Understanding Key Lines of Enquiry
Key Lines of Enquiry (KLOEs) are the specific questions CQC inspectors use to assess care quality under each of the five domains. While CQC is transitioning to quality statements under the Single Assessment Framework, understanding KLOEs remains valuable as they reflect the core evidence inspectors seek.
Below is a cheat sheet covering the main KLOEs and the evidence you need for each.
Safe
How do systems and processes protect people from abuse?
Evidence needed:
- Safeguarding policy and training records
- Incident and safeguarding referral documentation
- DBS check records for all staff
- Whistleblowing procedures
How is risk to individuals assessed and managed?
Evidence needed:
- Individual risk assessments (falls, pressure, nutrition)
- Care plans addressing identified risks
- Environmental risk assessments
- Evidence risks are reviewed when needs change
How does the service ensure safe staffing?
Evidence needed:
- Staffing rotas and dependency tool usage
- Recruitment processes and personnel files
- Training records and competency assessments
- Use of agency staff and their induction
How is medicine managed safely?
Evidence needed:
- MAR charts/eMAR records
- Controlled drugs register
- PRN protocols and effectiveness records
- Medication error records and learning
How is infection prevented and controlled?
Evidence needed:
- IPC policies and audit results
- Hand hygiene audit records
- Outbreak management protocols
- Staff training on infection control
Effective
Are people's needs assessed and care planned?
Evidence needed:
- Pre-admission assessments
- Person-centred care plans
- Evidence of resident/family involvement
- Regular care plan reviews
Is care delivered in line with best practice?
Evidence needed:
- Use of validated assessment tools
- Reference to NICE guidelines where relevant
- Evidence-based clinical pathways
- Outcomes monitoring
Is nutrition and hydration adequately provided?
Evidence needed:
- MUST assessments
- Food and fluid charts where needed
- Menu choices and dietary accommodation
- Weight monitoring records
How competent and supported is the staff team?
Evidence needed:
- Training matrix and completion rates
- Supervision and appraisal records
- Induction documentation
- Competency assessments for clinical tasks
Is consent obtained appropriately?
Evidence needed:
- Consent documentation in care records
- Mental capacity assessments
- Best interest decisions
- DoLS applications and authorisations
Caring
How kind, caring and respectful are staff?
Evidence needed:
- Feedback from residents and families
- Observation of staff interactions
- Complaints and compliments records
- Staff training on dignity
How is dignity and privacy maintained?
Evidence needed:
- Personal care practices
- Private space for conversations
- Confidentiality of records
- Knock-and-wait practices
How are people involved in their care?
Evidence needed:
- Care plan involvement records
- Residents meetings minutes
- Choice documentation
- Advocacy arrangements
Responsive
How are services tailored to individual needs?
Evidence needed:
- Life history and preferences documentation
- Personalised care plans
- Adaptation for changing needs
- Cultural and religious needs met
How are concerns and complaints handled?
Evidence needed:
- Complaints policy
- Complaints log with outcomes
- Evidence of learning from complaints
- Accessible complaints process
How is end of life care provided?
Evidence needed:
- Advance care planning documentation
- DNACPR records
- Preferred priorities of care
- Family involvement records
Well-led
Is there a clear vision and strategy?
Evidence needed:
- Statement of purpose
- Quality improvement plans
- Staff understanding of vision
- Strategic objectives
How effective is governance?
Evidence needed:
- Audit schedules and results
- Action plans from audits
- Quality monitoring systems
- Provider visits and reports
How engaged and supported are staff?
Evidence needed:
- Staff meeting minutes
- Staff survey results
- Recognition and reward systems
- Staff retention data
How is continuous improvement achieved?
Evidence needed:
- Incident analysis and learning
- Quality improvement projects
- External feedback acted upon
- Innovation and best practice adoption
Is there a duty of candour?
Evidence needed:
- Notification records to CQC
- Being open policy
- Evidence of honest communication
- Records of apologies and explanations
Using This Cheat Sheet
- Self-audit: Review each KLOE monthly and ensure evidence is current
- Inspection prep: Use this to brief staff on what inspectors will ask
- Evidence collection: Organise your documentation by KLOE for easy access
- Gap analysis: Identify where evidence is missing or weak
Related CQC Guides
KLOE Evidence at Your Fingertips
Revitaco organises your documentation by CQC domain, making it easy to find evidence for every key line of enquiry.
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