How to Carry Out a Care Home Audit: A Step-by-Step Method That Drives Improvement
An audit is only useful if it changes something. Here is a repeatable method: pick the standard, sample properly, observe as well as read, record findings, act and re-audit.
To carry out a care home audit, choose a clear standard, sample enough records and observations, compare what you find with that standard, record findings with evidence, give each an owner and a date, and re-audit to prove the fix worked. CQC expects regular audits baselined against the regulations and including people’s experiences, with results acted on without delay.
Plenty of care homes tick audit boxes that find nothing, and then are surprised when an inspector finds something in five minutes. This guide covers how to audit well, not which audits to run. For the list of audits and how often, see our care home audit schedule.
Key takeaways
- CQC guidance expects audits to be regular, baselined against Regulations 4 to 20A and to include people’s experiences where possible.
- Audit against a defined standard, not a general impression.
- Sample records and observe practice and speak to people, because paperwork alone misses problems.
- Every finding needs an owner, a date and a re-audit, or the audit is just a report.
- An audit that never finds anything is a warning sign, not reassurance.
In this guide
What CQC Expects From Audits
CQC’s Regulation 17 guidance says providers must have systems and processes “such as regular audits of the service provided”. The audits “should be baselined against Regulations 4 to 20A” of the 2014 Regulations and “should, where possible, include the experiences people who use the service”. The systems must let you identify where quality or safety is being compromised “and to respond appropriately and without delay”. Results should be escalated and action taken when required, and providers must monitor progress against their improvement plans (CQC: Regulation 17).
The Method: Seven Steps
| Step | What to do |
|---|---|
| 1. Define the standard | Say what “good” looks like. Use the relevant regulation, national guidance (for example NICE for medicines) and your own policy. Write the criteria as yes or no questions. |
| 2. Set scope and sample | Decide the period and how many records or residents to check. Cover different units, shifts and staff. Avoid always choosing your best files. |
| 3. Choose the auditor | Use someone competent who is not marking their own work. Rotate auditors, and use senior or provider staff for high-risk areas. |
| 4. Gather evidence three ways | Read the records, observe practice and speak to people using the service and staff. Where the paperwork and practice disagree, the practice wins. |
| 5. Score and record | Record compliant, partly compliant or not compliant against each criterion, with a specific note of what you saw, not a general comment. |
| 6. Act | Turn each gap into an action with an owner, a date and the evidence that will show it is done. |
| 7. Re-audit | Repeat the audit after the fix. Improvement only counts once the re-audit shows it. |
A Worked Example: Medicines Audit (Illustrative)
- Standard: medicines are administered as prescribed, recorded accurately and stored safely.
- Sample: ten MAR charts across two units, plus stock counts for five medicines and the medicines fridge log for the month.
- Evidence: MAR gaps and unsigned entries, stock against records, storage temperatures, and one observed medicines round.
- Finding: three unsigned entries on unit two; fridge temperature not recorded on four days.
- Actions: team leader to brief staff and review signing at handover, by Friday; manager to re-audit unit two in four weeks.
If errors emerge, follow what to do after a medication error.
Audit Practice, Not Just Paperwork
A tidy file does not prove good care. Add observation and conversation to every audit, for example watching a mealtime, listening to how staff speak to residents or asking a member of staff how they would raise a concern. Ask residents and families what they think, which is the “experiences of people” element CQC guidance refers to. Our mock inspection questions give you prompts for staff.
Turning Findings Into Actions
Findings that sit in a folder change nothing. Enter every gap in one action log with the owner, date and the evidence that will show completion, review the log at your governance meeting, and escalate what the manager cannot fix alone. When an action closes, attach the evidence and re-audit so the trail is complete.
Why Audits Fail
- Tick-box criteria so vague every service passes.
- Small or hand-picked samples that miss the real problem.
- Same person, same shift, every time.
- No re-audit, so nobody knows if the fix worked.
- No trend view, so repeat findings look like new ones.
Keeping Audits and Actions Together
CQCLogic’s audit schedule tracker comes with 12 pre-loaded audits, each with a frequency, linked regulation and quality statement. It logs completions and findings, sets re-audit dates, exports to PDF and can send audit actions into the governance action list, so findings move straight into follow-up.
Stop findings falling through the gaps
See a sample improvement plan, view pricing or get started free.
Frequently Asked Questions
How do you carry out a care home audit?
Define the standard, set the scope and sample, choose a suitable auditor, gather evidence from records, observation and conversation, record findings against each criterion, assign actions and re-audit to confirm the fix.
What does CQC expect from care home audits?
Regular audits baselined against Regulations 4 to 20A that include people’s experiences where possible, with results acted on without delay and progress monitored, as set out in Regulation 17 guidance.
How big should an audit sample be?
CQC gives no size. Choose a sample large enough to be representative and to cover different units and shifts. Increase it when you find problems.
Who should carry out audits?
Someone competent who is not auditing their own work. Rotate auditors and involve senior or provider staff for high-risk areas.
What should happen after an audit finds a problem?
Log it as an action with an owner and date, fix it, gather evidence and re-audit. Report the pattern at your governance meeting.
How often should a care home audit?
CQC sets no fixed schedule. See our audit schedule for suggested frequencies by area, adjusted for risk.
Is an audit with no findings good?
Not necessarily. It may mean the criteria are too loose or the sample too narrow. Occasionally check by having someone else re-audit a sample.
Sources: CQC: Regulation 17, Good governance