The 6 Cs of care explained: care, compassion, competence and more

The 6 Cs of care are care, compassion, competence, communication, courage and commitment: six values launched by NHS England in December 2012 as part of Compassion in Practice, a three-year strategy for nursing, midwifery and care staff. They are not law, but they are widely used in training and give families a practical way to judge the culture of a service.

At a glance

• Launched on 4 December 2012 in Compassion in Practice, by the Chief Nursing Officer for England and the Department of Health’s Director of Nursing.
• Intended for nursing, midwifery and care staff across the NHS, public health, and care and support.
• NHS England’s 2016 framework, Leading Change, Adding Value, builds on Compassion in Practice. We found no later replacement for the six values.
• The 6 Cs are values, not regulations. CQC judges services against the fundamental standards, which overlap with them.
• Families can turn each C into a question to ask on a visit.

What are the 6 Cs and where do they come from?

The 6 Cs were published on 4 December 2012 as the core of Compassion in Practice, described by the Department of Health as a three-year vision and strategy for building a culture of compassionate care. The strategy was launched by Jane Cummings, then Chief Nursing Officer for England, and Viv Bennett, Director of Nursing at the Department of Health, at the Chief Nursing Officer’s annual conference in Manchester.

It applied to nursing, midwifery and care staff across the NHS, public health, and the care and support system. In 2016 NHS England published a new framework, Leading Change, Adding Value, which it says builds upon Compassion in Practice. A later NHS England document on what the framework means for social care still presents the 6 Cs as the shared values for staff across health and social care. We did not find any announcement replacing them.

Compassion in Practice also set six action areas: helping people stay independent and improve wellbeing, working with people to provide a positive experience of care, delivering high-quality care and measuring impact, building leadership, ensuring the right staff with the right skills in the right place, and supporting positive staff experience.

What does each of the 6 Cs mean?

NHS England’s own descriptions are short. The table below gives them in our words, alongside what a family might notice.

Do the 6 Cs apply in social care and care homes?

Yes, as values rather than rules. NHS England’s social care document notes that about 49,500 nurses work in social care and that 85 per cent of them work in care homes with nursing, and says the 6 Cs are meant to help people say they receive caring, compassionate support delivered by competent people.

What care homes must do by law is set by the fundamental standards under the Health and Social Care Act 2008, which CQC inspects against. Several echo the 6 Cs:

• Regulation 10 (dignity and respect) reflects compassion.
• Regulation 12 requires staff to be qualified, competent and experienced, which is competence in legal form.
• Regulation 9 (person-centred care) requires providers to help people understand options and take part in decisions, which is communication.
• Regulation 20 (duty of candour) requires openness when things go wrong, and whistleblowing law protects people who raise concerns, which is courage.
• Regulation 17 (good governance) expects providers to monitor and improve quality and act on feedback, which is commitment.

See our guides to person-centred care, duty of care in social care and what the CQC is for how those standards work in practice.

How can you use the 6 Cs when choosing care?

The values are easiest to judge through specific questions. When you visit a home or interview an agency, try:

• Care: “Can you show me how a care plan was changed because of what a resident wanted?”
• Compassion: “How do you support someone who is distressed or frightened?” and watch how staff speak to residents.
• Competence: “What training do staff have in dementia, nutrition and medicines, and how is it checked?”
• Communication: “How and when will you update the family, and how do residents with sight or hearing loss get information?”
• Courage: “What happened the last time something went wrong, and what changed afterwards?”
• Commitment: “How long have the manager and key staff been here, and how often are care plans reviewed?”

Combine your impressions with the evidence. Check the latest CQC inspection report, and use our wider list of questions to ask when visiting a care home.

Where do the 6 Cs fit for new care workers?

For anyone starting out in care, the 6 Cs are a useful summary of what employers and inspectors expect. The Care Certificate, the introductory standards for non-regulated care staff, covers the same ground through standards on duty of care, equality and diversity, person-centred working, communication, privacy and dignity, safeguarding and more.

In practice that means learning the person’s preferences, speaking up when something is wrong and staying within your training. In an interview, giving a real example for each C is stronger than reciting the list.

Frequently asked questions

What are the 6 Cs of care?

They are care, compassion, competence, communication, courage and commitment. NHS England launched them in December 2012 as the values underpinning Compassion in Practice, a strategy for nursing, midwifery and care staff.

Who created the 6 Cs?

They were launched by Jane Cummings, then Chief Nursing Officer for England, and Viv Bennett, Director of Nursing at the Department of Health, as part of Compassion in Practice.

Are the 6 Cs a legal requirement for care homes?

No. They are values, not regulations. Care homes in England must meet the fundamental standards inspected by CQC, such as dignity and respect, safe care and duty of candour, which overlap with the 6 Cs.

Are the 6 Cs still used?

Yes. NHS England’s later framework, Leading Change, Adding Value, builds on Compassion in Practice, and a 2017 NHS England document on social care presents the 6 Cs for staff across health and social care. We did not find an announcement replacing them.

What is the difference between care and compassion in the 6 Cs?

Care is the core purpose: getting the support right for the individual. Compassion is how it is delivered: through relationships built on empathy, respect and dignity, sometimes described as intelligent kindness.

Where to get help next

To see how a home performs, read CQC ratings explained and compare local services with our care finder. If you are worried about the standard of care someone is receiving, see how to complain about a care home.

Sources

• GOV.UK: Top nurses announce new strategy to build culture of compassionate care across the NHS
• NHS England: Compassionate care strategy launch
• NHS England: Compassion in Practice, one year on
• NHS England: Leading Change, Adding Value
• NHS England: Leading Change, Adding Value, what it means for social care
• Skills for Health: The Care Certificate standards

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.