May 21, 2021

What is the CQC Effective KLOE and how can you achieve an Outstanding Rating?

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Discover in this post what you need to know about CQC KLOE

In your home care agency, we know that you constantly strive to deliver effective care. Part of your CQC inspection involves showing how your work is achieving the desired outcomes. One of the five CQC Key Lines of Enquiry (KLOEs) assesses how effective your service is. 

In this article, we’re going to take a closer look at the CQC Effective KLOE and how you can meet expectations to achieve a good or outstanding rating.

What are the key elements of the CQC Effective KLOE?

The CQC Effective KLOE measures the outcomes of your care and how effective it is in improving the lives of your clients. 

To understand how to demonstrate this, we need to know exactly what the CQC means by ‘effective’.

The CQC says:

“By effective, we mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.”

What does this mean for your home care agency?

As a service, the CQC expects you to use evidence and current guidance to ensure that you deliver the very best care. Your staff must be skilled and experienced, working with other organisations where necessary. As a result, clients should have their individual physical, mental health, and social needs met.

Gathering CQC KLOE evidence to show the effectiveness of your service can also boost staff morale, as they recognise the measurable differences they’re making to clients on a daily basis.

The CQC Effective KLOE is broken down into seven sections. Let’s take a closer look at each one.

The CQC asks:

“Are people’s needs and choices assessed and care, treatment and support delivered in line with current legislation, standards and evidence-based guidance to achieve effective outcomes?”

What does this mean for you?

The CQC is asking you to show how you assess and plan care for your clients, then deliver holistic care (attending to physical, mental health and social needs) to meet regulations. You need to demonstrate the whole process of care planning and delivery, and the evidence to back up your decisions. This can be as simple as using the NICE guidelines to allocate the length of visits or to create a procedure for raising a safeguarding concern. 

Across the five KLOEs, the CQC wants to see the use of technology to aid care delivery and to assist the client where possible. Birdie tools are designed with the CQC requirements in mind. We created a centralised, digital hub for care planning and record keeping that can be shared between staff, carers, the clients, and their families and accessed from anywhere at any time. See how Visit Planning with Birdie keeps you aligned to the CQC KLOEs, here.

The CQC asks:

“How does the service make sure that staff have the skills, knowledge and experience to deliver effective care and support?”

What does this mean for you?

You should already be taking measures to ensure that you’re recruiting employees who are well suited to caregiving. During your CQC inspection, you may be asked to show that your staff have the relevant qualifications, skills and knowledge to do their jobs well. (For more about the types of documentation you'll need to keep for your staff, click here to check out our article on the CQC Safe KLOE.) As a manager, you should ensure a good skill mix on shifts, so that newer carers are supported by more experienced colleagues.

The CQC asks:

“How are people supported enough to eat and drink enough to maintain a balanced diet?”

What does this mean for you?

One of the important roles of your service is to assist clients with mealtimes. For some clients, that involves carers preparing and serving a full meal, for others it can be reminding them to eat, or serving pre-prepared food. As a service, you must do all you can to support a healthy diet, while respecting client wishes and their ability to make their own decisions around food. 

Staff must have completed relevant food hygiene training and are responsible for serving food that is safe to eat. We know that clients’ relatives can sometimes leave meals or snacks, but carers must ensure that any food they serve, even if prepared by others, meets health and safety standards.

Birdie allows you to track and record meals or snacks eaten and keep a log of the amount of fluid a person drinks. This information is logged quickly on every visit and helps you to keep on top of trends and spot issues before they arise. At a glance you can be sure your clients are eating and drinking and maintaining a balanced diet. Find out more about Birdie's visit logs and care delivery tools here.

The CQC asks:

“How well do staff, teams and services within and across organisations work together to deliver effective care, support and treatment?”

What does this mean for you?

Your service must be open and willing to cooperate with other organisations to deliver the best care for your clients. For example, you might need to liaise with day care centres, healthcare teams, or other social care services. The CQC Effective KLOE asks that you proactively reach out to relevant organisations to coordinate and plan care for your clients.

The CQC asks:

“How are people supported to live healthier lives, have access to healthcare services and receive ongoing healthcare support?”

