Employee Spot check & Survey
Conducted on:
*
 /
Day
 /
Month
Year
Date
Staff name
*
Please Select
Adrian Telford
Aimee Smith
Alisha Martin
Allison Hudson
Amy Shepherd
Andrea Grydziuszko
Andrew Griffiths
Angela Johnston
Arran Hughes
Asher Morris
Ashton Crockett
Ayomide Okunola
Becky Theys
Bethany Hewson
Bethany McCreath
Brodie Nelson
Caitlin Butler
Caitlin Young
Catherine Sullivan
Charoline Ancheta
Chelcea Brough
Cheryl Lee
Christina Wills
Christopher Rood
Clayton Mguni
Corinne Luscombe
Courtney Armes
Daniel Chombo
Danielle Hagan
David Mather
David Monk
David Ratcliffe
Dency Kurian
Diane Baird
Diane Laidman
Donna Gardner
Ebony Woodhouse
Eileen Potter
Elaine Goddard
Eleanor Tyson
Elise Olga Alexander
Elizabeth Jones
Elizabeth Kennedy
Elizabeth McPhee
Ellie Bell
Elsie Terre
Emma Riley
Fuad Usman
Gail Clarke
Georgia Whitehall
Georgia Woodhouse
Gillian Blamire
Gladwin Sta Monica
Gladys Fiona Chikosha
Hazelyn Hidalgo
Jamie Hutchinson
Jamie Wright
Jenna Neale
Jessica Pearson
Joana Marie Sarmiento
Joanne Irving
Joanne McCullough
Joanne Ward
John Robe
John Sanni
Katie Hindley
Kayla Wager
Kelvin Forward
Kudzai Kunonga
Kyra Burgess
Kyra Luisi
Laura Booth
Laura Heap
Lauren Olliver
Lauren Ridge
Leah Chapple
Leslie Dockeray
Lincoln Zimbudzana
Logan Grosvenor
Lucy Gray
Lydia Chimutashu
Madelaine Peene
Madison Fryer
Mary Cris Edmonson
Max Ainsworth
Megan Allen
Melissa Hutchinson
Michael Clarke
Michele Heald
Michelle Jack
Michelle Terre
Naomi Taylor
Niamh Currie
Nicola Barclay
Oasa Fitzgerald
Oliver Hodgson
Olivia Corkill
Patricia Davies
Patricia Mwagale Nakimera
Poppy McClean
Poppy Muir
Raph Osia
Raphael Muyendesi
Rebecca Dodd
Rebecca Johnson
Rhianna Johnson
Rhiannon Bossio
Rizwana Sani
Ruby Palmer
Sam Loughran
Samantha Tucker
Samantha Wright
Sandiso M Dube
Sarah Smillie
Sharon Solari
Sheila Tendai Zengeni
Sherilyn Calma
Sian Hartley
Simon Garner
Skye Hodge
Starsky Terre
Steven Gaydon
Summer Duke
Susan Elliott
Suzanne Bradley
System triggered action
Teja Ursic
Tom Canavan
Tsitsi Juji
Vanessa Etchells
Wendy Lawson
Zuzanna Sankiewicz
Spot checker name
*
Spot checker email
*
example@example.com
Back
Next
Save
Appearance
1. Do the staff members have their MSH identity badges to show?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
2. Is the staff uniform compliant with the current company policy?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
3. Is the staff member's hair and nails in compliance with the current company policy?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
4. Is the jewellery being worn compliant with the current company policy?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
5. Is the company car up to the standards specified in the current company policy?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
Appearance: Is re-training needed?
*
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Appearance, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Appearance Q1
Appearance Q2
Appearance Q3
Appearance Q4
Appearance Q5
Back
Next
Save
Communication
1. Can the staff member name at least three of the 6Cs?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
2. Is the staff member displaying a positive attitude and approach?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
3. Is the staff member using appropriate language and tone?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
4. Does the staff member seek to maintain the dignity and respect of the service user?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
5. Is the content and topic of conversation appropriate, and was professionalism maintained?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
6. Does the staff member support the service user in making their own choices?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
7. Does the staff member communicate effectively to meet the needs of the service user?
*
Yes
No
N/A
If the answer was No or N/A, you are required to add notes.
