End of Life and Advanced Care Planning Audit - Domiciliary Care

Relevant CQC Fundamental Standards

Regulation 9: Person-centred care Regulation 10: Dignity and respect Regulation 12: Safe care and treatment Regulation 17: Good governance

Answered 0 / 33(0% complete)

Note: This is the "clipboard" version of the audit. Only allocate tasks to users once you are satisfied that the audit is complete and accurate. Once saved, it is added to your Compliance Calendar as the final version for that month, where you can allocate tasks, upload evidence, and manage actions.

Score

N/A counts as Yes (full credit). Unanswered reduces the score until completed.

Breakdown

0 Yes •0 No •0 N/A •33 Unanswered

0%100%

Answers Overview

Yes

N/A

Unanswered

Questions

0/33 answered

Q1 | Unanswered
When staff are asked about end of life care, can they explain how they support people to remain comfortable, dignified and involved in decisions while receiving care at home?
Evidence to check
- • End of life care and advance care planning policy is current and specific to domiciliary care
- • Staff can explain their role in supporting comfort, dignity and escalation
- • Policy reflects partnership working with GPs, district nurses, hospice and palliative care teams
- • Staff know where to find guidance when a person is deteriorating or approaching end of life
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q2 | Unanswered
Are staff trained and confident to recognise deterioration, communicate sensitively and respond appropriately when a person may be approaching end of life?
Evidence to check
- • End of life care training records
- • Staff can describe signs of deterioration, increased frailty, pain, distress or reduced intake
- • Staff know how to escalate concerns to the office, GP, district nurse or emergency services
- • Supervision or reflective discussions include end of life care where relevant
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q3 | Unanswered
Are people asked about their end of life wishes in a sensitive, timely and person-led way, rather than only during crisis or rapid deterioration?
Evidence to check
- • Care review notes show sensitive conversations about wishes and preferences
- • The person's readiness to discuss end of life is respected
- • Family, advocate or representative involvement is recorded where appropriate
- • Staff do not make assumptions about what the person wants
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q4 | Unanswered
Are advance care plans created with the person and/or relevant others, and do they reflect what matters to the person in their own home?
Evidence to check
- • Advance care plan completed where appropriate
- • The person's priorities, fears, wishes and preferences are recorded
- • Family, attorney, advocate or professional involvement is documented where relevant
- • Plan is reviewed when the person's condition or wishes change
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q5 | Unanswered
Where DNACPR or ReSPECT decisions are in place, are they recorded clearly, accessible to staff and supported by appropriate clinical decision-making, consent or best-interest rationale?
Evidence to check
- • DNACPR or ReSPECT documentation available and current
- • Decision-making records show consultation with the person or relevant others where appropriate
- • Mental capacity or best-interest records where the person lacks capacity
- • Staff understand they must follow the recorded decision and escalate if documentation is unclear
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q6 | Unanswered
Can staff access and understand the person's advance care plan, DNACPR or ReSPECT information during care delivery, including out of hours?
Evidence to check
- • Care records clearly identify where ACP, DNACPR or ReSPECT documents are kept
- • Staff know how to access relevant information during visits
- • Out-of-hours staff have access to current instructions
- • No conflicting or outdated end of life documents remain active
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q7 | Unanswered
Are preferred place of care and preferred place of death discussed, recorded and used to guide decisions wherever possible?
Evidence to check
- • Preferred place of care and death recorded where the person wishes to discuss this
- • Care plan reflects practical actions needed to support the preference
- • Professionals and family are aware where appropriate
- • Reasons are recorded if the person's preferred place cannot be achieved
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q8 | Unanswered
Are religious, spiritual, cultural and personal beliefs explored respectfully and reflected in end of life care?
Evidence to check
- • Care plan records spiritual, cultural or religious preferences
- • Specific wishes about rituals, prayer, modesty, visitors, food, music or after-death care are documented
- • Staff can explain how they support these preferences in practice
- • Family, faith leaders or community contacts involved where the person wants this
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q9 | Unanswered
When pain, discomfort or distress is observed, do staff respond promptly by recording concerns and escalating to the appropriate professional?
Evidence to check
- • Care notes record pain, discomfort, agitation, breathlessness or distress
- • Staff know how to recognise non-verbal signs of pain or distress
- • Escalation to GP, district nurse, hospice or palliative care team is documented
- • Follow-up records show whether the person became more comfortable
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q10 | Unanswered
During visits, do staff support comfort, dignity, reassurance and emotional wellbeing for people who are dying?
Evidence to check
- • Care notes show comfort measures, reassurance and emotional support
