Outstanding care rests on five principles, according to research by The King's Fund for the Care Quality Commission (CQC). CQC published the report in April 2026. The five principles are person-centred care, inclusive leadership, equity, continuous learning and a purposeful focus on outcomes. Each principle links to a Key Line of Enquiry (KLOE) in the CQC draft adult social care framework (2026). KLOEs are the specific areas CQC assesses under its five key questions.
Why this research matters
CQC is rebuilding its assessment approach after major reviews of its previous model. It asked The King's Fund to set out what distinguishes Outstanding care from Good care.
The report draws on a literature review and six stakeholder workshops. Researchers also interviewed CQC staff, providers and experts by experience. It covers care homes and other adult social care settings.
That makes it a rare thing: a clear description of Outstanding care, commissioned by the regulator itself.
The five principles explained
1. Delivering truly person-centred care
The King's Fund describes Outstanding care as always highly responsive to people's needs, preferences and aspirations. People using services said Outstanding care feels different. It recognises their strengths. It involves them in real decisions about their support.
Experts by experience described staff who were curious about people's lives. Those staff gave people real power over their day-to-day care.
In the draft framework, this sits under the Person-centred care KLOE, within the Caring key question. That KLOE asks whether people are at the centre of their care, support and treatment choices. Our post on what inspectors mean by person-centred care looks at how this shows up in daily practice.
2. Embedding compassionate and inclusive leadership
Leadership shapes the culture staff work in every day. The King's Fund found that Outstanding services help staff feel engaged and empowered. Leaders are visible, accessible and responsive to staff and to people who use services.
The research favours leadership that is flexible, collaborative and shared across teams. Shared leadership supports both innovation and continuous improvement.
This links to the Capable and compassionate leaders KLOE within Well-Led. That KLOE asks whether leaders at all levels lead with accountability, integrity and empathy. We explore this principle further in our post on compassionate and inclusive leadership.
3. Prioritising equity and inclusion
Outstanding services treat everyone fairly, including staff. The King's Fund found that inclusive cultures consistently deliver better care. In the report's words, care environments are welcoming and actively value and respect all people.
For staff, this links to the Workforce equity and culture KLOE within Well-Led. It asks whether the culture values diversity, supports staff wellbeing and tackles workforce inequalities. For people using services, the Equity in experiences KLOE within Responsive covers similar ground.
Equity also means recognising that people start from different places. Outstanding services adjust their approach to close gaps in experience and outcome.
4. Continuously integrating learning into practice
Outstanding services treat learning as part of daily work. The King's Fund found that reflection, learning and improvement are part of regular practice. Services use data and feedback from staff and people using services to spot what needs to change. Then they act on it.
This links to the Improvement, innovation and learning KLOE within Well-Led. That KLOE asks whether a service embeds continuous improvement, using evidence and lived experience.
5. Having a purposeful approach to making a positive difference
Outstanding care comes from a deliberate focus on outcomes. The King's Fund found that outcomes and experiences for people using services are excellent. There is also a constant drive to improve them. The difference a service makes shows in outcome measures and in feedback from people and staff.
This connects to the Strategic direction KLOE within Well-Led. It asks whether there is a clear vision and strategy that supports people's current and future needs.
How the five principles connect
Read together, the five principles describe a culture that runs through the whole service. Four of them link to Well-Led KLOEs, and one sits within Caring. That pattern puts leadership and culture at the heart of Outstanding care.
Outstanding care is built through consistent daily systems, long before an inspection is announced.
The research also shows that Outstanding care builds up over time. It comes from steady daily habits: capturing evidence, acting on feedback and showing improvement. For an overview of all six Well-Led KLOEs, see our post on what the Well-Led key question means.
How AlwaysReady shows what Outstanding looks like
Every KLOE in AlwaysReady has its own Rating characteristics page. It sets out the draft framework's descriptors for Outstanding, Good, Requires Improvement and Inadequate side by side. You can read the Outstanding descriptor for Capable and compassionate leaders, then compare it with the evidence you hold.
Mock inspections in AlwaysReady record a self-assessed rating against each KLOE. A trend arrow shows whether each rating has risen, held or fallen since the last one. Over time, that builds a record of improvement across the four Well-Led KLOEs this research highlights. These ratings stay private to your service and do not affect your official CQC rating.
AlwaysReady is Care Home Compliance Software built around the KLOEs in CQC's draft framework. It keeps CQC evidence management tied to the same structure CQC will use.
References
- Care Quality Commission (2026). What makes care outstanding? Report by The King's Fund, commissioned by CQC. Published 14 April 2026. Available at: cqc.org.uk
- Care Quality Commission (2026). Draft assessment framework for adult social care. Published 19 March 2026. Available at: cqc.org.uk