ACS Spot Check Record

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Section 1 - Spot check details

• Select date

  Date

• Employee Name

• Scheduled start time

• Did the carer start on time

  Yes

  No

  N/A

• Scheduled visit duration

• Comments:

• Was the visit performed Over Time, Under Time or within 7 minutes of Actual Time.

  Under

  Over

  Actual

Section 2 - Appearance

• Identity badge on show

  Yes

  No

  N/A

• Appropriate footwear worn

  Yes

  No

  N/A

• Wearing ACS uniform

  Yes

  No

  N/A

• Jewellery worn meets with ACS standards/policy

  Yes

  No

  N/A

Section 3 - Personal protective equipment

• Gloves available

  Yes

  No

  N/A

• Gloves used

  Yes

  No

  N/A

• Aprons available

  Yes

  No

  N/A

• Aprons used

  Yes

  No

  N/A

• Hand gel available

  Yes

  No

  N/A

• Hand gel used

  Yes

  No

  N/A

• Protective arm sleeves available

  Yes

  No

  N/A

• Protective arm sleeves used

  Yes

  No

  N/A

Section 4 Pre-work checks

• Logged into Care Manager Mobile

• Care plan reviewed

• Risk assessment reviewed

• Latest progress notes read

Section 5 - Moving & handling technique (where provided)

• All moves performed in an appropriate and safe manner

  Yes

  No

  N/A

• Hoist used in an appropriate and safe manner

  Yes

  No

  N/A

• Moving and handling equipment used where required<br>i.e. slide sheets/banana board/stand aids

  Yes

  No

  N/A

Section 6 - Task performance (personal care, where provided)

• All personal care is performed to meet the objectives outlined in the client's care plan

  Yes

  No

  N/A

• All personal care performed meets the company quality standards

  Yes

  No

  N/A

Care plan objectives - all objectives outlined in the care plan met

• All other tasks are performed as required to meet the objectives out-lined in the client's care plan

  Yes

  No

  N/A

Section 7 - Approach to client/work

• Employee displays a positive attitude and approach

  Yes

  No

  N/A

• Employee seeks to maintain the client's dignity and respect

  Yes

  No

  N/A

Section 8 - Communication

• Employee uses appropriate language and tone

  Yes

  No

  N/A

• Content and topic of conversation is appropriate and professionalism is maintaned

  Yes

  No

  N/A

Section 9 - Record keeping

• Progress sheet appropriately and legibly updated

  Yes

  No

  N/A

Section 9a - Administration of medication

Section 10 - Company & Client Confidentiality

• Has the carer followed the ACS policy on Company and Client Confidentiality

  Yes

  No

  N/A

• Is medication administered during the visit (if yes, please complete a Medication Competency Record)

  Yes

  No

  N/A

Section 11 - Waste disposal

• Waste disposed of appropriately (gloves, aprons, pads, etc)

  Yes

  No

  N/A

Outcome:

• Has the spot check been satisfactory

  Yes

  No

  N/A

• Employee feedback provided:

• Improvements/Training needs identified (bullet point areas where additional training is required/when it will take place/method of delivery

• Improvements/training identified

• Employee signature

  Sign

• Spot checkers signature

  Sign