Spot check dom care
Spot check document
What does this form include?
This form contains 15 sections:
Name of Supervisee:
STAFF DETAILS
Supervision Number:
APPEARANCE, FIRST AID & PPE
- Do they have a 'valid' ID Card?
ID Card Expiry Date Date
General Notes:
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
- 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)
MEDICATION
Record any tasks observed including Clinical etc:
STAFF CONCERNS
- Does they have any Concerns or Issues they wish to discuss?
OTHER RELEVANT INFORMATION or COMMENTS
- Does the Staff member 'Agree with all Recorded Information'?
DATE FOR NEXT SUPERVISION Date
Supervisee Signature
Supervisor Signature
Use this template