Staffing Levels and Dependency Audit - Care Homes

Q1 | Unanswered

Is there a documented Staffing Establishment / Workforce Planning policy that sets out how safe staffing is determined and reviewed?

Q2 | Unanswered

Is there a named lead responsible for staffing governance (e.g., Registered Manager/Deputy/HR lead) with clear accountability?

Q3 | Unanswered

Is staffing reviewed in governance meetings using evidence (dependency tools, incidents, complaints, outcomes) and actions recorded?

Q4 | Unanswered

Is there a clear escalation framework for staffing shortfalls (on-call, redeployment, agency approval, contingency actions)?

Q5 | Unanswered

Are staffing decisions demonstrably aligned to residents’ needs, safety, and outcomes (not purely budget-led)?

Q6 | Unanswered

Is there evidence the provider considers CQC expectations around sufficient numbers of suitably skilled staff across all shifts?

Q7 | Unanswered

Is the funded establishment defined for each role (RNs, senior carers, carers, activities, housekeeping, kitchen, maintenance) and reviewed periodically?

Q8 | Unanswered

Is skill mix planned per shift (e.g., nurse numbers, senior coverage, medication-trained staff, dementia/complex needs competence)?

Q9 | Unanswered

Are minimum staffing levels defined for day/night shifts and for different units (e.g., dementia unit vs residential unit)?

Q10 | Unanswered

Is there always an appropriately qualified nurse on duty where required (e.g., nursing home), with clear cover arrangements?

Q11 | Unanswered

Is there a clear shift leadership structure (nurse in charge/senior carer) with accountability for allocation and oversight?

Q12 | Unanswered

Are ancillary roles (activities, housekeeping, kitchen) adequate to prevent care staff being pulled away from direct care routinely?

Q13 | Unanswered

Are lone-working risks assessed (e.g., nights, small homes, single nurse) and mitigated with clear support mechanisms?

Q14 | Unanswered

Is a recognised dependency/acuity tool used (or a robust internal methodology) to assess resident needs and required staffing hours?

Q15 | Unanswered

Are dependency scores reviewed at a defined frequency and when residents’ needs change (falls, infections, hospital discharge, end-of-life)?

Q16 | Unanswered

Do dependency assessments consider both physical dependency (mobility, continence, feeding) and cognitive/behavioural needs (distress, wandering)?

Q17 | Unanswered

Are 1:1 or enhanced observations included in acuity calculations with clear rationale, duration, and review dates?

Q18 | Unanswered

Are night-time needs explicitly assessed (repositioning, toileting, dementia-related waking, monitoring) rather than assumed lower acuity?

Q19 | Unanswered

Are residents requiring complex interventions reflected in acuity (wound care, catheter care, insulin, PEG, oxygen, end-of-life care)?

Q20 | Unanswered

Are moving & handling demands included (2-person transfers, hoist dependency, bariatric care) and reflected in staffing numbers?

Q21 | Unanswered

Are activity and social engagement needs factored into staffing planning (to avoid ‘basic care only’ delivery)?

Q22 | Unanswered

Is there evidence dependency outputs translate into rota planning (not completed as a paper exercise only)?

Q23 | Unanswered

Are rotas produced in advance with sufficient oversight to ensure safe coverage across all areas and peak times?

Q24 | Unanswered

Do rotas evidence the required skill mix each shift (med-trained staff, nurse cover, senior presence)?

Q25 | Unanswered

Are staffing allocations documented and responsive to daily changes (sickness, admissions, deterioration, enhanced observations)?

Q26 | Unanswered

Are staffing levels reviewed at the start of each shift with a safety huddle (risks, acuity changes, priorities)?

Q27 | Unanswered

Are ‘pinch points’ identified and planned for (morning personal care, mealtimes, medication rounds, bedtime routines)?

Q28 | Unanswered

Is staff redeployment across units controlled to maintain safety and continuity (avoiding constant movement that increases risk)?

Q29 | Unanswered

Are breaks planned and covered safely without leaving areas unsafe (especially nights and small units)?

Q30 | Unanswered

Are overtime patterns monitored for fatigue risk and performance impact (excessive hours, short rest periods)?

Q31 | Unanswered

Are staffing gaps covered in a way that preserves continuity (bank first, familiar agency, consistent pairing)?

Q32 | Unanswered

Is the Registered Manager supernumerary as planned/required, with clear expectations documented?

Q33 | Unanswered

If the manager/deputy is counted in numbers, is this risk-assessed and escalated (impact on oversight, governance, safe care)?

Q34 | Unanswered

Is there a protected supernumerary allocation for key roles (clinical lead, trainer, dementia lead) where applicable?

Q35 | Unanswered

Are supernumerary hours used for quality oversight (audits, supervision, care plan reviews, incident investigations) with evidence of outputs?

Q36 | Unanswered

Is there a process to prevent routine ‘backfilling’ of supernumerary roles except in exceptional, recorded circumstances?

Q37 | Unanswered

When supernumerary cover is lost (e.g., staffing crisis), are compensating controls introduced (provider support, external nurse cover, prioritisation plan)?

Q38 | Unanswered

Are vacancy levels tracked (WTE gaps) and is there a live recruitment plan with timescales and accountability?

Q39 | Unanswered

Are turnover, sickness, and agency usage monitored with trend analysis and mitigation actions?

Q40 | Unanswered

Is there evidence of retention strategies (supervision, career pathways, wellbeing support, recognition, training access)?

Q41 | Unanswered

Are exit interviews completed and themes acted upon to reduce repeat staffing issues?

Q42 | Unanswered

Are there safe onboarding and induction processes to ensure new staff are not deployed beyond competence?

Q43 | Unanswered

Is there a plan for seasonal pressures (winter, outbreaks) and local labour market risks?

Q44 | Unanswered

Is agency use governed by a clear policy (approval, competence checks, right-to-work, DBS, training verification)?

Q45 | Unanswered

Are agency staff provided with a robust local induction covering residents’ key risks, safeguarding, infection control, and emergency procedures?

Q46 | Unanswered

Are agency/bank staff allocated appropriately (not in charge unless competent and approved, not lone nurse in complex settings unless verified)?

Q47 | Unanswered

Is medication administration restricted to competent, authorised staff, and is this visible on rotas/allocations?

Q48 | Unanswered

Are competency gaps identified and addressed promptly (spot checks, supervision, retraining)?

Q49 | Unanswered

Is continuity monitored (same agency staff returning) to reduce risk and improve resident experience?

Q50 | Unanswered

Are staffing levels correlated with incidents (falls, pressure ulcers, medication errors, safeguarding concerns) to identify causation patterns?

Q51 | Unanswered

Are call bell response times monitored and used as a staffing adequacy indicator where applicable?

Q52 | Unanswered

Are delays in care documented (missed turns, late meds, missed hydration rounds) and linked to staffing reviews?

Q53 | Unanswered

Are complaints/feedback regarding staffing (slow response, lack of time, rushed care) tracked and acted upon?

Q54 | Unanswered

Are resident quality-of-life indicators considered (activity participation, meaningful engagement) as part of staffing adequacy?

Q55 | Unanswered

Are staff stress/burnout indicators monitored (sickness, agency reliance, errors, morale) and used to adjust staffing plans?

Q56 | Unanswered

Are contingency staffing plans in place for outbreaks (cohorting, isolation support, increased cleaning demands)?

Q57 | Unanswered

Is staffing flexible enough to support enhanced IPC measures without compromising care delivery?

Q58 | Unanswered

Are staffing levels sufficient to safely manage admissions, discharges, and hospital transfers while maintaining on-floor care?

Q59 | Unanswered

Is there a plan for rapid escalation to external support (provider oversight, rapid response teams) during severe shortages?

Q60 | Unanswered

Can the home provide recent rotas (e.g., last 4–8 weeks) showing planned vs actual staffing, including sickness and agency cover?

Q61 | Unanswered

Can the home provide recent dependency/acuity reports and demonstrate how they informed staffing numbers and skill mix?

Q62 | Unanswered

Can leaders evidence supernumerary time being used for oversight (audit logs, supervision records, care plan review schedules)?

Q63 | Unanswered

Are staffing shortfall incidents documented with clear mitigation actions and evidence of escalation when safe staffing could not be maintained?