Bloom Care - Provider's Audit Copy

• Name of Home:

• Date:

  Date

• Completed by:

• INSTRUCTIONS
  ---------------------
  1. Please answer the items below.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Action click on the paperclip icon then "Add Action," provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link

SECTION 1

• 1. Pick 5 random care folders (Pick at least 2 new clients, 2 clients which conditions have changed, deteriorated, or displaying challenging behaviour)

• Click "Add Client"

Client

• • Initial:

• 1.1 Is the Life History completed?

  Yes

  No

  N/A

• Is the reason stated? (For example, client chooses not to provide their life<br>history)

  Yes

  No

  N/A

• 1.2 Is the Physical Health assessment of need profile completed?

  Yes

  No

  N/A

• 1.5 Is a staff signature sheet in place and completed?

  Yes

  No

  N/A

• 1.6 Does the client identification form have the client’s photograph?

  Yes

  No

  N/A

• 1.6 Is the physical identity form fully complete?

  Yes

  No

  N/A

• 1.10 Have risk assessments been developed based on the changes identified? Are risk assessments detailed?

  Yes

  No

  N/A

• 1.11 Are risk assessments detailed? Do they help the staff reduce the risk?

  Yes

  No

  N/A

• 1.12 Have risk assessments been updated monthly?

  Yes

  No

  N/A

• Have the clients views been considered during the risk assessment?

  Yes

  No

  N/A

• Have old risk assessments been archived?

  Yes

  No

  N/A

• 1.17 Risk management plans, is there one for each risk?

  Yes

  No

  N/A

• 1.26 Has a capacity assessment been completed?

  Yes

  No

  N/A

• 1.24

• 1.18 Have all sections of the risk management plan been completed?

  Yes

  No

  N/A

• • Is there an agreed review date for the risk management plan?

  Yes

  No

  N/A

• Are the key worker sessions signed by both the staff and the client?

  Yes

  No

  N/A

• • Is the support plan up to date? Are all sections complete?

  Yes

  No

  N/A

• • Is the recovery star being completed regularly?

  Yes

  No

  N/A

• • Are health appointments clear and understandable why they have an appointment?

  Yes

  No

  N/A

• 1.30

• • Does the client suffer from any long term illness, that require care management from the staff? (Diabetes, Asthma, Angina, Heart disease)

  Yes

  No

  N/A

• • Are specific care plans in place for this to ensure that clear instructions are available on how to respond in the event the illness is triggered? (For example, how to respond to a low or high blood sugar reading)

  Yes

  No

  N/A

• • Is this reviewed on a monthly basis?

  Yes

  No

  N/A

• 1.31 Is there evidence that key worker sessions are taking place?

  Yes

  No

  N/A

• Is there evidence of discharge planning?

  Yes

  No

  N/A

• 1.34 Is the personal inventory form completed?

  Yes

  No

  N/A

• 1.35 Are there any sections in the care folder that is blank, or do not contain much information?

  Yes

  No

  N/A

SECTION 2: MEDICAL ROOM

• 2.1 Is Medical Room clean and tidy?

  Yes

  No

  N/A

• 2.2 Are items and drugs clearly marked and locked away?

  Yes

  No

  N/A

• 2.3 Is Refridgerator securely locked?

  Yes

  No

  N/A

• 2.4

• Is Refrigerator temperature logged correctly?

  Yes

  No

  N/A

• Are there any out of range readings?

  Yes

  No

  N/A

• Has all medication in the fridge got an opening date?

  Yes

  No

  N/A

• 2.5 Are there any out of date or old medication from previous month?

  Yes

  No

  N/A

• 2.6 Is the medication room locked and secured?

  Yes

  No

  N/A

SECTION 3: MEDICATION ADMINISTRATION RECORD FOLDER (MAR)

• Select 5 random MAR Sheets

• Click "Add MAR Sheet"

MAR Sheet

• • Initial:

• 3.1 Do the clients have up to date MAR sheets?

  Yes

  No

  N/A

• 3.2 Has all medication been given at appropriate times?

  Yes

  No

  N/A

• 3.3 Have clients been given the opportunity to refuse?

  Yes

  No

  N/A

• Are there any gaps on the MAR sheet where medication has not been signed for?

  Yes

  No

  N/A

• If so, has a medication error form been filled, and actioned?

  Yes

  No

  N/A

• 3.4 Have PRN medication been given according to PRN protocols?

  Yes

  No

  N/A

• 3.5 Is there any evidence of medicines being disguised in food or drink?

