Innovation and Continuous Improvement Audit - Care Homes

Evidence to check

• • Quality improvement approach or improvement framework is documented.
• • Leaders can describe recent improvements and why they were needed.
• • Staff, residents and families are invited to contribute ideas.
• • Examples show improvements are acted on, not just discussed.

Evidence to check

• • Resident and relative meetings, surveys or feedback records.
• • Staff meeting minutes, supervision notes or suggestion logs.
• • Feedback from visiting professionals or commissioners.
• • Ideas are recorded, reviewed and responded to.

Evidence to check

• • Improvement records reference relevant guidance, audit findings, incident learning or professional advice.
• • Managers review updates from NICE, CQC, NHS, SCIE or local authority guidance where relevant.
• • Staff are briefed when best practice changes.
• • Practice changes are evaluated after implementation.

Evidence to check

• • Pilot or trial records include aim, timescale and expected outcome.
• • Resident safety, consent and dignity are considered before changes are tested.
• • Feedback from staff, residents and families is reviewed.
• • Changes are adapted before wider implementation where needed.

Evidence to check

• • Improvement projects clearly link to resident outcomes.
• • Measures include safety, dignity, wellbeing, choice, independence or satisfaction.
• • Residents affected by changes are reviewed for impact.
• • Projects are not focused only on paperwork or operational convenience.

Evidence to check

• • Staff suggestion systems, team meeting notes or supervision records.
• • Frontline staff ideas are acknowledged and reviewed.
• • Managers give feedback on whether ideas will be tested or not.
• • Staff report feeling safe to raise improvement ideas.

Evidence to check

• • Lessons learned records.
• • Actions from incidents, audits or complaints are added to the quality improvement plan.
• • Care plans, policies, training or staffing arrangements are changed where needed.
• • Follow-up checks confirm changes have improved practice.

Evidence to check

• • Quality improvement plan or project tracker.
• • Each project has an owner, timescale, expected outcome and review date.
• • Progress and impact are reviewed through governance.
• • Projects that do not work are adapted or stopped.

Evidence to check

• • Reflective practice, huddle or team meeting records.
• • Discussions focus on real care situations and resident outcomes.
• • Staff are encouraged to reflect without blame.
• • Learning is translated into care plan, policy or practice changes.

Evidence to check

• • Records of learning from CQC reports, webinars, provider forums, sector publications or professional networks.
• • Managers review external learning and decide whether it applies to the home.
• • Relevant learning is shared with staff.
• • External learning leads to practical improvement where appropriate.

Evidence to check

• • Resident and relative consultation records.
• • Residents are asked about proposed changes to routines, menus, activities, environment or communication.
• • Feedback influences final decisions.
• • Reasons are explained where suggestions cannot be implemented.

Evidence to check

• • Equality and accessibility considered before introducing changes.
• • Residents with dementia, sensory needs, communication needs or limited capacity are included where possible.
• • Changes do not disadvantage particular resident groups.
• • Feedback is gathered from quieter or less verbal residents using appropriate methods.

Evidence to check

• • Records of digital tools considered, trialled or implemented.
• • Consent, capacity, privacy and data protection are considered.
• • Staff and residents receive support to use new systems safely.
• • Technology is reviewed to check it improves care rather than adding burden.

Evidence to check

• • Baseline and follow-up measures are recorded where possible.
• • Resident feedback is used alongside audit, incident and complaint data.
• • Measures are linked to the intended improvement.
• • Results are discussed through governance and used to decide next steps.

Evidence to check

• • Post-implementation reviews include what worked and what did not.
• • Staff and residents are asked for feedback.
• • Learning is recorded even where the initiative did not succeed.
• • Managers avoid blame where a reasonable improvement trial did not work.

Evidence to check

• • Workflow or practice review records.
• • Staff and resident feedback identifies delays, duplication or task-focused practice.
• • Changes are made to reduce unnecessary bureaucracy or rushed care.
• • Impact on residents and staff is reviewed after changes.

Evidence to check

• • Training materials reflect current practice and systems.
• • Staff receive briefings or competency checks after changes.
• • New approaches are discussed in supervision or team meetings.
• • Staff can explain the new practice and why it was introduced.

Evidence to check

• • Case examples or outcome records.
• • Improvements are linked to resident experience or quality of life.
• • Evidence includes resident, relative or staff feedback.
• • Positive impact is reviewed and sustained over time.

Evidence to check

• • Team meeting minutes, newsletters or staff briefings share successes.
• • Good practice is recognised in supervision or appraisal.
• • Resident consent is considered before sharing personal examples.
• • Celebration of improvement encourages further ideas.

Evidence to check

• • Managers have clear responsibility for improvement work.
• • Strategic or service development plans include quality improvement priorities.
• • Leaders monitor progress and remove barriers.
• • Improvement work is not dependent on one individual only.

Evidence to check

• • Quality data is reviewed together rather than in isolation.
• • Priority areas are chosen based on risk, resident experience and outcomes.
• • Repeated themes lead to redesign or targeted improvement.
• • Improvement priorities are documented and reviewed.

Evidence to check

• • Professional input from GPs, nurses, therapists, pharmacists, dietitians, SALT, mental health teams or commissioners where relevant.
• • External advice is reflected in improvement plans.
• • Residents and relatives are included alongside professionals where appropriate.
• • Joint working leads to practical changes in care.

Evidence to check

• • Communication plan or briefing records for changes.
• • Staff on all shifts, including night, bank and agency staff, are informed where relevant.
• • Managers check understanding after changes are introduced.
• • Follow-up confirms the new practice is being used consistently.

Evidence to check

• • Evidence of links with local community groups, universities, charities, NHS teams, technology providers or pilot programmes.
• • Partnerships are chosen because they support resident needs and goals.
• • Funding or resource opportunities are considered where appropriate.
• • Impact of external partnerships is reviewed.

Evidence to check

• • Governance meeting minutes include improvement progress.
• • Quality improvement plan is current and reviewed.
• • Leaders can explain what has improved, what remains a priority and what impact has been seen.
• • Inspection evidence shows learning, action and measurable improvement.

Evidence to check

• • Post-change reviews consider staff workload and resident impact.
• • Staff feedback identifies whether the change helps or creates burden.
• • Resident experience is reviewed after process changes.
• • Processes are simplified where they do not add value.

Evidence to check

• • Audit reviews outcomes, resident experience and staff practice.
• • Initiatives are evaluated for safety, dignity, wellbeing and quality of life.
• • Projects with limited benefit are stopped or redesigned.
• • Governance focuses on what changed for residents, not only what was launched.