Care & Support Staff* Supervisor Location 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 SuggestionsHas the support worker any issues to discuss or any suggestions for improvement? If the support worker brought their own agenda to this supervision please discuss here. Any Concerns from FSW If FSW have any concerns regarding the attitude, service delivery, time keeping etc, please discuss hereFeedback formsExplained by your line manager? Yes No Feedback formsDo you understand the requirement? Yes No Submitting hours and mileageExplained by your line manager? Yes No Submitting hours and mileageDo you understand the requirement? Yes No Rota allocationExplained by your line manager? Yes No Rota allocationDo you understand the requirement? Yes No Contract/Zero hour contractExplained by your line manager? Yes No Contract/Zero hour contractDo you understand the requirement? Yes No Out of Hours On-CallExplained by your line manager? Yes No Out of Hours On-CallDo you understand the requirement? Yes No Monthly PayExplained by your line manager? Yes No Monthly PayDo you understand the requirement? Yes No Confidentiality with familiesExplained by your line manager? Yes No Confidentiality with familiesDo you understand the requirement? Yes No Befriending families/services on social mediaExplained by your line manager? Yes No Befriending families/services on social mediaDo you understand the requirement? Yes No Use of phones on service – emergency onlyExplained by your line manager? Yes No Use of phones on service – emergency onlyDo you understand the requirement? Yes No Social media useExplained by your line manager? Yes No Social media useDo you understand the requirement? Yes No Lateness and early finishingExplained by your line manager? Yes No Lateness and early finishingDo you understand the requirement? Yes No AWOLExplained by your line manager? Yes No AWOLDo you understand the requirement? Yes No Communicating with managers for support/helpExplained by your line manager? Yes No Communicating with managers for support/helpDo you understand the requirement? Yes No Areas 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?Probation Period - Further Support Needed Yes No Probation Period - Completed Yes No Probation Period - Details of further SupportProbation Extended Date 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 >> NameThis field is for validation purposes and should be left unchanged.
