End of Life and Advanced Care Planning Audit - Domiciliary Care

Your Score: 0%

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