Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Resident Full Name
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Date of Birth
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Room Number
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Has an Initial Care / Support Needs Assessment been 'Fully' completed?
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Please Complete Immediately
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Was a Pre-Admission visit conducted?
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Where did the visit take place?
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Has a Resident Inventory form been completed?
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Please Complete Immediately
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Has the Resident visited the Home before?
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Does the Resident have a Personal File?
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Has a 'Key Worker' been assigned?
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Name of Staff Member:
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Who will be apponted?
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Is the Key Worker on Duty during admission?
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Ensure they spend time with the Resident to settle them.
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Arrange for them to spend time during their next available shift and confirm this with the Resident.
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Has they been introduced to other residents?
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Have they been introduced to other Staff?
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Has a care and Support Plan been established based on the initial Assessment?
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Start to complete Form 063 with immediate effcet.
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Is their GP aware of the Service provision?
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Please contact GP immediately and Record in Care Notes.
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Have they arrived with any Medication?
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Will they be Self-Medicating?
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Is a Medication Self-Assessment Form completed
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Complete a Self-Medication Assessment Form immediately and record in the Care Notes.
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Has this been entered onto a MAR Sheet?
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Complete this immediately and Record in the Care Notes.
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Are there any Dietary considerations?
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Enter the details on Form 066 and Record in Care Notes and Care Plan.
Ensure the kitchen is informed following the correct procedure. -
Have Cultural and Religious preferences been discussed?
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Check the information is recorded correctly in the Care Plan.
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Has the Residents Register been updated?
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Please update the Register immediately.
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Have they been given a copy of the Contract of Services and facilities provided?
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Has it been signed by the Resident or their Representative?
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Ensure it is signed immediately.
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Have they received a Statement of Purpose?
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Give a copy of the Statement of Purpose now and tick to confirm.
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Have they received a copy of the Complaints Procedure and Forms?
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Give copies now and tick to confirm.
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Have they given consent for their photograph to be used on the front of their folder?
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Complete to consent form now and tick when done.
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If not 'Privately Funded', is there a Funding Agreement in place?
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Bring this to the attention of the Manager without delay.
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Do they have any allergies?
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Are the correct details recorded in the Initial Needs Assessment and Care Plan?
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Record the details immediately and tick the box when complete.
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Do they currently receive visits from Community Nursing Service?
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Are the correct details recorded in the Initial Needs Assessment and Care Plan?
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Record the details immediately and tick the box when complete.
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Do they have any Mobility Aids / Needs?
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Are they detailed in the care Plan and Specific risk Assessments completed?
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Complete the relevant forms immediately and tick the box when done.
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Do they require the use of a Hoist?
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Is there a suitable Sling available?
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Notify the Manager immediately and tick the box when done.
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Only Sign when form is completed.
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Signature:
