Practice Assessment Document. 2 Practice Placement Facilitator:

BSc in Nursing Studies / Registered Nurse Field: Adult Practice Assessment Document Cohort: Student Name: Guidance Tutor (GT): GT Tel No: Submission Dates Placement 1: 09/01/17 Placement 2: 08/05/17 Placement 3: 10/08/17 GT Email: GT Group Number: Base Trust: 2 Practice Placement Facilitator: i

VERIFICATION PAGE to be completed by anyone who signs this document SURNAME FIRST NAME DESIGNATION LOCATION SIGNATURE NMC pin number Any assessment in this document should only be completed by a registered nurse. Any professional completing any aspect of the documentation should have undergone training and development that has enabled them to be competent to support and assess students. 1

EVIDENCE DEVELOPMENT OPPORTUNUITIES Total Client Care (TCC) assessments to be completed twice during each placement. Team Assessment of Permance in Practice (TAPP) assessments are to be completed in the final two placements, if appropriate. Direct Observation of Practical Skills (DOPS) can be completed at any time in placement during year two and three and more than once as required. Witness testimony, structured reflection and documented discussion with mentor are other ms of evidence that can be completed at any point during the clinical experience (templates this evidence are contained within the student s PPDF). The Service User Evaluation (SUE) Questionnaires may also be completed if deemed appropriate. The students should discuss this with the mentor at the initial interview. Service User feedback should be obtained at least once during the year (normally x3 completed questionnaires). Service User Feedback obtained at least once during the year TAPP Assessments TAPP Assessments DOPS TCC Assessment DOPS TCC Assessment DOPS TCC Assessment PLACEMENT ONE PLACEMENT TWO PLACEMENT THREE Skills Passport* Updated Skills Passport* Safe Medicate report (mative)* Updated skills passport TAPP Report ** * Evidence from University and available at the beginning of the indicated placements ** TAPP reports will be available if and when the appropriate documentation has been completed 2

ASSESSMENT GUIDANCE Any individual who signs within this document must complete the verification section on page two At the start of each placement the student and mentor should carefully study the content of this practice assessment documentation. This should include a review of the students overall progress and any previous practice assessment and development plans At any point the mentor or student may contact the Practice Learning Team (GT or PPF) additional support or clarification The initial interview between mentor and student should be conducted within the first week. This interview should consider learning opportunities (including the collection of evidence), goals and. The student and mentor should agree which competencies will be targeted and these should be documented alongside a learning plan in the appropriate section A mid placement review must be conducted and documented If the student is failing to make the required progress or any other areas of concern are identified at any point during the placement, contact MUST be made with the Guidance Tutor or PPF The student must be made aware of any concerns as soon as possible Evaluation of student permance in individual competencies can take place throughout the placement. Prior to the evaluation of an individual competency the student should collect and identify relevant evidence By the end of the placement the mentor should have evaluated evidence and permance in all of the targeted competencies and document this evaluation During the final week of placement the summative assessment of the students overall permance should occur. This will involve the completion of the appropriate summative assessment m and identification of students strengths, areas development and an agreed development plan By the end of the year student ability in ALL competencies listed within this document must be evaluated. Competencies can and should be re-assessed if permance improves after assessment and in subsequent placements. Glossary of terms & evidence: PAD - Practice Assessment Document. All associated evidence should be documented within your PAD and stored within your PPDF. PPDF - Personal and Professional Development File. The PPDF is the file in which you store your record of learning, development and achievements in university and in practice. Potential evidence triangulation with observed student permance (examples are given each progression criteria/competency on their associated page): TAPP - Team Assessment of Permance in Practice report TCC - Total Client Care assessment DOPS - Direct Observation of Practical Skills assessment Safe Medicate - report Skills Passport - evidence of session attendance Structured reflection - template available in the PPDF Documented discussion with mentor - template available in the PPDF Witness Testimony report - template available in the PPDF SUE questionnaire - service user evaluation questionnaire Module assessments Other ms of relevant evidence that may be identified by mentor or student 3 See pass/fail criteria on the following page and the student and mentor guides additional inmation and guidance.

