The 6 C’s of care are Care, Compassion, Competence, Communication, Courage and Commitment. They are a set of professional values first published by NHS England in its “Compassion in Practice” strategy in December 2012, under the then Chief Nursing Officer Jane Cummings. Despite how often they are taught, the 6 C’s are not a law and not a Care Quality Commission (CQC) regulation, and they are not the same thing as the Care Certificate. They are a shared statement of the values and behaviours that good care is built on, and although they began life in a nursing and midwifery strategy they are meant for everyone in health and social care, not only nurses.
At a glance: Nexis CPD’s £9 Care Certificate course introduces the values and behaviours behind the 6 C’s and how they fit the wider standards new care workers are expected to meet. It is CPD accredited and 100% online with a verifiable e-certificate, and any three courses cost £18. It is awareness training, not a regulated qualification or a substitute for workplace competency sign-off.
What are the 6 C’s of care?
The 6 C’s are six words, each beginning with the letter C, that together describe the values expected of people working in health and social care. They are:
- Care — helping the individual person and improving the health of the whole community, delivered consistently at every stage of a person’s life.
- Compassion — care given through relationships based on empathy, respect and dignity, sometimes described as “intelligent kindness”.
- Competence — having the knowledge, skills and expertise to understand a person’s health and social needs and to meet them effectively.
- Communication — listening as much as talking, so there is “no decision about me without me”, and working well as a team.
- Courage — doing the right thing for the people we care for and speaking up when something is wrong.
- Commitment — a sustained dedication to improving the care and experience of the people we support.
A point that is easy to miss: NHS England was explicit that “each of these values and behaviours carry equal weight. Not one of the 6Cs is more important than the other five.” They are not ranked, and they are not a checklist to tick once. They are meant to sit behind every interaction, with the person being cared for at the centre. If you are new to the sector, the clearest way to see the 6 C’s in action is through the everyday work described in our guide to person-centred care.
Where did the 6 C’s of care come from?
The 6 C’s did not come from Parliament or from a regulator. They came from a strategy document. In December 2012, NHS England and the Department of Health published Compassion in Practice: Nursing, Midwifery and Care Staff — Our Vision and Strategy, led by Jane Cummings, who was then the Chief Nursing Officer for England. The document set out a three-year vision for compassionate care, and at its heart were six fundamental values that it called the 6Cs.
The timing matters. Compassion in Practice was written in the aftermath of serious, public failures in care, most notably at Mid Staffordshire NHS Foundation Trust, where the subsequent Francis Inquiry described a culture that had lost sight of patients as people. The 6 C’s were part of the response: a deliberately simple, memorable way to restate the values that should never have been allowed to slip. As the strategy itself put it, the values and behaviours “are not, in themselves, a new concept”, but setting them out together gave staff “an easily understood and consistent way” to explain their values and to hold themselves to account.
Because they were published in a nursing and midwifery strategy, the 6 C’s are still often described as “the 6 C’s of nursing”. That label is understandable but too narrow. The strategy was aimed at nursing, midwifery and care staff from the start, it said plainly that “the 6Cs are relevant to all staff”, and in the years since they have been adopted far more widely across health and social care, including by care homes, home care agencies and support services that employ no nurses at all.
What does each of the 6 C’s mean?
The definitions below are NHS England’s own words from Compassion in Practice, with a concrete care example for each so you can see what the value looks like on a normal working day.
Care
Care is described as “our core business” — the help we give that improves an individual’s life and the health of the wider community, delivered consistently throughout every stage of a person’s life. In practice this is the quiet reliability of good care: the person who is helped to wash, dress and eat in the way they prefer every single day, not just when someone remembers. It is care that is right for that person, repeated dependably, rather than an occasional good deed.
Compassion
Compassion is defined as how care is given “through relationships based on empathy, respect and dignity”, and the strategy memorably calls it “intelligent kindness”. The “intelligent” part matters: compassion is not just feeling sorry for someone, it is acting on that feeling in a way that actually helps. A care worker who notices a resident is withdrawn, sits with them, finds out they are grieving a late spouse and adjusts their day accordingly is showing compassion, not just sympathy. Protecting someone’s dignity in care is compassion made practical.
Competence
Competence means everyone in a caring role must have “the ability to understand an individual’s health and social needs” and the expertise and knowledge to meet them, based on evidence. This is the C that reminds us good intentions are not enough. A carer who moves a person without the correct moving-and-handling technique can injure them however kind they are. Competence is knowing how to use equipment safely, recognising when someone is deteriorating, following a care plan correctly, and knowing the limits of your own role and when to ask for help.
