Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

STAFF DETAILS

  • Name of Supervisee:

  • Job Title:

  • Supervision Number:

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

APPEARANCE, FIRST AID & PPE

  • Do they have a 'valid' ID Card? Record Expiry Date

  • Are they 'Dressed Appropriately' in accordance with Company Policy? (uniform, footwear, nails, jewellery etc)

  • Date of last 'First Aid' training:

  • Date of last 'Infection Control' training:

  • Date of last 'Moving & Handling' training:

  • Date of last 'Safeguarding' training:

  • Do they have access to their Personal First Kit in the Service?

  • Do they have adequate supply of 'Anti-Bacterial Hand Gel'?

  • Do they have adequate supply of 'Gloves'?

  • Do they have adequate supply of 'Aprons'?

SUPPORT AND CARE

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

  • Is the way in which General Support and Care is delivered in accordance with Service User wishes and Care Plan? Record Tasks Observed<br><br><br><br>

  • Do they deliver 'Personal Care' in a way that Promotes Respect and Dignity and in accordance with Service User wishes and Care Plan? Record Tasks Observed

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

  • Do they 'Communicate Clearly and Effectively' with the Service User?

  • Do they complete the relevant documentation in an appropriate manner? (factual, legible etc)

  • Are 'Current' Infection Control Measures followed according to procedures?

MEDICATION

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

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

STAFF CONCERNS

  • Does they have any Concerns or Issues they wish to discuss?

  • Do they wish to discuss them now? If 'NO' make an appointment for a meeting.

TASKS OBSERVED DURING SUPERVISION

  • Record any tasks observed including Clinical etc:

OTHER RELEVANT INFORMATION or COMMENTS

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

  • AGREE DATE FOR NEXT SUPERVISION

  • NEXT SUPERVISION WILL BE:

  • 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.