PASS/FAIL CRITERIA COMPETENCY SCALE All three placements will be assessed on a pass/fail basis by the students mentor Levels of Practice Mentors should triangulate evidence from a variety of tools and sources to aid and inm the evaluation of competency and the students overall permance. The final decision to pass or fail a student remains with the students identified mentor The student may be identified as failing the following reasons: The student fails to act with professionalism, integrity and/or within recognised ethical and legal frameworks MEETS EXPECTATIONS FOR REGISTRATION Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice ACHIEVED The student is unable to practise safely or demonstrate an awareness of their own limitations The student fails to make the required progress towards the target competencies by the end of the placement/year BORDERLINE FOR REGISTRATION Supported Needs occasional direct supervision or support MINIMUM PASS LEVEL 4 The student fails to provide appropriate evidence By the end of the year the student must reach the level of SUPPORTED or above in ALL competencies contained in this document. This will indicate that the student has also met the second progression point criteria identified by the NMC (2010) Students should however attempt to ACHIEVE all competencies by reaching the level of SKILLED Competencies not achieved (i.e. below skilled) this year must be carried over and re-assessed in the final year (alongside final year competencies). It is theree good practice to re-assess any competency where the student can demonstrate improved permance in subsequent placements. NEEDS DEVELOPMENT FOR REGISTRATION Assisted Dependent Needs regular direct supervision or support Needs constant direct supervision or support Criteria Appraisal of Competence Adapted from Bondy, K. N. (1983) Criterion-referenced definitions rating scales in clinical evaluation. Journal of Nursing Education, 22(9); 376-382

Nursing practice and decision making Professional Values PROGRESS Leadership management and team working Communication and interpersonal skills INSTRUCTIONS FOR USE This progress chart can be completed by the mentor, guidance tutor or student at any time but should be kept up to date. It is a summary of what has been assessed and the level of competency achieved. A1 D4 refer to the competencies that must be assessed by the end of the year. The documentation their assessment can be found from page 30 onwards. Remember the student must reach a minimum level of supported in all competencies to progress into the final year and should aim to achieve as many as possible by reaching the level of skilled or above. Placement (Tick box when Assessed) Level of practice (Tick box when level obtained) Placement (Tick box when Assessed) Level of practice (Tick box when level obtained) Competency 1 2 3 Supported (Pass) Skilled or above (Achieved) Competency 1 2 3 Supported (Pass) Skilled or above (Achieved) A1 C2 A2 C3 A3 C5 A6 C6 A7 C7 A1.1 C8 C9 C10 B1 B2 D4 B3 B6 B7 B8 5

MENTOR / STUDENT CHECK LIST 1. Pre placement contact PLACEMENT ONE 2. Orientation to practice area 3. Initial interview 4. Mid point mative assessment Clinical area: Mentor: 5. Discussion of reasonable adjustments 6. TCC Assessments completed Dates: From: To: 7. DOPS completed* 8. Summative assessment * (If appropriate) 6

PLACEMENT ONE ATTENDANCE RECORD Student Name Please Print) The chart below must be completed weekly and signed by the student and mentor or another member of the nursing staff. Please record the number of HOURS worked each day. Please enter ZERO or DO a day off (do not leave blank) and also document sickness and absence. This record must be completed prior to submission, failure to do so could cause disruption to your. * Please note students are required to complete 37.5 hours per week in practice. Week Commencing: Location (eg Ward 5, STGH) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mentor Signature Student Signature 31/10/16 07/11/16 14/11/16 21/11/16 28/11/16 05/12/16 12/12/16 THE ATTENDANCE SHEET MUST BE WRITTEN IN INK AND MUST NOT BE ALTERED. TIPPEX SHOULD NOT BE USED. 7

