25 checks for domiciliary care services

Inspection checklist

Review key safety and quality checks, note gaps and record the actions needed before an inspection.

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5 key questions25 practical checksPrivate working copy
Reviewed against published CQC guidance · 3 September 2026
Before you start

How to use this checklist

Choose recent information from different people, times, staff and levels of risk. For each item, mark what you can prove today, not what a policy says should happen.

Keep the working copy anonymous. Use short evidence references only; do not enter names or information that identifies a person receiving care in this browser tool.

  1. 01
    Choose a varied sample

    Include recent records from different people, staff and visits, including higher-risk care.

  2. 02
    Select a status for each check

    Compare records with what people and staff say and what happens in practice. Add an anonymous note if needed.

  3. 03
    Record the next actions

    Use the action plan at the end to record who will act, the date and how you will check the result.

This tool does not simulate an inspection. It is an independent preparation guide, not a complete legal checklist, official CQC assessment, score or rating prediction. CQC may change its approach, so check current guidance and what applies to your service.

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Key question 01

Safe

Can the service recognise risk, respond reliably and show that learning changes practice?

5 checks

Incidents, safeguarding and medicines concerns lead to learning and safer practice.

Recent events can be followed from the first concern and immediate protection through investigation, required reporting, learning, action and a later check that the response worked.

Sample: incident logs, safeguarding records, medicines errors, notifications, meeting minutes and repeat audits.
Status for S1

Person-specific risks are current and visible in delivered care.

Assessments reflect known risks, strengths and choices; controls are specific enough to guide staff; reviews follow important changes; daily records agree with the plan.

Sample: risk assessments, care plans, daily notes, review records, staff explanations and relevant feedback.
Status for S2

Medicines support is agreed, recorded and escalated consistently.

The care plan clearly states the support needed. Every occasion is recorded, refusals, omissions and errors are followed up, and staff competence and delegated duties are understood.

Sample: care plans, medicine administration records (MARs), instructions, staff competence checks, error reviews, ordering and disposal arrangements.
Status for S3

Recruitment and staffing controls match the risks of the service.

Required checks are complete before a new worker works alone. Rotas reflect assessed needs and travel, and staff understand competence, lone-working and on-call arrangements.

Sample: staff files, disclosure and reference checks, rotas, call-monitoring data, competency records and spot checks.
Status for S4

Emergency and service-continuity plans work in practice.

Staff know how to respond to urgent deterioration, missed calls, safeguarding concerns and service disruption; contact routes are current; contingency arrangements have been tested.

Sample: business-continuity exercises, on-call logs, how missed calls are reported, emergency plans and staff interviews.
Status for S5
Key question 02

Effective

Does assessed need lead to competent support, coordinated decisions and meaningful outcomes?

5 checks

Assessment and review produce a complete, current picture.

Physical, emotional, social, communication and cultural needs, strengths, preferences and goals are assessed; care plans respond to the findings; reviews follow the person’s changing circumstances.

Sample: initial assessments, care plans, review records, professional information and the person’s feedback.
Status for E1

Consent and decision-making are understood and recorded.

Consent is sought in a meaningful way. Where relevant, mental capacity is assessed for the specific decision, lawful best interests steps are followed and any restriction goes no further than needed.

Sample: consent records, capacity assessments, best interests decisions, care plans, staff understanding and reviews.
Status for E2

Training results in competent practice.

Training reflects each role and the people supported. Required learning is current, and supervision, observation or another suitable check shows that staff can use it safely.

Sample: training matrix, induction, competency observations, supervision, spot checks and development plans.
Status for E3

Coordination with external professionals changes the plan when needed.

Advice, referrals and interventions are documented; information is shared appropriately; responsibilities are clear; relevant changes reach the staff delivering support.

Sample: referral records, professional correspondence, handovers, care-plan changes and follow-up notes.
Status for E4

Results are reviewed, not just recorded.

The service can show whether agreed goals and desired outcomes are being achieved, identify patterns or barriers and change support where the evidence indicates a need.

Sample: goal reviews, outcome measures, audit trends, feedback, health information and proof that improvements were completed.
Status for E5
Key question 03

Caring

Are dignity, involvement, individual choice and respectful relationships visible in practice?

5 checks

Dignity, privacy and kindness are consistent across the sample.

People describe respectful support; records use appropriate language; personal care protects privacy; staff know the small details that matter to each person.

Sample: people’s feedback, compliments and concerns, observations, daily notes, spot checks and supervision.
Status for C1

Communication needs are specific and accessible.

Preferred communication, language, sensory needs and any support to understand or express choices are recorded, available to staff and reflected in information provided.

Sample: communication passports or care plans, accessible information, staff explanations and people’s feedback.
Status for C2

People are genuinely involved in planning and review.

The person’s voice can be distinguished from generic wording; chosen relatives, advocates or representatives are involved appropriately; disagreements and preferences are recorded respectfully.

Sample: signed or otherwise evidenced involvement, review notes, surveys, meeting records and care-plan wording.
Status for C3

Support protects independence, strengths and everyday choice.

Care plans identify what the person can and wants to do; staff avoid unnecessary dependence; routines, relationships, culture and personal priorities shape support.

Sample: goals, enablement plans, daily notes, activity or community records, observation and people’s feedback.
Status for C4

Confidentiality is protected in homes, conversations and records.

Information is accessed and shared on a need-to-know basis; mobile and paper records are secure; staff understand privacy expectations; breaches or near misses are acted on.

Sample: access controls, record storage, confidentiality training, breach logs, spot checks and staff interviews.
Status for C5
Key question 04

Responsive

Does support remain personal, timely and adaptable when circumstances change?

5 checks

Care plans are recognisably personal and usable.

Plans connect assessed needs with clear support, preferred routines, communication, desired outcomes and contingency arrangements; staff can find the information they need.

Sample: plans across different needs and authors, staff feedback, version history, daily notes and people’s views.
Status for R1

Late, missed and shortened calls are visible and acted on.

Exceptions are detected promptly, the person’s safety and preferences guide the response, relevant people are informed and recurring causes lead to service-level improvement.

Sample: electronic call monitoring, rotas, on-call logs, notifications, complaints, trend reports and action records.
Status for R2

Complaints are accessible, fair and connected to learning.

People know how to raise concerns. Responses are timely and easy to understand, results are recorded, and repeated themes, compliments and informal concerns influence service decisions and practice.

Sample: complaints information, response letters, logs, surveys, meeting minutes and evidence of resulting change.
Status for R3

Changes in need trigger a coordinated response.

Deterioration, hospital discharge, new risk, changing capacity or revised professional advice leads to timely reassessment, communication, referral and updated care delivery.

Sample: change-of-need records, referrals, handovers, plan updates, rota changes and professional feedback.
Status for R4

Continuity is planned around the person, not just the rota.

Preferences and important compatibility needs inform who provides care; unfamiliar staff receive relevant information; unavoidable changes are communicated; recurring continuity gaps are understood.

Sample: allocation records, continuity data, introductions, contingency plans, complaints and people’s feedback.
Status for R5
Key question 05

Well-led

Can leaders see quality clearly, act on risk and prove that improvement has been sustained?

5 checks

Leaders use several sources to understand current quality and risk.

Leaders bring together incidents, safeguarding, medicines, staffing, complaints, feedback, missed calls, results and audit findings. They look for patterns instead of viewing each source alone.

Sample: dashboards, provider reports, meeting records, risk registers, trend analysis and leadership interviews.
Status for W1

Audits lead to named actions and proof that they worked.

The sample is large and varied enough for the question. Findings are specific, actions have owners and dates, completion is proved, and repeat checks show whether improvement worked and lasted.

Sample: audit schedules, completed audits, action plans, proof of completion, repeat samples and leadership meeting notes.
Status for W2

Records, required notifications and leadership duties are under control.

Current documents are identifiable, records are accurate and retrievable, staff understand how long records are kept and who can access them, and required notifications or submissions are made when applicable.

Sample: document control, record audits, notification logs, required official records, delegated duties and provider checks.
Status for W3

Staff can raise concerns and receive useful support.

Supervision and appraisal cover practice and wellbeing, not just whether a form was completed. Staff know how to raise concerns or whistleblow, concerns are heard without unfair treatment, and repeated themes reach leaders.

Sample: supervision records, staff surveys, meeting minutes, speak-up information, exit themes and action taken.
Status for W4

Improvement is communicated, measured and sustained.

The service can explain what changed, why it changed, who was involved and how leaders know the change improved people’s experience, safety or outcomes over time.

Sample: improvement plans, learning communications, before-and-after evidence, repeat audits and feedback.
Status for W5
Turn review into action

Record your next actions

Do not hide serious risks in a long list. Record the clearest next actions, name realistic owners and decide what will prove each action worked.

Priority 01
Priority 02
Priority 03
Priority 04
Check the current source

This tool supports judgement; it does not replace it.

CQC’s current framework keeps Safe, Effective, Caring, Responsive and Well-led, with standards called quality statements under each. It groups the information it considers into six categories, but the sources vary with the point being assessed.

The checklist uses original, plain-English management questions. Check the regulations, current CQC guidance and any specialist clinical or legal requirements that apply before deciding a safeguard is sufficient.

01
CQC assessment frameworkFive key questions and quality statements
 02
CQC evidence categoriesPeople’s experience, feedback, observation, processes and outcomes
 03
Medicines administration recordsCQC guidance for adult social care providers
 04
Managing medicines in home carePlanning support, competency and responsibilities

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