Call Bell System Audit - Care Homes

Evidence to check

• • Call bell policy is current and accessible to staff
• • Policy defines expected response times, escalation, fault reporting and contingency arrangements
• • Staff can explain expectations for responding to call bells respectfully and promptly
• • Observed practice and call bell data match the policy

Evidence to check

• • Walkaround confirms call bell points are available in required areas
• • Call bells are working in sampled bedrooms, bathrooms and communal areas
• • Residents who spend time in communal areas can call for help if needed
• • Missing or inaccessible call points are risk assessed and escalated

Evidence to check

• • Sampled residents have call bells within reach
• • Call bells are not tied up, shortened, hidden behind furniture or left on the floor
• • Staff check call bell access after personal care, moving and handling, cleaning or repositioning
• • Residents unable to reach standard bells have alternative arrangements

Evidence to check

• • Admission records show resident was introduced to the call bell system
• • Care plans record whether the resident can understand and use the call bell
• • Residents are reminded or supported where cognition, anxiety or communication needs affect use
• • Room moves or equipment changes trigger review of call bell access

Evidence to check

• • Staff can explain their responsibility to respond to call bells
• • Observation shows staff respond calmly and respectfully
• • Staff do not ignore, silence or dismiss repeated calls
• • Supervision or team meetings address call bell culture and resident dignity

Evidence to check

• • Call bell response data or monitoring records are available
• • Response times are reviewed by unit, shift, time of day and resident risk
• • Delays are investigated and acted on
• • Response standards consider urgent needs such as falls risk, continence, pain, anxiety or end-of-life care

Evidence to check

• • Call bell testing schedule is in place
• • Testing records show rooms, bathrooms, communal areas and zones checked
• • Faults identified during testing are reported and tracked
• • Missed tests or repeated faults are escalated

Evidence to check

• • Fault log includes date, location, fault, action and repair date
• • Temporary safety arrangements are put in place while awaiting repair
• • High-risk resident areas are prioritised
• • Delays in repair are escalated to maintenance, management or provider level

Evidence to check

• • Maintenance records for the call bell system are current
• • Service reports and repair records are retained
• • Fault trends are reviewed to identify recurring technical issues
• • Records are organised and available for inspection

Evidence to check

• • Testing confirms lights, sounders, pagers and display panels work correctly
• • Staff can identify where a call is coming from
• • Alerts can be seen or heard in relevant staff areas
• • Faults in indicators are recorded and repaired promptly

Evidence to check

• • Care plans identify residents unable to use standard call bells
• • Alternatives such as pendant alarms, pressure mats, sensor mats, touch pads, voice-activated systems or planned checks are considered
• • Consent, capacity and least-restrictive practice are considered for monitoring devices
• • Alternative systems are tested and reviewed for effectiveness

Evidence to check

• • Call bell failure contingency plan is available
• • Plan includes manual checks, temporary alarms, radios, walkie-talkies, mobile phones or increased staffing where needed
• • Staff know what to do if the system fails
• • System failures are recorded, escalated and reviewed after resolution

Evidence to check

• • Training or induction includes the local call bell system and emergency alerts
• • Staff can explain the difference between routine calls, bathroom alerts, emergency pulls and linked devices
• • Staff know how to respond when working on another unit or supporting agency staff
• • Emergency alert response is tested through observation or drills

Evidence to check

• • Alert volume is audible to staff but not excessively distressing
• • Call bell alarms are not muted, disabled or turned down unsafely
• • Residents with sensory sensitivity, dementia or anxiety are considered
• • Noise-related concerns are reviewed and acted on

Evidence to check

• • Observation confirms call bells are accessible and not deliberately removed
• • Staff understand removing or withholding call bells may be abusive or neglectful
• • Any restriction of call bell access is risk assessed, lawful and reviewed
• • Concerns about call bells being withheld are investigated immediately

Evidence to check

• • Call bell data is reviewed for frequent callers and repeated patterns
• • Care plans are reviewed where call bell use suggests unmet need
• • Staff consider pain, continence, boredom, fear, confusion or emotional distress
• • Actions are taken to reduce distress rather than discourage calling

Evidence to check

• • Care reviews discuss ability to use the call bell where relevant
• • Falls and night-time risk plans include call bell access
• • Residents with cognitive or communication needs have tailored alert arrangements
• • Changes in need trigger review of call bell or monitoring arrangements

Evidence to check

• • Night response data is reviewed separately where available
• • Night audits include call bell accessibility and response
• • Delays during breaks, handover or reduced staffing are investigated
• • Night staffing and allocation are adjusted where call bell response is unsafe

Evidence to check

• • Emergency alerts such as falls, cardiac concerns, bathroom pulls or sensor alerts are recorded
• • Response time and actions taken are documented
• • Care plans and risk assessments are updated after emergency alerts
• • Family, GP, ambulance, safeguarding or CQC notifications are considered where appropriate

Evidence to check

• • Local induction includes call bell system training
• • Agency and bank staff know alert types, zones, panels and escalation routes
• • New staff are supervised until confident with the system
• • Call bell system understanding is checked during induction

Evidence to check

• • Handover records include call bell faults and temporary safety measures
• • Residents with altered call bell access or increased risk are highlighted
• • Staff are told about residents unable to use standard call bells
• • Faults and risks remain on handover until resolved

Evidence to check

• • Resident feedback includes call bell access, response and staff attitude
• • Feedback from residents with communication needs is gathered using suitable methods
• • Concerns about delays or feeling ignored are acted on
• • Resident feedback is compared with call bell data where available

Evidence to check

• • Governance minutes include call bell response data or themes
• • Trends are reviewed by shift, unit, resident, response time and fault type
• • Actions are added to the quality improvement plan where needed
• • Senior leaders monitor repeated delays, faults or resident concerns

Evidence to check

• • Exception reports or call bell data identify delayed or cancelled calls
• • Investigation considers staffing, allocation, culture, equipment and staff conduct
• • Resident impact is reviewed
• • Action is taken through supervision, training, staffing review or formal process where needed

Evidence to check

• • System records call origin, time raised, time acknowledged and time cleared where available
• • Data is retained for audit and incident investigation
• • Manual records are used where electronic reporting is unavailable
• • Data quality is checked so reports reflect real response

Evidence to check

• • System has battery backup, backup power or emergency arrangements as required
• • Fire and emergency procedures consider call bell dependency
• • Power failure contingency arrangements are tested or reviewed
• • Maintenance records confirm backup arrangements are serviced

Evidence to check

• • Backup communication equipment is available and working
• • Staff know when and how to use backup systems
• • Manual check frequency is risk assessed during system failure
• • Backup arrangements are tested or reviewed after any failure

Evidence to check

• • Staff can explain that alarms must not be cleared before the resident is checked
• • Call bell data is reviewed for immediate cancellations or suspicious patterns
• • Observation confirms staff attend before cancelling calls
• • Unsafe practice is addressed through supervision or disciplinary process where needed

Evidence to check

• • Service schedule and current service reports are available
• • Technician or vendor competence is evidenced
• • Recommendations from servicing are completed and recorded
• • Service records are reviewed by management

Evidence to check

• • Audit includes resident feedback, staff questioning, data review and direct observation
• • Audit checks whether residents feel safe asking for help
• • Audit reviews whether delays affect dignity, continence, pain, anxiety or falls risk
• • Actions from audits lead to measurable improvement in response and resident confidence

Evidence to check

• • Call bell trends are compared with staffing levels, agency use, resident dependency and unit layout
• • Repeated delays trigger review of deployment and workload
• • Managers consider whether residents need more proactive support
• • Actions address system, staffing and care planning causes as well as individual accountability