  Yes

  No

  N/A

• 3.6 Are all liquid dosages measured correctly?

  Yes

  No

  N/A

• 3.7 Does the number of tablets for the client tally with the MAR sheet?

  Yes

  No

  N/A

• 3.8 Are there sufficient quantities available for the next 3 days?

  Yes

  No

  N/A

• 3.9 Have the correct codes been used on the MAR sheet?

  Yes

  No

  N/A

• 3.10 Have explanations been recorded on the back of the MAR sheet for refused and “as required” medicines?

  Yes

  No

  N/A

• 3.11 Have all creams and other external preparations been signed for?

  Yes

  No

  N/A

• 3.12 Are all dose changes/ amendments clear and accurate?

  Yes

  No

  N/A

• 3.13

• • Are there any self medicators?

  Yes

  No

  N/A

• • If so, have verbal prompts or checks been conducted to ensure that medication has been taken?

  Yes

  No

  N/A

• 3.14

• • Have monthly medication audits been conducted?

  Yes

  No

  N/A

• • If yes, were there any findings in the last 3 medication audits?

  Yes

  No

  N/A

• • Were the findings actioned accordingly?

  Yes

  No

  N/A

• • What evidence is there to demonstrate this?

  Yes

  No

  N/A

• • Check the CD book, is there 2 signatures for each entry?

  Yes

  No

  N/A

• • Check the CD book, any errors?

  Yes

  No

  N/A

• • Check the CD book, has a weekly stock check been completed?

  Yes

  No

  N/A

SECTION 4: STAFF FOLDER

• Click "Add Initial

Initial

• • Initial

• 4.1 Please check 3 random staff files

  Yes

  No

  N/A

• 4.2

• • Has the staff been correctly inducted and documented?

  Yes

  No

  N/A

• • Have staff completed training before starting the role?

  Yes

  No

  N/A

• 4.3 Does the staff file contain their DBS number?

  Yes

  No

  N/A

• Is there evidence staff are completing annual declaration that all details remain the same?

  Yes

  No

  N/A

• 4.4 Does the file contain two references?

  Yes

  No

  N/A

• Are one of the references from their previous employment?

  Yes

  No

  N/A

• Has a reason been recorded?

  Yes

  No

• 4.5 Are all mandatory training been completed?

• • POVA

  Yes

  No

  N/A

• • Health & Safety

  Yes

  No

  N/A

• • Fire

  Yes

  No

  N/A

• • Infection Control

  Yes

  No

  N/A

• • Manual Handling

  Yes

  No

  N/A

• • Dementia

  Yes

  No

  N/A

• 4.6 Does the staff file have photo evidence and proof of address of staff, next of kin details?

  Yes

  No

  N/A

• 4.7 Has the staff received supervision in the past 3 months?

  Yes

  No

  N/A

• 4.8 Have staff feedback forms been filled out for the last 3 new starters?

• • First day

  Yes

  No

  N/A

• • First week

  Yes

  No

  N/A

• • First month

  Yes

  No

  N/A

SECTION 5: STAFFING & ROTA

• 5.1

• • Is there a dependency tool in place?

  Yes

  No

  N/A

• • Obtain rota for the last 3 weeks, current week and following week.

  Yes

  No

  N/A

• • Are there any absences or sickness?

  Yes

  No

  N/A

• • If yes, has the Manager logged this on the sickness records matrix online?

  Yes

  No

  N/A

• • Has the Manager spoken to HR regarding frequent absence/sickness?

  Yes

  No

  N/A

• 5.2 Are there sufficient staff on duty at all times?

  Yes

  No

  N/A

• 5.2 Are there 2 waking nights on each shift?

  Yes

  No

  N/A

• 5.3 Has the Manager identified staffing gaps, and planned for recruitment?

  Yes

  No

  N/A

• 5.4 Is the rota clear and easy to read?

  Yes

  No

  N/A

• 5.5 Are there many changes on the rota?

  Yes

  No

  N/A

• Manager's Explanation:

• 5.6 Are staff presentable?

  Yes

  No

  N/A

• 5.6 Are staff wearing name badges?

  Yes

  No

  N/A

• 5.7 Observe 3 care staff members interact with the clients, other professionals or visitors
  

• Click "Add Initial"

Initial

• • Initial

• • Do they communicate clearly, and in a good tone?

  Yes

  No

  N/A

• • Are they warm and friendly?

