Information

  • Carehome

  • Conducted on

  • Prepared by

  • Location of supervision

Staff Details

  • Name of Staff:

  • Job Title:

  • Observe and Discuss with the Staff Member, the Following:

Attitude and Approach

  • Is the Staff member 'Dressed Appropriately' in accordance with Company Policy?

  • How can they improve?

  • Are Residents, Visitors and Colleagues treated with Respect, Dignity and a professional approach at all times?

  • How can they improve?

  • Do they approach all tasks in an Organised and Professional Manner and in accordance with Procedures?

  • How can they improve?

  • Do they 'Communicate Clearly and Effectively' with Colleagues and Visitors?

  • Describe why and how they can improve.

  • Comments

Support and Care

  • Is the way in which General Support and Care is delivered in accordance with the Residents wishes and Care Plan?

  • Do they deliver 'Personal Care' in a way that Promotes Respect and Dignity and in accordance with the Residents wishes and Care Plan?

  • Do they Encourage and Promote the Residents to participate in all aspects of their Care?

  • Do they 'Communicate Clearly and Effectively' with Residents?

  • Do they select the correct PPE for tasks as required and in accordance with Procedures?

Medication (If Applicable i.e. Nurses, Nurse Assistant) Skip if not required

  • Do they Correctly Identify and Select the required Medication in accordance with Procedures?

  • Is the Medication Dispensed and Administered in the correct way and in accordance with Procedures?

  • Is the eMar system being used effectivley?

  • Describe concerns and action plan.

Staff Concerns

  • Does the Staff member have any Concerns or Issues they wish to discuss? If YES, please describe.

Other Relevant Information

  • Describe positive comments for the staff member. i.e. Look into areas where the staff member has gone above and beyond etc.

  • Discuss areas for improvement for the staff member. i.e. Look at areas where the staff member can improve their work and stay motivated etc.

  • Does the Staff member 'Agree with all Recorded Information'? If 'NO' record detials

  • What is the most challenging aspect of staff members job.

  • How can we assist you to over come your challenges?

  • What are your goals for the next 3 months?

  • Date for next supervision

  • Supervisee Signature

  • Supervisor 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.