INITIAL INTERVIEW PLACEMENT ONE This interview should be completed within the first week. A learning plan should be developed and documented below The aims of the interview are to discuss and identify learning opportunities including the collection of evidence The student and mentor should set goals which will include identifying target competencies, please summarise below Target competencies should reflect the students previous experience, their current learning needs and the nature of the clinical environment. When target competencies have been identified consideration should be given to what learning strategies and resources will be utilised to achieve these targets A suitable week the mid placement mative assessment and review of this learning plan should be identified Learning plan: Identified Competency Targets* (document in the boxes below) Mentor Signature & Date Student Signature & Date 8 * select approximately 1/3rd per placement, the number of targets is negotiable, additional targets can be added at the mid placement review.

FORMATIVE ASSESSMENT Student s Name: Intake: Placement: Student reflection on progress and self assessment Mentor / Educator signature: Mentor comments on progress and areas development Student signature: Date: Additional Action Plan required? (please circle): No Yes For further guidance on Action Planning see the reverse of this sheet. If an additional Action Plan is required the students Guidance Tutor and/or the PPF should be contacted support. 9

Criteria Actions / Resources No additional Action Plan required Is identified as working successfully towards all of the agreed learning outcomes /progression criteria/ competencies. No remedial action is necessary; to continue as per original learning plan Is working successfully towards most of the agreed learning outcomes /progression criteria/ competencies in the practice setting. However needs development in the identified area listed on the action plan. Inm GT/PPF of action plan status and arrange meeting as required Identify the specific learning outcome /progression criteria/ competency that needs development in an agreed action plan Identify how opportunities and evidence will be provided. Regularly review the action plan Additional Action Plan required Is not progressing as required to meet the agreed learning outcomes/ progression criteria/competencies. Failure to reach the appropriate level in these areas by the end of the identified practice experience will result in the student failing the placement and the associated module to which this period of practice is attached. (See the practice placements website the action plan template) Arrange a tripartite meeting with GT and seek support from practice learning team Identify specific learning outcomes/progression criteria/ competencies that need development in an agreed action plan Identify criteria success and identify how opportunities and evidence will be provided Instigate regular meetings between the mentor and student and provide regular feedback to the Guidance Tutor (See the practice placements website the action plan template) 10

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RECORD OF STUDENT FAILURE To be completed by the mentor if the student has failed Please indicate areas concern and the associated competencies RECORD OF VARIANCE Please record a detailed rationale where a decision has been made to mark a competency as achieved when the available evidence would suggest non-achievement. Or the student has not achieved a competency despite evidence to the contrary. Mentor / Educator signature: Student signature: Mentor / Educator signature: Student signature: Date: Date: 12

Additional Placement Comments This page can be used by the student, mentor or other member of the Practice Learning Team to make additional comments or the Guidance Tutor to record details of a clinical visit. Date Comment Outcome/Action Signature Designation 13

MENTOR / STUDENT CHECK LIST PLACEMENT TWO 1. Pre placement contact 2. Orientation to practice area 3. Initial interview 4. Mid point mative assessment Clinical area: 5. Discussion of reasonable adjustments Mentor: 6. TAPP Assessments* Dates: From: To: 7. TCC Assessments completed 8. DOPS completed* 9. Summative assessment * (If appropriate) 14

PLACEMENT TWO ATTENDANCE RECORD Student Name Please Print) The chart below must be completed weekly and signed by the student and mentor or another member of the nursing staff. Please record the number of HOURS worked each day. Please enter ZERO or DO a day off (do not leave blank) and also document sickness and absence. This record must be completed prior to submission, failure to do so could cause disruption to your. * Please note students are required to complete 37.5 hours per week in practice. Week Commencing: Location (eg Ward 5, STGH) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mentor Signature Student Signature 27/02/17 06/03/17 13/03/17 20/03/17 27/03/17 03/04/17 10/04/17 17/04/17 THE ATTENDANCE SHEET MUST BE WRITTEN IN INK AND MUST NOT BE ALTERED. TIPPEX SHOULD NOT BE USED. 15

