CQC Regulation 12 April 2026

CQC Mental Health Framework 2026: What Providers Need to Know

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Last updated: 12 April 2026 | Reviewed September 2026

CQC's current assessment approach for mental health services uses the five key questions — Safe, Effective, Caring, Responsive and Well-led — together with quality statements and specified evidence categories. Alongside this regulatory assessment role, CQC has separate statutory responsibilities for monitoring how services exercise their powers and duties under the Mental Health Act.

For mental health providers in 2026, preparation should therefore be grounded in CQC's current published assessment material, its mental health service evidence categories, Mental Health Act monitoring findings and applicable legislation — rather than predictions about unpublished future KLOEs.

Transparency Notice: This article was reviewed in September 2026 against CQC's current published mental health assessment guidance and its Monitoring the Mental Health Act in 2024/25 report.

How CQC Currently Assesses Mental Health Services

CQC publishes specific evidence-category guidance for mental health services. It states that, when assessing these services, it looks at evidence against its quality statements and groups evidence into six categories.

The five key questions remain:

For mental health services, CQC publishes the quality statements relevant under each key question and identifies the evidence categories it will usually consider.

The six evidence categories used across CQC's assessment framework are:

Not every evidence category applies to every quality statement or every type of mental health service. CQC's published mental health guidance specifies the categories it will usually consider for individual quality statements and, in some cases, limits particular evidence categories to specific service types.

Safe
Effective
Caring
Responsive
Well-led

people's experience of health and care services
feedback from staff and leaders
feedback from partners
observation
processes
outcomes

Current Mental Health Assessment Areas

This provides mental health organisations with a current, published basis for inspection preparation without needing to speculate about the content or timing of a future framework.

Key question	Examples of current quality statements relevant to mental health services
Safe	Learning culture; safe systems, pathways and transitions; safeguarding; involving people to manage risks; safe environments; safe and effective staffing; infection prevention and control; medicines optimisation
Effective	Assessing needs; delivering evidence-based care and treatment; how staff, teams and services work together; supporting people to live healthier lives; monitoring and improving outcomes; consent to care and treatment
Caring	Kindness, compassion and dignity; treating people as individuals; independence, choice and control; responding to people's immediate needs; workforce wellbeing and enablement
Responsive	Person-centred care; care provision, integration and continuity; providing information; listening to and involving people; equity in access; equity in experience and outcomes; planning for the future
Well-led	Shared direction and culture; capable, compassionate and inclusive leaders; freedom to speak up; workforce equality, diversity and inclusion; governance, management and sustainability; partnerships and communities; learning, improvement and innovation

Mental Health Regulation and Mental Health Act Monitoring Are Related but Distinct

CQC regulates the quality and safety of registered mental health services. It also has statutory duties under the Mental Health Act to monitor how services exercise their powers and discharge their duties when people are detained in hospital or subject to community treatment orders or guardianship.

CQC's Mental Health Act work includes visiting services and speaking with detained patients, requiring providers to take action where concerns are identified, providing the Second Opinion Appointed Doctor (SOAD) service, reviewing complaints relating to use of the Mental Health Act, and making proposals for changes to the Code of Practice.

Providers should therefore understand both dimensions of oversight. CQC assessment of service quality and CQC's statutory Mental Health Act monitoring interact in important areas of patient care and rights, but they should not be described as though they are the same regulatory process.

The Mental Health Act Changed in 2025 — But Implementation Is Phased

The Mental Health Act 2025 received Royal Assent in December 2025 and amends the Mental Health Act 1983.

This does not mean every reform took effect immediately.

CQC states that the reforms are likely to be implemented over a 10-year period and that it will develop its own processes in parallel. CQC is also working with the Department of Health and Social Care on revision of the Mental Health Act Code of Practice during 2026.

CQC identifies four guiding principles for that work:

Providers should therefore distinguish between the law receiving Royal Assent and individual provisions being commenced and implemented. Current practice should be based on the provisions and guidance actually in force at the relevant time.

choice and autonomy
least restriction
therapeutic benefit
treating the person as an individual

What CQC's Latest Mental Health Act Monitoring Tells Providers

CQC's Monitoring the Mental Health Act in 2024/25 report, published on 29 January 2026, provides current evidence about the pressures and concerns it is seeing in mental health services.

The report is based on 635 Mental Health Act monitoring visits covering 710 wards. CQC spoke with 3,642 patients and 717 family members or carers.

During those visits, CQC requested 3,248 actions from providers to address concerns. Of the concerns raised:

These findings provide a stronger basis for current preparation than predictions about unpublished inspection criteria.

33% related to patient experience
16% related to care planning
11% related to consent to treatment

Areas Requiring Particular Attention

Patient experience and involvement

CQC reports that staff often listened to patients and involved them in decisions, but some care plans did not adequately consider individual needs. Providers should be able to demonstrate meaningful involvement, individualised care and evidence that people's views affect decisions.

Care planning

Care planning accounted for 16% of the concerns CQC raised during its 2024/25 Mental Health Act monitoring visits. Records should demonstrate individual needs, preferences, risks, treatment, rights and involvement rather than functioning as generic documentation.

Consent and rights

Consent to treatment accounted for 11% of concerns raised during monitoring visits. Mental health providers need reliable processes for documenting consent, capacity, applicable Mental Health Act safeguards and information about people's rights.

Staffing and workforce capability

CQC continues to identify staffing pressures as affecting care. Inspection readiness therefore requires more than staffing numbers: providers should be able to evidence appropriate skills, support, supervision and workforce arrangements relevant to the people using the service.

Safe environments and restrictive practice

CQC continues to scrutinise whether environments are safe and whether people experience unnecessarily restrictive conditions. Providers should be able to demonstrate how environmental risks and restrictive practices are identified, reviewed and reduced where possible.

Transitions and discharge

CQC reports continuing concerns about collaboration, communication and community provision around discharge. Evidence should demonstrate safe transitions, continuity of care and effective information sharing between services.

Equality and racial inequality

CQC continues to identify significant inequalities in mental health care. Its 2024/25 report states that the detention rate for Black people was nearly four times that for White people.

The Patient and Carer Race Equality Framework (PCREF) is also now an important part of the regulatory landscape for relevant services. CQC's inspection guidance states that PCREF applies to NHS mental health trusts and providers of mental health services receiving public sector funding, and that providers within scope must show how they implement, evaluate and achieve PCREF actions and outcomes.

A Practical 2026 Mental Health Evidence Checklist

The appropriate evidence will depend on the service, people using it and the quality statement being assessed. This table should therefore be used as a preparation framework, not as a substitute for CQC's current service-specific guidance.

Area	Evidence providers should be able to demonstrate
Patient experience	Feedback, involvement in decisions, dignity, individualised care and evidence of response to concerns
Care planning	Current, person-centred assessments and care plans reflecting individual needs, risks and preferences
Consent and rights	Consent records, capacity considerations where relevant, rights information and applicable statutory safeguards
Safety	Risk management, safeguarding, learning from incidents and safe care environments
Staffing	Appropriate staffing arrangements, competence, training, supervision and workforce support
Medicines	Safe medicines management and evidence that treatment reflects people's needs, capacities and preferences
Transitions	Safe discharge, continuity, handover and effective working between teams and services
Restrictive practice	Governance, review and evidence of efforts to minimise unnecessary restriction
Equality	Evidence that inequalities in access, experience and outcomes are identified and addressed
Governance	Oversight of risk, performance, outcomes, improvement actions and accountability

How ReporticaAI Supports Mental Health Providers

ReporticaAI produces CQC-aligned documentation for mental health and healthcare providers, including policy documents, meeting notes, governance reports, and compliance evidence. Our Policy Drafter includes mental health-specific policies covering:

ReporticaAI's documentation tools can support providers in organising policy and governance documentation against current requirements and service needs.

Restrictive Practice and De-escalation
Observation and Constant Engagement
Patient Safety and Ligature Risk
Mental Health Act Compliance and Rights
Safeguarding and Abuse Reporting
Therapeutic Environment and Recovery

Prepare Against Current Mental Health Requirements

Providers can use CQC's current quality statements, evidence categories, Mental Health Act monitoring findings and applicable legislation to review governance and documentation.

Preparation should remain focused on evidence of safe, effective, caring, responsive and well-led services, alongside the statutory duties and guidance that apply to the service.

Create My First Policy Document Free

Choose from mental health-specific policies. No credit card required.

Or explore our CQC tools:

CQC Inspection Preparation Pack — Comprehensive self-audit and documentation bundle
24 Draft Adult Social Care KLOEs Explained — Companion article on the Adult Social Care framework
CQC 2026 New Assessment Framework Overview — Broad overview of all four frameworks

Frequently Asked Questions

Q: Does CQC currently use a separate mental health assessment framework?

A: CQC publishes mental-health-specific evidence-category guidance within its current assessment approach. Mental health services are assessed against quality statements under the five key questions — Safe, Effective, Caring, Responsive and Well-led — with CQC identifying the evidence categories it will usually consider.

Q: Does CQC currently use mental health KLOEs?

A: CQC's current published assessment material for mental health services uses quality statements and evidence categories. Providers should prepare against current CQC guidance rather than treating predicted or unpublished mental health KLOEs as established requirements.

Q: What are CQC's six evidence categories?

A: They are people's experience of health and care services, feedback from staff and leaders, feedback from partners, observation, processes and outcomes. The evidence categories used vary according to the quality statement and, in some cases, the type of mental health service.

Q: Are the five CQC key questions still relevant to mental health services?

A: Yes. CQC's current mental health evidence guidance is organised under Safe, Effective, Caring, Responsive and Well-led.

Q: What is CQC's role under the Mental Health Act?

A: CQC has a statutory duty to monitor how services exercise their powers and discharge their duties under the Mental Health Act when patients are detained in hospital or subject to community treatment orders or guardianship. Its work also includes the SOAD service and reviewing complaints relating to use of the Act.

Q: Is Mental Health Act monitoring the same as a CQC quality assessment?

A: No. CQC's regulation of service quality and its statutory Mental Health Act monitoring responsibilities are related but distinct functions. Providers may encounter both, and evidence about patient safety, rights, care and governance can be relevant across them.

Q: Is the Mental Health Act 2025 already fully implemented?

A: No. The Mental Health Act 2025 received Royal Assent in December 2025, but CQC says implementation of the reforms is likely to take place over a 10-year period. Providers should check which provisions and associated guidance are in force rather than assuming the entire reform package applies immediately.

Q: What is happening to the Mental Health Act Code of Practice?

A: CQC says it is working with the Department of Health and Social Care to revise the Code of Practice during 2026, with a strong focus on choice and autonomy, least restriction, therapeutic benefit and treating people as individuals.

Q: What did CQC find during Mental Health Act monitoring in 2024/25?

A: CQC carried out 635 monitoring visits covering 710 wards and requested 3,248 actions from providers. Of the concerns raised, 33% related to patient experience, 16% to care planning and 11% to consent to treatment.

Q: What is PCREF and which mental health providers does it apply to?

A: The Patient and Carer Race Equality Framework is designed to support action to reduce racial inequalities in mental health services. CQC's inspection guidance says it applies to NHS mental health trusts and providers of mental health services receiving public sector funding. CQC looks at how organisations within scope implement, evaluate and achieve PCREF actions and outcomes.