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Learner Name:

Date:

!!Current Course / Learning / Employment status

Learners Address:

Telephone Number:

School / Work Contact Name and Contact details (if applicable)

Preferred Work Experience Area (in order of preference)

1.

2.

3.

Q1) What new skills do you wish to gain from the Work Experience?

Q2) Why have you chosen this area of Work Experience?

These resources have been produced as

part of the Traineeship Staff Support

Programme commissioned and funded by

Work Experience Sector Request Form

Q3) How do you think the Work Experience will help you with your career?

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Teacher IAG (for relevance/appropriate)

Work Experience Confirmation

Employer Name:

Address:

Telephone Number:

Email Address:

Dates of Work Experience (if known):

Last day at Placement:

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Between In Touch Care, (Organisation Name) and (Learner Name)

We will facilitate the unpaid Work Experience of ……………………………….. as follows: Effective Start Date: Effective End Date: Location: Hours: Activities: Contact Details Supervisor: Supervisor Contact number: ITC / School Contact name or other: ITC / School emergency contact number or other: ITC / School Visit or other: A representative from In Touch Care will conduct a placement visit on ……… Agreed Learner Responsibilities during the placement Behaviour You will be expected to be courteous and respectful to other staff and learners during your placement. Transport and Lunch You will be responsible for making arrangements for transport and lunch Health and Safety You must: • Take reasonable care to avoid injury to yourself and to others • Report any accident or injury immediately and record the details in the accident / incident book You must not: • Interfere with, or misuse any clothing or equipment provided to protect your Health and Safety

In Touch Care will take reasonable care of your Health and Safety under this agreement. A Health and Safety Risk Assessment will be undertaken, identifying measures to be taken to control or eliminate any identified risks.

These resources have been produced as part of the Traineeship Staff Support Programme commissioned and funded by

Work Experience Agreement

Confidentiality You must not, at any time whether during or after the placement, disclose to a third party, any confidential information you obtain during your placement which is not available to the public. In Touch Care will meet responsibilities for confidentiality of your data under In Touch Care Data Protection Policy. Liability In Touch Care’s public liability insurance policy covers those conducting voluntary work. (Insert name of Work Experience learner) has received the following documents:

• Written confirmation of Work Experience including contact details • Learner Handbook • Learner Journal • Work Experience Charter • Standard 10

Signed: Date: (Insert Name) (Insert Job Title) In Touch Care Signed: Date: Learner Signed: Date: Employer !

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Placement Logbook

Learner Name

Placement Details

Start Date

Placement Manager

Placement Mentor

These resources have been produced as part of the Traineeship Staff Support Programme commissioned and funded by

Introduction Purpose of the Log Book We have devised Log Books to help you with your learning journey. Entries should be made regularly, kept up to date and signed to ensure that the information you are recording is timely and accurate. It is envisaged that you will make entries (either hand written or word processed) that reflect the work you have undertaken while on placement and how you think and feel about it. Reflection Reflection is associated with learning from experience and is viewed as an important learning strategy in health and social care settings. It is seen as a way of promoting self-development through consideration and discussion of particular incidents, and closes the gap between theory and practice. There are a number of frameworks that exist to help us reflect i.e. ask questions about, and make sense of our experiences. A fairly straightforward example is: 1. What? (describe the situation) 2. So what? (how do we feel about what has happened) 3. Now what? (what would we do if the situation happened again) Responsibilities While you will be supported throughout your learning journey, you must also take responsibility for your own learning. You will be expected to ask questions about what you see and hear, and if you are ever unsure about tasks or activities that you are involved in, ASK - do not take any chances.

Placement Aims and Objective

Decide a list of aims and objectives you want to achieve from your time on work placement. Detail these below and sign and date each one as you achieve it.

Aim/Objective What I have

learnt

Date

Achieved

Signatures

About Your Placement

Answer the following about your work placement What is the management structure of your placement?

(draw an organisation chart if you wish, identifying key posts and personnel) What is the age range of people who access services in this placement? What different care

needs do the service users have?

What services does your placement provide?

What are the underpinning values of the service?

Reflective Journal

You are now required to complete your four week reflective journal thinking about all your areas of development and what you have learnt during your time on placement. Be honest about your time on placement as this will help you identify areas of further development for you to undertake.

