Last updated: 28 October 2026 ยท Written by Laxmi Hanji, dental compliance consultant
Every CQC inspection of a dental practice comes back to five questions. Is the practice safe? Is it effective? Is it caring? Is it responsive? Is it well-led? Inspectors may phrase things differently on the day, and the CQC’s assessment framework has changed more than once, but these five questions have stayed the same since 2014.
If you understand what sits behind each one, you can prepare for an inspection properly instead of guessing. This guide explains the CQC key questions in plain terms for dental teams, with the evidence inspectors usually expect to see under each heading.
The five CQC key questions at a glance
| Key question | What it means in a dental practice | Main regulations |
|---|---|---|
| Safe | Patients and staff are protected from avoidable harm and abuse | Regulation 12 (safe care and treatment), 13 (safeguarding), 15 (premises and equipment) |
| Effective | Care is based on current evidence, gets good outcomes and is delivered by competent staff | Regulation 11 (consent), 18 (staffing) |
| Caring | Patients are treated with kindness, dignity and respect, and are involved in decisions | Regulation 9 (person-centred care), 10 (dignity and respect) |
| Responsive | The service meets people’s needs, including access, adjustments and complaints | Regulation 9, 16 (complaints) |
| Well-led | Leadership and governance make sure care is high quality and the culture is open | Regulation 17 (good governance), 19 (fit and proper persons employed), 20 (duty of candour) |
Safe
This is where inspectors spend a lot of their time in dental practices, because so much of a practice’s risk sits here. They want to see that you have identified the risks in your building and your clinical work, and that you control them.
Evidence they commonly look at:
- Decontamination records and six-monthly infection control audits under HTM 01-05
- Emergency drugs, oxygen and AED checks, usually weekly (see our guide to medical emergencies in dental practice)
- Radiation protection file, local rules and X-ray equipment testing
- Fire, COSHH, sharps and Legionella risk assessments
- Safeguarding policy, a named lead and staff training
- Recruitment records for every team member, including DBS checks and Hepatitis B immunity for clinical staff
A practical test: if an inspector picked any member of staff at random, could they tell you who the safeguarding lead is and where the emergency kit is kept? If not, that is a gap worth closing before anything else.
Effective
“Effective” is about whether the care you provide actually works and follows current guidance. For a dental practice that usually means clinical records, consent and the competence of the team.
- Clinical records: complete notes, updated medical histories, and record-keeping audits
- Consent: options, risks, benefits and costs discussed and written down. The Mental Capacity Act 2005 applies where capacity is in doubt.
- Evidence-based care: use of current guidance on prevention, recall intervals and antimicrobial prescribing
- Training and CPD: a training matrix showing who has done what and when it is due again
- Referrals: a way of tracking urgent and routine referrals so none get lost
Caring
Caring is the question practices worry about least, and it is rarely where problems are found. Inspectors look for signs that patients are treated as individuals.
- Patient feedback, such as surveys, online reviews and comment cards, and what you did with it
- Privacy at reception, closed surgery doors during treatment and secure handling of records
- How the team supports nervous or vulnerable patients
Inspectors may also speak to patients on the day or read comment cards sent to the practice beforehand.
Responsive
Responsive means the service is organised around the people who use it. In dentistry that comes down to access and complaints.
- Clear opening hours, emergency appointment arrangements and out-of-hours information
- Reasonable adjustments, such as step-free access or an alternative, a hearing loop and interpreter services
- A complaints policy patients can find easily, a complaints log, and evidence that you learned from complaints (Regulation 16)
Well-led
If you only have time to focus on one key question, make it this one. In its Dental Mythbuster 27, the CQC says most breaches of regulation are found under well-led. That is because well-led is where your systems are checked: policies, audits, oversight and culture.
What inspectors look for:
- Practice-specific policies and procedures that are in date and that staff have read
- Named leads for infection control, safeguarding, radiation protection, data protection, fire and first aid
- An audit programme with action plans and re-audits
- Team meeting minutes that show learning from incidents and complaints
- Whistleblowing and duty of candour policies
- Information governance, including GDPR policies and a breach log
- An accurate statement of purpose and correct registration details
The same mythbuster points out that a practice does not need a written business strategy or a written modern slavery policy to show it is well-led. What matters is that the systems you do have work.
How the CQC key questions relate to the fundamental standards
The five key questions are how the CQC organises its assessment. The legal requirements behind them are the fundamental standards, set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. When an inspector finds a problem, the report will link it to a specific regulation, for example Regulation 17 for governance or Regulation 12 for safe care. Knowing which regulation sits under each key question makes inspection reports much easier to read. Our guide to CQC compliance for dental practices lists all the fundamental standards.
Are the CQC key questions changing?
In 2026 the CQC consulted on new draft assessment frameworks for different sectors, including primary care and community services, which covers dentistry. The drafts propose bringing back key lines of enquiry in place of the current quality statements. The five key questions themselves are not going away. If your evidence is organised under safe, effective, caring, responsive and well-led, you will be in a good position whatever the final framework looks like.
Organising your evidence
A simple way to prepare is to create five folders, physical or digital, one for each key question. Put the relevant policies, logs, audits and certificates in each. When an inspector asks for something, you know exactly where it is. Our dental CQC inspection checklist lists the documents to include under each heading, and the CQC dental mythbusters show how inspectors interpret the rules.
Common questions
Do dental practices get a CQC rating for each key question?
No. Dental practices are not rated. The inspection report says whether the practice meets the regulations or not, and explains any concerns under the relevant key question.
Which of the CQC key questions causes most problems for dental practices?
Well-led. The CQC says most breaches of regulation are found there, usually because of gaps in governance, audits or oversight rather than poor clinical care.
Does every key question carry equal weight?
Each one is assessed, but in practice inspectors spend more time on safe and well-led in dental settings, because that is where most of the risk and most of the paperwork sits.
Want an outside view of where your practice stands against the five key questions? Our CQC inspection preparation service includes a full review, or read more about ongoing CQC compliance support for dental practices.
General information only, not legal advice. Check the latest CQC guidance for your practice.
