Audit Template

• Service Name

• Address
  Address

• Service Manager

• Operations Manager

• Managing Director

• Conducted on

  Date

• Prepared by

Inspection

• Are traffic routes/parking facilities suitable for vehicle and pedestrians?

  Compliant

  Non-Compliant

  N/A

• Is there sufficient external lighting?

  Compliant

  Non-Compliant

  N/A

• Are there gritting facilities available at site?

  Compliant

  Non-Compliant

  N/A

• What condition are external walkways in?

  Good

  Fair

  Poor

  N/A

• Are all external handrails available at all sloped edges/steps?

  Compliant

  Non-Compliant

  N/A

• Is there adequate refuse facilities available (with secure clinical bins where applicable)?

  Compliant

  Non-Compliant

  N/A

• What condition are the grounds being maintained in?

  Good

  Fair

  Poor

  N/A

• Are external grounds suitably secured (including workshops/garages/storage areas)?

  Compliant

  Non-Compliant

  N/A

• Is the building structure free of any obvious defects or problems (i.e. damaged windows, loose drainpipes, damaged/unsecured roof tiles, etc)?

  Compliant

  Non-Compliant

  N/A

• Has a structural condition survey been carried out for any large trees in grounds?

  Compliant

  Non-Compliant

  N/A

• Are there adequate security arrangements at the premises?

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to exterior safety? (please detail below)

  Compliant

  Non-Compliant

  N/A

• Are there adequate toilet/washing/changing facilities for personnel?

  Compliant

  Non-Compliant

  N/A

• Is there sufficient drinking water available for all persons?

  Compliant

  Non-Compliant

  N/A

• If cold water machine available at site – Is there evidence of 6 monthly sanitisation in place?

  Compliant

  Non-Compliant

  N/A

• If the workplace is uncomfortably warm/cool, have measures been taken to ensure reasonable comfort?

  Compliant

  Non-Compliant

  N/A

• Where smoking facilities are provided for both colleagues/people we support, is the environment signed/adequately ventilated/controlled?

  Compliant

  Non-Compliant

  N/A

• Is indoor lighting sufficient in all areas?

  Compliant

  Non-Compliant

  N/A

• Are changes in internal floor levels marked clearly (e.g. steps between floors/handrails fitted where necessary)?

  Compliant

  Non-Compliant

  N/A

• Are restricted access areas secure (i.e.: boiler/plant rooms, electric panels, chemical cupboards)?

  Compliant

  Non-Compliant

  N/A

• Are all furniture coverings in good/clean condition?

  Good

  Fair

  Poor

  N/A

• Are all walkways in good condition and free of any obstructions or trip hazards?

  Good

  Fair

  Poor

  N/A

• Is the waste cleared regularly from the premises?

  Compliant

  Non-Compliant

  N/A

• If any waste is contaminated or hazardous, are special arrangements made for its disposal (e.g. sharps, needles, soiled clothing, etc.)?

  Compliant

  Non-Compliant

  N/A

• Was the interior premises free of any other hazards related to the working environment? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Notes and observations. Please details any corrective action that needs to be taken not covered within the questions above.

Food Safety

• Has the kitchen been registered with the local authority?

  Compliant

  Non-Compliant

  N/A

• Are the domestic extraction system grease filters regularly cleaned (evidenced in cleaning schedules)?

  Compliant

  Non-Compliant

  N/A

• Has the whole extraction system been contract cleaned within the last 12 months and certificate available for evidence (Commercial Extraction Cleaning Only)?

  Compliant

  Non-Compliant

  N/A

• Are the storage areas clean (floors, walls, shelves, etc)?

  Good

  Fair

  Poor

  N/A

• Are all appliances in clean good working order?

  Good

  Fair

  Poor

  N/A

• Are dirty and clean equipment clearly segregated?

  Compliant

  Non-Compliant

  N/A

• Are raw and cooked foods clearly segregated?

  Compliant

  Non-Compliant

  N/A

• Are meat and dairy foods clearly segregated?

  Compliant

  Non-Compliant

  N/A

• Are products covered and labelled with details (including ingredient, date made or opened, use by date)?

  Compliant

  Non-Compliant

  N/A

• Are coloured chopping boards provided and in good condition for the preparation of different products (e.g. red, green, and white, etc.)?

  Compliant

  Non-Compliant

  N/A

• Are the chopping boards being used correctly (observation)?