INITIAL INTERVIEW PLACEMENT TWO This interview should be completed within the first week. A learning plan should be developed and documented below The aims of the interview are to discuss and identify learning opportunities including the collection of evidence The student and mentor should set goals which will include identifying target competencies, please summarise below Target competencies should reflect the students previous experience, their current learning needs and the nature of the clinical environment. Please refer to the Development Plan completed in the previous placement and take account of overall progress towards competency achievement in each domain (documented on page five) When target competencies have been identified consideration should be given to what learning strategies and resources will be utilised to achieve these targets A suitable week the mid placement mative assessment and review of this learning plan should be identified Learning plan: Identified Competency Targets* (document in the boxes below) Mentor Signature & Date Student Signature & Date 16 * select approximately 1/3rd per placement, the number of targets is negotiable, additional targets can be added at the mid placement review.

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MENTOR / STUDENT CHECK LIST 1. Pre placement contact PLACEMENT THREE 2. Orientation to practice area 3. Initial interview 4. Mid point mative assessment Clinical area: Mentor: 5. Discussion of reasonable adjustments 6. TAPP Assessments* Dates: From: To: 7. TCC Assessments completed 8. DOPS completed* 9. Summative assessment * (If appropriate) 22

PLACEMENT THREE ATTENDANCE RECORD Student Name Please Print) The chart below must be completed weekly and signed by the student and mentor or another member of the nursing staff. Please record the number of HOURS worked each day. Please enter ZERO or DO a day off (do not leave blank) and also document sickness and absence. This record must be completed prior to submission, failure to do so could cause disruption to your. * Please note students are required to complete 37.5 hours per week in practice. Week Commencing: Location (eg Ward 5, STGH) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mentor Signature Student Signature 26/06/17 03/07/17 10/07/17 17/07/17 24/07/17 31/07/17 07/08/17 * * Thursday the 10th is submission day. It may be possible to gain a short extension, if absolutely necessary, but this MUST be authorised via the normal extension process. Mentors will be unable to sign off attendance in the final week. The proposed off duty should be filled in prior to submission but if the student is sick/absent at all in the final week after submission it is requested that the mentor notify the students Guidance Tutor to ensure that this has been recorded. THE ATTENDANCE SHEET MUST BE WRITTEN IN INK AND MUST NOT BE ALTERED. TIPPEX SHOULD NOT BE USED. 23

INITIAL INTERVIEW PLACEMENT THREE This interview should be completed within the first week. A learning plan should be developed and documented below The aims of the interview are to discuss and identify learning opportunities including the collection of evidence The student and mentor should set goals which will include identifying target competencies, please summarise below Target competencies should reflect the students previous experience, their current learning needs and the nature of the clinical environment. Please refer to the Development Plan completed in the previous placement and take account of overall progress towards competency achievement in each domain (documented on page five) In the final placement students should target ANY competency NOT previously assessed at the level of SUPPORTED or above as this is the minimum pass level. In addition they should continue to strive to ACHIEVE ALL competencies by getting re-assessed any not at SKILLED or above When target competencies have been identified consideration should be given to what learning strategies and resources will be utilised to achieve these targets A suitable week the mid placement mative assessment and review of this learning plan should be identified Learning plan: Identified Competency Targets* (document in the boxes below) Mentor Signature & Date Student Signature & Date 24

