Liz Audit (11/2/15 Updated)

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Clinical Governance

• We're there any issues with random questioning for nurses on CQC Outcomes?

  Yes

  No

  N/A

• We're there any issues with random questioning of Nurses about tests being carried out? Provide details what tests were checked

  Yes

  No

  N/A

• Are Daily, Weekly and Monthly checklists being completed

  Yes

  No

  N/A

• Is the Compliance Calendar in place and up to date?

  Yes

  No

  N/A

Clinical Governance Document Checklist

• Is the Health and Safety Poster displayed?

  Yes

  No

  N/A

• Is the employers liability insurance certificate displayed?

  Yes

  No

  N/A

• Are Local Rules for Radiographic Equipment Displayed

  Yes

  No

  N/A

• Is the CQC Registration Certificate displayed?

  Yes

  No

  N/A

• Is the practice policy on health and safety and accident book available?

  Yes

  No

  N/A

• is the Risk assessment and COSHH Available?

  Yes

  No

  N/A

• is the Emergency drugs kit, Oxygen check dates and service records available?

  Yes

  No

  N/A

• Are certificates of autoclaving servicing/maintenance up to date and available

  Yes

  No

  N/A

• Are certificates of pressure vessel inspection for all compressors operating above 250bar available and up to date?

  Yes

  No

  N/A

• Are service records for compressors up to date and available?

  Yes

  No

  N/A

• Is the Performing Rights certificate up to date and available?

  Yes

  No

  N/A

• Are the safety checks and pat testing on all electrical equipment and all certificate of testing fixed supplies up to date and available.

  Yes

  No

  N/A

• Are clinical waste and special waste including sharps consignment notes up to date and available?

  Yes

  No

  N/A

• Are domestic waste consignment notes up to date?

  Yes

  No

  N/A

• Are records of cleaning up to date and available? Is there a cleaning schedule?

  Yes

  No

  N/A

• Are records relating to radiation safety assessment of all radio graphic equipment up to date and available?

  Yes

  No

  N/A

• Are signs for fire exits, fire risk assessments and procedures in case of fire present and displayed correctly?

  Yes

  No

  N/A

Staff records

• All GDC Registrations and professional indemnities in place?

  Yes

  No

  N/A

• All immunisation records for all staff in place?

  Yes

  No

  N/A

• All staff inductions in place?

  Yes

  No

  N/A

• All staff contracts in place?

  Yes

  No

  N/A

• All CRB checks in place?

  Yes

  No

  N/A

• All CPR for staff up to date?

  Yes

  No

  N/A

• All child protection/vulnerable adults certificates up to date and available?

  Yes

  No

  N/A

F.A.O MURTAZA KANANI CHECKLiST

• Please enter the Number of UDAs performed and targeted for this month so far. <br>I.e. 'Surgeon' 123 UDAs performed 321 UDAs targeted <br>

  Yes

  No

  N/A

• Please state the reason for a difference in UDAs performed/targeted if applicable

  Yes

  No

  N/A

• Please enter the Private performed per surgeon

  Yes

  No

  N/A

F.A.O ESMAIL HARUNANI CHECKLIST

ORDERING

• Is the ordering currently within budget? If not state the amount of overspend

  Yes

  No

  N/A

• Does the practice require any particular materials?

  Yes

  No

  N/A

• Does the practice use dentsply rewards

  Yes

  No

  N/A

• Are all points within their availability date? If not, how soon are they going to expire?

  Yes

  No

  N/A

FINANCE

• Is a petty cash book in place and being used?

  Yes

  No

  N/A

• Have bank statements been checked?

  Yes

  No

  N/A

• Have private/NHS receipts been checked?

  Yes

  No

  N/A

REFUNDS

• Has Maggie been informed of refunds required? Have refund request forms been sent?

  Yes

  No

  N/A

EQUIPMENT & FIXTURES/FITTINGS

• Cleanliness/decor of waiting rooms, surgeries and other rooms ok?

  Yes

  No

  N/A

• Are all suction motors in working order?

  Yes

  No

  N/A

• Are the Suction Motor Filters been cleaned regularly?

  Yes

  No

  N/A

• Have any engineer visits been required?

  Yes

  No

  N/A

• If yes to the above, have you kept the old part to show to Dr Kanani?

  Yes

  No

  N/A

• All Large Equipment e.g. Chairs ok and in working order?

  Yes

  No

  N/A

SMALL EQUIPMENT CHECKLIST

• Handpieces ok?

  Yes

  No

  N/A

• Curing lights ok?

  Yes

  No

  N/A

• Instruments ok?

  Yes

  No

  N/A

• Intra oral cameras ok?

  Yes

  No

  N/A

• All other small equipment ok? Please give details of any issues

  Yes

  No

  N/A

• Yes

  No

  N/A

F.A.O NADEEM HARUNANI CHECKLIST

• Have the gas/electricity meter readings for this week been sent to Nadeem?

  Yes

  No

  N/A

Friends and Family Test (FFT) Questionnaires

• Are FFT Questionnaires being completed for every patient seen?

  Yes

  No

  N/A

• Have the last months FFT Questionnaires Results been sent to management@dentistryforyou.co.uk? This must be done by the 10th of the month.

  Yes

  No

  N/A

MARKETING

• Is the monthly new patient referrals chart being completed and sent to Mehria/Nadeem?

  Yes

  No

  N/A

• Are Patient Satisfaction Questionnaires being completed and uploaded online (at least 10/week)

  Yes

  No

  N/A

• Is there a record of new patients registered last month? If so, how many?

  Yes

  No

  N/A

• Are there any outstanding recalls to be sent? If so, how many?

  Yes

  No

  N/A

IT

• Is all software and hardware in working order?

  Yes

  No

  N/A

• Is one server PC being left on to allow for remote access?

  Yes

  No

  N/A

• Is the Google Calendar being updated with all important dates/deadlines?

  Yes

  No

  N/A

ACCOUNTS & EXEMPTION REPORTING

• Are the accounts/incorrect claims up to date and have they been sent to Andrea?

  Yes

  No

  N/A

• Which months are outstanding still to do?

  Yes

  No

  N/A

SALARIES

• Has the monthly cash book for last month been sent to Maggie/Nadeem?

  Yes

  No

  N/A

• Have last months lab bills been sent to Maggie/Nadeem?

  Yes

  No

  N/A

SUNDRIES

• Does this practice stock sundries?

  Yes

  No

  N/A

• Do the sundries in stock match the sundries log?

  Yes

  No

  N/A

• Is everything in order with the sundries cash book entries?

  Yes

  No

  N/A

Text Messaging

• Does the practice follow up on daily text messaging reports? Please indicate how many patients details have been altered and how many have been removed from the messaging list.

  Yes

  No

  N/A