Regular audits help care providers identify risks, maintain standards and improve the quality of care they deliver. While auditing can add an administrative burden, particularly when records are stored across different systems, consistent audits can identify problems before they affect care quality or become CQC inspection findings.
Read our complete guide to CQC inspections for care providers.
An audit is a structured review of your records, processes, and care delivery against agreed standards. It can help you manage risks, identify gaps between care delivery and care plans and show whether your governance processes are working.
Under CQC Regulation 17 (Good governance), care providers must have effective systems for assessing, monitoring and improving the quality and safety of their services. Regular auditing is one way to meet these requirements.
While CQC expects care providers to continuously monitor and improve quality, it doesn’t prescribe a universal audit checklist or schedule. An audit differs from a mock inspection as it usually focuses on a specific area, while mock inspections take a broader view of the service.
For example, a medication audit might identify repeated gaps in administration records, while a mock inspection would look at medication safety alongside other aspects of care, including staff training, risk management and people's experiences.
Learn more about conducting a CQC mock inspection.
The areas you audit will depend on the needs of your service and the people you support. Use these questions as a starting point for your audits.
How this might work in practice. After someone experiences a fall, check whether their risk assessment and care plan have been reviewed, whether any additional support is needed and whether staff are following the updated guidance.
NICE guidance on managing medicines in care homes recommends clear processes for recording medication administration, reporting errors and reviewing medicines-related problems.
If medication administration records contain unexplained gaps, investigate whether the dose was administered but not recorded, missed or refused. Check that the appropriate action was taken and documented.
Several falls in the same communal area could point to an environmental hazard, staffing arrangements or outdated risk assessments. Your audit should establish whether the cause has been investigated and what action has been taken.
If a staff member's moving and handling training is overdue, check whether they've received a refresher, whether their competency has been assessed and whether any immediate action is needed to protect the people they support.
Check whether cleaning schedules are being followed in practice, whether staff have access to appropriate protective equipment and whether any infection prevention concerns have been identified and addressed.
If several people have raised concerns about limited activity choices, check whether the service has responded by introducing new activities or changing how people are involved in planning them. Follow up to see whether people are happier with the options available.
Your audit frequency should reflect the needs of your service and the risks involved. Below are some suggested starting points, but these are not mandated by the CQC.
|
Audit area |
Potential frequency |
|
Medication records |
Daily checks, with regular formal audits |
|
Care plans and risk assessments |
Monthly sampling and reviews when needs change |
|
Incidents and safeguarding |
Ongoing monitoring, with monthly trend reviews |
|
Staff training and recruitment |
Monthly checks |
|
Health, safety and infection prevention |
Routine checks, plus scheduled audits |
|
Complaints and feedback |
Ongoing monitoring, with periodic reviews |
|
Overall quality assurance |
Monthly or quarterly management reviews |
Some activities, such as fire safety checks and medication management, are subject to specific requirements or guidance, so make sure your audit schedule reflects these.
You may also need to increase the frequency of audits if concerns arise. For example, if a medication audit identifies repeated recording errors, you might introduce weekly checks until you're confident the issue has been resolved.
How to turn your audit findings into improvements
Record your audit findings clearly, including what was checked and the evidence you reviewed. Identify the underlying cause of each issue rather than correcting individual records. For example, if an audit of your medication records shows repeated gaps in documentation, is this because your staff forgot to record administered doses, medication has been missed, someone has refused their medication, or the records no longer reflect their current prescription?
Understanding the cause will help you decide what needs to change. For example, if staff struggle to complete records during busy medication rounds, additional training may not resolve the problem. Instead, you may need to review staffing arrangements or how you organise medication rounds.
Prioritise the actions you’ll take according to risk and assign responsibilities and deadlines. Share relevant findings with staff and encourage them to share their experiences and solutions. Once you’ve implemented actions, repeat checks to establish whether changes have worked. Monitor trends over future audits to check that improvements are maintained over time.
Keep a record of the actions taken and their outcomes. This can help you demonstrate to CQC how your service identifies concerns, responds and learns from its findings.
Manually sampling care plans is time-consuming, especially across larger services. It also makes it hard to get a complete picture of your documentation and spot patterns.
Log my Care's AI-powered Care Plan Audits can review every person's active care plan alongside their profile, risk assessments, goals and consent forms, plus incidents from the last 30 days. It assesses across six areas, flagging missing information and inconsistencies. Unlike manual sampling, it reviews every active care plan and links managers directly to records that need attention.
The AI doesn't write to or change care records. It supports your team's professional judgement by assessing documentation quality, not the quality of care itself or the CQC rating a service will receive.
Your audit checklist should reflect your service’s risks and needs, rather than being treated as a fixed set of questions. Review it regularly, particularly when incidents, complaints or changes in care needs highlight new areas of concern.
Download the CQC inspection checklist.
Audits of care plans, medication, safeguarding, staffing, health and safety, and quality assurance should be specific to your service's needs. The exact audits required will depend on the risks, activities and regulatory requirements relevant to your service.
Frequency depends on risk, the type of audit and relevant regulatory requirements. Higher-risk areas or recurring concerns may require more frequent checks.
Managers and designated staff may conduct audits, while the registered provider remains accountable for effective governance. Responsibilities should be clearly assigned, with arrangements in place to review findings and follow up actions.
An audit is an internal quality assurance activity. A CQC inspection is part of external regulatory oversight. Audits help providers monitor performance and identify improvements between inspections.
Software can help you identify gaps in records, but it won't tell you everything about the quality of care being delivered. You'll still need to observe practice and speak to staff and people receiving care.