Care Plan Review Home Care

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Client details

• Client name

• Add location
  Address

Service user needs

• Are there any new or changed special requirements or care alerts?

  Yes

  No

  N/A

• Details (if applicable)

• Yes

  No

  N/A

• Has the client's communication needs changed?

  Yes

  No

  N/A

• Details (if applicable)

• Have there been any changes in the clients mobility?

  Yes

  No

  N/A

• Details (if yes please list equipment and last service date if applicable)

• Does the client require a further mobility assessment?

  Yes

  No

  N/A

• If yes detail action taken

• Does the client use any assistive technology? (Pendant alarm, sensors, fall bells etc.)

  Yes

  No

  N/A

• Please detail, also noting who supplies aid

• Any changes to the clients toilet needs?

  Yes

  No

  N/A

• Please select - is the client continent

  continent

  incontinent

• Please select - does the client require assistance with going to the toilet?

  requires full assistance

  some help required

  no help required

• Any changes to the client's personal care needs?

  Yes

  No

  N/A

• Please detail

• Does the client require any help with hair care?

  Yes

  No

  N/A

• Details (if applicable)

• Are there any pressure areas?

  Yes

  No

  N/A

• Please detail

• Add a photo if applicable

  Media

• Does the client need any assistance with eating and drinking?

  Yes

  No

  N/A

• Please detail

• Has the client ever had a swallowing assessment?

  Yes

  No

  N/A

• Details

• Are there any diet controlled conditions present? (Diabetes, high cholesterol etc.)

  Yes

  No

  N/A

• Details

• Are there any changes to the clients sleeping?

  Yes

  No

  N/A

• Details

• Is the client on any medication?

  Yes

  No

  N/A

• Please list (including dosage)

• Do the carers assist with medication?

  Yes

  No

  N/A

• Details

• Are there any other specialist care plans in use? (Pain management, wound care etc)

  Yes

  No

  N/A

• Detail:

• Are these plans up to date and applicable?

  Yes

  No

  N/A

• Details and further action taken if needed

• Are there any risks to the client?

  Yes

  No

  N/A

• Details

• Are any of these risks new - do the existing risk assessments need updating?

  Yes

  No

  N/A

• Detail and further action

• Yes

  No

  N/A

• Are there any risks to the health and safety of staff members?

  Yes

  No

  N/A

• Details

• Are any of these risks new - do any risk assessments need updating?

  Yes

  No

  N/A

• Details

• Are there changes to domestic tasks included in the care plan?

  Yes

  No

  N/A

• If yes, please list chemicals that carer may be expected to use

• Are there any changes to shopping needs if applicable?

  Yes

  No

  N/A

• Details (please note if carer handles client money)

• Does the client need a financial transaction log addy to their care pack?

  Yes

  No

  N/A

• Details of action taken

• Are there any new behavioural issues?

  Yes

  No

  N/A

• Detail

• Has there change in clients social and/or religious needs and/or emotional needs as relates to the care plan?

  Yes

  No

  N/A

• Detail

Summary

• Does the existing care plan still fully meet the needs of the client?

  Yes

  No

  N/A

• If no, detail of action taken

• DOES NEW CARE PLAN NEED TO BE COMPLETED?

  Yes

  No

  N/A

• Action taken

• Any comments or concerns from the client about their care plan?

• Any further notes or comments

• Assessor signature

  Sign

• Date

• Client signature

  Sign

• Date