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 completed 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.
Pressure Prevention: the case for auditing
Auditing the standard of pressure prevention helps you ensure best practice guidelines are being followed and identify any areas of concern. This information can inform your local and senior decision-making, resource allocation, and any training requirements, whilst giving you valuable evidence on overall compliance.
A robust and effective pressure prevention audit will support you to reduce the risk of pressure ulcers occurring. When they do occur, it will ensure that a full and open investigation takes place in a timely manner, and lessons learnt to reduce the risk of reoccurrence are shared and embedded.
Auditing pressure prevention allows you to identify potential risks, 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.
Pressure Prevention: achieving compliance
Audits enable you to provide valid, up to date evidence to the CQC that you are managing pressure prevention effectively and meeting the required regulations such as:
- Regulation 9: Person-centred care
- Regulation 12: Safe care and treatment
- Regulation 17: Good governance
- Regulation 20: Duty of candour
Findings: what does the pressure prevention audit tell you?
Example 1:
An audit revealed service users not being repositioned as their care plans indicate is required, as a provider you should:
- Review your pressure prevention policies and procedures
- Add in additional checks of repositioning charts by senior staff that may pick up and prevent future failure to reposition as required
- Provide further training and support to staff in pressure prevention
- Ensure service users who require repositioning are clearly handed over to staff at each handover
- Review staffing levels
Example 2:
An audit revealed not all staff have received training in pressure prevention, as a provider you should:
- Arrange training sessions for those staff who are non-compliant
- Meet with staff to discuss the need to attend training
- Ensure training requirements are discussed at supervisions and appraisals with staff
- Review your training matrix
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
