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Spot Checks Policy

1. Purpose

At {{org_field_name}}, we are committed to maintaining high standards of care quality, safety, and compliance in line with CQC regulations. This policy sets out our approach to conducting spot checks to ensure that staff adhere to best practices, policies, and regulatory requirements while delivering care to individuals receiving support.

Spot checks provide an effective monitoring and quality assurance tool that helps identify areas of excellence, highlight concerns, and support continuous improvement. This policy aligns with Regulation 17 – Good Governance, Regulation 12 – Safe Care and Treatment, and Regulation 13 – Safeguarding Service Users from Abuse and Improper Treatment under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

2. Scope

This policy applies to all staff, including permanent, temporary, agency, and volunteer workers, as well as managers responsible for overseeing care delivery within our Supported Living service. Spot checks may be conducted across all aspects of service provision, including direct care, medication management, infection control, documentation, and safeguarding procedures.

3. Related Policies

• SL07 – Person-Centred Care Policy
• SL08 – Dignity and Respect Policy
• SL12 – Safe Care and Treatment Policy
• SL13 – Safeguarding Adults from Abuse and Improper Treatment Policy
• SL21 – Medication Management and Administration Policy
• SL16 – Infection Prevention and Control Policy
• SL17 – Good Governance Policy
• SL34 – Confidentiality and Data Protection (GDPR) Policy

4. Objectives of Spot Checks

Spot checks are carried out to:

• Monitor compliance with policies, procedures, and CQC fundamental standards.
• Ensure safe, effective, and person-centred care is consistently delivered.
• Identify training and support needs to enhance staff performance.
• Detect and prevent poor practices, neglect, or safeguarding concerns.
• Reinforce accountability and professionalism in the workplace.
• Enhance service user safety, dignity, and overall well-being.

5. Types of Spot Checks

Spot checks may be announced or unannounced and will cover the following areas:

5.1 Care Delivery and Person-Centred Support

• Observation of how staff interact with individuals receiving support.
• Ensuring dignity and respect are upheld at all times.
• Reviewing compliance with care plans, risk assessments, and personal preferences.
• Ensuring appropriate use of personal protective equipment (PPE) and adherence to infection control procedures.

5.2 Medication Administration and Management

• Verifying that medications are administered safely and correctly.
• Checking for proper documentation in Medication Administration Records (MAR).
• Ensuring secure storage and disposal of medication.
• Confirming that staff adhere to prescribed dosages and protocols.

5.3 Record-Keeping and Documentation

• Reviewing daily care logs, incident reports, and health monitoring records.
• Ensuring accurate and timely documentation of care activities.
• Checking GDPR compliance and confidentiality standards.

5.4 Safeguarding and Risk Management

• Identifying potential safeguarding concerns.
• Reviewing staff awareness of reporting procedures.
• Assessing compliance with risk assessments and escalation protocols.

5.5 Infection Prevention and Control

• Ensuring compliance with hand hygiene, cleaning, and PPE use.
• Checking that service environments remain clean, safe, and free from hazards.

5.6 Staff Conduct and Professionalism

• Observing staff attitudes, engagement, and teamwork.
• Ensuring compliance with lone working policies and safe working practices.
• Identifying potential training or disciplinary needs.

6. Frequency and Process of Spot Checks

• Spot checks will be conducted at least once per quarter and more frequently where concerns are identified.
• Checks will be carried out by senior managers, team leaders, or designated quality assurance staff.
• Staff may or may not be informed in advance to ensure genuine observations of practice.
• Each spot check will be documented using a structured checklist, with findings recorded and reviewed.

7. Reporting and Follow-Up Actions

• Findings from spot checks will be shared with relevant staff and management.
• Any concerns or policy breaches will be addressed through:
  • Immediate corrective actions if required.
  • Additional training and supervision.
  • Formal investigations where serious concerns arise.
• Positive findings will be acknowledged to reinforce good practices.
• Findings will be reviewed in monthly team meetings to drive continuous improvement.

8. Staff Support and Development

• Spot checks are not intended to be punitive but to support staff development and learning.
• Where improvement is needed, staff will receive coaching, mentoring, and refresher training.
• Staff are encouraged to provide feedback on challenges they encounter and suggest improvements.

9. Confidentiality and Data Protection

• All information obtained through spot checks will be handled in line with GDPR and confidentiality policies (SL34).
• Spot check reports will be stored securely and accessed only by authorised personnel.

10. Monitoring and Continuous Improvement

• The effectiveness of spot checks will be reviewed quarterly to assess:
  • Compliance with CQC standards and internal policies.
  • Impact on service quality and staff performance.
  • Any recurring themes that require wider organisational changes.
• Lessons learned from spot checks will be incorporated into future policy updates and staff training.

11. Policy Review

This policy will be reviewed annually or sooner if required due to:

• Changes in CQC regulations or best practice guidance.
• Findings from spot checks or internal audits.
• Feedback from staff, individuals receiving support, or external regulators.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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