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MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A1 All nurses must practise with confidence according to The Code: Professional Standards of practice and behaviour nurses and midwives (NMC 2015), and within other recognised ethical and legal frameworks. They must be able to recognise and address ethical challenges relating to people s choices and decision-making about their care, and act within the law to help them and their families and carers find acceptable solutions. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 30 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A1 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Total Client Care Assessment (TCC) Team Assessment of Permance in Practice (TAPP) Patient/client completed witness testimony report SUE Questionnaire Documented discussion with mentor Structured reflection GUIDANCE: Supported Level: Progression point two criteria 10.2 Works with the limitations of own knowledge and skills to question and provide safe and holistic care 11.4 Documents concerns and inmation about people who are in vulnerable situations 14.2 Supports and assists others appropriately Skilled Level: Progression point three criteria 1.10 Acts as a role model in promoting a professional image 8.4 Uses helpful and therapeutic strategies to enable people to understand treatments and other interventions in order to give inmed consent 8.5 Works within legal frameworks when seeking consent 8.6 Assesses and responds to the needs and wishes of carers and relatives in relation to inmation and consent 8.7 Demonstrates respect the autonomy and rights of people to withhold consent in relation to treatment within legal frameworks and in relation to people s safety 31

MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A2 All nurses must practise in a holistic, non-judgmental, caring and sensitive manner that avoids assumptions, supports social inclusion; recognises and respects individual choice; and acknowledges diversity. Where necessary, they must challenge inequality, discrimination and exclusion from access to care. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 32 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A2 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Total Client Care Assessment (TCC) Team Assessment of Permance in Practice (TAPP) Witness testimony report DOPS Nutrition GUIDANCE: 33 Supported Level: Progression point two criteria Skilled Level: Progression point three criteria 2.3 Determines people s preferences to maximise comt and dignity 3.4 Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs to not compromise care 3.5 Is proactive in promoting and maintaining dignity 3.6 Acts autonomously to challenge situations or others when someone s dignity may be compromised 4.4 Upholds people s rights and speaks out when these are at risk of being compromised 4.5 Is acceptant of differing cultural traditions, beliefs, UK legal frameworks and professional ethics when planning care with people and their families and carers 4.6 Acts autonomously and proactively in promoting care environments that are culturally sensitive and free from discrimination, harassment and exploitation

MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A3 All nurses must support and promote the health, wellbeing, rights and dignity of people, groups, communities and populations. These include people whose lives are affected by ill health, disability, ageing, death and dying. Nurses must understand how these activities influence public health. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 34 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A3 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Public health module viva feedback Documented discussion with mentor Witness testimony report GUIDANCE: Supported Level: Progression point two criteria 9.3 Understands the concept of public health and the benefits of healthy lifestyles and the potential risks involved with various lifestyles or behaviours, example, substance misuse, smoking, obesity Skilled Level: Progression point three criteria 9.18 Discusses sensitive issues in relation to public health and provides appropriate advice and guidance to individuals, communities and populations example, contraception, substance misuse, smoking, obesity 9.4 Recognises indicators of unhealthy lifestyles 9.22 Works within a public health framework to assess needs and plan care individuals, communities and populations 35

MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A6 All nurses must understand the roles and responsibilities of other health and social care professionals, and seek to work with them collaboratively the benefit of all who need care. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 36 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A6 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Documented discussion with mentor Witness testimony report GUIDANCE: Supported Level: Progression point two criteria Skilled Level: Progression point three criteria 9.15 Works within the context of a multi-professional team and works collaboratively with other agencies when needed to enhance the care of people, communities and populations 14.10 Works inter-professionally and autonomously as a means of achieving optimum outcomes people 7.7 Acts appropriately in sharing inmation to enable and enhance care (carers, MDT and across agencies boundaries) 37

MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A7 All nurses must be responsible and accountable keeping their knowledge and skills up to date through continuing professional development. They must aim to improve their permance and enhance the safety and quality of care through evaluation, supervision and appraisal. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 38 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A7 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Total Client Care (TCC) Assessment Documented discussion with mentor Structured reflection DOPS GUIDANCE: Supported Level: Progression point two criteria 1.7 Uses professional support structures to learning from experience and make appropriate adjustments Skilled Level: Progression point three criteria 12.3 Uses supervision and other ms of reflective learning to make effective use of feedback 14.4 Reflects on own practice and discusses issues with other members of the team to enhance learning 39 17.5 Uses supervision as a means of developing strategies managing own stress and working safely and effectively

