for care purposes; confidentiality is never a reason to withhold information where someone is at risk.
• Breaches (lost folders, wrong-recipient emails, gossip that identifies people) must be reported internally at once — serious ones go to the ICO within 72 hours.
• People can request their records (subject access): route requests to the right person immediately; the clock runs from receipt.
• The Data (Use and Access) Act 2025 updates UK GDPR in stages — including a "reasonable and proportionate" approach to SARs and a required complaints route.
• Social media and personal phones are where care confidentiality goes to die: no photos, no stories, no exceptions without explicit consent and policy.

Full topic page

• If it isn't recorded, you'll struggle to show it happened; if it's recorded wrongly, it's worse than nothing.
• Records must be accurate, complete, legible and contemporaneous (Regulation 17) — write at or near the time, never in advance.
• Facts, not opinions: what you saw, heard, did and were told, with quotes for anything significant.
• Never alter history: correct errors with a single line, date and initial — no erasing, no overwriting, no rewriting pages.
• Records are the person's story and legal documents at once: dignity in language, precision in content.
• Retention and storage follow the Records Management Code of Practice and UK GDPR — secure, accessible to the right people, kept no longer than needed.

Full topic page

• A policy states what the organisation commits to; a procedure says exactly how it's done here, by whom, step by step.
• Policies must reflect current law and guidance — 2026 changes (deprivation of liberty, data protection, CQC framework) make review cycles genuinely matter this year.
• Staff can't follow what they haven't met: induction, supervision and team meetings are where policy becomes practice.
• Version control is not optional: dated, numbered, old versions withdrawn — two versions of a medication policy in circulation is a live hazard.
• Buying a policy pack is a starting point only — unlocalised templates ("insert name here" still visible) are a classic inspection finding.
• When an incident reveals the policy and reality differ, fix one of them deliberately — usually both.

Full topic page

• A good form makes the right information easy to capture and the wrong habits hard — design is a safety feature.
• Every form needs: person's identifier, date/time, author's name and signature (or secure login), and a home in the filing system.
• Use your organisation's approved forms first; the printable examples here are generic aids for training and discussion.
• Daily notes, MAR charts, incident forms, body maps, supervision records and audits form the core paper spine of most services.
• Digital systems change the medium, not the standards: contemporaneous, attributable, accurate still rule.
• Review forms annually with the people who fill them in — every redundant box breeds workarounds.

Full topic page

• The Care Certificate is the expected induction standard for new, non-regulated care staff — 15 standards covering the fundamentals.
• It is completed in the workplace: learning plus observed, competency-based assessment in real practice, not just e-learning clicks.
• CQC expects new starters to work towards it from day one and not to work unsupervised until assessed as competent in relevant standards.
• The Level 2 Adult Social Care Certificate (from 2024) is the Ofqual-regulated, portable qualification built on the same standards — funding has been available through the Learning and Development Support Scheme.
• The certificate is the floor, not the finish line: specialist and refresher training builds on it.
• Employers sign it off honestly — a certificate without competence behind it protects nobody.

Full topic page

• Fast answers to the most-asked questions, with links to the full topics.
• When to report, who to tell, what the law presumes, and what CQC actually checks.
• If the answer here and your organisation's policy ever differ, follow your policy and raise the question.
• Nothing here is legal advice — check the linked official sources for anything that matters.

Full topic page

• There is no single statutory list of "mandatory training" — the duty (Regulation 18) is training appropriate to the role and the people supported; sector norms define the core set.
• The usual core: safeguarding, moving and handling, medication, infection control, health and safety, fire, food hygiene, basic life support, MCA/DoLS, equality — plus Oliver McGowan training on learning disability and autism.
• Specialist needs drive specialist training: dementia, dysphagia, diabetes, catheter and stoma care, epilepsy, end of life — match the matrix to the people, not the brochure.
• Certificates prove attendance; competence is observed. Blend e-learning with practical assessment and supervision.
• A live training matrix with refresher dates is the manager's radar — and one of the first documents CQC requests.
• Skills for Care's Care Workforce Pathway and funding schemes support progression beyond induction.

Full topic page