First, a quick orienter

• Since late 2023, CQC has assessed against the Single Assessment Framework (SAF). It keeps the 5 Key Questions but replaces KLOEs with quality statements — what “good” looks like in plain English. Mapping your evidence to those statements is now essential. Care Quality Commission+1

• For LD and autistic people, Right support, right care, right culture (RSRCRC) still underpins registration and inspection expectations (small, community‑based, rights‑respecting care). Care Quality Commission+1

The 10 most common issues — and quick fixes

Each point lists the typical inspection finding and a quick solution linked to a regulation/quality statement so you can course‑correct immediately.

1. Weak governance & patchy audits (Reg 17, Well‑Led)
   What CQC sees: Audits that don’t detect risks; action plans that stall; leaders not triangulating incidents, complaints and outcomes. Care Quality Commission+1
   Quick fix: Stand up a monthly Quality Cycle: risk register → themed audits → action log with owners/dates → evidence of impact. Align each audit to the SAF quality statements and Reg 17 requirements. Care Quality Commission

2. Mental Capacity & Consent errors (Reg 11) and DoLS gaps
   What CQC sees: Generic capacity assessments; missing best‑interest decisions; un‑authorised restrictions; delayed renewals. CQC’s 2023/24 review found MCA non‑compliance was a leading registration concern and DoLS backlogs leave people without legal protection. Care Quality Commission+2Care Quality Commission+2
   Quick fix: Implement a two‑step MCA check for every significant decision: 1) decision‑specific capacity assessment; 2) best‑interest record (involving family/advocates). Track DoLS status on a live dashboard with expiry alerts. Cross‑reference your evidence to the “Consent to care and treatment” quality statement. Care Quality Commission

3. Medicines management that isn’t consistently safe (Reg 12)
   What CQC sees: Incomplete MAR/eMARs, weak PRN protocols, poor reconciliation after hospital appointments, and limited learning from near‑misses. Care Quality Commission+1
   Quick fix:

• Standardise PRN guidance and review frequency.

• Introduce a weekly MAR spot‑check and a monthly end‑to‑end medicines audit (ordering → admin → disposal).

• Update medicines support care plans for every person receiving support. Care Quality Commission

4. Restrictive practices & “closed culture” risks (Reg 13)
   What CQC sees: Heavy reliance on restrictions; limited access to community life; care that feels institutional rather than person‑led. Care Quality Commission
   Quick fix: Adopt Positive Behaviour Support (PBS) principles; review every restriction for necessity, proportionality and time‑limiting; record de‑escalation first; board‑level oversight of restraint data. Align your model to RSRCRC (size, setting, access to community). Care Quality Commission

5. Insufficient staffing, skills mix or LD/autism training (Reg 18; Safe staffing quality statement)
   What CQC sees: Rotas not matched to assessed needs; limited supervision; LD/autism training not role‑appropriate. Since 1 July 2022, LD/autism training has been a legal requirement; the Oliver McGowan Code of Practice commenced 6 Sept 2025 and guides what “appropriate to role” means. Care Quality Commission+2Care Quality Commission+2
   Quick fix: Complete an acuity‑based rota review; refresh supervision matrix; ensure every role meets the Oliver McGowan standards and record competence in practice, not just attendance. Care Quality Commission

6. Care that isn’t truly person‑centred (Reg 9; Responsive: Person‑centred care)
   What CQC sees: Copy‑paste care plans; limited involvement of people and families; weak reasonable adjustments. Care Quality Commission+1
   Quick fix: Re‑write plans with the person (and circles of support), embed communication passports, and evidence reasonable adjustments (e.g., sensory, timing, accessible formats). Reference the Accessible Information Standard in your documentation. Care Quality Commission

7. Risk assessments that don’t balance safety with choice (Reg 12; Safe: Involving people to manage risks)
   What CQC sees: Out‑of‑date or generic risk plans; little evidence of positive risk‑taking with people’s goals in mind; weak learning after incidents. Care Quality Commission+1
   Quick fix: Move to person‑centred, decision‑specific risk plans reviewed at each change; add a “learning note” after any safety event and show how practice changed (link to the Learning Culture statement). Care Quality Commission

8. Complaints and Duty of Candour not embedded (Reg 16 & Reg 20)
   What CQC sees: Slow acknowledgement/investigation; people/families not kept informed; DoC applied inconsistently after notifiable safety incidents. Care Quality Commission+2Care Quality Commission+2
   Quick fix: Create a 48‑hour response standard for complaints with staged updates; build a DoC decision flowchart into incident reviews; keep a clear audit trail (apology, explanation, learning, actions). Care Quality Commission

9. Premises & environment not consistently safe or personalised (Reg 15; Safe environments)
   What CQC sees: Maintenance backlogs; ligature or scald risks left unresolved; environments that don’t meet sensory needs; weak equipment checks. Care Quality Commission+1
   Quick fix: Run a monthly environmental walk‑round (PPE, water temps, fire safety, equipment servicing, accessibility) with an actions tracker — and evidence how sensory needs inform room adaptations. Care Quality Commission

10. Records that don’t tell the story (Reg 17; Digital records & access)
    What CQC sees: Incomplete or hard‑to‑navigate digital notes; eMAR not aligned with paper guidance; delays giving inspectors access. Care Quality Commission+1
    Quick fix: Agree a records taxonomy (where to find what), complete a DSPT‑aligned digital records check, and set up read‑only inspector access on site so access never obstructs an inspection. Care Quality Commission+1

Why these 10 matter right now

• They map directly to SAF quality statements and the fundamental standards that underpin ratings. Care Quality Commission+1

• For LD/autistic services, CQC’s 2023/24 State of Care flagged persistent concerns about excessive restrictive practices and access to rights‑based, community life — core to RSRCRC. Care Quality Commission

• Services that don’t improve risk special measures and enforcement. Care Quality Commission

A 7‑day “inspection‑ready” mini‑plan (steal this)

1. Day 1 – Governance: RAG‑rate the 5 Key Questions against the quality statements; refresh the risk register and action log. Care Quality Commission

2. Day 2 – MCA/DoLS & Consent: Audit 10 care records for decision‑specific capacity/best‑interest evidence; fix gaps and chase DoLS renewals. Care Quality Commission+1

3. Day 3 – Medicines: Do a full medicines audit (including PRN, homely remedies, reconciliation); update MAR/eMAR and care plans. Care Quality Commission+2Care Quality Commission+2

4. Day 4 – Staffing & Training: Re‑match rotas to people’s needs; check supervision; bring LD/autism training in line with Oliver McGowan standards. Care Quality Commission

5. Day 5 – Culture & PBS: Review restrictive practices, community access and PBS plans; evidence reduction and human‑rights focus. Care Quality Commission

6. Day 6 – Environment: Complete an estates safety walk‑round; close quick wins; schedule any specialist remedials. Care Quality Commission

7. Day 7 – Records & DoC/Complaints: Tidy the evidence pack; test inspector access; check recent incidents for Duty of Candour compliance. Care Quality Commission+1

How a specialist consultancy helps

Preparing for CQC while running a complex LD home is hard. My consultancy supports providers to get “inspection‑ready” without the overwhelm:

• Rapid SAF evidence map (turns your existing documents into quality‑statement proof).

• Mock inspections & staff coaching (including manager interviews and bite‑size PBS/MCA refreshers).

• Medicines & MCA spot‑checks with immediate action plans.

• Records make‑over (clear structure, digital access tested, DSPT signposting).

If you’d like a second pair of eyes before your next assessment, message me and I’ll share a simple check‑template you can use with your team.