MINIMUM PASS LEVEL ACHIEVED Domain: Professional Values COMPETENCY: A1.1 Adult nurses must understand and apply current legislation to all service users, paying special attention to the protection of vulnerable people, including those with complex needs arising from ageing, cognitive impairment, long-term conditions and those approaching the end of life. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 40 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: A1.1 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Documented discussion with mentor Structured reflection Witness testimony report GUIDANCE: Supported Level: Progression point two criteria Skilled Level: Progression point three criteria 41

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B1 All nurses must build partnerships and therapeutic relationships through safe, effective and non-discriminatory communication. They must take account of individual differences, capabilities and needs. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 42 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B1 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Service User completed witness testimony report SUE Questionnaire Total Client Care (TCC) assessments GUIDANCE: Supported Level: Progression point two criteria 1.6 Forms appropriate and constructive professional relationships with families and other carers 2.2. Actively empowers people to be involved in the assessment and care planning process 2.4 Actively support people in their own care and self care 2.5 Considers with the person and their carers their capability self care Skilled Level: Progression point three criteria 1.11 Acts as a role model in developing trusting relationships, within professional boundaries 1.12 Recognises and acts to overcome barriers in developing effective relationships with service users and carers 1.13 Initiates, maintains and closes professional relationships with service users and carers 2.8 Is sensitive and empowers people to meet their own needs and make choices and considers with the person and their carer(s) their capability to care 2.13 Works autonomously, confidently and in partnership with people, their families and carers to ensure that needs are met through care planning and delivery, including strategies self care and peer support 43

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B2 All nurses must use a range of communication skills and technologies to support person-centred care and enhance quality and safety. They must ensure people receive all the inmation they need in a language and manner that allows them to make inmed choices and share decision making. They must recognise when language interpretation or other communication support is needed and know how to obtain it. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 44 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B2 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Total Client Care Assessment (TCC) Witness testimony report SUE Questionnaire GUIDANCE: Supported Level: Progression point two criteria 6.6 Uses strategies to enhance communication and remove barriers to effective communication minimising risk to people from lack or poor communication Skilled Level: Progression point three criteria 2.11 Uses strategies to manage situations where a person s wishes conflict with nursing interventions necessary the person s safety 45

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B3 All nurses must use the full range of communication methods, including verbal, non-verbal and written, to acquire, interpret and record their knowledge and understanding of people s needs. They must be aware of their own values and beliefs and the impact this may have on their communication with others. They must take account of the many different ways in which people communicate and how these may be influenced by ill health, disability and other factors, and be able to recognise and respond effectively when a person finds it hard to communicate. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 46 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B3 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Total Client Care Assessment (TCC) Documented discussion with mentor SUE Questionnaire GUIDANCE: Supported Level: Progression point two criteria 6.6 Uses strategies to enhance communication and remove barriers to effective communication minimising risk to people from lack or poor communication 5.7 Makes appropriate use of touch Skilled Level: Progression point three criteria 5.8 Listens to, watches, and responds to verbal and non-verbal cues 6.7 Consistently shows ability to communicate safely and effectively with people providing guidance others 6.10 Acts autonomously to reduce and challenge barriers to effective communication and understanding 6.11 Is proactive and creative in enhancing communication and understanding 6.12 uses the skills of active listening, questioning, paraphrasing and reflection to support a therapeutic intervention 47