- • Staff maintain privacy, dignity and calm communication
- • The person's preferred routines, positioning, personal care and environment are respected
- • Family or carers are updated and supported where appropriate
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q11 | Unanswered
Where palliative care medicines are involved, are staff clear about their role and do they escalate medication concerns safely without acting outside their competence?
Evidence to check
- • Medication support plan clearly states staff responsibilities
- • Staff know which medicines are managed by nurses, GP, hospice or family carers
- • Medication changes are communicated promptly to care staff
- • Concerns about pain relief, side effects, missed doses or stock are escalated
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q12 | Unanswered
Where anticipatory medicines are present in the home, are storage, access, recording and professional administration arrangements clear and safely managed?
Evidence to check
- • Care plan records that anticipatory medicines are in place where relevant
- • Storage arrangements are safe and known to relevant staff
- • Staff know who is authorised to administer anticipatory medicines
- • Concerns about availability, expiry, missing medicines or unclear instructions are escalated promptly
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q13 | Unanswered
Are families and informal carers supported with practical, emotional and spiritual needs while the person is approaching end of life?
Evidence to check
- • Care notes show communication with family or informal carers where appropriate
- • Family concerns, questions or distress are recorded and escalated where needed
- • Information is provided about who to contact for clinical or emotional support
- • Staff respect family involvement while keeping the person's wishes central
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q14 | Unanswered
Is end of life care coordinated effectively with GPs, district nurses, hospice teams, palliative care teams and other professionals?
Evidence to check
- • Records of communication with external professionals
- • Professional advice is added to the care plan promptly
- • Staff know who is leading clinical care
- • Actions from professionals are followed and reviewed
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q15 | Unanswered
Are emergency contacts, escalation routes and out-of-hours instructions clear, current and followed when the person deteriorates or dies at home?
Evidence to check
- • Emergency contact information is current and accessible
- • Out-of-hours escalation instructions are clear
- • Staff know when to contact family, office, GP, district nurse, hospice, 111 or 999
- • Previous emergency events show escalation was timely and appropriate
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q16 | Unanswered
Are end of life care needs clearly flagged in the care plan, risk assessments, visit schedules and staff handovers so staff arrive prepared?
Evidence to check
- • Care plan clearly identifies end of life or palliative care needs
- • Rotas or visit notes highlight key risks and instructions appropriately
- • Staff handovers include changes in condition, comfort needs and escalation instructions
- • Visit times and staffing are adjusted where the person's needs increase
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q17 | Unanswered
Is bereavement support information offered to families, informal carers and staff where appropriate?
Evidence to check
- • Bereavement information or signposting available
- • Families are offered support after death where appropriate
- • Staff know how to access emotional support after a death
- • Records show bereavement communication was handled sensitively
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q18 | Unanswered
After a person dies, do staff follow respectful and accurate procedures for notifications, records, property, equipment and communication?
Evidence to check
- • After-death procedure is available and understood by staff
- • Staff know who to contact and what not to do beyond their role
- • Records of death notification, visit notes and communication are completed accurately
- • Equipment retrieval, medicines, keys or property arrangements are handled respectfully
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q19 | Unanswered
Are complaints, concerns or poor experiences relating to end of life care reviewed and used to improve practice?
Evidence to check
- • Complaints and concerns reviewed for end of life themes
- • Family feedback is considered sensitively
- • Actions are recorded and followed up
- • Learning is shared with staff and reflected in care planning or training
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q20 | Unanswered
Is staff emotional wellbeing supported after the death of a person they cared for, especially where the death was distressing or unexpected?
Evidence to check
- • Supervision or debrief offered after deaths
- • Staff know how to access emotional support
- • Managers check on staff involved in difficult end of life care
- • Staff feedback shows they feel supported, not blamed or ignored
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q21 | Unanswered
Are reflective reviews or debriefs held after deaths to identify what went well, what could improve and whether the person's wishes were met?
Evidence to check
- • Case review or debrief records
- • Learning includes communication, comfort, care coordination and responsiveness
- • Family feedback considered where appropriate
- • Actions from reviews lead to changes in practice
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q22 | Unanswered
Are changes such as increased frailty, weight loss, reduced intake, falls, pressure damage, confusion or withdrawal recognised and escalated promptly?