Communication
Communication is “central to successful caring relationships and to effective team working”, and the strategy stresses that “listening is as important as what we say and do”. It ties communication to the principle of “no decision about me without me”. In practice this is checking what a person wants rather than assuming, explaining what you are about to do before you do it, and writing clear handover notes so the next shift knows what happened. Poor communication is behind a large share of care complaints and safeguarding incidents, which is why this C carries as much weight as clinical skill.
Courage
Courage “enables us to do the right thing for the people we care for, to speak up when we have concerns”. This is the C that connects the 6 C’s to whistleblowing and safeguarding. It takes courage for a junior care worker to challenge a senior colleague who is cutting corners, or to report that a resident has an unexplained bruise. Courage also means having the confidence to try better ways of working. It is closely tied to a worker’s duty of care, which can require you to raise a concern even when it is uncomfortable.
Commitment
Commitment is described as “a cornerstone of what we do” — a dedication to improving the care and experience of the people we support and to meeting the challenges ahead. On the ground this looks like keeping going on a hard shift without letting standards drop, keeping your training up to date, and staying focused on the person rather than the task. Commitment is what turns the other five C’s from a one-off effort into a consistent standard that a person can rely on year after year.
Are the 6 C’s of care a law or a CQC requirement?
No. This is the single most common misunderstanding, and getting it right matters because people conflate three different things. The 6 C’s are values. They are not legislation, and no one can be prosecuted or have their service closed simply for “breaching a C”. What can be enforced are the CQC fundamental standards, which are a separate thing entirely.
The fundamental standards are, in the Care Quality Commission’s words, “the standards below which your care must never fall”. They are legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and they cover things such as person-centred care, dignity and respect, consent, safety, safeguarding, good governance and staffing. Because they are law, the CQC can and does take enforcement action against providers that fail to meet them, up to and including prosecution and cancelling a provider’s registration.
So how do the two relate? Think of the 6 C’s as the culture and the fundamental standards as the floor. The values describe the attitude and behaviour that produce good care; the regulations set the minimum that the law will accept, and give the regulator teeth. A service can meet the letter of the regulations while still lacking compassion, and it is possible to live the 6 C’s enthusiastically while still breaching a regulation through, say, poor record-keeping. Good providers use the values to lift practice well above the regulatory floor. The 6 C’s are also reflected in the professional codes of regulated staff — the Nursing and Midwifery Council’s Code, for example, is built around prioritising people, practising effectively, preserving safety and promoting professionalism and trust, which map closely onto the same values.
How are the 6 C’s different from the Care Certificate?
This is the second common mix-up. The Care Certificate is not the 6 C’s either. It is an agreed set of 16 standards (expanded from 15 in March 2025, when a new Standard 16 on learning disability and autism awareness was added) that new health and social care workers are expected to meet during their induction, covering topics such as duty of care, equality and diversity, privacy and dignity, safeguarding, basic life support and infection control. It was introduced in 2015 following the Cavendish Review and was developed by Skills for Care, Health Education England and Skills for Health. You can read more in our guide to what the Care Certificate is, and Skills for Care publishes the full standards on its Care Certificate pages.
The difference is one of purpose. The 6 C’s are values that apply across a whole career; the Care Certificate is a structured induction benchmark that confirms a new worker has the basic knowledge and skills to practise safely. The two overlap — the Care Certificate standards are shot through with the same values, and compassion, communication and competence run all the way through them — but they are not interchangeable. You demonstrate the 6 C’s; you complete the Care Certificate. One is a mindset, the other is a measurable set of standards with assessment.
It is also worth being honest about what the Care Certificate is not. It is an induction standard, not a regulated qualification in its own right, and it does not replace a diploma, an NVQ or professional registration. The same is true of short CPD awareness courses, including ours: they are useful for understanding and evidencing values like the 6 C’s, but they are not equivalent to a vocational qualification or to competency sign-off in your actual workplace.
Who do the 6 C’s of care apply to?
Everyone involved in care. The label “6 C’s of nursing” sticks because of where they were born, but Compassion in Practice stated directly that “the 6Cs are relevant to all staff, and should be embedded throughout career pathways”. In the years since, they have become a common language across the sector.
In practice that means they apply to healthcare assistants and support workers, to care home and domiciliary care staff, to allied health professionals, to administrative and ancillary staff who come into contact with people using services, and to managers and leaders whose job is to create the conditions for compassionate care. A kitchen assistant who notices a resident has stopped eating and quietly flags it is showing care, communication and courage just as much as a registered nurse would. The values do not belong to any one profession.
For employers, the 6 C’s are a useful framework for recruitment, induction, supervision and appraisal, because they give a shared vocabulary for talking about behaviour and culture rather than just tasks. For individual workers, they are a simple self-check: at the end of a shift, you can ask honestly whether your work showed each of the six. That everyday reflection, rather than a certificate, is where the 6 C’s actually live.
How do you demonstrate the 6 C’s in practice?
Because the 6 C’s are values rather than tasks, demonstrating them is about consistent behaviour, not a single grand gesture. Some practical examples for each, drawn from ordinary care work:
- Care: following each person’s care plan properly and keeping standards the same on a busy day as on a quiet one.
- Compassion: noticing when someone is anxious, frightened or lonely and responding to the person, not just the task in front of you.
- Competence: keeping your mandatory training current, using equipment correctly, and asking for help when something is outside your knowledge.
- Communication: explaining what you are about to do and why, checking the person’s wishes, and writing accurate records and handovers.
- Courage: raising a safeguarding concern, challenging poor practice, and being honest when something has gone wrong.
- Commitment: turning up reliably, reflecting on your practice, and staying focused on the people you support rather than on getting through the list.
Supervisors can make the values concrete by using them as the structure for one-to-one meetings and appraisals, asking staff to describe a recent example of each. Many employers also weave the 6 C’s into values-based recruitment, hiring for attitude as well as skills on the basis that competence can be taught more easily than compassion. The common thread is that the 6 C’s work only when they are reflected on and talked about regularly, not printed on a poster and forgotten.
Which courses help you put the 6 C’s into practice?
These three £9 courses work well together for care workers, senior carers, induction programmes and anyone who wants to put the values of the 6 C’s into practice, each with a verifiable certificate:
- Care Certificate — the induction knowledge new care workers are expected to have, with the 6 C’s running through it.
- Dignity in Care — putting compassion, respect and privacy into everyday practice.
- Person-Centred Care — keeping the individual at the heart of their care, which is exactly what the 6 C’s are designed to do.
Any three courses cost £18 with the pay-for-2-get-3 offer. Add them to the cart and the discount applies automatically. These are awareness courses: CPD accredited, but not regulated qualifications, and not a substitute for hands-on competency sign-off in the workplace.
Learn the values behind good care
Nexis CPD’s Care Certificate course gives new and existing care workers a clear, plain-English grounding in the values and behaviours behind the 6 C’s and how they fit the wider standards expected in health and social care.
£9 per course. CPD accredited, 100% online, verifiable e-certificate. Pay for 2, get 3 — any 3 courses for £18. It is awareness training to support your development and induction, not a regulated qualification or a replacement for workplace competency assessment.
Frequently asked questions
What are the 6 C’s of care?
The 6 C’s of care are Care, Compassion, Competence, Communication, Courage and Commitment. They are a set of professional values first set out by NHS England in its Compassion in Practice strategy in December 2012. NHS England stated that each of the six carries equal weight and that none is more important than the others.
Who created the 6 C’s of care and when?
The 6 C’s were introduced by NHS England and the Department of Health in the Compassion in Practice strategy, published in December 2012 and led by Jane Cummings, the Chief Nursing Officer for England at the time. The strategy was partly a response to well-publicised failings in care, including those examined by the Francis Inquiry into Mid Staffordshire.
Are the 6 C’s the same as the CQC fundamental standards?
No. The 6 C’s are values and are not legally enforceable. The CQC fundamental standards are legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and the Care Quality Commission can take enforcement action against providers who fail to meet them. The values describe the culture of good care; the regulations set the legal minimum.
Are the 6 C’s only for nurses?
No. Although they first appeared in a nursing and midwifery strategy, Compassion in Practice said the 6 C’s are relevant to all staff. They apply across health and social care, including healthcare assistants, support workers, care home and home care staff, allied health professionals and managers, not only registered nurses.
What is the difference between the 6 C’s and the Care Certificate?
The 6 C’s are values that apply across a whole career, while the Care Certificate is a set of 15 induction standards that new health and social care workers are expected to meet, introduced in 2015 and developed by Skills for Care, Health Education England and Skills for Health. The same values run through the Care Certificate, but the two are not the same: you demonstrate the 6 C’s and you complete the Care Certificate.
This article is general information about the 6 C’s of care in the UK and is not legal advice. Regulatory duties depend on your role, your employer and your professional registration. For advice on a specific situation, consult your manager, your professional regulator or a qualified professional, and refer to current CQC guidance and the relevant legislation.