  Compliant

  Non-Compliant

  N/A

• Is there comprehensive evidence (by cleanliness of kitchen & equipment) and uptodate cleaning schedule for:

• Daily

  Compliant

  Non-Compliant

  N/A

• Periodic (Weekly/Monthly)

  Compliant

  Non-Compliant

  N/A

• Are cleaning chemicals stored away separately from any food?

  Compliant

  Non-Compliant

  N/A

• Are hand wash basins within the kitchen fully stocked, clean, and in good working order?

  Compliant

  Non-Compliant

  N/A

• Have kitchen the following kitchen forms been completed accordingly?

• HACCP review

  Compliant

  Non-Compliant

  N/A

• Daily fridge and freezer temperature checks

  Compliant

  Non-Compliant

  N/A

• Daily food temperature checks

  Compliant

  Non-Compliant

  N/A

• Delivery inspection records

  Compliant

  Non-Compliant

  N/A

• Food allergens inventory

  Compliant

  Non-Compliant

  N/A

• Monthly probe calibration

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to the kitchen? (please detail below)

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

Housekeeping

• Is there a clearly defined laundry - 'dirty in and clean out' process in operation?

  Compliant

  Non-Compliant

  N/A

• Is there suitable PPE available (i.e. goggles, gloves, aprons)?

  Compliant

  Non-Compliant

  N/A

• Are isolation points of all laundry equipment identified/suitable signage in place?

  Compliant

  Non-Compliant

  N/A

• Is there evidence of up to date cleaning schedules:

• Daily

  Compliant

  Non-Compliant

  N/A

• Monthly (Equipment)

  Compliant

  Non-Compliant

  N/A

• Please give a subjective assessment of how clean the Bathrooms are? (detail findings in notes)

  Good

  Fair

  Poor

  N/A

• Please give a subjective assessment of how clean the Bedrooms are? (detail findings in notes)

  Good

  Fair

  Poor

  N/A

• Please give a subjective assessment of how clean the Communal areas are? (detail findings in notes)

  Good

  Fair

  Poor

  N/A

• Were resident areas free of cleaning trolleys/chemicals unless supervised?

  Compliant

  Non-Compliant

  N/A

• Are colleagues following the Microfiber colour coding system:

  Compliant

  Non-Compliant

  N/A

• CLOTHS

• Red – bathroom & toilet

  Compliant

  Non-Compliant

  N/A

• Green – public areas

  Compliant

  Non-Compliant

  N/A

• Blue – resident rooms

  Compliant

  Non-Compliant

  N/A

• MOPS

• Red – bathrooms & toilets

  Compliant

  Non-Compliant

  N/A

• Blue – other areas

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to housekeeping? (please detail below)

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

H&S Communication and Signage

• Are there prominently displayed H&S Law poster(s) posted around the site and filled in correctly (i.e. identifying H&S contacts/reps, if applicable)?

  Compliant

  Non-Compliant

  N/A

• Is the visitor signing in procedure being adhered to?

  Compliant

  Non-Compliant

  N/A

• Is the contractors information sheet accessible and is there evidence available of its use?

  Compliant

  Non-Compliant

  N/A

• Are details of the business continuity plan accessible?

  Compliant

  Non-Compliant

  N/A

• Give a subjective assessment on H&S as a standard agenda item in team meetings and supervisions?

  Good

  Fair

  Poor

  N/A

• Are the following topics discussed with colleagues:

• Risk assessments and control measures?

  Compliant

  Non-Compliant

  N/A

• Fire drills and evacuation plans?

  Compliant

  Non-Compliant

  N/A

• Accidents and incidents and lessons learned?

  Compliant

  Non-Compliant

  N/A

• Safety alerts and H&S communications?

  Compliant

  Non-Compliant

  N/A

• Actions from the fire and legionnaires risk assessments?

  Compliant

  Non-Compliant

  N/A

• Are the results of the meeting communicated to all colleagues & actions implemented?

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

Accidents and Incidents

• Is first aid equipment checked regularly and the contents restocked/in date?

  Compliant

  Non-Compliant

  N/A

• Are accident and near miss forms signed/dated by manager with actions identified and implemented?

  Compliant

  Non-Compliant

  N/A

• Have all accidents been uploaded onto CMS within a timely fashion?

  Compliant

  Non-Compliant

  N/A

• Were all RIDDOR reportable incidents within the last 12 months communicated to the H&S Team and reported to HSE on time?

