An Outstanding CQC evidence pack shows exceptional practice in at least 2 key questions, with evidence of what it changed for patients, and no quality statement anywhere scoring below good. Under the single assessment framework a key question is rated Outstanding at 88% or more of its maximum score, with no quality statement scoring 1 or 2.
The bar, in CQC's own numbers
CQC scores each quality statement it assesses from 1 to 4. A score of 4 means the evidence shows an exceptional standard. Key question scores are a share of the maximum possible, and 88% and above is Outstanding. A key question in the Outstanding range is limited to Good if any of its statements scores 1 or 2.1
An overall Outstanding normally needs at least 2 of the 5 key questions rated Outstanding and the others rated Good.1 So the pack has two jobs. Make the case for exceptional practice in two or more key questions, and make sure no statement anywhere falls below good.
How CQC tells exceptional practice from good practice
Good practice describes what you do, and exceptional practice shows what changed for people because of it. CQC's guidance on the factual accuracy check describes the test. In a factual accuracy check you may send further examples of exemplary practice that demonstrate real benefits for people using the service, which may support a rating of outstanding rather than good.2 Real benefits for people is the phrase to build around.
| Key question | Good evidence | Exceptional evidence |
|---|---|---|
| Safe | Incidents are reported and reviewed | An incident changed a pathway, and the repeat rate fell |
| Effective | Notes follow guidelines | Outcomes are measured, compared and improving |
| Caring | Patients say staff are kind | Patients describe being known, in their own words |
| Responsive | Patients can book online | Waits fell, and access widened for people who struggled to reach you |
| Well-led | Governance meetings happen | Leaders can show a decision, its data and its result |
How to structure the pack
- Choose your two strongest key questions. Pick where your practice is genuinely exceptional, not where you hope it is. Two is the minimum CQC normally needs.
- Write one claim per quality statement. One sentence, specific and testable. “We answer every enquiry the same working day” beats “we are responsive”.
- Attach the effect on people. For each claim, show what changed for patients, with a number, a quote or an outcome over time.
- Prove it from the live record. Point to evidence an inspector can see for themselves, not a summary written for them.
- Close every gap below good. Any statement scoring 1 or 2 caps an Outstanding key question at Good. Fix the floor before you polish the ceiling.
- Rehearse the follow-up. For every claim, ask the second question an inspector would ask, and make sure the answer is one click away.
- Key question ______ The claim in one sentence ______
- Quality statements it rests on ______
- What changed for people, with a number ______
- What a patient said, in their words ______
- Where an inspector can see it live ______
- What we will improve next ______
Common weaknesses in an evidence pack
- Evidence produced for the visit, which an inspector can tell from evidence produced by the work.
- Claims with no number and no patient in them.
- A single excellent month presented as a trend.
- Strength in four key questions and a statement scoring 1 in the fifth.
- A pack that cannot answer a follow-up question without someone going to find a file.
CQC is consulting on sector frameworks that would bring back rating characteristics, describing what Outstanding looks like in each sector, and remove scoring.3 Under either method, CQC looks for exceptional practice shown through its effect on the people using the service.
Questions
How many key questions need to be Outstanding for an overall Outstanding?
Normally at least 2, with the other 3 rated Good, under CQC's current rating principles.
Can one weak area stop an Outstanding?
Yes. A key question in the Outstanding range is limited to Good if any of its quality statements scores 1 or 2.
Can I add evidence of outstanding practice after the visit?
In the factual accuracy check you can send exemplary practice that was in place at the time of the assessment. Action taken afterwards is not usually part of the judgement.
Sources
- 1CQC, 2025How we reach a ratingRead source
- 2CQC, 2025How to submit factual accuracy commentsRead source
- 3CQC, 2026Our initial response to our public consultation, Better regulation, better careRead source
Written by the wai team from Care Quality Commission guidance, checked on 15 October 2026. This is guidance, not legal advice. CQC does not endorse wai or any software.