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Daily Record Form - DC - CM302 - Night Shift
Daily Record Form – DC – CM302 – Night Shift
Name of Support Worker
*
First
Last
Date of Support Session
*
MM slash DD slash YYYY
Time Shift Started
*
:
Hours
Minutes
Time Shift Ended
*
:
Hours
Minutes
1. Personal Care
*
Showering/bathing/dressing etc. Was support delivered by staff or parents? If so, what care was given? Was this completed as per the Care Plan? Yes or no, (delete as appropriate) if no, please detail why.
2. Bowel Movements AM & PM
What bowel movements observed (eg wet pull up, urinating in toilet, bowel movement in toilet).
3. Seizure activity
*
Did Douglas have a. observable seizure seizure during your shift? If so, please give details including any intervention made- document seizure diary.
4. Diary
*
Please document patterns of sleep
5. Any Other Feedback
Staff to include observations on what they felt went really well/felt positive about? or ‘no further comment’.
Records maintained in the Clients home should include the following details as a CQC requirement.
* The full name, date and arrival and shift times of every staff member
* Goals, actions, or practice as specified in the care plan
* Changes in the clients needs, usual behaviour or routine and action taken.
* Unusual or changed circumstances that affect Client, highlight any deviations
* Contact between the support worker and primary health/social care services regarding client
* Contact with Clients Team Manager or Case Manager about matters or concerns regarding their health and wellbeing
* Requests made for assistance over and above that agreed in the care plan
* Incidents, ABC’s accidents or near misses and action taken.
* Risks and action taken to minimise them
