E: support@e-carehub.co.uk




This questionnaire is adapted for domiciliary care services from Government guidance and the KLOE developed by the CQC to help its inspectors assess how well care homes have managed the infection control requirements to reduce the spread and risks of Covid-19. It can be used as a quick guide to self- assessing compliance and as a first step to carrying out more in the related in-depth self-audits, which follow the themes here.
                                                A = Very satisfied                                                 B = Quite satisfied                                                 C = Not very satisfied                                          D = Very unsatisfactory
How satisfied are you that you have addressed the following adequately and effectively?
1.0  Policies and Procedures
You have robust policies and procedures for all key aspects of infection control including:
1.1  Safe service user care in terms of:
making visits to their homes to consider or deliver care, including decision -making and information sharing with partner agencies
how to treat service users who are self-isolating or in quarantine because of their vulnerabilities to infection or diagnosis of Covid-19 or who have been recently discharged from hospital
infection control precautions for carrying out all aspects of service users care
ensuring physical distancing of care staff from other household occupants as much as possible and taking the necessary precautions such as their wearing of face masks during the visit
ensuring care workers carry out basic hygiene with hand washing/use of sanitisers before, during, after and between visits
ensuring safe working practices before, during, after and in between visits, particularly where more than one worker is needed and/or to reduce numbers of contacts between care works and service users
1.2  Correct use of PPE, including putting on and taking off as well as appropriate use in relation to risk before, during, after and in between visits
1.3  Testing, eg testing arrangements and protocols for care staff and information about any testing of service users
1.4  Particular policies impacted by the situation, eg on service users without capacity to give their consent, end-of-life care, use of medicines and in the event of a death of a service user
1.5  Providing management oversight, support and communication through remote methods and reduction of face to face meetings
2.0  Risk Assessments and Control Plans
2.1  You have regularly carried out risk assessments with a view to improving infection control for:
clinically vulnerable and vulnerable service users
clinically vulnerable and vulnerable staff including BAME staff
the households being visited (with a view to ensuring they are safe to visit) with, eg dedicated teams for different levels of vulnerability as recommended by Government guidance
reducing risks of cross-infection from visiting schedules and/or working in households visited by other professionals/agencies, eg community nurses
the appropriate wearing of PPE, including face coverings
transport to and entry into {{org_field_name}}, by care staff including reducing use of shared cars and public transport
results of information received from NHS test and trace and similar systems
3.0  Staff Training and Support
3.1  You have provided focused staff training in:
infection control policies and procedures
knowledge and understanding of the SARS-CoV-2 virus, how it spreads and causes Covid-19
knowledge and understanding of signs and symptoms and methods of observation and reporting
care practices for people with or suspected as having Covid-19
importance of using PPE, physical distancing and hand hygiene
testing procedures, including support of care workers and/or service users and other household members requiring testing
use of specialist equipment to monitor or be used in a person’s care
4.0  External Guidance and Support
You are satisfied with the advice and support given to {{org_field_name}}:
4.1  Guidance and advice from national government and Public Health
4.2  Availability and procuring of PPE and equipment
4.3  Partner organisations such as local authority, CGC
4.4  Access and availability of suitable staff training resources
4.5  Care regulator and its inspectors
4.6  Professional organisations such as UKHCA
Additional comments/assessments
Completed by     Date      

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next review date: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.

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