Daily Record Form – Roger M | Libertatem Healthcare

Plans for today
Plans for today:*
Morning routine
Was the handover completed?*
- Yes
- No
What time R woke up?*

: HH

MM
What time was the morning routine started?*

: HH

MM
Duration*
Please enter minutes of how long it took you to support R with morning routine
Was the morning routine completed as per care plan?*
- Yes
- No
Was the continence pad wet in the morning?*
- Yes
- No
Was R's clothing/bedding wet?*
- Yes
- No
If so, state what was wet - clothes, Kylie sheet, sheets, duvet cover, duvet, pillowcases, pillows.
Any other comments about the morning routine?*

Playing cards/games
How many times did you play games with R today?*
Game 1: which game, duration, your observations?*
Your observations should include R's accuracy /keeping to the rules, physical help needed, prompts needed, concentration, attention, enjoyment etc.
Game 2: which game, duration, your observations?*
Your observations should include R's accuracy /keeping to the rules, physical help needed, prompts needed, concentration, attention, enjoyment etc.
Game 3: which game, duration, your observations?*
Your observations should include R's accuracy /keeping to the rules, physical help needed, prompts needed, concentration, attention, enjoyment etc.

Financial
Number of times R used his bank card today*
If he didn't, write 0
Please detail purchase made, cost, whether PIN or contactless, help needed and what R managed himself.*

Please detail any other activities or appointments today not already recorded elsewhere.*
What, when, where. How did you assist. Challenges and successes.
Contact with family and with others
List all contact that R has had with family, MDT, or other today.*
please state who, time from and to and how (person or by facetime)
List all contact that you (SW) have had with family, MDT, or other today.*
please state who, time from and to and how (person or by facetime)

Evening routine
What time evening routine started?*

: HH

MM
Duration:*
How long it took you to complete evening routine
Time R asleep*

: HH

MM
R in bed, seizure and pressure mat alarm on. Audio monitor on.*
- Yes
- No
Was the evening routine completed as per the care plan?*
- Yes
- No
If no, what was different?*
Any other comments about the evening routine?*
Did R sleep through the night?*
If not, please explain what happened.
Fatigue
Detail if changes to usual level of fatigue seen, e.g. slept for longer than usual, or if asked to go to bed earlier than usual.*

Home environment
Any problems or concerns about bungalow, furniture or equipment?*
- Yes
- No
If yes, please provide details
Is the dropdown rail in R bathroom secure?*
- Yes
- No
You must report any changes to the case manager before completing your shift. All post addressed to R, or to the occupied, must be given to Jennie who will open it with him. Jennie will then share letters with the support team as needed. SW to open post addressed to the SW team and scan to the office at debbieeaton.com
Any post addressed to R or occupier?*
- Yes
- No
All post addressed to Roger, or to the occupier, must be given to Jennie who will open it with him. Jennie will then share letters with the support team as needed. Support workers to open post addressed to the support worker team and scan to office@debbieeaton.com
Any post addressed to SW team?*
- Yes
- No

Accidents, injuries or safeguarding
To you, R or others
Have there been any near misses, accidents or injuries?*
If so, please provide more information. scan the relevant page of the accident book and send it in.

Important Messages
Do you have any safeguarding concerns which LHG and case manager need to be aware of?*
- Yes
- No
Please provide details:*
Signature
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