What does this mean for you?

The CQC wants to see that clients are involved in their own care. This section of the CQC Effective KLOE assesses how your service supports clients to monitor their own health and understand their treatment options. For example, you might work alongside a healthcare team to support a diabetic client responsible for monitoring and recording their own blood sugar levels. You also need to show that your clients know how to access help, and that you make appropriate referrals to other services when necessary. 

The CQC asks:

“How are people’s individual needs met by the adaptation, design and decoration of premises?”

What does this mean for you?

This section is primarily aimed at care homes and accommodation provision. However, as a home care agency, you can also have a positive influence over a client’s immediate surroundings. Risk-assessing can help to identify and remove safety hazards, and in some cases, carers might carry out some light housekeeping duties. 

Birdie makes it easy for you to assess a client's home with our easy to use risk assessment tools. We’ve built our environment and risk assessment to be simple and easy to complete. We worked with our network of care managers and care professionals to build a tool that takes the stress out of manually creating assessments.

When you start or update a fire risk or environmental assessment within Birdie, you’ll be able to quickly navigate to a room, e.g. the living room, entrance or bathroom and then note down any risks you have observed. All of this is immediately available for your care staff to see from within their app when they visit your clients home.

For example, if you notice that the carpet at the entrance of your client’s home is a trip hazard, your care staff will be aware of this before they attend their visit, keeping everyone safe.

Every time you complete a section, you’ll see the number of completed risks update, so you can keep track of your assessment as you go.

Birdie's risk assessement tools make it easy to record and mitigate risks in a client's home

The CQC asks:

“Is consent to care and treatment always sought in line with legislation and guidance?”

What does this mean for you?

Consent is a vital part of caregiving. Where possible, a client’s consent must be sought at every stage of assessment, planning and intervention. with Birdie, you can record this digitally with an e-signature. You must provide CQC KLOE evidence that your service complies with the relevant legislation, including the Mental Capacity Act 2005. 

What is absolutely crucial is that a client never feels pressured, or that they have no choice in their care. 

Birdie's e-signature tool keeps you compliant and makes it easy to gain consent at every step of the way

Barriers to achieving a good or outstanding rating in the CQC Effective KLOE

  • A lack of consistency in care delivery.
  • Care does not always reflect current evidence-based guidance.
  • Staff are not supported with ongoing training to maintain professional skills.
  • Clients’ mealtimes are rushed or food is served too hot or too cold.
  • Cultural or dietary preferences are not considered when providing food and drinks.
  • The service doesn’t monitor the hydration or nutrition of clients or fails to refer to dietary or nutritional specialists when necessary.
  • Clients are not consulted about their care, or consent is not clearly obtained.
  • Staff are not clear on legislation around caring for people who lack capacity to make decisions.

Woman working at her computer with a link to care planning downloads

At Birdie, we know that you work hard to provide effective care for your clients, and we are here to help you achieve a good or outstanding rating in your CQC inspection.


Birdie’s tools are closely aligned with the CQC inspection frameworks and can help you meet requirements for the CQC Effective KLOE. Our system allows you to keep CQC KLOE evidence in one place, so you’re prepared for your inspection. Find out more.

Have you got an upcoming CQC Inspection? Check out our resources:

Learn more about the other KLOEs: Safe, Well-Led, Responsive and Caring.

Call to action button with a mans hand holding a pen over a clipboard. Text reads: Discover more about the CQC KLOEs and get set for your next inspection

If you've got a CQC inspection coming up, why not check out our guide to getting prepared, here.

Want to find out more about CQC inspections? Check out our blog roundup of a talk held by Deanna Westwood, Head of CQC Inspections, held earlier this year. She talks about CQC's 2021 digital strategy and how they're evolving the ESF framework in the wake of COVID-19. Or if you're looking to capture evidence that proves your business is outstanding, get some top tips here, or find out how to improve your rating, here

You might also be interested in our on-demand webinar which focuses on improving your CQC score with care management software like Birdie and our free downloadable, printable tip sheet to help improve your CQC rating. Just click here to download yours now.

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