Onboarding New Service Users

Are robust environmental and personal risk assessments completed and documented before or on the very first visit?

What we look for: Review the risk assessments for new packages. Ensure the physical environment (e.g., trip hazards, pets, equipment) and personal risks are assessed. Good practice involves identifying hazards and documenting clear mitigation strategies. Missing home environment checks before staff enter the property constitutes a fail.

Evidence: Home environment risk assessment, moving and handling risk assessment, fire risk assessment, specific health risk assessments (e.g., falls).

Where medication support is required, are safe systems established immediately, including accurate MAR charts and clear instructions?

What we look for: For any new user requiring medication support, audit the medication setup. Check that MAR charts are populated accurately against a pharmacy list or prescription, and that specific instructions (e.g., PRN protocols) are active from day 1. Any ambiguity in medication instructions upon onboarding is a critical fail.

Evidence: Medication care plans, MAR (Medication Administration Record) charts, pharmacy printouts, PRN protocols.

Have staff been properly matched to the new service user based on skills and preferences, and appropriately briefed before their first visit?

What we look for: Review how the first week's roster was built for the new service user. Look for evidence that staff have the right skills (e.g., hoist training if required) and were briefed on the person's needs. Sending untrained staff or staff who have not read the care plan to a new package is a fail.

Evidence: Rosters showing shadow shifts, staff briefing notes/handover logs, matching matrices, staff profiles sent to user.

Is a comprehensive initial assessment completed prior to the commencement of the care package, detailing all care, support, and health needs?

What we look for: Sample the files of 3-5 recently onboarded service users. Check that a thorough assessment was completed before the first care visit. Good looks like a holistic assessment covering physical, mental, and social needs. A fail would be starting care based only on a brief local authority summary without the agency's own assessment.

Evidence: Initial assessment documents, hospital discharge summaries, local authority care/support plans, pre-admission checklists.

Is there clearly documented, signed consent to care and data sharing obtained from the person or their legal representative prior to care delivery?

What we look for: Check the onboarding paperwork for explicit consent to receive care, share information, and (if applicable) manage keys/codes. If the person lacks capacity, look for an MCA assessment and evidence of who has the legal right to consent (e.g., LPA for Health and Welfare). Missing signatures or unverified LPAs are fails.

Evidence: Signed consent forms, Mental Capacity Act (MCA) specific assessments, Best Interests decision records, verified LPA documentation.

Is a mechanism in place to formally review the care package within the first 4-6 weeks to ensure it meets the person's needs and expectations?

What we look for: Check the CRM or scheduling system to see if an initial review has been booked or completed for recently onboarded clients. Good practice is a documented check-in (phone or face-to-face) shortly after care starts to adjust the plan if timings or tasks aren't working. Missing this initial review is a fail.

Evidence: Scheduled review dates on digital system, 4-week review records, initial quality assurance telephone call logs.

Is an interim or full person-centred care plan in place from day one, detailing specific routines, preferences, and tasks?

What we look for: Verify that care workers have a clear, actionable plan to follow from their very first visit. Good looks like a plan that captures preferences (e.g., how they like their tea, morning routines) not just clinical tasks. Expect a fail if staff are sent into a new package with no documented instructions on what to do.

Evidence: Initial/Interim care plans, daily routine documents, 'About Me' profiles, detailed task lists.

Has the service user been provided with a Service User Guide containing the complaints procedure, safeguarding info, and out-of-hours contacts?

What we look for: Check onboarding checklists to confirm the service user received their welcome pack/guide. Good looks like providing this in a format accessible to the person (e.g., large print if visually impaired) and ensuring they understand how to complain or contact the office in an emergency. Failure to evidence this provision is a breach.

Evidence: Signed receipt of service user guide, accessible format guides, complaints policy provided to user, welcome letter.