Contingency and Business Continuity Audit - Care Homes

Evidence to check

• • Business continuity plan is current and specific to the care home.
• • Plan covers fire, flood, severe weather, pandemic, power failure, water failure, gas leak, cyber incident, staffing shortage and building closure.
• • Plan identifies essential services that must continue, such as personal care, medicines, nutrition, hydration, heating and clinical support.
• • Staff and managers can explain how the plan would work in practice.

Evidence to check

• • BCP review date and version control.
• • Plan updated after incidents, exercises, outbreaks, building changes or changes in resident dependency.
• • Learning from real events is recorded and added to the plan.
• • Staff are informed when emergency procedures change.

Evidence to check

• • Risk assessments or risk register include business continuity risks.
• • Each risk has control measures, escalation routes and named responsibilities.
• • High-risk or unresolved issues are escalated to senior leadership.
• • Controls are realistic for the current building, staffing and resident needs.

Evidence to check

• • Staff training or briefing records on business continuity.
• • Staff can answer scenario-based questions about emergency response.
• • Plan is accessible to day, night, bank and agency staff where appropriate.
• • New staff receive emergency planning information during induction.

Evidence to check

• • Emergency contact list is up to date.
• • Contacts include staff, next of kin, GP, pharmacy, commissioners, local authority, contractors, utility providers and emergency services.
• • Out-of-hours numbers are included.
• • Contact lists are available if digital systems fail.

Evidence to check

• • Critical incident escalation procedure.
• • Named roles for registered manager, senior staff, on-call and provider leadership.
• • CQC, safeguarding, commissioner, local authority and emergency service notification requirements are included.
• • Incident records show timely escalation during previous events.

Evidence to check

• • Emergency plans include evacuation and shelter-in-place options.
• • Drill or tabletop exercise records.
• • Exercises include different shifts, staffing levels and resident dependency scenarios.
• • Learning from drills leads to updates and staff briefings.

Evidence to check

• • Relocation plan identifies possible alternative accommodation or mutual aid arrangements.
• • Plan covers transport, staffing, medicines, records, equipment, food, clothing and continence supplies.
• • High-dependency residents are prioritised.
• • Arrangements are reviewed for feasibility and current contact details.

Evidence to check

• • Medication continuity plan is included in the BCP.
• • Emergency access to MAR charts or eMAR downtime records is available.
• • Arrangements for medicines fridge failure, controlled drugs, oxygen and urgent prescriptions are clear.
• • Pharmacy and prescriber contact details are current.

Evidence to check

• • Contingency plan includes nutrition, hydration and specialist diets.
• • Resident dietary needs, allergies, texture-modified diets and diabetes requirements are accessible in an emergency.
• • Food and fluid monitoring continues for at-risk residents.
• • Professional escalation routes are clear where medical needs change during disruption.

Evidence to check

• • Utility failure plans are included in the BCP.
• • Contacts for utility providers and emergency contractors are available.
• • Backup heating, lighting, bottled water, generator or alternative arrangements are considered where applicable.
• • Residents at higher risk from cold, heat or equipment failure are identified.

Evidence to check

• • Emergency food, fluid and essential supplies stock list.
• • Stocks include specialist diets, thickener, supplements or texture-modified options where needed.
• • Stock is rotated and checked for expiry.
• • Supply levels are proportionate to the size and needs of the home.

Evidence to check

• • Digital downtime procedure.
• • Manual MAR, care record, rota and contact backup arrangements are available.
• • Staff know how to record care safely during system failure.
• • Downtime process is tested or reviewed after digital incidents.

Evidence to check

• • Outbreak or pandemic plan is current.
• • PPE stock monitoring and reorder arrangements are in place.
• • Isolation, cohorting, enhanced cleaning and staff sickness arrangements are included.
• • Learning from previous outbreaks is reflected in the plan.

Evidence to check

• • Emergency communication plan.
• • Named people responsible for contacting relatives, professionals, commissioners and staff.
• • Resident communication needs are considered, including dementia, sensory impairment or anxiety.
• • Previous incidents show communication was timely, clear and recorded.

Evidence to check

• • BCP identifies roles and responsibilities by shift and seniority.
• • Staff know who leads in the absence of the registered manager.
• • On-call arrangements are current and tested.
• • Decision-making authority is clear during nights, weekends and bank holidays.

Evidence to check

• • Staff shortage contingency plan.
• • Cross-training or skill mix planning is evident.
• • Bank, agency or redeployment arrangements are identified.
• • Safe staffing decisions are based on resident dependency and risk.

Evidence to check

• • Critical contractor list with emergency contacts.
• • Service level agreements or emergency call-out arrangements where applicable.
• • Alternative providers or backup options are identified where possible.
• • Contractor failures are logged, escalated and reviewed.

Evidence to check

• • Agency and temporary staff contingency arrangements.
• • Local induction covers emergency procedures, resident risks, fire safety, safeguarding and confidentiality.
• • Temporary staff are not allocated tasks beyond competence.
• • Volunteers are risk-assessed and supervised where used.

Evidence to check

• • Resident-specific emergency needs are identified.
• • PEEPs and care plans reflect current dependency and equipment needs.
• • High-risk residents are flagged for evacuation, welfare checks or clinical continuity.
• • Staff can explain how they would support sampled high-risk residents.

Evidence to check

• • Current insurance documents are available.
• • Cover includes business interruption and relevant liability where applicable.
• • Senior leaders review whether cover matches current service risks.
• • Insurance contact details and claims process are accessible.

Evidence to check

• • Backup arrangements for key digital and paper documents.
• • Backups are stored securely and access-controlled.
• • Backups are current and updated when information changes.
• • Staff know how to access backups during an emergency.

Evidence to check

• • Emergency plans consider anxiety, dementia, distress and communication needs.
• • Staff provide reassurance and maintain routines where possible.
• • Family contact is supported during disruption where appropriate.
• • Post-incident support and debrief are offered to residents where needed.

Evidence to check

• • Debrief or lessons learned records.
• • BCP, risk assessments or procedures updated after learning.
• • Staff briefings or training reflect lessons learned.
• • Actions are tracked until completed.

Evidence to check

• • BCP audit records.
• • Governance minutes include continuity risks, drills, incidents and outstanding actions.
• • Senior leaders review whether the home is prepared for major disruption.
• • Actions have owners, deadlines and evidence of completion.

Evidence to check

• • Scenario testing includes nights, weekends or bank holidays.
• • Night staff can access key contacts, emergency plans and escalation support.
• • On-call response is tested or reviewed.
• • Learning from out-of-hours incidents is included in governance.

Evidence to check

• • Audit includes staff questioning, walkaround checks and scenario testing.
• • Audit checks availability of supplies, contacts, backups and resident-specific plans.
• • Findings are linked to practical improvements.
• • Follow-up confirms staff confidence and emergency readiness improved.