Evidence to check
- • Care notes record deterioration or changes in wellbeing
- • Staff know triggers for escalation
- • Escalation to office, GP, district nurse or palliative care team is documented
- • Care plan reviewed after deterioration is identified
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q23 | Unanswered
Do staff feel confident to question unclear, outdated or inappropriate end of life care plans and escalate concerns without delay?
Evidence to check
- • Staff can explain how to challenge unclear instructions
- • Records show concerns escalated to managers or professionals
- • Care plans are updated when staff identify gaps or contradictions
- • Managers respond to staff concerns promptly
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q24 | Unanswered
Are end of life care goals aligned with recognised good practice and translated into practical actions for staff during home visits?
Evidence to check
- • Care plan includes clear goals for comfort, dignity, communication and preferred care
- • Goals are personalised to the person, not generic
- • Staff understand how to support the goals during visits
- • Reviews check whether goals are being achieved
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q25 | Unanswered
Is feedback from families about end of life care collected sensitively and used to improve quality?
Evidence to check
- • Family feedback requested in a sensitive and optional way
- • Feedback themes are reviewed by managers
- • Compliments and concerns are used for learning
- • Changes made as a result of family feedback are recorded
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q26 | Unanswered
Where digital tools are used, do they support safe coordination of end of life care without compromising confidentiality, accuracy or timely communication?
Evidence to check
- • Digital care plan contains current end of life information
- • Access is limited to authorised staff
- • Updates are communicated promptly across staff and office teams
- • Digital records do not conflict with paper ACP, DNACPR or ReSPECT documents
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q27 | Unanswered
Are key professionals involved in reviewing end of life care arrangements, especially where needs are changing or symptoms are difficult to manage?
Evidence to check
- • GP, district nurse, hospice or palliative care input recorded
- • Professional review dates and advice documented
- • Care plan updated after professional review
- • Staff know when further professional review is needed
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q28 | Unanswered
Is the service proactive in starting advance care planning early, where appropriate, rather than waiting until crisis, rapid deterioration or hospital discharge?
Evidence to check
- • Advance care planning discussed during reviews where appropriate
- • People are given time and choice about whether to discuss future care
- • Early signs of deterioration trigger review and planning
- • Care records show planning conversations are revisited over time
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q29 | Unanswered
Is diversity considered when exploring and supporting end of life wishes, including culture, religion, language, disability, sexuality, gender identity and family structure?
Evidence to check
- • Care plan records individual identity, beliefs and preferences where the person wishes
- • Staff avoid assumptions about family roles, beliefs or relationships
- • Communication support, interpreters or advocacy used where needed
- • Chosen family or significant others are recognised where the person wants this
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q30 | Unanswered
Is end of life care performance reviewed through governance so the service can identify themes, improve quality and sustain good practice?
Evidence to check
- • Governance reports include end of life care themes
- • Deaths, complaints, compliments, incidents and family feedback are reviewed
- • Actions are added to the quality improvement plan where needed
- • Learning is shared with staff and followed up
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q31 | Unanswered
Are visit schedules and call durations reviewed when a person is approaching end of life so care is not rushed and changing needs can be met safely?
Evidence to check
- • Visit times reviewed after deterioration or palliative care involvement
- • Call durations allow time for comfort, dignity, communication and recording
- • Additional or longer visits requested where needed
- • Staff report concerns if visits are too short to meet end of life needs
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q32 | Unanswered
Are nutrition, hydration, mouth care, skin integrity and pressure area risks reviewed sensitively as the person deteriorates?
Evidence to check
- • Care plan reflects changing needs around eating, drinking, mouth care and skin care
- • Staff understand comfort-focused support where intake reduces
- • Concerns about pressure damage, dehydration, swallowing or discomfort are escalated
- • Professional advice is followed and documented
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.
Q33 | Unanswered
Are staff clear about what to do if they arrive and the person appears to have died, including preserving dignity, contacting the right people and recording accurately?
Evidence to check
- • Staff can explain the procedure if they find a person deceased
- • Emergency and family contact instructions are accessible
- • Staff understand their role and limits around verification or certification of death
- • Records from previous deaths show respectful and timely action
Supporting Notes
No notes yet.
Notes are stamped with your name, date and time.

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