*
Communication: Is re-training needed?
*
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Communication, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Communication Q1
Communication Q2
Communication Q3
Communication Q4
Communication Q5
Communication Q6
Communication Q7
Back
Next
Save
Medication
1. Can the staff member state at least 4 of the 8 rules of Administering Medication safely?
*
Yes
No
If the answer was No, you are required to add notes.
*
Is there a medication due to be administered at the call?
*
Yes
No
2. Right person: Did the staff member check the medication label against MAR chart?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
3. Right Medication: Did the staff member check that the medication against the prescription label?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
4. Right Dose: Did the staff member check medication dosage against the prescription label?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
5. Right Route: Did the staff member check the medication route against the prescription label?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
6. Right Time: Did the staff member check the time of the medication against the MAR Chart?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
7. Right Documentation: Did the staff member complete the MAR Chart after the medication was administered?
*
Yes
No
If the answer was No or N/A, you are required to add notes.
*
Medication: Is re-training needed?
*
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Medication, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Medication Q1
Medication Q2
Medication Q3
Medication Q4
Medication Q5
Medication Q6
Medication Q7
Back
Next
Save
Health & Safety
1. Did the staff member follow the Hand washing Technique in line with the company policy?
*
Yes
No
N/A
If the answer was No or N/A for Hand washing Technique, you are required to add notes.
*
2. Did the staff member change the gloves after every task in line with the company policy?
*
Yes
No
N/A
If the answer was No or N/A for changing the gloves, you are required to add notes.
*
3. Did the staff member change the apron after every task in line with the company policy?
*
Yes
No
N/A
If the answer was No or N/A for changing the apron, you are required to add notes.
*
4. Did the staff member wear a mask throughout the visit in line with the company policy?
*
Yes
No
N/A
If the answer was No or N/A for wearing a mask, you are required to add notes.
*
5. Did the staff member disposed all the PPEs in line with Infection Control Policy and Procedure?
*
Yes
No
N/A
If the answer was No or N/A for PPE disposal, you are required to add notes.
*
Is there a manual handling procedure during the call?
*
Yes
No
6. Does the staff member followed Manual Handling Risk Assessment in line with company's current Policy and Procedure?
*
Yes
No
If the answer was No for M&H risk assessment, you are required to add notes.
*
7. Does the staff member undertaken Manual Handling task correctly in line with company's current Policy and Procedure?
*
Yes
No
If the answer was No for M&H task correct undertaken, you are required to add notes.
*
8. Does the staff member do a visual check of equipment including inspection dates, if applicable carried out?
*
Yes
No
If the answer was No for checking equipment, you are required to add notes.
*
Health & Safety: Is re-training needed?
*
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Health & Safety, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Health & Safety Q1
Health & Safety Q2
Health & Safety Q3
Health & Safety Q4
Health & Safety Q5
Health & Safety Q6
Health & Safety Q7
Health & Safety Q8
Back
Next
Save
MSH Policy & Procedures
1. Does the staff member know how to access the policies?
*
Yes
No
If the answer was No for knowing how to access policies, you are required to add notes.
*
2. Does the staff member have a reasonable understanding about the Duty of Candour Policy?
*
Yes
No
If the answer was No for understanding Duty of Condour Policy, you are required to add notes.
*
3. Does the staff member have a reasonable understanding about the Whistleblowing Policy?
*
Yes
No
If the answer was No for understanding Whistleblowing Policy, you are required to add notes.
*
4. Does the staff member have a reasonable understanding about the Equality and Human Rights Policy?
*
Yes
No
If the answer was No for understanding Equality & Human Rights Policy, you are required to add notes.
*
5. Does the staff member have a reasonable understanding about the Confidentiality Policy?
*
Yes
No
If the answer was No for understanding Confidentiality Policy, you are required to add notes.
*
6. Does the staff member have a reasonable understanding about the Safeguarding Policy?
*
Yes
No
If the answer was No for understanding Safeguarding Policy, you are required to add notes.
*
7. Does the staff member have a reasonable understanding about the Mental Capacity Act?
*
Yes
No
If the answer was No for understanding Mental Capacity Act, you are required to add notes.
