Care Home Audit Checklist: What to Audit and How Often

A care home audit is how you find problems before an inspector does. Your audit schedule is also, under good governance, one of the things CQC looks at directly.

Most services audit. Fewer finish the job, and the findings come from the unfinished half.

A care home audit schedule for the year

A workable default. Adjust for your service, your size and your risks.

Monthly: medication, accidents and incidents, complaints, infection prevention and control.

Quarterly: care plans, health and safety, staff files, training and supervision compliance, falls.

Every six months: catering and nutrition, environment and equipment, dignity and privacy observation.

Annually: governance overview, business continuity test, policy review status, information governance.

The frequency matters less than whether it happens at all. A quarterly audit done four times a year beats a monthly audit done twice.

What each audit should look at

Medication. Not just whether MAR charts are signed. Look for gaps, handwritten entries, PRN with no protocol, stock counts that do not reconcile, and how errors were handled.

Care plans. Does the plan reflect the person now? Did reviews change anything? Do the risk assessments match the care plan? Does the person's own voice appear anywhere?

Infection prevention and control. Practice, not just the cleaning rota. Hand hygiene observation, equipment decontamination, and whether staff can explain what they do and why.

Staff files. DBS in date, references verified, employment gaps explained, right to work checked, induction completed. This one catches services out because it is easy to fix and easy to spot.

Accidents and incidents. Themes, not counts. Three falls in the same corridor at the same time of day is information. A total is not.

Complaints. Response times, but more importantly what changed as a result. A complaints log with no outcomes column is a record of things you did nothing about.

Closing the actions

Finding the problem is the easy part. The evidence is what happened next.

An audit finding needs four things to count as evidence:

1. What was found, specifically. Not "some gaps in MAR charts" but "four unexplained gaps on unit 2 in week commencing 8 September".

2. An owner. A named person, not a role.

3. A date. When it will be done by.

4. A closure. Evidence it was done, and a check that it stayed done.

An action plan with owners and dates but nothing closed is worse than no action plan, because it proves you knew and did not act.

Audit it again sooner than the schedule says

When an audit finds a problem and you fix it, audit the same thing again sooner than the schedule says.

If the same finding comes back, the fix did not work and you need a different one. If it does not, you have written evidence that your governance system caught something and corrected it.

Who should audit

Not always the person responsible for the area. A senior carer auditing their own unit's care plans will find less than someone from another unit.

Rotating auditors also spreads the skill, which matters when your manager is on leave and an inspector arrives.

Three practical arrangements that work:

Swap units. Unit leads audit each other's areas. Costs nothing, finds more, and the conversation afterwards is usually more useful than the audit itself.

Bring in a second pair of eyes twice a year. A peer from another service in your group, or a manager you trust from another provider. They will notice things you stopped seeing months ago.

Involve people who use the service. For dignity, food and activities, the people living there are better auditors than you are. A short structured conversation beats an observation form.

What to do when an audit finds something serious

Most findings go on the action plan and get fixed in the normal way. Some do not.

If an audit uncovers actual or suspected abuse, a safeguarding referral comes first and the audit becomes secondary. If it uncovers something notifiable, send the notification. An audit finding does not replace either duty, and inspectors will check the dates line up.

Sometimes an audit finds a pattern rather than an incident, such as repeated medication errors on the same shift. Treat that as a governance issue, not a training one. Training the individual will not fix a system that produces the same error twice.

Auditing the policies themselves

One audit that gets forgotten: whether your policies are current.

Once a quarter, list every policy with its review date and its owner. Anything past its review date is a finding. Anything with no owner is a bigger one, because it means nobody is responsible for keeping it right.

This is quick when your documents carry a review date on the cover page, and painful when they do not.

How this connects to your rating

Good governance is one of the fundamental standards, and CQC's assessment looks at governance, quality assurance and risk management directly.

Your audit schedule, findings, action plans and closures are the evidence. Not the fact that you own an audit tool.

Three questions about your last three audits

Pick your last three audits. For each, can you show what was found, who owned the actions, when they were due, and evidence they closed?

If you cannot do that for all three, your audits are currently a cost rather than a control.

Two things make this easier to sustain. Give every document a review date and an owner so the policy half of governance runs itself, and export the readiness report before each audit cycle so you are auditing against the gaps in front of you.

Sources

• CQC, the fundamental standards of care, which includes good governance, page last updated 3 March 2026.

• CQC, how we reach a rating, on how quality statement scores build into a rating.

Last checked: 21 September 2026.