Care Home Audits – What are the Key Principles to Follow

Care Home Audits – What Are the Benefits and Why Are They Necessary  

Social care aims to maintain or improve the quality of people’s lives and well-being through empowerment and personalisation.

To understand the true success of social care practice and the things you can do to improve it, care audits must be undertaken to measure outcomes and to check that services are working for service users. Some of the benefits include supporting: 

• Outcomes for the supported person 
• Safety 
• Staff development
• Business efficiency and effectiveness
• Personalisation of services
• Service Integration 
• Protecting and enhancing ratings with regulators

Managers, staff, service users and regulators must know that their policies and procedures that point the service in the right direction are functioning as intended. Audit reports offer written evidence to staff and service users of the performance of a care service and compliance with standards.

Auditing evidence can be given to your independent health and social care regulator as proof that the service is compliant and running as it should be.  

Typically, robust care home audits will align closely with the standards frameworks of their regulator (such as the CQC in England, the Care Inspectorate in Scotland and so on). Using the criteria that inspectors from these regulators use to assess care services gives you a structured way of auditing your service.

It also gives a clear idea of what is considered very good, good, or poor and acceptable, or unacceptable in any area, for example, the environment of the care home itself, or your care planning processes. 

Care Home Audits – What Are the Key Audits You Need to Carry Out 

Whether you are an auditor or a manager, the key audits that need to be carried out must be fully understood. The stages include planning and preparation, reviewing quality, improving practice, and sustaining improvement. Below is a closer look into the basic steps of conducting an internal audit: 

• Identify the areas that need auditing – This should cover all areas of planning, delivering, and recording care, including the supported person, staff, environment, and observations.
• Determine the frequency of auditing – Some areas may only need to be audited on an annual basis to ensure compliance, so audit schedules should be risk-based. 
• Create an audit calendar – It is essential to schedule and track the completion of audits, so assurances (positive and negative) are available to inform quality improvement and influence the frequency of future audit schedules
• Make your staff aware of scheduled audits – Give your team notice of any audits so they can get the necessary documents and materials prepared for the auditor.
• Always be prepared – Prepare your staff for audits and inspections by practising and coaching.
• Interview your staff – An auditor should interview the staff and test their understanding of why they do things they are required to do (I.e., Infection Control best practice, safeguarding, moving, and handling, etc.
• Document the results – Findings must be recorded by the auditor, clearly highlighting areas for improvement and associated actions. 
• Reporting any findings – Auditors must create an audit report that is easy to understand. This should be reviewed with senior management. As a result, this will lead to the improvement and development of a care service.

After an audit, the risks to the service must be considered. These may include reputation, operational, compliance, strategic, legal and/or IT risks. The implementation of the manager’s improvement plan should be monitored. A follow-up audit is also recommended, as this will help ensure that any improvements put in place are working as intended and that the service is now compliant with their independent health and social care regulator.  

What Are the Key Principles to Follow in a Care Home Audit?  

The key to robust auditing is to make sure that the person conducting an audit is competent to do so and has the right questions and prompts to follow and undertake a thorough assessment.  They must review evidence, this might come from observation of practice, review of policies, procedures, and documentation (written or digital) and feedback from the supported person, staff, and the senior team, as well as external stakeholders (commissioners, visiting professionals, and visitors). 

Care Home Audit Checklist 

To help improve practices for service users across the UK, we have written a daily care home audit checklist as an example. This covers essential care home aspects that should be audited daily, including rotas, meals, cleanliness, medication charts and more. Please note that this checklist is only a suggestion and should be amended to meet the needs of your service users, your local guidelines and accepted best practices.  

Daily Care Home Audit - Task	Circle Response	Photo and/or Comment
Does the rota reflect the staff on duty?	Yes No N/A
Are shifts covered for the day shift?	Yes No N/A
Are shifts covered for the night shift?	Yes No N/A
Is the handover sheet complete/available?	Yes No N/A
Has the care home cleaning schedule been completed?	Yes No N/A
Have the kitchenettes been checked and cleaned?	Yes No N/A
Have clinical waste bins been stored appropriately?	Yes No N/A
Are laundry bins stored appropriately?	Yes No N/A
Have dishwashers and fridges been checked and cleaned?	Yes No N/A
Are the rooms of residents clean and in order?	Yes No N/A
Are call bells accessible to residents in all areas?	Yes No N/A
Is an appropriate response time to call bells achieved?	Yes No N/A
Have the dates and storage of medication been checked?	Yes No N/A
Spot check that 3 residents’ topical MAR (Medication Administration Records) charts are complete.	Yes No N/A
Has the fridge and room temperature been checked for the day?	Yes No N/A
During mealtimes, have tables been set correctly?	Yes No N/A
In general, are staff assisting residents appropriately?	Yes No N/A
Have modified texture diets been served appropriately?	Yes No N/A
Do meals correspond to the menu?	Yes No N/A
Have meals been checked (temperature and taste)?	Yes No N/A

Care Home Compliance Audits 

In addition to regular care audits conducted in a home, there are also ‘compliance audits’, which should be designed to identify and compare the ways of working in a service against the 2014 Regulations (The Health and Social Care Act 2008 – Regulated Activities), and the standards of your national regulator, as well as Health and Safety regulations. These should be used to create objective and comprehensive appraisals of how your care service is running.  

Care home compliance audits should be designed to assure the Registered Manager and Senior Team that the service is safe and compliant, that any areas of risk are effectively mitigated, or that there are actions in place to mitigate them, which are actively monitored. 

Care Home Audit Tools  

Care home audits are an essential measuring tool that brings a significant benefit to managers of all types of care services. This evaluation of a service's performance provides management with the information they need to decide whether the policies and procedures of a service are functioning as intended.

This ensures standards of the service and the needs and expectations of people requiring care are being met. To help simplify this process, you should consider using care home audit tools.  

Here at The Access Group, we believe that care compliance software will help you improve care quality compared to manual auditing. It enables a consistent and tracked schedule of auditing to be deployed, tracked, action planned and monitored to deliver better outcomes, improved compliance, and more efficient governance processes, giving providers the freedom to deliver outstanding care.  

Our care compliance software aims to make your audits more systematic and effective while increasing compliance. Some of the advantages of our digital care home audits are that they can be personalised to meet the needs and requirements of your care service and include templates to get you started, they have built-in reporting and analytics, and they can be conducted through our mobile app.  

Access Care Compliance is deployed by providers in England, Scotland, Wales, and Northern Ireland to help them achieve their quality goals and achieve positive regulatory compliance outcomes. Please get in touch with us today to learn more or book a demo.