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B6 All nurses must take every opportunity to encourage health-promoting behaviour through education, role modelling and effective communication. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 48 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B6 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Total Client Care Assessment (TCC) Documented discussion with mentor Structured reflection Witness testimony report GUIDANCE: Supported Level: Progression point two criteria 6.6 Uses strategies to enhance communication and remove barriers to effective communication minimising risk to people from lack or poor communication Skilled Level: Progression point three criteria 4.7 Manages and diffuses challenging situations effectively 5.6 Anticipates how people might feel in a given situation and responds with kindness and empathy to provide physical and emotional comt 5.11 Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising care 6.13 Uses appropriate and relevant communication skills to deal with difficult and challenging circumstances, example, responding to emergencies, unexpected occurrences, saying no, dealing with complaints, resolving disputes, de-escalating aggression, conveying unwelcome news 49

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B7 All nurses must maintain accurate, clear and complete records, including the use of electronic mats, using appropriate and plain language. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 50 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B7 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Total Client Care Assessment (TCC) DOPS GUIDANCE: Supported Level: Progression point two criteria 14.5 Communicates with colleagues verbally, face-to-face and by telephone, and in writing and electronically in a way that the meaning is clear, and checks that the communication has been fully understood Skilled Level: Progression point three criteria 6.9 Provides accurate and comprehensive written and verbal reports based on best available evidence 21.2 Participates in assessing and planning care appropriate to the risk of infection thus promoting the safety of service users 21.3 Participates in completing care documentation and evaluation of interventions to prevent and control infection 51

MINIMUM PASS LEVEL ACHIEVED Domain: Communication and interpersonal skills COMPETENCY: B8 All nurses must respect individual rights to confidentiality and keep inmation secure and confidential in accordance with the law and relevant ethical and regulatory frameworks, taking account of local protocols. They must also actively share personal inmation with others when the interests of safety and protection override the need confidentiality. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 52 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed

COMPETENCY: B8 Student documentation of evidence review: To be completed by the student prior to evaluation Potential evidence triangulation with observed student permance Team Assessment of Permance in Practice (TAPP) Documented discussion with mentor Structured reflection 53 GUIDANCE: Supported Level: Progression point two criteria 9.10 With the person and under supervision, plans safe and effective care by recording and sharing inmation based on the assessment 13.1 Assists in preparing people and carers the transfer and transition through effective dialogue and accurate inmation 13.3 Assists in the preparation of records and reports to facilitate safe and effective transfer Skilled Level: Progression point three criteria 7.5 Acts professionally and autonomously in situations where there may be limits to confidentiality, example, public interest and protection from harm 7.6 Recognises the significance of inmation and acts in relation to who does or does not need to know 7.7 Acts appropriately in sharing inmation to enable and enhance care (carers, MDT and across agencies boundaries) 7.8 Works within the legal frameworks data protection including access to and storage of records 7.9 Acts within the law when confidential inmation has to be shared with others 8.4 Uses helpful and therapeutic strategies to enable people to understand treatments and other interventions in order to give inmed consent 11.6 Shares inmation safely with colleagues and across agency boundaries the protection of individuals and the public

MINIMUM PASS LEVEL ACHIEVED Domain: Nursing Practice and Decision Making COMPETENCY: C2 All nurses must possess a broad knowledge of the structure and functions of the human body, and other relevant knowledge from the life, behavioural and social sciences as applied to health, ill health, disability, ageing and death. They must have an indepth knowledge of common physical and mental health problems and treatments in their own field of practice, including co-morbidity and physiological and psychological vulnerability. Further guidance specific to this competency is provided over the page. Mentor to identify the level of practice based on triangulation of evidence and document below * Only use if re-evaluated (no need to re-evaluate if previously achieved) Level of practice Level of support Signature & Date: *Signature & Date: * Signature & Date: Meets Accomplished Skilled Demonstrates capability independent practice and often exceeds Demonstrates capability independent practice Borderline Supported Needs occasional direct Needs development Assisted Dependent Needs regular direct Needs constant direct 54 Evidence Reviewed: Please sign in the box that the evidence highlighted over the page has been reviewed