Client Review - Home Care

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Client information

• Client name

• Add location
  Address

Changes in details

• Have you changed your telephone number?

• Has there been any changes to your emergency contacts and NOK?

• Has there been a change in doctors etc.?

• Are there any changes in accessing the property? (I.e key codes etc.)

Changes in health

• Are there any changes in mobility?

• Have there any changes in medication?

• Please list current medication taken?

• Are these changes recorded in the care plan?

  Yes

  No

  N/A

• Are there any changes in the client's skin integrity?

• Add a photo if applicable?

  Media

• Does the client have any pressure areas?

• Add a photo if applicable?

  Media

• Are there any changes in the capacity of the client's senses (eg eyesight, hearing) and communications skills?

• Is the client fully continent? If not, please if urine incontinent or fecal or both. Are any incontinence products used?

• Has the client had any falls since the last review?

• General comments:

Food and drink

• Does the client eat well?

• Who prepares the client's food?

• Self

• Carer

• Family

• Meals on wheels etc

• Does the client drink well?

  Yes

  No

  N/A

Changes to the living environment?

• General comments:

Equipment

• Does the service user use a hoist or bath lift? If yes, enter date of last service.

• Any other equipment used? Please add details.

Further action?

• Does the care plan continue to meet the needs of the service user?

  Yes

  No

  N/A

• Are all care plans and risk assessments up to date?

  Yes

  No

  N/A

• Any further action required?

  Yes

  No

  N/A

• Please detail if yes.

• Client signature

  Sign

• Date

• Assessor signature

  Sign

• Date