Audit Tool 1 – Patient Representative

Ward Name…………………………Date……………………

Patient representative - Ask three patients the following questions:

Are services caring?

Questions Comments/observations
1 Have we explained and Yes Yes Yes
involved you in your plan of No No No
care? n/a n/a n/a

2 Do you feel staff have Yes Yes Yes

protected your privacy and No No No
have treated you in a n/a n/a n/a
dignified way?
Such as making sure the
curtains are drawn and/or
checking its ok to enter?
3 Do staff introduce Yes Yes Yes
themselves to you and ask No No No
permission when delivering n/a n/a n/a
care for example when
taking your blood pressure?

4 If you’ve needed help with Yes Yes Yes

personal care have staff No No No
helped you? n/a n/a n/a

5 When you’ve had to call for Yes Yes Yes

assistance, such as pressing No No No
the call bell - have staff n/a n/a n/a
answered promptly?

Are services effective?

Questions Comments/observations
6 Have you been offered a Yes Yes Yes
choice at meal-times? No No No
n/a n/a n/a
7 Have there been occasions Yes Yes Yes
when there wasn’t anything No No No
you liked/could eat? n/a n/a n/a

8 Have you had enough to Yes Yes Yes

eat? No No No
n/a n/a n/a
9 Was the food hot? Yes Yes Yes
No No No
n/a n/a n/a

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10 Have you been offered Yes Yes Yes
the opportunity to wash No No No
your hands in preparation n/a n/a n/a
for meal times?

11 Have staff helped you Yes Yes Yes

with your meals and drinks No No No
when you’ve needed this? n/a n/a n/a

12 Have you missed any Yes Yes Yes

mealtimes through having to No No No
have a test or x-rays away n/a n/a n/a
from the ward?
If yes go to Question 13:
13 Were you offered Yes Yes Yes
anything else to eat when No No No
you returned to the ward? n/a n/a n/a
14 Has staff’s behaviour Yes Yes Yes
and attitude towards you No No No
been caring and kind? n/a n/a n/a

Are services responsive? Comments/observations

15 If you’ve had a concern, Yes Yes Yes

have you felt able/confident No No No
to speak with staff about n/a n/a n/a
this?
16 Was your concern Yes Yes Yes
resolved? No No No
n/a n/a n/a

Are services safe?

17 Have you observed Yes Yes Yes

staff washing their hands or No No No
using the alcohol gel before n/a n/a n/a
and after caring for you?

18 Is the bathroom you Yes Yes Yes

use clean and free from No No No
clutter? n/a n/a n/a

19 Do you feel reassured Yes Yes Yes

that your bed area/ward is No No No
clean and safe? n/a n/a n/a
20 Do staff check your Yes Yes Yes
identity before giving you No No No
your medications? n/a n/a n/a

21 If you have allergies to Yes Yes Yes

medications – are these No No No
checked by staff when giving n/a n/a n/a
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you your medications?
22 Have you had the Yes Yes Yes
opportunity to discuss your No No No
medications with someone? n/a n/a n/a

Enter overall observations and comments here:

i.e.

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