Title Page
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Conducted on
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Prepared by
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Date and Time
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Where Spot Check has taken place?
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CSW name:
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FCS name:
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Client name:
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Call Time:
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Did the CSW arrive at the correct time?
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Did the CSW arrive promptly?
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Was Call Monitoring System used correctly?
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Did the CSW stay for the planned duration of the call?
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Comments on above questions:
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Is CSW’s dress code acceptable?
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Is the correct uniform being worn?
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Was the CSW able to produce their ID badge?
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Is the CSW wearing sensible shoes?
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Is the CSW’s hair appropriate and safe for work?
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Are the CSW’s nails in an acceptable state for work?
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Is the CSW wearing acceptable jewellery?
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Is the CSW’s hygiene acceptable for providing Care?
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Did the CSW use PPE appropriately throughout the call?
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Did the Client remain safe throughout the call?
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Comments on the above questions:
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Did the CSW greet the client appropriately?
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Did the client respond well to the CSW?
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Was client communication appropriate to their needs?
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Was the CSW respectful of the client?
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Was dignity and privacy respected throughout the call?
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Did the CSW meet the needs of the client?
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Was the care and support person cantered?
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Was the CSW kind and caring?
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Was the CSW responsive to the clients needs?
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Comments on the above questions:
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Did the CSW refer the the Care and Support Agreement?
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We’re the tasks/activities being supported compliant with support plans and risk assessment guidelines?
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Did the CSW give feedback about the service?
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Did the Client give any feedback about their service?
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Does any part of the service need reviewing?
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Comments on the above questions:
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Log sheets completed correctly?
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Monitoring forms completed correctly?
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Medication documents completed correctly?
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Comments on the safety and well-being of the client:
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Comments made by the client about their care and support:
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Comments made by the CSW:
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Any actions resulting from the spot check:
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CSW signature
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FCS signature
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Date of next supervision?
