Pillar one
Move
Physical
Strength, balance, mobility and the confidence to keep moving safely at home.
Home / The Programme
The Framework
Five domains of preventative care. One integrated Programme.
The Five Pillars Programme gives a home care business a shared language for everything that shapes whether an older person stays capable, confident and at home, along with a practical way to act on it. Always in the same order: Move, Think, Nourish, Connect, Live.
Most care plans describe what a person can no longer manage. The Five Pillars Programme asks a more useful question at every visit: what capability can still be supported, encouraged and maintained, and who needs to know if it changes?
Why this matters
Why explore a shift to preventative care?
CQC’s draft assessment framework for adult social care, published on 19 March 2026 and currently in draft, puts explicit weight on supporting people to live healthier lives — including physical activity and healthy eating.
It also emphasises being able to evidence outcomes rather than describe activities. Providers who can already measure what the Five Pillars Framework describes will be answering that question before it is asked.
Draft status: This refers to CQC’s draft assessment framework, not a finalised framework.
The five pillars, in order
Each pillar has three dimensions: assess, deliver, evidence
That structure is what stops prevention becoming an aspiration. A pillar only counts if you measure it properly, deliver it inside real visits, and can show what happened.
Pillar two
Think
Cognitive
Noticing cognitive change early and building meaningful engagement into every visit.
Pillar three
Nourish
Nutritional
Nutrition, hydration and appetite: the quiet foundations of everyday capability.
Pillar four
Connect
Social & emotional
Loneliness and emotional wellbeing treated as part of care, not an add on.
Pillar five
Live
Home safety
The home itself: hazards, lighting, equipment and small changes that prevent harm.
Pillar one · Physical
Move
Falls prevention, strength, balance and mobility
- Assess
- Strength and balance are checked properly at the start and reviewed regularly rather than guessed at.
- Deliver
- Safe movement is built into ordinary visits rather than parked in a separate exercise slot.
- Evidence
- Falls rates, mobility trends and admissions data give you something concrete to show.
“We don’t just help people get up after a fall. We help them not fall in the first place.”
Pillar two · Cognitive
Think
Cognitive screening, stimulation and meaningful engagement
- Assess
- Simple, structured screening at onboarding and at intervals, so change is spotted rather than assumed.
- Deliver
- Brief cognitive engagement woven into every visit: orientation, conversation prompts and memory activities.
- Evidence
- Score trajectories and referral rates show whether early detection is genuinely happening.
“Every visit is an opportunity to notice, engage and intervene early.”
Pillar three · Nutritional
Nourish
Nutritional screening, hydration and malnutrition prevention
- Assess
- Recognised nutritional screening at onboarding, with regular weight monitoring afterwards.
- Deliver
- Fortified plate protocols, hydration monitoring and meal observation during ordinary visits.
- Evidence
- Screening score trends and weight trajectories, with clear escalation to clinical colleagues.
“Malnutrition affects around one in ten older people in the UK.”
Pillar four · Social & emotional
Connect
Loneliness screening, emotional wellbeing and social connection
- Assess
- Loneliness and social network screening treated with the same seriousness as physical risk.
- Deliver
- Connection plans: structured social activity, community referrals and genuine interaction on visits.
- Evidence
- Loneliness score trajectories and the community referrals your team has actually made.
“Companionship is not a service add on. It is part of the care itself.”
Pillar five · Home safety
Live
Environmental risk, hazard identification and assistive technology
- Assess
- A structured environmental assessment of the home at onboarding, not a glance on the way in.
- Deliver
- A quick hazard scan at every visit covers rugs, lighting, clutter and rails, and gets recorded.
- Evidence
- Incident rates, hazard resolution times and the environmental improvements you made.
“Every home has risks. The question is whether anyone is looking for them.”
What changes in practice
The difference a family would actually notice
Assessment gets specific
Instead of a single general review, each pillar has a recognised starting measure and a review interval, so change is visible rather than anecdotal.
Visits carry more purpose
Prevention is folded into the visit that was already happening. No separate sessions, no new delivery team, no extra software.
Escalation becomes routine
Carers know what they are looking for and exactly who to tell, so concerns reach the right professional earlier.
Claims become evidence
You end up with a record of what you promised, what you did and what changed. This is useful for families, commissioners and regulators alike.
Boundaries
What the Programme is not
- Not a medical treatment plan
- Not a rehabilitation service
- Not a substitute for clinical advice
- Not a replacement for your safeguarding processes
- Not a piece of software you have to buy
- Not a promise of a particular commercial result
It is designed to strengthen preventative everyday care for generally well older adults, alongside the right professional input whenever a person's needs require it.
Where to go next
Putting the Programme to work
For care providers
Build it into your service
Three routes, a coached Programme and a set of practical tools for owner led home care businesses.
EverFit: Move in practice, expanding to Nourish
Add EverFit: Move in practice
EverFit began as the Move pillar in practice: a structured strength, balance and mobility Programme your own carers deliver. It is expanding to cover other pillars, starting with Nourish.
See where your business sits across the five pillars
A Personalised Sameness Report shows how your service reads next to every other provider in your local market.