  Compliant

  Non-Compliant

  N/A

• Is the workplace free of any current absences that are due to H&S/any recent cases of serious incidents (i.e. stress, violence)?

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other concerns related to first aid and accident management? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Notes and Observation

Training

• Have all new employees, including those who are temporary, received induction training (with records available)?

  Compliant

  Non-Compliant

  N/A

• What is compliance rate for following courses:

• Albac Mat

  91-100%

  75-90%

  less than 75%

  N/A

• First Aid (basic life support)

  91-100%

  75-90%

  less than 75%

  N/A

• Fire Evacuation Chair

  91-100%

  75-90%

  less than 75%

  N/A

• Fire Safety Awareness

  91-100%

  75-90%

  less than 75%

  N/A

• Food Safety

  91-100%

  75-90%

  less than 75%

  N/A

• Health and Safety

  91-100%

  75-90%

  less than 75%

  N/A

• Infection Prevention and Control

  91-100%

  75-90%

  less than 75%

  N/A

• Lone Working

  91-100%

  75-90%

  less than 75%

  N/A

• Moving and Handling (level 1)

  91-100%

  75-90%

  less than 75%

  N/A

• Moving and handling (level 2) if applicable

  91-100%

  75-90%

  less than 75%

  N/A

• Risk Assessment for Managers

  Compliant

  Non-Compliant

  N/A

• Give a subjective assessment on the safe systems of work in place for specific tasks including Hoists, vehicle tail lifts, wheelchair vehicle restraints, and cleaning of spillages of bodily fluids?

  Good

  Fair

  Poor

  N/A

• Notes and Observations

Risk Management

• Are there adequate records of suitable and sufficient risk assessments for: (give a subjective assessment of the quality)

• Access to Dangerous Areas?

  Good

  Fair

  Poor

  N/A

• DSE?

  Good

  Fair

  Poor

  N/A

• Electrical Safety?

  Good

  Fair

  Poor

  N/A

• Equipment Safety - Lifting Equipment?

  Good

  Fair

  Poor

  N/A

• Equipment Safety - Profiling Beds?

  Good

  Fair

  Poor

  N/A

• Equipment Safety - Bedrails & Bumpers? (Generic Risk Assessment & Specific Tool)

  Good

  Fair

  Poor

  N/A

• First Aid?

  Good

  Fair

  Poor

  N/A

• Gas Supply & Fitted Appliances

  Good

  Fair

  Poor

  N/A

• Manual handling of Loads?

  Good

  Fair

  Poor

  N/A

• Pregnant/nursing mothers?

  Good

  Fair

  Poor

  N/A

• Outside Safety?

  Good

  Fair

  Poor

  N/A

• Violence to colleagues?

  Good

  Fair

  Poor

  N/A

• Work at height?

  Good

  Fair

  Poor

  N/A

• Use of oxygen/gas?

  Good

  Fair

  Poor

  N/A

• Working Alone?

  Good

  Fair

  Poor

  N/A

• Young Persons/Workers?

  Good

  Fair

  Poor

  N/A

• Persons we support Activities?

  Good

  Fair

  Poor

  N/A

• Securing Furniture?

  Good

  Fair

  Poor

  N/A

• Transport and driving?

  Good

  Fair

  Poor

  N/A

• Supported persons - moving & handling?

  Good

  Fair

  Poor

  N/A

• Infection Prevention Control?

  Good

  Fair

  Poor

  N/A

• Laundry Risk Assessment

  Good

  Fair

  Poor

  N/A

• COSHH (with datasheets available)?

  Good

  Fair

  Poor

  N/A

• Is there evidence that assessments are reviewed at least annually?

  Compliant

  Non-Compliant

  N/A

• Are all risk assessments easily accessible to all colleagues?

  Compliant

  Non-Compliant

  N/A

• Have the service regularly reviewed and signed off open actions relating to H&S within their consolidated action plans?

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other concerns related to risk management? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

Property Compliance

• Legionella

• Is there a water survey and risk assessment available on VPS? This should include a written scheme and schematic diagram for controlling the risk from exposure to legionella bacteria from hot and cold-water systems

  Compliant

  Non-Compliant

  N/A

• ANNUAL:

• Inspection and disinfection of cold water storage tank (Cistern)

  Compliant

  Non-Compliant

  N/A

• Cold storage tank temperature remote from ball valve

  Compliant

  Non-Compliant

  N/A

• Inspection of calorifier

  Compliant

  Non-Compliant

  N/A

• Clean/disinfect ponds/water features (where applicable

  Compliant

  Non-Compliant

  N/A

• TMV Service

  Compliant

  Non-Compliant

  N/A

• QUARTERLY

• Clean and descale all showerheads and aerosol generating outlets

  Compliant

  Non-Compliant

  N/A

• MONTHLY:

• Check temperatures of cold water sentinels

  Compliant

  Non-Compliant

  N/A

• Check temperatures of hot water sentinels (outlets with TMVs fitted are identified and temperatures taken from pipework)

  Compliant

  Non-Compliant

  N/A

• Check temperature of flow and return pipes on the calorifier

  Compliant

  Non-Compliant

  N/A

• Has the probe that is used to record temperatures been calibrated

  Compliant

  Non-Compliant

  N/A

• WEEKLY:

• Flushing of little used outlets

  Compliant

  Non-Compliant

  N/A

• Has suitable and sufficient training, instruction and information been given to employees, as appropriate, on the safety procedures that are necessary to obviate legionnaire’s disease?

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to water safety/legionella prevention? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Electrical Safety

• Is the electrical fixed installation system subject to periodic inspection and testing - fixed test certificate/EICR report?

  Compliant

  Non-Compliant

  N/A

• If recommendations noted - have they been actioned?

  Compliant

  Non-Compliant

  N/A

• Has Portable Appliance Testing been completed within last 12 months and records up to date?

  Compliant

  Non-Compliant

  N/A

• Are electrical systems free from overloading? (as could be observed)

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to electrical safety? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Has an asbestos survey been conducted and a register available which identifies where the asbestos is in the building

  Compliant

  Non-Compliant

  N/A

• If so, is it made available to relevant personnel/contractors?

  Compliant

  Non-Compliant

  N/A

• Have all the required remedial actions, identified in the asbestos management plan, been carried out?

  Compliant

  Non-Compliant

  N/A

• Are isolation procedures clearly made available to all colleagues? (Gas, Electricity, Water)

  Compliant

  Non-Compliant

  N/A

• Has the heating/air conditioning system received regular maintenance and servicing

  Compliant

  Non-Compliant

  N/A

• Has the tumble dryer received as minimum an annual service and clean? (Commercial Style)

  Compliant

  Non-Compliant

  N/A

• Has an annual Gas Safe examination been completed and certification available on VPS?

  Compliant

  Non-Compliant

  N/A

• Have 6-monthly LOLER inspections/thorough examinations of all lifting equipment including any hoists/baths/slings/passenger lifts been completed and certification available on VPS?

  Compliant

  Non-Compliant

  N/A

• Within the last 12 months, has there been any high risk works that have needed a PTW/HWP and were these issued?

  Compliant

  Non-Compliant

  N/A

• Comments / Observations

Internal checks and Inspections

• Are all company vehicles being maintained and serviced at intervals detailed in the manufacturer’s instructions?

  Compliant

  Non-Compliant

  N/A

• Are the company vehicles in good condition with no visible damage to the exterior or interior

  Compliant

  Non-Compliant

  N/A

• Is there evidence of the following local inspections (where applicable):

• H&S Hazard Checklist

  Compliant

  Non-Compliant

  N/A

• Lint Removal, Fire Panel & Escape Routes

  Compliant

  Non-Compliant

  N/A

• Vehicle safety checks

  Compliant

  Non-Compliant

  N/A

• Temperature of medication storage

  Compliant

  Non-Compliant

  N/A

• Ligature cutters

  Compliant

  Non-Compliant

  N/A

• Bedrails checks

  Compliant

  Non-Compliant

  N/A

• Wheelchairs

  Compliant

  Non-Compliant

  N/A

• Walkers

  Compliant

  Non-Compliant

  N/A

• Shower chairs

  Compliant

  Non-Compliant

  N/A

• Shower trolleys

  Compliant

  Non-Compliant

  N/A

• Profiling beds

  Compliant

  Non-Compliant

  N/A

• Mattress Inspections

  Compliant

  Non-Compliant

  N/A

• Tail lifts and Accessories

  Compliant

  Non-Compliant

  N/A

• Hoist Check

  Compliant

  Non-Compliant

  N/A

• Slings

  Compliant

  Non-Compliant

  N/A

• Window restrictor checks

  Compliant

  Non-Compliant

  N/A

• Assistive technology/Nurse Call system

  Compliant

  Non-Compliant

  N/A

• Is there evidence that all checks and inspections are being adequately completed with any identified actions being completed and signed off?

