Care & Support Staff* Supervisor Date Supervision Date of Previous Supervision Date of Next Supervision Have both supervisor and support worker brought the following with them?Last supervision notes Yes No Last supervision notes commentsSpot check forms Yes No Spot check forms commentsPersonal Agenda Yes No Personal Agenda commentsOther Yes No Other commentsAbout youHow is the support worker, are they well, general well-being in relation to work.About those you supportWho do you currently work with? Are there any issues? Have you noticed any change in the individual’s needs (care plan, risk assessment, etc.) how is your relationship with the parents/carers? How is your relationship with the co-worker, Has the individual raised any concerns or have any complaints that may require a follow up? What activities do you access whilst on session? Please feedback on the individuals person centred plan – is it working? Are there any issues regarding transport?Are there any Health & Safety Issue, Incidents, near misses or suspected signs of abuse?Please review the services you are involved in and relate any possible concerns or issues that could be important to the safety and welfare of children/adults you support.Have you any concerns or issues with any Family Support Wales staff?Are there any concerns with other community staff? Have you concerns or issues with the office staff or senior management? Training & Development NeedsAre you managing your training plan (QCFs, etc) are there any areas you feel you need further training in? Is there any other specialist training you would like to undertake?Any Other Issues and SuggestionsAny Concerns from FSWAreas to improveWhat needs to improve, please detail?Action & SupportWho will assist and support staff member to complete improvement.Expected OutcomeWhat is the expected outcome and what do FSW and Support worker expect to achieve?Date to CompleteWhen is action expected to be completed by? DBS: Renewal Date DBS: Completed Yes No Car Insurance: Renewal Date Car Insurance: Completed Yes No Car MOT: Renewal Date Car MOT: Completed Yes No Support Worker Name Date (Support Worker) Supervisor Name Date (Supervisor) Privacy* By using this form you agree with the storage and handling of your data by this website. More information >> PhoneThis field is for validation purposes and should be left unchanged.