Questions to ask yourself to help you to fill in your journal are:

• How did you feel?

• What are your strengths today?

• What are your areas of development today?

• What duties have I done today and how have they gone?

• What are your expectations for tomorrow?

• Have you learnt anything new?

• What skills/qualities have you improved/gained today?

• What were the negatives and positives of today?

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Week One

Day One – Date: …………………………………….. Reflection on today… Day Two – Date: …………………………………………. Reflection on today… Day Three – Date: …………………………………………. Reflection on today…

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Day Four – Date: …………………………………………. Reflection on today… Day Five – Date: …………………………………………. Reflection on today…

!Reflection on the week… What has gone well and why? Identify a task that you feel you could have done more effectively and how

Week Two

Day One – Date: …………………………………….. Reflection on today… Day Two – Date: …………………………………………. Reflection on today… Day Three – Date: …………………………………………. Reflection on today…

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Day Four – Date: …………………………………………. Reflection on today… Day Five – Date: …………………………………………. Reflection on today… Reflection on the week… What has gone well and why? Identify a task that you feel you could have done more effectively and how

Week Three Day One – Date: …………………………………….. Reflection on today… Day Two – Date: …………………………………………. Reflection on today… Day Three – Date: …………………………………………. Reflection on today…

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Day Four – Date: …………………………………………. Reflection on today… Day Five – Date: …………………………………………. Reflection on today… Reflection on the week… What has gone well and why? Identify a task that you feel you could have done more effectively and how

Week Four Day one – Date: …………………………………….. Reflection on today… Day Two – Date: …………………………………………. Reflection on today… Day Three – Date: …………………………………………. Reflection on today…

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Day Four – Date: …………………………………………. Reflection on today… Day Five – Date: …………………………………………. Reflection on today… Reflection on the week… What has gone well and why? Identify a task that you feel you could have done more effectively and how

Placement Evaluation Reflect on the work you have undertaken during your time on placement. E.g. social activities, personal care, moving/handling, risk assessment, arranging transport. Give examples of positive and appropriate behaviour to have while on work placement. Why is it important you demonstrate positive and appropriate behaviour while on placement? Give examples of positive communication methods. Why is it important you use effective verbal and non-verbal communication methods? Is there anything you feel did not go well? E.g. thoughts, feelings, tasks/duties.

Have you discussed the issues with anyone? If so who and what was the outcome/if not why and who should have discussed it with? Would you do anything differently as a result of your experience if you were to go on work placement again?

Knowledge Check

From research and your setting please answer the questions below:

1. Where are the company’s policies and procedures kept? 2. Outline the health and safety policies and procedures of the work setting and how you have followed these. 3. Identify the lines of responsibility and reporting for health and safety in the work setting.

4. Describe the reporting procedures for accidents, incidents, emergencies and illnesses.

5. Identify which legislation, policies and codes of practice relating to equality, diversity and discrimination apply to your role.

Placement Review To be completed by placement supervisor/manager E = Excellent, VG = Very Good, S = Satisfactory, ND = Needs Development E VG S ND*

Personal Skills

Introduction to self

Timekeeping

Attendance

Appearance

Flexible/adaptable

Communication Skills

Oral

Written

Non verbal

Clarity

Professional Relationships

Supervisor

Mentor

Colleagues

People who use service

Personal Strengths

Ability to work with others

Ability to work alone

Used appropriate behaviour according to situation

Responsible attitude

Professional Strengths

Ability to follow instruction/check understanding

Ability to solve problems

Report writing

Able to prioritise

Ability to respond to feedback

Asked appropriate questions

Copes with pressure

Shows initiative

Cooperative

Commitment/motivation

Follows/implements health and safety requirements

Complete tasks given to standards and within set guidelines

Placement Feedback from Employer *Where ND is identified please provide further information for development How do you feel the learner has contributed to your service delivery? Signature of Mentor/Supervisor: ___________________________________________ Print Name: __________________________________________________________ Signature of Learner: _____________________________________________ Print Name: ___________________________________________________________ Date: ________________________________________________________________ Signature of In Touch Care Staff: Print Name: Date:- !

