Supervision Form

Staff First and last Name

Do you consider you have received the support you need from your managment/senior staff?

Have you got any issues that needs resolving and would you like to discuss these with us?

Is there any training that might help you to do your job better?

Are there any changes in your health or DBS Information?

Can you briefly describe what it is safeguarding and how would you apply the concept to your job on a daily basis?

Can you briefly describe what is the Mental capacity Act and how you can apply the concept to your job on a daily basis?

Can you briefly describe all types of abuse and how can you spot them when visiting your service users?

What do you most enjoy when delivering care services to your service users? Is there any improvement that should be made that we should be made aware (company or staff improvement in general)?

Please share with us your own auto reflection about your work since your induction, or last supervision and your spot checks. Is there any areas you believe you need to improve? Explain also how should we help you with this. Which areas have you failed and have you corrected these? (please answer all the questions or this supervision will be invalid)

Select a date

Your Signature