RQIA inspection checklist: what inspectors look at and the evidence to have ready

The Regulation and Quality Improvement Authority (RQIA) registers and inspects care homes, nursing homes and domiciliary care agencies in Northern Ireland. An RQIA inspection checks you against two things: the regulations, which are law, and the Department of Health's minimum care standards, which RQIA must take into account. Most care home inspections are unannounced, so the evidence needs to be ready on any given Tuesday.

For England, see our CQC inspection checklist.

The law and standards RQIA inspects against

The minimum standards are published under Article 38 of the 2003 Order. They aren't law in themselves, but RQIA's areas for improvement cite them as well as the regulations.

How an RQIA inspection works

• Notice. Care home inspections are mostly unannounced. RQIA sometimes gives notice when it needs a particular person to be available.
• The four questions. Inspectors look at whether care is safe, effective and compassionate, and whether the service is well led.
• What they do. They talk to residents, relatives and staff, observe care and examine a sample of records, having first reviewed previous areas for improvement, notifications and any concerns raised.
• Feedback and report. You get feedback on the day. The published report records how you performed against the regulations and standards and lists areas for improvement, each referenced to a regulation or standard.
• Quality improvement plan (QIP). Each area for improvement has a "to be completed by" date. You write what you've done and return the QIP through RQIA's Web Portal. If an area isn't met by the next inspection it is "stated for a second time", and repeated failures are a route into enforcement.
• Enforcement. Where RQIA has serious concerns it can call the responsible individual to a serious concerns meeting, issue failure to comply notices with a compliance date, add conditions, or move towards cancelling registration. Enforcement action is published.

Unlike CQC, CIW and the Care Inspectorate, RQIA's care home reports don't currently carry ratings or grades; the report and QIP are what people read.

The evidence to have ready

Staffing

• Rotas, planned and worked, that show staffing met the assessed needs of residents at all times, including nights. The regulations require staff "in such numbers as are appropriate" (law); the residential standards add that a competent person is in charge at all times (minimum standard).
• A record of who worked over each 24 hours and in what capacity (residential Standard 25.6).
• Handover arrangements and staff meeting minutes. Residential homes should hold staff meetings at least quarterly (Standard 25.8).

Our care home rota guide covers planning safe cover.

Recruitment

For every member of staff, evidence of the checks in the regulations and Standard 19 (residential), Standard 38 (nursing) or Standard 11 (domiciliary):

• an enhanced AccessNI check (with the adults' barred list check for regulated activity). Northern Ireland uses AccessNI, not DBS, for criminal record checks;
• two written references, one from a recent employer, and gaps in employment explored;
• registration status confirmed: NISCC for social care staff, NMC for nurses. The regulations say a care worker isn't fit to work unless registered in the relevant part of the NISCC register (volunteers and people registered with another statutory body, such as nurses, are excepted). See our NISCC registration guide;
• right to work and visa status, and qualifications confirmed.

If you sponsor overseas staff, the Home Office sponsor duties apply across the UK; see sponsor licence duties for care providers.

Training, supervision and appraisal

• A training matrix showing mandatory training is in date for everyone, with names, dates, trainer and content recorded (residential Standard 23.6). Our training matrix template is a starting point.
• Fire training for all staff at the start of employment and at least twice a year, given by a competent person (residential Standard 29.4; the nursing standards say the same).
• Supervision recorded at least every six months for staff performing satisfactorily, more often for new staff and anyone struggling, and an annual appraisal (residential Standard 24, nursing Standard 40). These are minimum standards, not law. Domiciliary agencies set the frequency in their own policy (Standard 13) and are inspected against it. See supervision and appraisal for care staff.

Fire, premises and equipment

• A current fire risk assessment with its significant findings recorded (law under the 2006 Order and 2010 Regulations), and any NIFRS inspection report that needs action sent to RQIA (residential Standard 29.3).
• Fire drills: every member of staff takes part in an evacuation drill at least once a year, with action on problems recorded (residential Standard 29.6 and the nursing standards). Our fire drill record shows what to capture.
• Fire alarm, emergency lighting and extinguisher checks.
• Lifting equipment: HSENI's care home inspections ask for LOLER thorough examination reports for hoists and slings, at least every six months, not just certificates.
• Legionella: a risk assessment, a written scheme of control and up-to-date records. See water temperature checks.

Governance

• Monthly monitoring visit reports. In residential care, the registered provider (or for a company, the responsible individual, another director or an employee not involved in running the home) must make an unannounced visit at least monthly, unless RQIA agrees otherwise, and write a report on the conduct of the home (regulation 29, law). Missed visits and reports that don't follow up actions regularly appear in QIPs.
• Audits with time-bound actions that are signed off.
• Incident records and notifications sent.
• Complaints log and outcomes.
• Your previous QIP, with evidence for every area for improvement.

Notifying RQIA

Care homes must notify RQIA without delay of a resident's death, a serious infectious disease outbreak, serious injury, any event that adversely affects a resident's care, health, welfare or safety, theft or burglary, any accident in the home, and any allegation of misconduct against the registered person or staff (regulation 30 of the residential and nursing home regulations, law). That list is wider than CQC's. Notifications go through RQIA's Web Portal, and RQIA publishes guidance on statutory notification of incidents and deaths for providers and managers. A registered manager's absence of more than 28 days is also notified (residential Standard 20.4).

Mistakes that show up in QIPs

• Supervision schedules that slip past six months with nothing recorded.
• Monthly monitoring visits missed, or reports that don't check the last QIP.
• Staff starting before registration status has been checked.
• Accidents logged but not notified.

How ShiftComplete helps

ShiftComplete for care keeps the non-clinical evidence dated, named and in one place. To be clear about the fit for Northern Ireland:

• The inspection pack is built around CQC's five key questions, not an RQIA template. It still pulls together the dated records RQIA asks to see: checks, the training matrix, supervisions, audits and actions, incidents and the "sent on" date of each notification, complaints and an audit trail summary.
• Rotas with minimum cover and required roles per period, so you can show staffing met need, day and night.
• Supervisions and appraisals on a frequency you choose (set six months to match the standards), signed on the phone, with overdue alerts.
• Training matrix with refresh periods you set and certificate photos. The staff compliance file holds DBS, right to work, visa and NMC details but has no AccessNI or NISCC fields, so record AccessNI references in your own HR system. You could also add NISCC registration as a training matrix item with a refresh period and a photo of the registration confirmation.
• Care checks for fire alarms, emergency lighting, drills (who took part and evacuation time), water temperatures and hoist checks, and certificate due dates for LOLER, gas and electrical.
• Care audits with an action list from every "no".

It works alongside your care-records system (no care plans, eMAR or daily notes) and costs £2.49 per active staff member per month, with a 60-day free trial and no card needed.

See how it works for residential care on our care homes page, for nursing care on our nursing homes page, or for domiciliary care on our home care page.