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Contact Us
Home
About Us
Our Official Charity Partner
Meet the Team
Clients
Testimonials
Acquired or Traumatic Brain Injury
Spinal Injury
Other Medical Conditions
Live Vacancies
Register CV
Candidates
Apply online
Supporting Our Official Charity Partner
Subject Access Requests
Refer a Friend Scheme
Care Packages for Brain and Spinal injury
Contact Us
Submit a Daily Record
Step 1 of 7
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User's Email
Username:
Client Name
*
Name of Support Worker on shift today
*
Date of Shift
*
Date Format: DD slash MM slash YYYY
If you are undertaking night shifts, please remember to enter the correct date the shift started.
Shift Start Time
*
:
HH
MM
AM
PM
Shift End Time
*
:
HH
MM
AM
PM
Brief Overview of the evening shift (what, when, how)
*
Goal Progress
Please list the goals you have worked on with John during your shift
For each goal listed above, please provide a detailed description of the actions achieved or completed
Managing Fatigue
Did John's level of fatigue impact on his participation in activities during shift?
*
Yes
No
If yes, then please describe how this presented and affected John
*
Was John able to independently recognize signs of fatigue this evening
*
Yes
No
Mobility
Did you have any concerns regarding John's mobility during your shift this evening?
*
Did John require and hands on assistance or contact guarding to maintain his safety/balance this evening?
*
Yes
No
If yes, please provide details
*
Were there any falls/near falls that required your intervention this evening?
*
Please give a summary of how John’s mobility is during your shift.
*
Medication
Did you administer John's medication this evening?
*
Yes
No
If you answered no, did you split the evening and night medication into 2 x pots and leave them on johns table with a drink for John to self-administer and set a timer/ alarm on his phone?
*
Communication
Was John able to communicate his needs during your evening shift?
*
Yes
No
Have there been any healthcare professionals visit or calls today?
Did John say anything inappropriate on the evening shift?
*
Yes
No
If so, what was said?
*
Diet
What meals were covered during your Shift ( please keep the CRTL button down to select multiple)
*
Dinner
Snacks
Please details below what John ate during the meals
Please give an overview on how they chose their meals
*
Please give an overview of Johns fluid input during your shift.
*
Were there any episodes of choking? If so please describe when and how this was resolved.
*
Finances
What expenses have been used this evening?
*
General
What time did John go to bed this evening?
*
Any safeguarding concerns or important information to be reported to Libertatem or the case manager?
*
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