Wellbeing and Independence Promotion Audit - Domiciliary Care

Evidence to check

• • Care plans include personal wellbeing and independence goals
• • Goals are meaningful to the person, not generic
• • Daily notes show staff supporting progress toward goals
• • Goals are reviewed when needs, confidence or preferences change

Evidence to check

• • Care plans describe what the person can do for themselves
• • Support guidance promotes involvement rather than staff taking over
• • Staff can explain the person's abilities and preferences
• • Care records show the person is encouraged to remain involved

Evidence to check

• • Training records for enablement, reablement or person-centred support
• • Staff can explain how they promote independence in practice
• • Spot checks show staff encouraging participation where safe
• • Supervision records discuss independence and wellbeing outcomes

Evidence to check

• • Care notes show the person participating in tasks where possible
• • Staff allow time for the person to do what they can
• • Examples include washing, dressing, meal preparation, mobility or household routines
• • Staff do not routinely take over tasks the person can safely do

Evidence to check

• • Care plan identifies equipment or assistive technology in use
• • Staff know how equipment supports independence
• • Equipment is available, safe and used as intended
• • Concerns about equipment suitability are reported and followed up

Evidence to check

• • Reviews consider whether aids and adaptations remain suitable
• • Changes in mobility, cognition, vision or strength trigger reassessment
• • Referrals to OT, physiotherapy or equipment services where needed
• • Outdated, unsafe or unused equipment is reviewed

Evidence to check

• • Care plans record preferences and choices
• • Observation or spot checks show staff offering choices
• • Care notes record refusals, changes of mind or preferences
• • The person's routine is respected rather than staff convenience taking priority

Evidence to check

• • Personal goals are recorded in the care plan
• • Goals are broken into practical actions
• • Progress and setbacks are recorded
• • Staff, family or professionals support the goal where appropriate

Evidence to check

• • Care plan includes mood, emotional wellbeing and mental health needs
• • Staff record changes in mood, motivation, anxiety or distress
• • Concerns are escalated to family, GP, mental health services or other professionals where needed
• • Reviews consider whether emotional wellbeing support is effective

Evidence to check

• • Care plans record hobbies, interests and preferred activities
• • Care notes show staff supporting meaningful activity where this is part of agreed care
• • Activities are chosen by the person, not imposed
• • Support is adapted if the person's interests, confidence or ability changes

Evidence to check

• • Assessment or care plan identifies loneliness or isolation where relevant
• • Actions are tailored to the person's wishes and relationships
• • Staff know signs that the person may be lonely or withdrawn
• • Reviews check whether interventions are improving wellbeing

Evidence to check

• • Care plan identifies important family, friends, neighbours or community contacts
• • Support with calls, visits, letters, video calls or community contact is recorded where agreed
• • The person's consent and preferences around relationships are respected
• • Concerns about loss of contact or isolation are escalated

Evidence to check

• • Care plan records preferences for outdoor access or nature
• • Risk assessment considers mobility, weather, equipment and support needs
• • Care notes show outdoor access or alternatives where agreed
• • Staff avoid unnecessary restrictions where the person wants to go outside

Evidence to check

• • Care plan records meal, drink and dietary preferences
• • Staff encourage the person to participate in food or drink preparation where safe
• • Nutrition and hydration risks are monitored and escalated
• • Care notes show preferences and independence are supported

Evidence to check

• • Care plan includes mobility, movement or activity goals where relevant
• • Professional advice from physiotherapy or OT is followed
• • Staff encourage safe movement during daily routines
• • Reduced mobility, falls or fear of movement are escalated

Evidence to check

• • Communication needs are clearly recorded in the care plan
• • Staff use hearing aids, glasses, communication aids, prompts or interpreters where needed
• • Staff can explain how the person communicates consent, refusal or distress
• • Communication support is reviewed when needs change

Evidence to check

• • Care plan records dignity and privacy preferences
• • Spot checks or feedback show staff explain care and seek consent
• • Staff protect privacy during personal care
• • The person's preferred routines, clothing and modesty needs are respected

Evidence to check

• • Risk assessments balance safety with choice and independence
• • The person's views are recorded in risk decisions
• • Less restrictive options are considered
• • Staff understand when to support choice and when to escalate risk

Evidence to check

• • Supervision or team discussions include wellbeing and independence
• • Staff can describe creative ways they support people's goals
• • Care plans allow flexibility where appropriate
• • Good practice examples are shared with the team

Evidence to check

• • Care reviews discuss wellbeing and independence goals
• • The person's own view of progress is recorded
• • Representative input is included where appropriate
• • Support is adjusted when outcomes are not being met

Evidence to check

• • Care notes record progress, decline, changes in confidence or loss of skills
• • Staff escalate concerns about reduced independence or wellbeing
• • Care plans are updated following changes
• • Referrals are made where additional support is needed

Evidence to check

• • Care plans describe fluctuating needs and best times for support
• • Staff can explain how they adapt support on good and difficult days
• • Medication timing, fatigue, cognition or mobility changes are considered
• • Changes are recorded and escalated where patterns emerge

Evidence to check

• • Care notes show changes in mood or behaviour are recorded
• • Staff know how to escalate mental health concerns
• • Referrals to GP, mental health services, social prescribers or community support where appropriate
• • Risk of self-neglect or safeguarding is considered where relevant

Evidence to check

• • Care notes or reviews record achievements and progress
• • Staff celebrate success respectfully and with the person's consent
• • Achievements are linked to personal goals
• • Progress is used to build confidence and update future goals

Evidence to check

• • Feedback records, surveys or review notes
• • The person's suggestions lead to changes where possible
• • Complaints or concerns are reviewed for wellbeing themes
• • People are told what changed as a result of feedback where appropriate

Evidence to check

• • Care plan records cultural, religious, identity or lifestyle preferences where the person wishes
• • Staff understand and respect these needs during care
• • Support is provided for faith, diet, routines, community links or important events where agreed
• • No assumptions are made about the person's beliefs, identity or lifestyle

Evidence to check

• • Care plan changes are made promptly when needs change
• • Rota or visit arrangements are reviewed where goals or risks change
• • Staff report when current support is no longer working
• • The person is involved in agreeing changes

Evidence to check

• • Referrals to OT, physiotherapy, falls services, social prescribing, GP or community groups
• • Care notes show staff identify opportunities for extra support
• • Follow-up actions are recorded after referrals
• • Outcomes from referrals are reviewed and reflected in the care plan

Evidence to check

• • Staff can explain MECC in practical terms
• • Care notes show appropriate wellbeing conversations or signposting
• • Staff support without lecturing, pressuring or judging the person
• • Advice or signposting is tailored to the person's wishes and readiness

Evidence to check

• • Service values and quality monitoring include wellbeing and independence
• • Supervision and team meetings discuss outcomes, not only tasks
• • Audits check whether care promotes independence in practice
• • People's feedback shows they feel listened to, respected and supported to live as they choose

Evidence to check

• • Late, missed or shortened visit records
• • Impact on routines, meals, personal care, medication or emotional wellbeing considered
• • Person and family feedback reviewed where relevant
• • Changes made to reduce recurrence

Evidence to check

• • Care notes record changes in confidence, motivation or engagement
• • Staff escalate concerns about withdrawal or reduced independence
• • Care plan reviewed when activities or abilities reduce
• • Support is adapted to rebuild confidence where possible

Evidence to check

• • Care plan records digital preferences and support needs
• • Support with video calls, online appointments, reminders or digital services where agreed
• • Consent, privacy and online safety considered
• • Digital support is not used to replace needed in-person care