Agency Usage Audit - Care Homes

Q1 | Unanswered

Is there a current Agency / Temporary Staffing policy that defines when agency can be used, approval routes, and compliance checks?

Q2 | Unanswered

Is there a named lead responsible for agency governance (e.g., Registered Manager/Provider/HR lead) with clear accountability?

Q3 | Unanswered

Is agency usage monitored through governance meetings with actions to reduce reliance and improve continuity?

Q4 | Unanswered

Are thresholds/triggers in place for escalation (e.g., % of hours by agency, spend levels, repeated short-notice gaps)?

Q5 | Unanswered

Is there a documented contingency plan for staffing shortfalls that prioritises safer alternatives (bank, overtime, redeployment) before agency?

Q6 | Unanswered

Is agency usage analysed alongside quality indicators (falls, meds errors, complaints, call bell response times) to identify risk correlation?

Q7 | Unanswered

Is there a strategy to build a preferred agency list with performance monitoring and removal criteria?

Q8 | Unanswered

Are agencies used under contract/framework with agreed rates, roles, compliance requirements, and escalation arrangements?

Q9 | Unanswered

Are rates agreed in advance and consistently applied (including enhancements for nights/weekends/short notice)?

Q10 | Unanswered

Is there a process to validate invoices against booked shifts and actual hours worked (to prevent overbilling)?

Q11 | Unanswered

Are agency spend reports produced (weekly/monthly) and reviewed against budget and staffing plan?

Q12 | Unanswered

Is there evidence of competitive rate checking and cost-control measures (caps, preferred suppliers, block bookings)?

Q13 | Unanswered

Are cancellations and no-shows recorded and challenged with agencies where appropriate?

Q14 | Unanswered

Are agencies required to provide evidence of right to work, DBS, references, training, and immunisation/health status as applicable?

Q15 | Unanswered

For nurses, is NMC registration status verified and rechecked at defined intervals?

Q16 | Unanswered

Are professional indemnity arrangements and insurance verified for agency nurses where required?

Q17 | Unanswered

Are restrictions defined for non-compliant agencies/staff (e.g., cannot work until documents received/verified)?

Q18 | Unanswered

Are agency bookings authorised by a designated manager and not arranged informally without oversight?

Q19 | Unanswered

Is the role and competency required specified at booking (e.g., medication-trained carer, nurse-in-charge experience, dementia experience)?

Q20 | Unanswered

Are agency staff allocated appropriately (not left as lone nurse, not placed in charge unless verified and authorised)?

Q21 | Unanswered

Are staffing allocations adjusted to reduce risk when agency staff are used (buddying, increased supervision, simpler task allocation)?

Q22 | Unanswered

Are agency staff deployment patterns monitored to avoid repeated use in high-risk roles without demonstrated competence?

Q23 | Unanswered

Are agency staff used to support rather than replace supernumerary management, and if not, is this risk assessed and escalated?

Q24 | Unanswered

Is there a documented local induction checklist that is completed for every agency worker on every first shift (and refreshed periodically)?

Q25 | Unanswered

Does induction cover emergency procedures (fire, gas leak, missing person, choking, first aid, safeguarding escalation)?

Q26 | Unanswered

Does induction cover infection prevention and control (PPE, hand hygiene, isolation/cohorting, outbreak rules, waste handling)?

Q27 | Unanswered

Does induction cover medication boundaries (who can administer, MAR/TAR expectations, PRN protocols, error reporting routes)?

Q28 | Unanswered

Does induction cover moving & handling essentials (equipment locations, key resident transfer plans, hoist/sling rules, ‘no lift’ guidance)?

Q29 | Unanswered

Does induction include tour/orientation (layout, call bells, exits, sluice, clinical rooms, storage, staff base)?

Q30 | Unanswered

Does induction include key policies: safeguarding, whistleblowing, incident reporting, confidentiality, professional boundaries?

Q31 | Unanswered

Are key resident risks shared before starting (falls risks, choking/IDDSI, pressure care, behaviours of concern, allergies, oxygen use)?

Q32 | Unanswered

Are communication needs shared (dementia approaches, preferred names, language needs, sensory impairments, MCA/DoLS flags)?

Q33 | Unanswered

Is induction evidence recorded (signature/time) and retained for audit?

Q34 | Unanswered

Is agency-provided competency evidence reviewed before the shift for key tasks (meds, catheters, insulin, PEG, wound care)?

Q35 | Unanswered

Are agency staff observed/spot-checked on first shift for high-risk tasks (e.g., medication round, documentation quality)?

Q36 | Unanswered

Are clear restrictions applied where competence is not proven (e.g., no meds, no catheter care, no being in charge)?

Q37 | Unanswered

Are agency nurses assessed for clinical leadership and decision-making before being allocated as nurse-in-charge?

Q38 | Unanswered

Do agency staff understand escalation routes (who is senior, how to contact GP/111/999, when to call manager/on-call)?

Q39 | Unanswered

Are agency workers trained in dementia care/de-escalation where working with residents who display distress behaviours?

Q40 | Unanswered

Are language/communication competence and understanding of documentation systems adequate (English comprehension, digital systems training)?

Q41 | Unanswered

Are agency staff supported to use the home’s care recording systems correctly (paper/electronic notes, incident forms, body maps)?

Q42 | Unanswered

Is there a process to provide immediate coaching or remove staff from duties if unsafe practice is observed?

Q43 | Unanswered

Are incidents involving agency staff identified and reviewed (med errors, falls, safeguarding, documentation failures) with learning recorded?

Q44 | Unanswered

Are complaints/feedback about agency staff recorded and escalated to the agency with outcomes tracked?

Q45 | Unanswered

Are agency staff performance ratings captured (punctuality, competence, attitude, teamwork, resident feedback)?

Q46 | Unanswered

Is there a ‘do not return’ process for poor performance, with evidence of action taken and agency notified?

Q47 | Unanswered

Are near-misses and positive feedback also captured to improve selection of preferred staff?

Q48 | Unanswered

Is continuity monitored (same agency workers returning) to reduce risk and improve resident experience?

Q49 | Unanswered

Do agency workers sign in/out with verified times, and are hours matched to rota and invoicing?

Q50 | Unanswered

Are shift allocation sheets retained showing duties assigned and who supervised/checked key tasks?

Q51 | Unanswered

Are agency staff included in handovers and safety huddles with documented attendance where applicable?

Q52 | Unanswered

Are agency staff supervised during shift (named buddy/supervisor) and is this recorded in allocation notes?

Q53 | Unanswered

Are safeguarding disclosures/concerns raised by agency workers recorded and followed up appropriately?

Q54 | Unanswered

Is agency spend tracked by week/month, role, unit, and reason for use (sickness, vacancies, enhanced observations, surge demand)?

Q55 | Unanswered

Are the most expensive drivers identified (short notice bookings, high enhancements, repeat cancellations) and addressed with a plan?

Q56 | Unanswered

Are agency costs compared to alternatives (bank/overtime/recruitment) to support decision-making?

Q57 | Unanswered

Is there a plan to reduce agency reliance (recruitment pipeline, retention actions, bank development, roster improvements)?

Q58 | Unanswered

Are vacancy costs and agency costs reported together to show true staffing cost impact and inform strategic decisions?

Q59 | Unanswered

Are block booking arrangements reviewed for effectiveness and cost control (quality, continuity, compliance)?

Q60 | Unanswered

Can the home produce an agency compliance pack for recent workers (DBS, right to work, training, competencies, NMC checks where applicable)?

Q61 | Unanswered

Can the home provide evidence of completed local induction checklists for a sample of agency shifts?

Q62 | Unanswered

Can the home provide an agency spend report for the last 3–6 months with trend analysis and actions to reduce reliance?

Q63 | Unanswered

Can the home demonstrate how agency performance is monitored and how poor performers are removed from the rota?