Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
STAFF DETAILS
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Name of Supervisee:
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Job Title:
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Supervision Number:
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
TRAINING MATRIX CHECK
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Date of last 'Moving & Handling' training:
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Date of last 'Safeguarding' training:
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Date of last 'Infection Control' training:
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Date of last 'First Aid' training:
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Date of last 'Food Hygiene' training:
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Date of last 'Health & Safety' training:
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Date of last 'Dementia' training:
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Date of last 'Equality & Diversity' training:
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Are any of the above 'out of date'?
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List subjects and inform Manager
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Highest Qualification
- NVQ/QCF 2
- NVQ/QCF 3
- NVQ 4
- QCF 5
- NCFE
- None
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Which NCFE's have been completed?
Observe and Discuss with the Staff Member, the Following:
APPEARANCE, FIRST AID & PPE
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Are they 'Dressed Appropriately' in accordance with Company Policy? (uniform, footwear, nails, jewellery etc)
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Details:
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Do they know how to access a First Kit in the Home?
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Do they know how to access Gloves in the Home?
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Do they know how to access Aprons in the Home?
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Do they have adequate supply of personal 'Anti-Bacterial Hand Gel'?
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General Notes:
ATTITUDE & APPROACH
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Do they 'Communicate Clearly and Effectively' with the Residents?
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Do they 'Communicate Clearly and Effectively' with Colleagues and Visitors?
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Are Residents, Visitors and Colleagues treated with Respect, Dignity and a professional approach at all times?
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Do they approach all tasks in an Organised and Professional Manner and in accordance with Procedures and Care Plans?
SUPPORT AND CARE
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Is the way in which General Support and Care is delivered in accordance with Residents wishes and Care Plan? <br><br><br><br>
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List interactions observed:
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Detail concerns:
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Do they deliver 'Personal Care' in a way that Promotes Respect and Dignity and in accordance with Residents wishes and Care Plan? Record Tasks Observed
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List interactions observed:
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Detail concerns:
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Do they Encourage and Promote the Residents to participate in all aspects of their Care?
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Do they complete the relevant documentation in an appropriate manner? (factual, legible etc)
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Do they select the correct PPE for tasks as required and in accordance with Procedures?
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Are any 'Special' Infection Controls Measures in place at present?
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Are they being followed according to procedures?
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Details:
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General Notes:
MEDICATION
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Was Medication given?
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Do they Correctly Identify and Select the required Medication in accordance with Procedures and Care Plans?
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Details:
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BOOK FOR RETRAINING....
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Is the Medication Dispensed and Administered in the correct way and in accordance with Procedures and Care Plans?
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Details:
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BOOK FOR RETRAINING....
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Was the MAR Chart completed correctly?
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Details:
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BOOK FOR RETRAINING....
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General Notes:
TASKS OBSERVED DURING SUPERVISION
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Record any tasks observed including Clinical etc:
STAFF CONCERNS
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Does they have any Concerns or Issues they wish to discuss?
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Do they wish to discuss them now? If 'NO' make an appointment for a meeting.
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Arrange a suitable date and time for a one to one meeting:
OTHER RELEVANT INFORMATION or COMMENTS
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Does the Staff member 'Agree with all Recorded Information'?
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Details:
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NEXT SUPERVISION WILL BE:
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DATE FOR NEXT SUPERVISION
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Supervisee Signature
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Supervisor Signature