  Yes

  No

  N/A

• 5.8 Speak to 3 care staff

• Click "Add Initial"

Initial

• • Initial

• • Do they understand how to help a client make a complaint?

  Yes

  No

  N/A

• • Do they understand Safeguarding?

  Yes

  No

  N/A

• • Do they know what to do in the event of a fire?

  Yes

  No

  N/A

• 5.9 Speak to Senior or Nurse in charge.

• • Do they know how to make a safeguarding referral?

  Yes

  No

  N/A

• • Do they know what to do in the event of a medication error?

  Yes

  No

  N/A

• • Do they know what to do in the event of a fire?

  Yes

  No

  N/A

SECTION 7: CONFIDENTIALITY & SECURITY OF DOCUMENTS

• 7.1 Are all care plans stored and locked away in a lockable cabinet?

  Yes

  No

  N/A

• 7.2 Are the MAR folder stored away in a lockable cabinet?

  Yes

  No

  N/A

• 7.3 Are all staff files locked away in a lockable cabinet?

  Yes

  No

  N/A

• 7.4 Is there any confidential and sensitive information on display to the public or other people at the home?

  Yes

  No

  N/A

SECTION 8: ENVIRONMENT

• 8.1 Is the communal areas clean?

  Yes

  No

  N/A

• 8.2 Is the communal areas tidy?

  Yes

  No

  N/A

• 8.3 Are there any foul smells in the home?

  Yes

  No

  N/A

• Where? :

• 8.4 Does the home look presentable at the entrance?

  Yes

  No

  N/A

• 8.5 Check 5 client bedrooms

• Click "Add Client"

Client

• • Room number

• • Is the bedroom clean and tidy?

  Yes

  No

  N/A

• • Is the wardrobe tidy?

  Yes

  No

  N/A

• • Are the clothes in the wardrobe belonging to the client and labelled?

  Yes

  No

  N/A

• • Is there any smell?

  Yes

  No

  N/A

• • Is the mattress and linen in good condition?

  Yes

  No

  N/A

• • Is the wardrobe, side cabinet, table and chair in good order?

  Yes

  No

  N/A

• • Is the en-suite in good working order?

  Yes

  No

  N/A

• • Is the curtains/blind in good condition?

  Yes

  No

  N/A

• • Are there any prescribed creams left out within reach?

  Yes

  No

  N/A

• • Is the carpet in good condition?

  Yes

  No

  N/A

• • Are there window restrictors on the windows?

  Yes

  No

  N/A

• • Is the window restrictor in good condition?

  Yes

  No

  N/A

• • Are the screws on the window anti-tamper screws?

  Yes

  No

  N/A

• • Is the nurse call system in good working order in the bedroom?

  Yes

  No

  N/A

• • Is the heating adequate in the home?

  Yes

  No

  N/A

• • Check thermometer in 5 areas. Readings should not be lower than 21.5 degrees.

  Yes

  No

  N/A

• 8.6 Is there sufficient lighting in communal areas?

  Yes

  No

  N/A

• 8.7 Are there any trailing wires, frayed/ripped carpets or low objects that could be tripping hazard?

  Yes

  No

  N/A

• 8.8 Is the fire roll list up to date?

  Yes

  No

  N/A

• 8.9 Are the fire escapes clutter free?

  Yes

  No

  N/A

• 8.10 Are there separate male and female sections?

  Yes

  No

  N/A

• 8.11 Do female clients have to walk past male bedrooms on the route to the bathroom?

  Yes

  No

  N/A

• 8.12 Are clients adhering to the separate sections? Any incidents?

  Yes

  No

  N/A

• 8.13 Are the clients adhering to the 8pm curfew?

  Yes

  No

  N/A

• 8.14 Are the clients signing in and out of the building at all times?

  Yes

  No

  N/A

• 8.15 Have risk assessments been completed on the building to reduce the risk of harm towards the clients? (Risk assessments for self harm, sexual abuse)

  Yes

  No

  N/A

SECTION 9: MACHINERY AND EQUIPMENT

• 9.3 Is the lift well litted?

  Yes

  No

  N/A

• 9.4 Has the lift been serviced in the last 6 months? Please check service certificates.

  Yes

  No

  N/A

• 9.9 Are the dining chair and tables in good order?

  Yes

  No

  N/A

• 9.10 Are the arms chairs and coffee tables in good order?

  Yes

  No

  N/A

• 9.11 Is the SONOS working and being used?

  Yes

  No

  N/A

• 9.12 Is the weighing scales in good working order?

  Yes

  No

  N/A

• 9.13 Are all the equipment in the kitchen in good working order?

• • Fryer

  Yes

  No

  N/A

• • Grill

  Yes

  No

  N/A

• • Dishwasher

  Yes

  No

  N/A

• • Hob

  Yes

  No

  N/A

• • Cooker

  Yes

  No

  N/A

• • Oven

  Yes

  No

  N/A

• • Water boiler

  Yes

  No

  N/A

• 9.14 Are all the equipment in the laundry room in good working order?

• • Dryer

  Yes

  No

  N/A

• • Washing machine

  Yes

  No

  N/A

• • Ironing board

  Yes

  No

  N/A

• • Iron

  Yes

  No

  N/A

SECTION 10: SERVICE AND MAINTENANCE RECORDS

• 10.1 Are all service certificates up to date?

• • Lift (6 monthly)

  Yes

  No

  N/A

• • Electrical (5 yearly)

  Yes

  No

  N/A

• • Gas safety (Yearly)

  Yes

  No

  N/A

• • Hoist (6 monthly)

  Yes

  No

  N/A

• • PAT Test (Yearly)

  Yes

  No

  N/A

• • Legionnaires (Yearly)

  Yes

  No

  N/A

• • Fire Equipment (6 monthly)

  Yes

  No

  N/A

• • Emergency Lighting (6 monthly)

  Yes

  No

  N/A

• • Fire Alarm (6 monthly)

  Yes

  No

  N/A

• 10.2 Look at the Maintenance Folder

• • Has the weekly checks been done?

  Yes

  No

  N/A

• • Fire alarm

  Yes

  No

  N/A

• • Emergency Lighting

  Yes

  No

  N/A

• • Water temperature

  Yes

  No

  N/A

• • Window restrictors

  Yes

  No

  N/A

• • Weekly flushing of little used outlets

  Yes

  No

  N/A

• 10.3 Are records of fire equipment replacement, replenishment and maintenance kept in the maintenance folder?

  Yes

  No

  N/A

• 10.4 Have timed simulated fire drills been logged in the maintenance folder?

  Yes

  No

  N/A

• 10.5 Are the quarterly shower head clean records maintained and checked in the maintenance folder?

  Yes

  No

  N/A

• 10.6 Check kitchen records, have the cleaning schedules been completed?

  Yes

  No

  N/A

• 10.7 Have temperature checks been completed?

  Yes

  No

  N/A

• 10.8 Has the daily log been completed?

  Yes

  No

  N/A

• 10.9 Have the fridge and freezer temperature records been recorded?

  Yes

  No

  N/A

• 10.10 Have the opening and closing checks been recorded?

  Yes

  No

  N/A

SECTION 11: LEADERSHIP AND MANAGEMENT

• 11. Speak to 3 members of staff.

• • Do they understand their responsibility and accountability at the home?

  Yes

  No

  N/A

• • Do they feel supported and confident with their Manager?

  Yes

  No

  N/A

• • Do they understand how to keep people living at the home safe?

  Yes

  No

  N/A

• • Do staff receive feedback from the Manager in a constructive and motivating way, so that staff understand what action they need to take?

  Yes

  No

  N/A

• 11.1 Have staff meeting been conducted on a 6 weekly basis?

  Yes

  No

  N/A

• 11.2 Has the Manager been communicating all concerns to the Head Office. Safeguarding, letter of concern from CCG, CQC, and other agencies.

  Yes

  No

  N/A

• 11.3 Look at the accident and incidents forms.

• • Where appropriate, have safeguarding alerts been made?

  Yes

  No

  N/A

• • Where appropriate, have RIDDOR notifications been made?

  Yes

  No

  N/A

• • Has the accident and incidents been analysed each month?

  Yes

  No

  N/A

• • Please record any concerns

• 11.4 Please record a statement from the Manager on how he/she ensures that all incidents are reported to the Manager and documented.

  Yes

  No

  N/A

• 11.5 Have there been incidents where the Manager was not made aware or where the Manager was not aware of a situation?

  Yes

  No

  N/A

• 11.5

• • Check this knowledge through the accidents and incidents form, and daily notes.

  Yes

  No

  N/A

• • Have there been any incidents where a record was not made?

  Yes

  No

  N/A

SIGN OFF

• Auditor's Name & Signature:

  Sign

• • Designation:

• Is there other second person assisting with the audit?

  Yes

  No

• Assisting Auditor's Name & Signature:

  Sign

• • Designation: