Visits Audit - Domiciliary Care

Evidence to check

• • Care plan records assessed needs, outcomes and preferred visit times
• • Rota matches the care plan and commissioned support
• • Scheduling considers medication, meals, continence, mobility, personal care and wellbeing needs
• • Any difference between agreed times and rota is explained and reviewed

Evidence to check

• • Care plan records agreed visit times or time windows
• • Person or representative involvement is documented
• • Rota reflects agreed times wherever possible
• • Changes to visit times are discussed and recorded

Evidence to check

• • Rota includes travel time between visits
• • Travel time is realistic for geography, traffic, parking and rural areas
• • Staff feedback about unrealistic travel is reviewed
• • Late calls are not repeatedly caused by poor route planning

Evidence to check

• • Late call reports or ECM data
• • Trend analysis by staff, person, route and time of day
• • Actions taken such as rota changes, travel adjustment or staff support
• • Repeated lateness is escalated through supervision or governance

Evidence to check

• • Planned versus actual visit duration reports
• • Short calls reviewed for impact on care
• • Patterns of short calls investigated
• • Commissioners, people or representatives informed where care time changes significantly

Evidence to check

• • Missed, short and late visit logs
• • Immediate welfare checks or follow-up calls recorded
• • Medication, nutrition, continence, pressure care or safeguarding impact considered
• • Root cause and prevention actions documented

Evidence to check

• • ECM records or equivalent visit logs
• • Start and end times match visit records
• • Manual entries are explained and authorised
• • Managers use ECM alongside care notes, feedback and risk review

Evidence to check

• • ECM exception reports
• • Reason for exception recorded
• • Office verifies attendance and duration where needed
• • Repeated exceptions are followed up with staff or system provider

Evidence to check

• • Agreed time window recorded in policy or care plan
• • Rota and ECM data reviewed against the time window
• • Reasons for early or late arrivals recorded where relevant
• • Person's agreement documented where flexibility is accepted

Evidence to check

• • Call logs or communication records
• • Person or family notified of delays where required
• • Revised estimated arrival time provided
• • High-risk delays escalated to coordinator or on-call staff

Evidence to check

• • Communication records about carer changes
• • Continuity reports or rota patterns
• • Care plan identifies where continuity is important
• • People with dementia, anxiety, autism or communication needs are prioritised for continuity where possible

Evidence to check

• • Absence escalation process
• • Contingency rota or standby arrangements
• • Records showing how sickness or emergencies were covered
• • High-risk visits prioritised and monitored

Evidence to check

• • On-call rota and procedure
• • Out-of-hours call records
• • Response times and actions recorded
• • Staff know how to contact on-call support

Evidence to check

• • Double-up calls clearly identified on rota
• • ECM data confirms staff arrive together or within safe timing
• • Moving and handling plan matches double-up arrangement
• • Delays or single-handed attempts are investigated

Evidence to check

• • Lone working risk assessments
• • Check-in, escalation and staff safety procedures
• • Known risks in homes flagged appropriately
• • Incidents involving staff safety are reviewed and acted on

Evidence to check

• • Rota allocation considers skills and competency
• • Training records for specialist tasks
• • Staff are not allocated tasks they are not competent to complete
• • Complex care needs are matched to suitably trained staff

Evidence to check

• • Shadowing records
• • Mentor or buddy notes
• • Competency sign-off before lone visits
• • Feedback from the person, family or experienced staff

Evidence to check

• • Care plan identifies need for consistency
• • Rota shows stable staff allocation where possible
• • Changes are explained to the person where appropriate
• • Distress or incidents linked to unfamiliar staff are reviewed

Evidence to check

• • Care plan and rota reviewed after changes
• • Hospital discharge information reflected in visit planning
• • Increased visit length or frequency requested where needed
• • Staff updated before the next relevant visit

Evidence to check

• • Time-critical tasks flagged in care plan and rota
• • Examples include insulin, Parkinson's medication, meals, repositioning and continence care
• • Late visit escalation rules are in place
• • Time-critical delays are reviewed as incidents where appropriate

Evidence to check

• • Nutrition and hydration needs recorded in care plan
• • Visit times align with meal and drink support
• • Missed or late meal support reviewed for impact
• • Food and fluid concerns escalated where needed

Evidence to check

• • Continence care plan identifies timing and support needs
• • Visit times align with toileting routines where possible
• • Care notes record continence concerns or accidents
• • Repeated issues lead to review of schedule and care plan

Evidence to check

• • Rota review records
• • Travel and route efficiency considered
• • Changes assessed for impact on people and staff
• • Efficiency improvements do not create rushed or unsafe visits

Evidence to check

• • Visit duration matches assessed care tasks and outcomes
• • Staff feedback about insufficient time is reviewed
• • Spot checks show care is not rushed
• • Visit length reviewed when tasks increase or the person's pace changes

Evidence to check

• • ECM or visit duration data
• • Care notes explain early departure where relevant
• • Person's choice recorded if they ask staff to leave early
• • Patterns of early departures are reviewed

Evidence to check

• • Care notes record refusal or early finish
• • Staff record what was refused and why, where known
• • Risk impact considered, including medication, nutrition or personal care
• • Repeated refusals trigger review or professional escalation

Evidence to check

• • Failed access procedure
• • Staff know escalation steps and timescales
• • Records show welfare checks and follow-up action
• • Emergency services, family or office contacted where required

Evidence to check

• • Key safe codes stored in secure system
• • Access limited to authorised staff
• • Code changes recorded and communicated securely
• • Lost keys, wrong codes or security concerns are investigated

Evidence to check

• • No-access log
• • Trends reviewed by person, time, staff or route
• • Care plan updated where no-access risk changes
• • Preventive actions such as contact checks, code review or family involvement

Evidence to check

• • Staff have access to current care plans
• • System alerts or handovers highlight changes
• • Staff can explain recent changes for sampled people
• • Spot checks confirm staff use current information

Evidence to check

• • Daily notes sampled across visits
• • Records describe care delivered and not just ticked tasks
• • Outcomes, refusals and concerns are recorded
• • Notes support continuity for the next carer

Evidence to check

• • Time stamps on digital notes or ECM system
• • Late entries are identifiable and explained
• • Staff understand contemporaneous recording expectations
• • Patterns of delayed recording are followed up

Evidence to check

• • Care notes include factual observations
• • Changes from usual presentation are recorded
• • Subjective or vague wording is avoided
• • Concerns are escalated and followed up

Evidence to check

• • Escalation records linked to visit notes
• • Staff know when and how to escalate
• • Follow-up actions and outcomes recorded
• • No repeated recording of concerns without action

Evidence to check

• • Safeguarding concern records
• • Staff can identify abuse, neglect, self-neglect, domestic abuse and exploitation
• • Referral dates compared with concern dates
• • Rationale recorded where safeguarding threshold is considered but not met

Evidence to check

• • Staff can explain MCA principles in visit scenarios
• • Care records show choices and refusals are respected
• • Capacity and best-interest records are reflected in daily care
• • Restrictions are identified, justified and reviewed

Evidence to check

• • Spot checks or feedback confirm staff seek consent
• • Care notes record refusals or changes of mind
• • Staff explain tasks before providing support
• • People say they feel listened to and not rushed or pressured

Evidence to check

• • Spot check observations
• • Person feedback about dignity and respect
• • Care plan records dignity and privacy preferences
• • Concerns about disrespectful or rushed care are investigated

Evidence to check

• • PPE available to staff
• • Hand hygiene and PPE use observed or checked
• • Staff follow IPC guidance between visits
• • IPC concerns or stock shortages are escalated

Evidence to check

• • Moving and handling care plan and risk assessment
• • Correct equipment and number of staff used
• • Spot checks or competency observations
• • Changes in mobility trigger review

Evidence to check

• • Care plan lists required equipment
• • Equipment checked before use
• • Faults or missing equipment reported promptly
• • Staff know how to use hoists, slide sheets, rotastands, commodes or other equipment

Evidence to check

• • Medication support plan aligns with rota
• • MAR or eMAR entries match visit times
• • Medication-related calls are prioritised appropriately
• • Late medication visits are escalated and reviewed

Evidence to check

• • Time-critical medication flagged in care plan and rota
• • Staff and coordinators know escalation rules
• • Delayed calls are reviewed for medication impact
• • Examples include insulin, Parkinson's medicines, epilepsy medicines and anticoagulants

Evidence to check

• • Emergency procedures available to staff
• • Staff can answer emergency scenario questions
• • Records of emergencies show timely escalation
• • Post-incident reviews identify learning

Evidence to check

• • Visit-related incident records
• • Root causes and immediate actions recorded
• • Learning shared with staff and coordinators
• • Changes made to rota, care plans or staff support

Evidence to check

• • Spot check schedule and records
• • Checks include observation of care where appropriate
• • Feedback given to staff
• • Actions followed up after poor practice

Evidence to check

• • Spot check forms include timing and duration
• • Person's feedback recorded
• • Task completion compared with care plan
• • Outcomes and concerns reviewed, not just attendance

Evidence to check

• • Supervision records include call performance where relevant
• • Punctuality, short calls or recording issues discussed
• • Support, coaching or capability action recorded where needed
• • Improvement reviewed at follow-up supervision

Evidence to check

• • Coordinator training records
• • Coordinators understand care risks, travel time and priority calls
• • Scheduling decisions reflect person-centred care, not only availability
• • Managers review coordinator decisions where incidents or patterns occur

Evidence to check

• • Governance reports or KPI dashboards
• • Visit performance trends reviewed by managers
• • Actions agreed for poor performance or repeated issues
• • Impact of actions measured over time

Evidence to check

• • Survey, review or feedback records
• • Feedback includes timing, consistency, rushing and dignity
• • Themes are reviewed and acted on
• • People are told about changes made where appropriate

Evidence to check

• • Complaint and concern records
• • Investigation includes rota, ECM, care notes and staff accounts
• • Outcome and apology shared where appropriate
• • Learning leads to changes in scheduling or staff practice

Evidence to check

• • Supervision or performance records
• • Evidence of support before formal action where appropriate
• • Training or coaching offered for recording, punctuality or care quality issues
• • Capability or disciplinary action used where risks persist

Evidence to check

• • Commissioned versus delivered care time reports
• • Shortfalls or over-delivery reviewed
• • Commissioners, people or representatives informed where required
• • Care package reviewed when commissioned time no longer matches needs

Evidence to check

• • Rota includes travel time
• • Staff feedback about pay, travel and pressure is reviewed
• • Rota arrangements comply with organisational policy and employment requirements
• • Patterns of rushed visits linked to travel pressure are addressed

Evidence to check

• • Rota review considers gaps, waiting time and travel
• • Complex visits are allocated sufficient time
• • Person-led care is not reduced to task completion
• • Staff wellbeing and fatigue are considered

Evidence to check

• • Care plans include outcomes and priorities
• • Visit notes record wellbeing, independence and choices
• • Staff understand what matters to each person
• • Rota decisions support routines, preferences and meaningful outcomes

Evidence to check

• • Care plans identify priority tasks and desired outcomes
• • Staff can explain what must be completed and what is flexible
• • Notes from different carers are consistent
• • Outcomes are reviewed when visit time is insufficient

Evidence to check

• • Handover records or communication logs
• • Important changes are shared before the next relevant visit
• • Office follows up concerns raised by carers
• • No repeated missed information between visits

Evidence to check

• • Risk assessments identify timing-related risks
• • Rota aligns with risk control measures
• • Incidents are reviewed for timing factors
• • Visit times are changed where timing creates avoidable risk

Evidence to check

• • Escalation procedure for staffing pressure
• • Records of commissioner or local authority contact where required
• • Priority calls protected during staffing pressure
• • Safeguarding considered where people are left at risk

Evidence to check

• • Devices use secure apps, passwords or screen locks
• • Staff do not leave screens visible to unauthorised people
• • No shared logins or inappropriate messaging
• • Data protection training covers mobile working

Evidence to check

• • Quarterly or regular visit audit records
• • Audit covers lateness, missed calls, duration, continuity and complaints
• • Action plans include named owners and deadlines
• • Follow-up checks confirm whether actions improved performance

Evidence to check

• • Improvement records linked to visit audits and incidents
• • Changes made to rota planning, staff support or care plans
• • Impact measured through KPIs, feedback and reduced incidents
• • Learning shared across care staff, coordinators and managers

Evidence to check

• • High-risk people identified in rota and contingency planning
• • Visit changes trigger welfare checks where required
• • Office staff understand which visits cannot safely be delayed
• • Family, representative or professional contacts are used appropriately

Evidence to check

• • Rota review considers hours, travel, breaks and visit intensity
• • Staff feedback about fatigue or workload is reviewed
• • Patterns of errors or late calls are checked against workload
• • Adjustments are made where workload creates risk

Evidence to check

• • Cross-reference between audit findings
• • Missed or late visits reviewed for wider safety impact
• • Governance meetings consider linked themes
• • Actions address root causes across the service