Title Page

  • Conducted on

  • Prepared by

  • Date and Time

  • Where Spot Check has taken place?
  • CSW name:

  • FCS name:

  • Client name:

  • Call Time:

  • Did the CSW arrive at the correct time?

  • Did the CSW arrive promptly?

  • Was Call Monitoring System used correctly?

  • Did the CSW stay for the planned duration of the call?

  • Comments on above questions:

  • Is CSW’s dress code acceptable?

  • Is the correct uniform being worn?

  • Was the CSW able to produce their ID badge?

  • Is the CSW wearing sensible shoes?

  • Is the CSW’s hair appropriate and safe for work?

  • Are the CSW’s nails in an acceptable state for work?

  • Is the CSW wearing acceptable jewellery?

  • Is the CSW’s hygiene acceptable for providing Care?

  • Did the CSW use PPE appropriately throughout the call?

  • Did the Client remain safe throughout the call?

  • Comments on the above questions:

  • Did the CSW greet the client appropriately?

  • Did the client respond well to the CSW?

  • Was client communication appropriate to their needs?

  • Was the CSW respectful of the client?

  • Was dignity and privacy respected throughout the call?

  • Did the CSW meet the needs of the client?

  • Was the care and support person cantered?

  • Was the CSW kind and caring?

  • Was the CSW responsive to the clients needs?

  • Comments on the above questions:

  • Did the CSW refer the the Care and Support Agreement?

  • We’re the tasks/activities being supported compliant with support plans and risk assessment guidelines?

  • Did the CSW give feedback about the service?

  • Did the Client give any feedback about their service?

  • Does any part of the service need reviewing?

  • Comments on the above questions:

  • Log sheets completed correctly?

  • Monitoring forms completed correctly?

  • Medication documents completed correctly?

  • Comments on the safety and well-being of the client:

  • Comments made by the client about their care and support:

  • Comments made by the CSW:

  • Any actions resulting from the spot check:

  • CSW signature

  • FCS signature

  • Date of next supervision?

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.