Night Visit Audit - Care Homes

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  • Is the night visit documented with date, time, staff present, and duration of visit?
  • Is the senior person in charge clearly identified and aware of their responsibilities during the night shift?
  • Is the staff allocation and rota for the night clear, appropriate, and aligned with residents’ needs and dependency levels?
  • Have staff breaks been scheduled fairly, and are they monitored to ensure safe coverage of care during rest periods?
  • Are staff aware of emergency procedures, including fire, falls, and medical escalation protocols during night hours?
  • Are there any unpleasant odours in the home, particularly near communal areas, bathrooms, or resident bedrooms?
  • Is the home quiet and calm, with no excessive noise, shouting, or disruptive behaviours reported or observed?
  • Are all residents appropriately settled, safe, and comfortable in their rooms or communal spaces?
  • Are residents who are awake receiving appropriate supervision, reassurance, and care?
  • Is lighting at night appropriate for safety and sleep (e.g., dim in hallways, bright in nursing stations)?
  • Is the temperature throughout the home appropriate and consistent, with no hot or cold spots?
  • Are windows secure, and are environmental checks (e.g., fire doors, call bells, exits) completed and documented?
  • Are call bells accessible, functioning, and responded to in a timely manner?
  • Are staff presentable and wearing appropriate PPE (including face masks if required by IPC guidance)?
  • Are staff alert, responsive, and engaging respectfully with residents and visitors (if any)?
  • Are fluid jugs available and within reach for residents who are awake or have night-time fluid requirements?
  • Are continence needs being met, and are checks conducted with dignity and appropriate frequency?
  • Is repositioning/turning of residents done in line with care plans and documented accurately in turning charts?
  • Is the fluid balance chart completed correctly and in line with each resident’s plan of care?
  • Are all MAR charts for night medication up to date, complete, and stored securely?
  • Have all medications due at night (including PRN) been administered appropriately and recorded accurately?
  • Are wound dressings and pressure-relieving equipment (e.g., air mattresses) checked and functioning?
  • Are night domestic or cleaning duties completed or in progress with minimal disruption to residents?
  • Are kitchen and food storage areas secure, clean, and compliant with food safety standards?
  • Are laundry areas tidy and machines safely operated if used overnight?
  • Have staff raised any clinical concerns or safeguarding issues during the shift, and were these escalated appropriately?
  • Is there evidence of meaningful staff engagement with residents who are awake or distressed?
  • Is a handover system in place for early staff or agency relief, and is it prepared and thorough?
  • Are agency staff present, and are they familiar with residents and supported by permanent staff?
  • Have any incidents (e.g., falls, aggression, deterioration) occurred, and are they documented with appropriate actions?
  • Are any DoLS or night-time restrictions (e.g., sensor mats, locked doors) in place and reviewed for proportionality?
  • Is CCTV, where used, operating as expected and aligned with privacy and data protection policies?
  • Are staff aware of and compliant with night-time infection prevention and control measures (e.g., zoned areas)?
  • Are night-time charts (fluid, repositioning, bowel, observation) signed, complete, and legible?
  • Are any night admissions, discharges, or end-of-life care situations documented and supported compassionately?
  • Is there evidence that night leadership (e.g., nurse in charge) is monitoring standards and mentoring junior staff?
  • Are shift leaders aware of audit findings, previous night visit outcomes, and follow-up actions?
  • Is staff morale during the night observed and discussed, with any issues escalated?
  • Is there a record of any complaints or compliments related to night care?
  • Have any required improvements from previous visits been addressed and sustained?
  • Is a summary discussion held with the senior person in charge before completing the visit?
  • Are new concerns raised during the visit clearly documented with follow-up actions identified?
  • Is the visit recorded, signed, and submitted for governance review and any necessary escalation?