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Care Staff Supervision Template

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Care Staff Supervision Template

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

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

(check name not set)

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