Employer Name:

Placement Officers Name:

Learners Name: Date: Q1) How did you feel the Work Experience was facilitated? (Please tick)

a) Outstanding b) Good

c) Requires Improvement

d) Unsatisfactory

Q2) Do you feel the Placement Officer understood and fulfilled the learner’s training needs? Q3) How could the Work Experience process provided by In Touch Care be improved? Q4) What did you think of the level of support and contact your received during the Work Experience from the In Touch Care team? 1 = Poor 10 = Excellent (Please Circle)

1

2 3 4 5 6 7 8 9 10

Q5) What support did you give the learner during their time with you?

These resources have been produced as part of the Traineeship Staff Support Programme commissioned and funded by

Work Experience Evaluation Form (Employer)

!

Q6) How satisfied were you with the suitability of the learner? (Please tick)

a) Extremely b) Very

c) Satisfied

d) Not Satisfied

Q7) How do you think the Work Experience has helped the learner in their education/career development? Q8) How likely would you be to recommend In Touch Care to others looking to participate in Work Experience and why?

a) Extremely Likely b) Very Likely

c) Possibly

d) Not Likely

Q9) How satisfied are you overall?

a) Outstanding b) Good c) Requires Improvement d) Unsatisfactory

Q10) Would you be interested in speaking to a member of the ITC Team regarding gaining recognition for the Work Experience Quality Standard? YES / NO

Thank you for your time in completing the survey! !

Learner Name: About the Work Experience Supervisor / Mentor Their Name: Q1) How did the Work Experience Supervisor / Mentor help you during your Work Experience? Q2) Was there anything on your timetable that you could not achieve or were not given the opportunity to try? Please give details: Q3)How could the Work Experience be improved? About you Q1) What skills have you gained from this Work Experience? Q2) How has this helped you decide about your chosen career / further education? Q3) Would you recommend this employer to others looking to do Work Experience and why?

These resources have been produced as part of the Traineeship Staff Support Programme commissioned and funded by

Work Experience Evaluation Form (Learner) !

Q4) What part of the Work Experience did you enjoy / not enjoy? Q5) How satisfied are you overall?

a) Outstanding b) Good

c) Requires Improvement

d) Unsatisfactory

Q6) Would you recommend In Touch Care to a friend?

a) Yes b) No

Q7) Any other comments?

Thank you for your time in completing the evaluation!

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Placement)Checklist))Task Completed or N/A

(please tick)

Introduction to team, key members of staff and roles explained

Location of toilet facilities

Location of food / drink facilities

Lunch refreshments and break facilities

Place and areas of work

Standards of behaviour and appearance

Smoking Policy

How to answer telephone (formal greeting), how to transfer calls and make internal and external calls (where appropriate)

Post arrangements (if required)

Introduction to Intranet / Staff handbook / policies / procedures

Other issues:

Health and Safety Induction (to be completed on the first day) Completed or N/A

(please tick)

Health and Safety policy provided and read

Good housekeeping (tidy work area, closed drawers etc)

Emergency evacuation procedures

Location of fire extinguishers / blankets etc

Location of first aid box and contact details for First Aider

Accident reporting procedures and location of accident book

Protective clothing arrangements, barrier creams etc

These resources have been produced as part of the Traineeship Staff Support Programme commissioned and funded by

Personal protective equipment issued (where required)

Fault personal protective equipment reporting procedure

Instruction and training on equipment to be used

Instruction on manual handling (where required)

Interactive health and safety desk assessment for display screen equipment regulations / procedures (if appropriate)

Prohibited areas, workplace hazards and dangerous substances

Other issues:

Data Protection Act Completed

(please tick)

Job specific Data Protection issues discussed and agreed

Confidentiality issues discussed and understood

Other issues:

Safeguarding Completed

(please tick)

Job specific Safeguarding issues discussed and agreed

Other issues:

)

Signature of learner:- Date:

Signature of Work Experience Supervisor / Mentor: Date:

   

These resources have been produced as part of the Traineeship Staff Support

Programme commissioned and funded by The Education and Training Foundation.

Find out more on the TSSP website: www.traineeship-staff-support.co.uk

© In Touch Care