End of Life and Palliative Care Audit - Care Homes

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  • Is there a policy in place for end of life and palliative care that aligns with national guidelines (e.g., NICE, Gold Standards Framework)?
  • Are staff trained in end of life care, communication, and supporting residents and families through bereavement?
  • Are residents’ wishes for end of life care discussed and documented in advance care plans?
  • Are Do Not Attempt CPR (DNACPR) decisions clearly recorded and reviewed regularly?
  • Are advance decisions or statements respected and included in the care plan?
  • Are staff aware of residents’ preferred place of care and preferred place of death?
  • Is spiritual, cultural, or religious support provided in line with the resident’s preferences at the end of life?
  • Is anticipatory medication available and administered in line with professional guidance and protocols?
  • Are palliative medications stored, monitored, and documented securely and correctly?
  • Are pain and symptom management needs reviewed regularly by trained staff or external professionals?
  • Are multidisciplinary professionals involved in end of life planning (e.g., GPs, district nurses, hospices)?
  • Are residents and their families involved in decision-making, and are changes clearly communicated?
  • Are individual care plans updated promptly following changes in a resident’s condition or prognosis?
  • Are residents supported to maintain dignity and comfort throughout the final stages of life?
  • Are staff supported emotionally and practically during and after the death of a resident?
  • Is bereavement support offered to families and carers before and after a resident’s death?
  • Are after-death procedures respectful, timely, and carried out in line with policy and family wishes?
  • Are incidents or concerns about end of life care reviewed and used to improve practice?
  • Is feedback from families on end of life care collected and used to develop the service?
  • Are residents with complex conditions referred appropriately to palliative care specialists?
  • Are staff trained in recognising and responding to signs of deterioration or terminal decline?
  • Are visual or sensory impairments considered in the delivery of compassionate end of life care?
  • Are nutrition, hydration, and comfort support addressed in the last days of life with sensitivity?
  • Are any concerns around capacity or best interest decisions properly assessed and documented?
  • Is the effectiveness of end of life care reviewed in governance meetings and quality reports?
  • Are care environments adapted to ensure privacy, quiet, and comfort for the dying resident?
  • Are residents’ choices around personal appearance, rituals, or final arrangements respected?
  • Is there a consistent, respectful approach to informing other residents about a peer's passing?
  • Are end of life care champions or leads designated to guide and support good practice?
  • Are any delays in receiving palliative input or equipment escalated appropriately and recorded?