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General HCA & Mental

Health Support
Workers Checklist

PLEASE READ
Once completed, please email or post the form back to us.
NOTE: Form not compatible with iMac and MacBook.

TICK AS APPROPRIATE
General HCA Mental Health Support Worker

NO LIMITED HIGHLY
EXPERIENCED
EXPERIENCE EXPERIENCE SKILLED

OBSERVATIONS & RECORDING


TPR
Blood pressure:
Manual
Automatic
O2 Saturation monitoring

Fluid balance chart
Intentional rounding chart
Food & Diet Chart
Blood glucose (BM):
Monitoring
Recording
Stool chart

SKILLS
Personal care
Oral care
Pressure area care
Catheter care
Toileting
Escalating changes in patient condition
Care of pre & post op patient
Care of the diabetic patient
Documentation

General & Mental Health Hca / Support Workers Checklist / Page 1 of 2


Your World Recruitment Group | Level 5, Broadgate Tower, 20 Primrose Street, London, EC2A 2EW | Tel: 020 7220 0811 | Fax: 020 7220 0810 | www.yourworldhealthcare.com | info@ywhealthcare.com | Company No. 8275588
EQUIPMENT:
NO LIMITED HIGHLY
EXPERIENCED
EXPERIENCE EXPERIENCE SKILLED

Hoists:
Please list any hoists you are familiar with:

All types
Pressure relieving equipment
Please list any pressure equipment you are familiar with:

BM machine
Tympanic thermometer
Any other please list below:

MENTAL HEALTH SUPPORT WORKER ONLY:


Levels of observation
Understanding of safeguarding
Ensuring rights & dignity
Escalation of concerns
De-escalation techniques
Security of ward/unit
Escort of section
Working within the MDT
Reporting to the MDT or Nurse in charge
Therapeutic & group activities
Any other please list below:

PERSONAL DETAILS
I confirm that I have completed this checklist honestly and to the best of my knowledge and abilities.
Print Name: Mohammad Tayyab Khan
Sign: M T Khan
Date: 12/11/16

General & Mental Health Hca / Support Workers Checklist / Page 2 of 2


Your World Recruitment Group | Level 5, Broadgate Tower, 20 Primrose Street, London, EC2A 2EW | Tel: 020 7220 0811 | Fax: 020 7220 0810 | www.yourworldhealthcare.com | info@ywhealthcare.com | Company No. 8275588

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