End of Life and Advanced Care Planning Audit - Domiciliary Care
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- Q1: Is there a policy in place for end of life care and advance care planning, aligned with national guidance?
- Q2: Are staff trained in end of life care, communication, and recognising signs of deterioration?
- Q3: Are service users asked about their end of life wishes and preferences in a sensitive, appropriate way?
- Q4: Are advance care plans (ACPs) created in partnership with service users and/or their families?
- Q5: Are Do Not Attempt CPR (DNACPR) decisions recorded clearly, with documented consent or best interest rationale?
- Q6: Are staff aware of and able to access DNACPR and ACP documents during care delivery?
- Q7: Are discussions about preferred place of care and death documented and respected?
- Q8: Are religious, spiritual, or cultural preferences explored and recorded for end of life care?
- Q9: Are pain management needs regularly assessed and responded to promptly?
- Q10: Are staff trained to provide comfort, dignity, and reassurance to people who are dying?
- Q11: Are palliative care medications managed safely and in accordance with clinical guidance?
- Q12: Are anticipatory medications stored, recorded, and administered according to protocols?
- Q13: Are families and carers supported with practical, emotional, and spiritual needs during end of life?
- Q14: Is care coordinated with palliative or hospice teams, district nurses, and GPs where needed?
- Q15: Are emergency contacts and escalation procedures clearly documented and followed?
- Q16: Are end of life care needs flagged in the care plan, risk assessments, and staff rotas?
- Q17: Is bereavement support information offered to families, carers, and staff?
- Q18: Are after-death procedures (notifications, reporting, equipment retrieval) followed respectfully and accurately?
- Q19: Are complaints or concerns about end of life care reviewed and used to improve services?
- Q20: Is staff emotional wellbeing supported following the death of a service user?
- Q21: Are case reviews or reflective debriefs held after deaths to identify learning opportunities?
- Q22: Are changes in a person’s condition (e.g., increased frailty, weight loss) escalated promptly?
- Q23: Are staff confident in raising concerns about the appropriateness or clarity of care plans?
- Q24: Are end of life care goals aligned with national frameworks such as the Gold Standards Framework or NICE?
- Q25: Is feedback from families on end of life care collected and analysed for quality improvement?
- Q26: Are digital tools used to coordinate end of life care planning across teams and agencies?
- Q27: Are key professionals involved in regular review of end of life cases or protocols?
- Q28: Is the service proactive in initiating advance care planning early, not just in crisis?
- Q29: Is diversity considered in how end of life wishes are explored and supported (e.g., beliefs, LGBTQ+ needs)?
- Q30: Is performance in end of life care reviewed as part of the service’s quality governance framework?