CQC key questions for dental practices: what inspectors look for

The CQC key questions are the five things the Care Quality Commission asks of every health and care service in England: is it safe, effective, caring, responsive to people's needs, and well-led? For a dental practice they frame every assessment, every report and every judgement. This guide explains what sits under each question for dental services, how CQC reaches a judgement when it does not give dental practices a rating, and what is changing in CQC's framework.

What are the CQC 5 key questions?

The five key questions have been the backbone of CQC's approach for years and they remain so. CQC's assessment framework sets out a short description of what good looks like for each. In plain terms:

The five key questions are the same for a single-surgery practice as for a hospital trust. What changes is the detail underneath, which is where the quality statements come in.

How the key questions work for dental practices

Dental practices are treated differently from most services in one important way: CQC does not rate them. Its page on services it does not rate lists primary dental services as exempt from its legal duty to give a rating. There is no Outstanding, Good, Requires improvement or Inadequate, and no scores.

Instead, CQC judges whether the practice is meeting the regulations. Inspectors judge each evidence category they assess as either Regulations met or Not all regulations met. Those judgements roll up into a judgement for each quality statement, and those roll up into a judgement for each key question. One detail matters a great deal: a "not all regulations met" judgement in any single evidence category means the related quality statement and key question also show as "not all regulations met". One weak area is enough to mark a whole key question.

The regulations behind those judgements are the fundamental standards, set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. They include safe care and treatment, safeguarding, premises and equipment, complaints, good governance, staffing, fit and proper staff and the duty of candour.

What are the CQC quality statements?

Under each key question sits a set of quality statements, written as "we statements" that describe what a provider should be doing. There are 34 across the whole framework. These are the statements under each key question, as CQC lists them:

Safe (8)

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 (6)

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 (5)

Kindness, compassion and dignity. Treating people as individuals. Independence, choice and control. Responding to people's immediate needs. Workforce wellbeing and enablement.

Responsive (7)

Person-centred care. Care provision, integration and continuity. Providing information. Listening to and involving people. Equity in access. Equity in experiences and outcomes. Planning for the future.

Well-led (8)

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. Environmental sustainability.

CQC's dental-specific pages list the statements it applies to primary dental services. The dental well-led page lists seven, without environmental sustainability.

In practice, a dental assessment is narrower than that list suggests. The independent review of CQC published in October 2024 found that dental inspections used seven quality statements: three under safe (staffing, environment, and infection prevention and control) and one under each of the other four key questions, with 15 evidence categories across them. CQC's own pages still set out the full list, so it is worth knowing all of it, but those seven are where most of the attention goes.

What are the 6 evidence categories?

CQC groups the evidence it collects into six evidence categories:

1. People's experience of health and care services
2. Feedback from staff and leaders
3. Feedback from partners
4. Observation
5. Processes
6. Outcomes

For each quality statement, CQC says which categories it will look at for each type of service. The primary dental services pages are worth reading line by line, and three things stand out:

• Feedback from staff and leaders appears against every dental quality statement. Your team will be asked about how the practice works, so they need to know.
• Processes appears against almost every statement. This is your written evidence: policies, audits, logs, checks and records.
• Observation is listed only for safe environments, infection prevention and control, medicines optimisation, and kindness, compassion and dignity. These are the areas where what an inspector sees in the building counts directly. The outcomes category does not appear on the dental lists at all.

CQC also says there isn't a full list of evidence that fits every service, and that it may follow up specific risks that need particular evidence.

What is CQC looking for in a dental practice?

CQC says it does not want providers to prepare special documents for an assessment, and that it asks for information you already have. So the honest answer to "what is CQC looking for" is evidence that the practice runs well every day. Mapped to the key questions, that typically means:

• Safe: infection prevention and control audits and decontamination records, safeguarding training and a named lead, medical emergency drugs and equipment checked to a schedule, radiography records, and complete recruitment checks for every member of staff.
• Effective: clear records of assessment and consent, clinical audits that lead to changes, and referral processes that work.
• Caring: patient feedback you collect and act on, privacy at reception, and support for anxious patients.
• Responsive: information that is accurate and up to date, including on your website, access arrangements, how urgent patients are seen, and a complaints process people can actually use.
• Well-led: governance you can show, such as a policy review cycle, minuted team meetings, incident learning and a way for staff to raise concerns.

CQC's information for dental providers also links its dental mythbusters, which correct common misunderstandings about what inspectors expect, and guidance on ionising radiation.

What is the CQC well-led framework?

Well-led is the key question about leadership, governance and culture. For dental practices it covers the seven statements listed above, and the evidence comes almost entirely from feedback from staff and leaders and from processes. In other words: can the people running the practice explain how they keep it safe and good, and can they show the systems that do it?

It matters more than its size suggests. When CQC reported on the first year of its dental inspection programme in a 2016 news story, it said most requirement and enforcement actions were associated with the well-led key question, and the most common breach was Regulation 17, good governance. That was a different framework, but governance remains where small practices most often come unstuck, because it is the paperwork that slips when the diary is full.

CQC questions for dental nurses and reception staff

Because feedback from staff and leaders is collected against every dental quality statement, your dental nurses, hygienists and reception team are part of the evidence. CQC does not publish a fixed list of interview questions, so do not rehearse scripts. Instead, make sure each person can talk confidently about the areas closest to their role:

• how they would raise a safeguarding concern, and who the lead is
• what happens in a medical emergency, and where the kit is
• how decontamination works in the surgery they use
• how a complaint is handled, from the first phone call
• how they would raise a concern about the practice itself
• what training and support they have had

CQC changes in 2026: what is changing in the framework

CQC's framework is in transition, so it is worth being precise about what is current.

1. CQC consulted on changes in Better regulation, better care, which closed on 11 December 2025. Its initial response confirmed a move away from a single framework.
2. On 24 March 2026 CQC published four draft sector-specific frameworks, including one for primary care and community services. According to its March update, the five key questions remain, key lines of enquiry framed as structured questions would replace the quality statements, and scoring would be removed. Feedback closed on 12 June 2026.
3. CQC said it would refine the frameworks and pilot them. Its June update set the pilots to run from June to October 2026, alongside normal inspections, with a final evaluation in November 2026, and said pilot judgements have no legal standing. In its 27 August 2026 update it said it was still testing and piloting the draft frameworks, and planned further sector-specific engagement in the autumn.
4. For dental practices specifically, CQC has said it will work with the sectors it does not rate to develop the detail of how it will assess them and which framework it will use.

So, as of CQC's latest published update, assessments of dental practices still run on the current framework, with the quality statements and evidence categories above. Watch CQC's announcements before your next assessment, and do not rebuild your compliance files around a draft.

How to use the key questions to prepare

1. Print the dental evidence category pages and go through each quality statement with your practice manager. For each, write down the evidence you already have.
2. Find the gaps in processes first. An audit that was never repeated, a policy with no review date, a recruitment file missing a check.
3. Brief the whole team on the areas they will be asked about, in their own words.
4. Walk the building as an inspector would, looking at the four observation areas: environment, infection control, medicines and how patients are treated.
5. Read your own patient-facing information, from the website to the leaflets, and correct anything out of date.

If you are also weighing up your local market, our study of NHS dental contract values in England shows how much contract values vary between neighbouring practices, and the features page shows the CQC and NHS view Practice Radar gives of practices near you.