Our fundamental standards

Published: 8 July 2014 Page last updated: 3 November 2022
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The regulations published today are an important part of the changes the Care Quality Commission is making to the way it inspects health and care services.

We have already done much to strengthen our inspections and to make our judgements clearer to people who use services.

In every inspection we ask whether the service is safe, caring, effective, responsive to people’s needs and well-led. At present, we use 16 ‘essential standards’ of quality and safety to underpin our assessments on whether care has fallen below acceptable standards. The fundamental standards laid before Parliament today will replace these and give people who use services and those who provide them a clearer picture of the standards that must be met, in line with Robert Francis’s recommendations in his report about Mid Staffordshire NHS Foundation Trust.

Today’s regulations also cover the new duty of candour, which will require NHS bodies to be open and transparent with service users about their care and treatment, and the fit and proper person requirement. This will mean that all directors appointed to NHS secondary care organisations must meet a new fit and proper person test. The CQC will be able to insist on the removal of directors that fail this test.

The fit and proper person requirement and the duty of candour will come in to force for NHS bodies in October 2014, or as soon as possible following this, subject to Parliamentary timetables.  

The fundamental standards will come in to force for all providers in April 2015, and at the same time, subject to Parliament, the fit and proper person requirement and the duty of candour will be extended so they also cover all providers from then on. 

The fundamental standards are...

  • care and treatment must be appropriate and reflect service users’ needs and preferences.
  • service users must be treated with dignity and respect.
  • care and treatment must only be provided with consent.
  • care and treatment must be provided in a safe way.
  • service users must be protected from abuse and improper treatment.
  • service users’ nutritional and hydration needs must be met.
  • all premises and equipment used must be clean, secure, suitable and used properly.
  • complaints must be appropriately investigated and appropriate action taken in response.
  • systems and processes must be established to ensure compliance with the fundamental standards.
  • sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed.
  • persons employed must be of good character, have the necessary qualifications, skills and experience, and be able to perform the work for which they are employed.
  • registered persons must be open and transparent with service users about their care and treatment (the duty of candour).

We will consult later in the summer on what services can do to make sure they meet these fundamental standards, and on our approach to enforcing them.

The fundamental standards will come in to force for all providers in April 2015...