Staff Evaluation

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Paid Staff Annual Quality Assurance Survey

Name (optional) *

First

Last

* Indicates required field

Job Role *

Primary base/location (tick all that apply): *

ACIW sessions Parklands Café Wellbeing Club Admin/Reception

Reporting period: *

Last 12 months from _ / _ / _ to _ / _ / _

Date completed *

1) Overall service quality (last 12 months

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

1. People using ACIW/Parklands services are welcomed warmly and respectfully. *

1 2 3 4 5

2. I have felt confident supporting people living with dementia and carers in my work over the last 12 months. *

1 2 3 4 5

3. The environment(s) I work in are generally calm, safe, and dementia-friendly. *

1 2 3 4 5

4. Support and activities offered are generally meaningful, inclusive, and responsive to need. *

1 2 3 4 5

5. I usually have what I need (staffing, equipment, information) to do my job well. *

1 2 3 4 5

Over the last 12 months, what have been the main strengths of our service? (2–3 bullets) *

2) Safety and safeguarding (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

I know how to raise a safeguarding concern and who to speak to. *

1 2 3 4 5

Dignity, consent, privacy and professional boundaries are consistently upheld in our work. *

1 2 3 4 5

Incidents/near misses are recorded and escalated appropriately when they occur. *

1 2 3 4 5

Over the last 12 months, have you had any safeguarding concerns, low-level worries, or patterns you think we should review? *

No Yes

If yes, please explain briefly *

Communication and teamwork (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

Team communication is generally clear (handover, briefings, debriefs, day-to-day updates). *

1 2 3 4 5

Roles and responsibilities are usually clear (including who leads, who supports, who records, and who escalates). *

1 2 3 4 5

I have felt supported by colleagues and able to ask for help when needed. *

1 2 3 4 5

One change that would improve communication/teamworking over the next 12 months: *

Dementia-friendly practice and inclusion (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

We consistently adapt communication well (pace, tone, visuals, reassurance). *

1 2 3 4 5

We respond well to sensory needs, mobility needs, distress, and fluctuating capacity. *

1 2 3 4 5

We are inclusive and respectful of diversity (culture, language, disability, LGBTQ+, neurodiversity, faith) *

1 2 3 4 5

Over the last 12 months, where could we improve dementia-friendly practice and inclusion? *

5) Environment, infection control and food safety (last 12 months, if relevant to your role)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

The spaces I work in are generally clean, clutter-free, and easy to navigate. *

1 2 3 4 5

Accessibility is generally good (signage, toilets, seating, lighting, routes). *

1 2 3 4 5

Infection prevention and control routines are followed consistently. *

1 2 3 4 5

Food/drink service is generally safe and well-managed (allergens, hot drinks, spills). *

1 2 3 4 5

Over the last 12 months, have you noticed any recurring hazards or environmental issues (trip risks, lighting, seating, hot drinks, storage, etc.)? *

No Yes

If yes, please briefly explain *

Information governance and confidentiality (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

Confidential conversations and paperwork are handled appropriately. *

1 2 3 4 5

I am confident about what can/can’t be shared and with whom (including families, partners and professionals *

1 2 3 4 5

Feedback, learning and improvement (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

We gather feedback from people using services and respond appropriately. *

1 2 3 4 5

We reflect on issues/learning and make improvements (including debriefs, lessons learned, and sharing good practice). *

1 2 3 4 5

Over the last 12 months, what compliments or positive feedback stood out (quotes welcome)? *

Over the last 12 months, have there been any complaints/themes/recurring concerns? If yes, what do you think would help? *

Training, induction and role modelling (last 12 months)

Rate 1 – 5 (1 = strongly disagree / 5 = strongly agree) based on your experience over the last 12 months.

I feel up to date with essential training for my role. *

1 2 3 4 5

My induction (when I started/changed role) prepared me well for ACIW/Parklands expectations, systems, boundaries and escalation routes. *

1 2 3 4 5

Ongoing training/refreshers are accessible and relevant to my role. *

1 2 3 4 5

Managers and Trustees consistently role model our values and expected standards (dignity, safeguarding, boundaries, inclusion, professionalism). *

1 2 3 4 5

I feel comfortable raising concerns or asking questions with managers/Trustees. *

1 2 3 4 5

Training and induction you have received over the last 12 months (or since starting, if newer). Please list key items and approximate dates: *

How effective has training/induction been overall in helping you do your role safely and confidently? *

1 2 3 4 5

What would improve training/induction for the next 12 months? *

Role modelling: over the last 12 months, any examples of excellent role modelling (or gaps) from managers/Trustees that have impacted practice? *

One area I’d like more guidance/training on over the next 12 months (tick all that apply): *

Safeguarding MCA/consent Communication & distress Moving & handling Food hygiene/allergens First aid Dementia-friendly environments Record keeping

Any other areas? *

Action focus (next 12 months)

Top 3 improvements to prioritise for the next 12 months (specific and practical): *

What support/resources do you need from managers/Trustees to deliver these improvements? *

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Home
Calendar of events
Cafés Near You
- Sandown
- East Cowes
- Totland
- Cowes
- ACE7
- Ryde - PAUSED
- Melody Memory Choir
Parklands
Dementia Training
Donate
- Gift Aid
- Donating in Memory
Latest News & Events
Blogs and Articles
Information and Signposting Leaflet
Shop
Volunteer
- Volunteer Opportunities
Links & Resources
Dementia Awareness Partnership
Board of Trustees
Dementia Hints & Tips
Privacy Policy