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other concerns related to internal checks, records or documentation? (please detail in here)

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

Fire Safety and Documentation

• Has a Fire Risk Assessment (FRA) or Fire Risk Assessment review been conducted as part of ongoing best practices (ideally within the last 12 months)?

  Compliant

  Non-Compliant

  N/A

• If so when, date / signed / reviewed:

• Has an action plan been implemented / signed off within stated timescales?

  Compliant

  Non-Compliant

  N/A

• Discuss / note priorities

• Are any local fire/emergency/evacuation procedures documented and communicated?

  Compliant

  Non-Compliant

  N/A

• Please give a subjective assessment of the quality of the service's fire emergency plan.

  Good

  Fair

  Poor

  N/A

• Are the fire/emergency procedures accessible/available to the emergency services?

  Compliant

  Non-Compliant

  N/A

• Give a subjective assessment on the quality of the fire zonal map

  Good

  Fair

  Poor

  N/A

• Have Personal Emergency Evacuation Plans (PEEPs) been completed for all relevant persons?

  Compliant

  Non-Compliant

  N/A

• Please give a subjective assessment of the quality of PEEPs.

  Good

  Fair

  Poor

  N/A

• If so, are these regularly reviewed and correspond with overall PEEPs summary (and available for the Fire Brigade)?

  Compliant

  Non-Compliant

  N/A

• Give a subjective review of the Person Centered Fire Risk Assessments for high risk individuals (Fire Setters, Smokers, Independent cookers)

  Good

  Fair

  Poor

  N/A

• Are all colleagues trained locally in fire emergency plans and if applicable the use of fire evacuation equipment?

  Compliant

  Non-Compliant

  N/A

• Are daytime fire drills being completed routinely (at least quarterly) with detailed records including: night colleagues, different scenarios, assisted evacuation?

  Compliant

  Non-Compliant

  N/A

• Are nighttime fire drills being completed routinely (at least quarterly) with detailed records including: night colleagues, different scenarios, assisted evacuation?

  Compliant

  Non-Compliant

  N/A

• Give a subjective assessment on the quality of fire drills?

  Good

  Fair

  Poor

  N/A

• Is suitable Fire Action Signage in place and suitably posted around the site?

  Compliant

  Non-Compliant

  N/A

• Is the Grab Bag in an accessible location with all contents checked?

  Compliant

  Non-Compliant

  N/A

• Fire Maintenance – Contractual Service & Maintenance Evidence at site:

• Fire Alarm & Detection

  Compliant

  Non-Compliant

  N/A

• Emergency Lighting

  Compliant

  Non-Compliant

  N/A

• Firefighting Equipment - extinguishers/blankets/hose reels/suppression system

  Compliant

  Non-Compliant

  N/A

• Sprinkler System – if relevant

  Compliant

  Non-Compliant

  N/A

• Fire Maintenance – internal checks / tests:

• Fire alarm testing (weekly – testing different call points on a rotational basis)

  Compliant

  Non-Compliant

  N/A

• Sprinkler System – if relevant (weekly check)

  Compliant

  Non-Compliant

  N/A

• Smoke vents- if relevant (weekly)

  Compliant

  Non-Compliant

  N/A

• Automatic closing doors (weekly – check doors close fully)

  Compliant

  Non-Compliant

  N/A

• Emergency lighting function (at least monthly)

  Compliant

  Non-Compliant

  N/A

• Visual inspection of Fire fighting equipment (monthly)

  Compliant

  Non-Compliant

  N/A

• Carbon Monoxide Detectors/Automatic Detectors (Monthly)

  Compliant

  Non-Compliant

  N/A

• Dorgard Checks (Monthly)

  Compliant

  Non-Compliant

  N/A

• Visual inspection of Fire doors (monthly)

  Compliant

  Non-Compliant

  N/A

• Was the premises free of any other hazards related to fire safety? (please detail here)

  Compliant

  Non-Compliant

  N/A

• Notes and Observations

• Inspection

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Food Safety

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Housekeeping

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• H&S Communication and Signage

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Accidents and Incidents

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Training

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Risk Management

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Property Compliance

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Internal Checks and Inspections

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Fire Safety and Documentation

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_

• Overall Audit Score

  less than 55% (Inadequate)

  56-74% (Requires Improvement)

  75-89% (Good)

  90-100% (Outstanding_