Why do we need to complete audits?
To achieve good governance in your service you must demonstrate continuous quality improvement. To do this, auditing and documenting the effectiveness of the processes and systems you have in place, and taking time to observe and document how people experience your service, is essential.
Auditing and action plans offer evidence of the great care and support you provide. Where improvements are needed, they allow you to demonstrate openly and clearly how you plan to make the changes required that you have identified.
Accidents and Incidents: the case for auditing
Auditing accident and incident data helps you identify patterns, peaks, trends, and areas of concern. This information can inform your local and senior decision-making, resource allocation, and the development of safety and risk management strategies whilst giving you valuable evidence on overall compliance aims and objectives.
A robust and effective accident and incident audit will support you to reduce the risk of adverse events occurring. When they do occur, it will ensure that a full and open investigation takes place in a timely manner, and lessons learned to reduce risk of reoccurrence are shared and embedded.
Auditing accidents and incidents allows you to identify potential risks and hazards specific to the people you support and to the settings you support them in and take necessary measures to deliver that support safely acknowledging and acting upon identified risk.
- Audits are vital for promoting a culture of continuous learning and improvement
- Audits enable providers to examine and improve existing policies, procedures, and practices
- Audits can support and identify areas that require improvements
We know that in delivering our services we support a range of individuals with complex needs, such as older people who may be frail or have dementia, individuals with physical, sensory, and cognitive disabilities including those with mental health conditions. In addition to these we also support people on their journey to independence whether in a step-down rehabilitation bed or a supported living service focused on independent living skills.
Your audit process and structure should be part of your services culture, embedded at the very centre of your good governance and quality assurance process. If not, then the above description of just another thankless task means that you and your team will gain nothing from the process and instead of being a live document it becomes a time stamped piece of paper completed and shelved as a result.
Accidents and Incident auditing: achieving compliance
Audits enable you to provide valid, up to date evidence to the CQC that you are managing the Accident and Incidents process effectively and meeting the required regulations such as:
- Regulation 12: Safe care and treatment
- Regulation 13: Safeguarding service users from abuse and improper treatment
- Regulation 15: Premises and equipment
- Regulation 17: Good governance
- Regulation 20: Duty of candour
To be compliant with CQC regulations on incident/accident reporting and learning from mistakes within the social care sector your process’ must be noticeably clear.
Findings: what does the accident and incident audit tell you?
Example 1:
An audit revealed a series of medication errors as a provider you should:
- Review your medication management policies and procedures
- Add in any additional checks and balances that may pick up and prevent future errors
- Provide further training/support to staff members involved in medication administration
- Make any notifications that may be required if any service user was harmed, or the errors met any safeguarding thresholds for reporting
Example 2:
Your Accidents and Incidents audit highlights that you have peak times throughout the day when falls happen as a provider you should:
Review further against your ROTA, staffing levels and any activities that may be leading to the increase.
You may find that you need additional staff or that this just may be the time when:
- Increased numbers of people are moving about such as before lunch or teatime
- There is an increase in visitors
The learning from this is that you have accepted the findings and put measures in place to prevent future occurrences.
So, what happens next?
Effective auditing can encourage providers and staff to have confidence in your process and in turn foster an open and transparent culture, where staff feel comfortable reporting incidents and near misses especially if this is part of a no blame culture.
But it does not stop once the audit is complete. Your good governance systems then take over creating an environment where learning and improvement thrive, benefiting the safety and well-being of those receiving care and support.
Once you have had a chance to review your audits, you can then (if needed):
- Allocate resources
- Implement prevention measures
- Increase/implement/refresh staff training
- Consider environmental changes
- Consider the use of assistive devices
- Share the findings and actions with the team
Now help your team learn about accident and incident auditing by completing our QCS Resource 4: Accidents and Incidents Auditing: Group Learning Exercise.
