Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Registered Manager

  • Date of last report

Actions from Previous Audit

  • undefined

  • undefined

  • undefined

  • undefined

  • undefined

Summary & Feedback

  • Condition of environment / decoration and cleanliness. (Comment on any planned / scheduled building works).

  • Discussion with service users and summary of their views on the quality of support being provided

  • Discussion with staff and summary of their views on quality of support being provided.

  • Discussion with relatives / visitors and summary of their views on quality of support being provided.

  • Scheduling - comment on staffing (for date of visit) numbers / mix of staff / sickness levels.


  • is the registration certificate displayed

  • is the inspection report rating displayed

  • What is the current CQC rating

  • Visitors Book, is the recording accurate

  • is the public Liability Insurance certificate displayed

  • Date of Public Liability Insurance renewal

Health & Safety :Fire

  • Date of last fire alarm test

  • Date & time of last fire evacuation

  • Date of last night time fire evacuation

  • Date of last fire fighting equipment servicing (annual)

  • Date of last fire detection equipment service (annual)

  • Date of last emergency lighting test

  • Date of last fire risk assessment

  • Have fire risk assessment actions been completed

Health & Safety: Food

  • Fridge & Freezer checks completed without omissions ?

  • Date of last Fridge & Freezer Check

  • Is the food appropriately covered and dated in fridge

  • Are work surfaces cleaned regularly

  • Comment on food hygiene practice within the home

Health & Safety : Water

  • Date of last Legionella survey

  • Have all actions from Legionella survey been completed

  • Water temperature checks completed without omission?

  • Date of last water temperature check

  • Date of last shower head descaling

  • Date of Last TMV service

Health & Safety Equipment , Appliances , Vehicles

  • Date of last boiler (Gas safe inspection)

  • Date of asbestos risk assessment / have all actions been completed

  • Date of last PAT testing

  • Date of last 5 yearly wiring test

  • Car 1 Date of MOT

  • Car 1 Date of Last service

  • Car 1(add VRN) Condition of vehicle, cleanliness and functionality

  • Car 1(Add VRN) : Mileage

  • Car 2 Date of Last MOT

  • Car 2 Date of last service

  • Car 2 (Add VRN) condition of vehicle, cleanliness and functionality

  • Car 2 (Add VRN): Mileage

  • Car 2 (add VRN)

Registered Managers Governance

  • Financial audit completed

  • Health & Safety audit

  • Infection control audit

  • Medication audit

  • Staff file Audit

  • Date of last spot check

Complaints / compliments / surveys

  • Number of complaints

  • Progress of complaints

  • Number of compliments

  • Progress of compliments

  • date of last staff survey

  • Themes of last staff survey

  • Date of last Service User survey

  • Themes of last Service User survey

Safer Recruitment / Staffing

  • Staff Name

  • Photo ID

  • Date of DBS

  • Date of last supervision

  • Date of Last appraisal

  • Application form on file

  • Reference 1

  • Reference 2

  • Medication Competency

  • Interview questions on file

  • Date of Signing: Working Time Directive

  • Date of Check: Right to work

  • Date of Signing: Job offer / Acceptance

  • Training Stats


  • Do staff understand their responsibility towards data security

  • Are staff are aware of data protection policy

  • Have staff completed training on data protection

  • Do staff know what to do in the event of a data breach

  • All offices , files and cabinets are locked when not in use

Service user file audit

  • Initials of Service User

  • Date of formal review

  • Date of care plan last review (monthly)

  • Does the care plan meet the identified needs of the service user

  • Do MCA assessments underpin the care plan

  • DOLS date of authorisation

  • Is the service able to demonstrate how targets and goals of the individual have been met.

  • Is the service able to demonstrate how the service user is consulted about their views wishes and feelings.

  • Is the Service able to evidence multi agency involvement in the individuals care and support.

  • Is the service engaging the service user in engaging in meaningful activities

  • Is the service encouraging positive risk taking

  • Date of Risk assessment review

  • Date of PEEP review

  • Date of Last optician visit

  • Date of last health assessment / GP / DN

  • Date of last dentist visit

  • Date of last health action plan review

  • Date of last hospital passport review

  • Date of last communication passport review

  • Has all old material been safely archived

  • Is the file in an organised state


  • Initial of service user

  • Date and time of last medication administration

  • Is MAR sheet countersigned for the above administration

  • Is guidance in place for homely remedies

  • Is there appropriate protocols for the use of PRN medication

  • Medication stock check completed

  • Is all liquid medication dated (when opened)

  • Are all creams / ointments dated (when opened) and display disposal date

  • Are all eye drops dated (when opened) and display disposal date

  • Are any alterations to MAR sheet - clear and countersigned?

Incident / accidents

  • Number of incidents (add detail in notes)

  • Number of accidents (add details in notes)

Medication Errors

  • Number of medication errors (add detail in notes)

Regulation 40 Notifications

  • Number of Regulation 40 notifications (add detail in notes)


  • Number of safeguarding referrals (add detail in notes)

  • comment on services effectiveness in managing safeguarding matters

Audit Summary

  • Is the Service safe

  • Safeguarding and protection from abuse Managing risks Suitable staff and staff cover Medicines management Infection control Learning when things go wrong

  • Is the service effective

  • Assessing needs and delivering evidence-based treatment Staff skills and knowledge Nutrition and hydration How staff, teams and services work together Supporting people to live healthier lives Accessible premises Consent to care and treatment

  • Is the service caring

  • Kindness, respect and compassion Involving people in decisions about their care Privacy and dignity

  • is the service responsive

  • Person-centred care Concerns and complaints End of life care

  • Is the service well led

  • Vision and strategy Governance and management Engagement and involvement Learning, improvement and innovation Working in partnership

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.