*
8. Does the staff member have a reasonable understanding the Infection Control Policy?
*
Yes
No
If the answer was No for understanding Infection Control Policy, you are required to add notes.
*
9. Does the staff member have a reasonable understanding the Recording the Administration of Medication Policy?
*
Yes
No
If the answer was No, you are required to add notes.
*
10. Does the staff member have a reasonable understanding the Administration of Medicines Policy?
*
Yes
No
If the answer was No for understanding Administration of Medication policy, you are required to add notes.
*
Policy & Procedure: Is re-training needed?
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Policy & Procedures, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Policy & Procedures Q1
Policy & Procedures Q2
Policy & Procedures Q3
Policy & Procedures Q4
Policy & Procedures Q5
Policy & Procedures Q6
Policy & Procedures Q7
Policy & Procedures Q8
Policy & Procedures Q9
Policy & Procedures Q10
Back
Next
Save
Systems & Processes
1. Can the staff member check in/out correctly of the care software?
*
Yes
No
If the answer was No for checking in/out correctly, you are required to add notes.
*
2. Did the staff member completed the tasks set during the visit?
*
Yes
No
If the answer was No for completing tasks, you are required to add notes.
*
3. Did the staff member completed visit notes and been factual?
*
Yes
No
If the answer was No for factual notes, you are required to add notes.
*
4. Is the staff member aware of what must be in the care notes?
*
Yes
No
If the answer was No for awareness in care notes, you are required to add notes.
*
5. Is the staff member aware that family members can read the notes?
*
Yes
No
If the answer was No for family member notes awareness, you are required to add notes.
*
6. Is the staff member know the name of the Registered Manager, Care Manager & Field Care Supervisor?
*
Yes
No
If the answer was No for knowing managers, you are required to add notes.
*
7. Is the staff member able to tell how to raise a Safeguarding Concerns?
*
Yes
No
If the answer was No for raising safeguarding concerns, you are required to add notes.
*
8. Is the staff member able to tell who the Care Quality Commission (CQC) are?
*
Yes
No
If the answer was No for knowing CQC, you are required to add notes.
*
System & Processes: Is re-training needed?
*
No
Verbal prompt
Full re-training required
If the answer was Verbal prompt or Full re-training for Systems & Processes, you are required to add notes.
*
Browse Files
Drag and drop files here
Choose a file
Upload file
Cancel
of
Systems & Processes Q1
Systems & Processes Q2
Systems & Processes Q3
Systems & Processes Q4
Systems & Processes Q5
Systems & Processes Q6
Systems & Processes Q7
Back
Next
Save
Staff Member Survey
1. What aspect of working with MSH Healthcare do you enjoy the MOST?
*
2. What aspect of working with MSH Healthcare do you enjoy the LEAST?
*
3. Do you feel you need more support in your role?
*
Yes
No
If the answer was Yes you need more support in your role, you are required to add notes.
*
4. Are you happy with your current role within MSH?
*
Yes
No
If the answer was not happy with your current role, you are required to add notes.
*
5. Would you recommend MSH to a potential employee?
*
Yes
No
If the answer was not recommend MSH to a potential employee, you are required to add notes.
*
6. Do you feel you have a good working relationship with your colleagues?
*
Yes
No
If the answer was not having good working relationship with your colleagues, you are required to add notes.
*
7. Are you happy with your current contracted hours?
*
Yes
No
If the answer was not happy with your current contracted hours, you are required to add notes.
*
8. Are you aware that the MSH Carer Portal allows you to access the online training courses
*
Yes
No
If the answer was not aware of MSH Carer portal, you are required to add notes.
*
Any additional comment:
Spot Check Staff Survey Q3
Spot Check Staff Survey Q4
Spot Check Staff Survey Q5
Spot Check Staff Survey Q6
Spot Check Staff Survey Q7
Spot Check Staff Survey Q8
Back
Next
Save
Staff member feedback:
*
Do you feel you will benefit from any re-training?
*
Yes
No
If the answer is Yes, what training course(s) you think you would benefit?
*
Staff member's signature:
*
Back
Next
Save
Asessor's feedback:
*
Staff member's signature:
*
Save
Continue
Should be Empty: