Essential KLOE Evidence

This table displays examples of three different types of evidence that would be considered ‘must-have’  or essential for each key line of enquiry (KLOE).[1]  Use this table as a guide to help you gather your own KLOE evidence using the audit tool or template of your choice.

Please note: Use the ‘Search’ box to select particular domains or KLOEs.[2]  Use the ‘Show entries’ drop-down to display fewer or more entries on a single page.[3]

DomainKLOEKLOE descriptionEssential evidence 1Essential evidence 2Essential evidence 3
SafeS1 How do systems, processes and practices safeguard people from abuse?Up to date and comprehensive safeguarding (SG) policy and procedures. Should include detailed procedures for reporting and investigating SG incidents.Training records showing that all staff have attended safeguarding training and this has been kept updated. Give staff numbers and explain gaps. Useful to have this information displayed on staff training matrix.Feedback from staff that shows they have a clear understanding of safeguarding issues and how to manage them. Could include training exercises in staff meetings, etc.
SafeS2How are risks to people assessed and their safety monitored and managed so they are supported to stay safe and their freedom is respected?Completed and up-to-date risk assessments in every service user's care plan. Records of all relevant health and safety checks and audits.Feedback from service users and relatives* regarding how safe they feel in the service. *Could also be friends of service user.
SafeS3How does the service make sure that there are sufficient numbers of suitable staff to keep people safe and meet their needs?Up-to-date and completed staff rotas with appropriate number of staff for each shift (residential services) or client visit (domiciliary care). Feedback from staff, service users and relatives on whether they feel the service is properly staffed.Staff recruitment and training records showing that proper checks (DBS, etc.) were carried out and new staff have suitable entry level care qualifications (NVQ, etc., and have completed all mandatory training. Useful to have this on a training matrix.
SafeS4How does the provider ensure the proper and safe use of medicines?Up to date and comprehensive medicines policy and procedure. Up to date and complete audit of medicines records (MAR, etc.). Need to explain any gaps or anomalies. Feedback from service users regarding their experience of receiving medicines, and from staff regarding their understanding of how best to administer medicines.
SafeS5How well are people protected by the prevention and control of infection?Comprehensive and up to date infection control policy and procedures. Training records showing that all staff have attending infection control training since joining the service and this has been kept up to date. As with all training need to explain any gaps. Feedback from service users and relatives regarding their views on cleanliness of premises and equipment, and their experience of care being delivered in a clean and safe way.
SafeS6Are lessons learned and improvements made when things go wrong?Up to date management reports showing how safety issues have been dealt with, lessons learnt and actions takenComprehensive and completed safeguarding incident records. Should include evidence these were shared with CQC and other relevant agencies, e.g. local authority. Feedback from service users and relatives regarding their experiences of raising concerns and how these were dealt with.
EffectiveE1Are 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?Completed and comprehensive initial and ongoing care plan assessments for all service users. Should include detailed life history of each service user and their specific needs, interests and preferences.Feedback from service users and relatives regarding their experiences of assessments and reviews. Comprehensive and up to date equality and diversity policy and procedures.
EffectiveE2How does the service make sure that staff have the skills, knowledge and experience to deliver effective care and support?Record of all staff members' qualifications, appraisals, registrations (where appropriate) and training and development plans. Feedback from service users and relatives regarding their views on staff members' knowledge and experience of delivering care.Record of management observations of staff delivery of care.
EffectiveE3How are people supported to eat and drink enough to maintain a balanced diet?Comprehensive and up to date records of fluid and food intake for each service user. Should include food and fluid charts, weight records, etc.Menus showing good choice of food and drink options for service users. Should include at least one vegetarian/vegan option for each meal. Care plans clearly showing dietary requirements and preferences for each service user.
EffectiveE4How well do staff, teams and services within and across organisations work together to deliver effective care, support and treatment?Records detailing service user referrals to and from other services. Comprehensive and up to date referral policy and procedures.Feedback from service users, relatives and staff regarding how referrals are managed by service.
EffectiveE5How are people supported to live healthier lives, have access to healthcare services and receive ongoing healthcare support?Feedback from service users and relatives regarding their experience of access to healthcare services and advice.Care plan records detailing referrals to healthcare services (GPs, hospitals, etc.). Feedback from staff regarding their experience and knowledge of referring service users to healthcare services.
EffectiveE6How are people’s individual needs met by the adaptation, design and decoration of premises?Feedback from service users and relatives regarding their experience of the service premises and whether they are consulted regarding any improvements to the environment. Could include complaints and survey records.Records of management and staff observations of premises. Should detail issues such as cleanliness, proper functioning of toilets, bathrooms, call buttons, etc., fire hazards and their management, storage of food, medicines and equipment. Care plans detailing specific adaptation needs for each service user.
EffectiveE7Is consent to care and treatment always sought in line with legislation and guidance?Feedback from service users and relatives regarding their experience of consent to care and treatment.Comprehensive and up to date consent to care and treatment policy and procedures. Should include meaningful summary of all relevant legislation and guidance, e.g. DoLS, MCA, etc. Training records showing that all relevant staff have attended all relevant training relating to consent to care and treatment (DoLS, MCA, etc.) and this has been kept updated.
CaringC1How does the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed?Feedback from visiting professionals regarding their experiences of how service users are treated by staff. Feedback from service users and relatives regarding their experience of care.Record of management observations of how staff interact with service users and relatives.
CaringC2How does the service support people to express their views and be actively involved in making decisions about their care, support and treatment as far as possible?Feedback from service users and relatives regarding how they are involved in decisions about their care and treatment.Records detailing the involvement of professional advocates where appropriate to help service users express their views.Feedback from staff regarding their experience of involving service users and relatives in decision making.
CaringC3How are people’s privacy, dignity and independence respected and promoted?Comprehensive and up to date policies and procedures on independence, privacy, dignity, confidentiality and data management. Feedback from service users and relatives regarding their experience of how their dignity and independence is respected and promoted.Feedback from staff regarding how they promote the dignity and independence of service users.
ResponsiveR1How do people receive personalised care that is responsive to their needs?Person-centred care plans showing that each plan is tailored to the specific needs of the individual.Feedback from service users and relatives/ friends regarding their experience of personalised care.Feedback from staff regarding their understanding of person-centered care. Could be part of training exercise in staff meetings.
ResponsiveR2How are people’s concerns and complaints listened and responded to and used to improve the quality of care?Comprehensive and up to date complaints policy and procedures. Should include details of how complaints are reported, investigated and acted upon. Record of all complaints in last twelve months with details of how they were investigated and actions taken to address issues. Feedback from service users and relatives regarding their understanding of the complaints process and their experience of making a complaint.
ResponsiveR3How people are supported at the end of their life to have a comfortable, dignified and pain free death?Comprehensive and up to date end-of-life policy and procedures.Feedback from relatives on how service users were treated at the end of their lives.Training records showing that all staff have attended end-of-life training and that this has been kept updated.
Well-ledW1Is there a clear vision and credible strategy to deliver high-quality care and support, and promote a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people?Vision and/or mission statements. These could be part of service welcome packs, business plans, induction material, etc. Feedback from staff, service users, relatives and other stakeholders regarding their understanding and experience of the culture of the service. Feedback from manager and/or provider regarding the vision, mission and culture of the service.
Well-ledW2Does the governance framework ensure that responsibilities are clear and that quality performance, risks and regulatory requirements are understood and managed?Feedback from staff regarding their understanding and experience of line management. Important to establish that they are aware of who they are accountable to. Robust and effective quality assurance and governance systems. Need to show that these can monitor quality across the whole service and that any issues detected are acted upon in a timely manner. Registered manager in place. Need to produce evidence of CQC registration.
Well-ledW3How are the people who use the service, the public and staff engaged and involved?Up to date and meaningful stakeholder surveys (for staff, service users, relatives, health professionals, etc.). Need to show example questionnaires and how results are analysed and acted upon. Feedback from staff, service users, relatives and other stakeholders regarding their experience of being involved in the service. This would include taking part in surveys and meetings, and being consulted regarding important decisions affecting the service.Comprehensive and up to date staff whistle-blowing policy and procedures. This shows that the service management is not afraid to receive criticism from its staff.
Well-ledW4How does the service continuously learn, improve, innovate and ensure sustainability?Management reports and similar documents showing that feedback from complaints, incidents, surveys, audits, etc. have been properly analysed and used to improve the service. Feedback from staff, service users and relatives regarding their views on how well the service learns from its mistakes and from stakeholder input (feedback from staff, service users, etc.). Concrete examples of innovative practices used to improve and develop the service. E.g. use of technology to improve care planning and delivery.
Well-ledW5How does the service work in partnership with other agencies?Feedback from other visiting professionals and other agencies regarding partnership working with the service. This could include input from commissioners, the local Healthwatch, etc.Staff feedback regarding their experience of partnership working. Documentation showing evidence of partnership working with other agencies. E.g. email exchanges regarding specific service users.
  1. Three types of evidence from different sources is the recommended minimum by the CQC. If you want to see more possible types of evidence please click here. []
  2. For example, type Safe to see all the Safe KLOEs, or S1 just to see the S1 KLOE. []
  3. There are a total of 24 entries for the whole table. []