• Service User Name & Address

  • Time & Date of Spot Check

  • Prepared by

  • Carer Name

Section 1 - Spot check details

  • Employee Name

  • Rostered Call Time

  • Did the carer/support worker start on time

  • Actual finish time

  • Scheduled visit duration

  • Actual visit duration in minutes

Section 2 - Appearance

  • Identity badge on show

  • Appropriate footwear worn

  • Wearing appropriate clothing for the job role

  • Jewellery worn meets with CCNW standards/policy

Section 3 - Personal protective equipment

  • Gloves available

  • Gloves used

  • Aprons available

  • Aprons used

  • Hand gel available

  • Hand gel used

Section 4 Pre-work checks

  • Logged into ACP

  • 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

  • Hoist used in an appropriate and safe manner

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

  • Comments

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

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

  • All personal care performed meets the company quality standards

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

  • All Objectives in the care plan met ?

  • Comments

Section 7 - Approach to client/work

  • Employee displays a positive attitude and approach

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

  • Comments

Section 8 - Communication

  • Employee uses appropriate language and tone

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

Section 9 - Company & Client Confidentiality

  • Has the carer followed the CCNW policy on Company and Client Confidential

Section 10 - Administration of medication

  • Is medication administered during the visit

  • If yes then has the MARS chart been completed correctly

Section 11 - Waste disposal

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

Section 12 - Record keeping

  • Full factual care notes was written for the visit


  • Has the spot check been satisfactory

  • 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

  • Spot checkers signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.