SLIC - End of Placement Feedback Form

End of Placement Feedback Form

How was the Carer in the Placement?
Carers Name

First NameLast Name
Start Date

DayMonthYear
Date
End Date

DayMonthYear
Date
Your Customers Surname
Did carer have good communication with the CCL/Supervisor & Office throughout placement?
If No, Why?
Did you feel the carer did a thorough handover covering everything the replacement carer needed?
If No, Why?
Did you feel the carer left the customers home and carers bedroom clean and tidy?
If No, Why?
Do you feel they would benefit from any further training? If so, what?
Did you feel they had adequate support from your office?
If No, Why?
What is the Carers Strengths?
What is the Carers Difficulties?
Carer Summary:
Overall feedback of the carers work
Would you be happy to use this carer again for this package?
If No, Why?
Would you be happy to use this carer again for another one of your packages?
If No, Why?
Name of Your Office:
Completed By:

First NameLast Name
Should be Empty: