Sensory & Communication Assessment (QMS-F062) SENSORY & COMMUNICATION ASSESSMENT (QMS-F062) Subscribe Document Ref: QMS-F062 (Sensory & Communication Assessment) Version: 1.0 Confidentiality Level: HIGH (Medical Records) CQC Alignment: Responsive (Accessible Information Standard) Service User Full NameService User ID NumberOperating Local Authority- Select -HaringeyIslingtonWaltham ForestBarnetCare Funding & Financial Arrangements- Select -Local Authority Managed (Direct Commissioning)NHS Funded (Continuing Healthcare - CHC)Direct Payments (Personal Budgets)Self-Funded (Full Cost)OtherSECTION 1 - Vision BaselineVisual Capability- Select -Adequate vision (No aids required)Wears glasses / contact lensesPartially sighted / Legally blindCompletely blindVisual Impairment Conditions & Aids Cataracts Glaucoma Macular Degeneration Diabetic Retinopathy Requires reading glasses only Requires distance glasses None applicableDo Care Workers need to assist with cleaning glasses or administering eye drops?- Select -Yes (Ensure drops are recorded on Medication Form 81)NoSECTION 2 - Hearing BaselineHearing Capability- Select -Adequate hearing (No aids required)Hard of hearingSeverely deafProfoundly deafHearing Aids & Support Hearing aid (Left ear) Hearing aid (Right ear) Care workers must assist with inserting/removing hearing aids Care workers must assist with changing hearing aid batteries (WARNING Requires staff to face them clearly for lip-reading None applicableSECTION 3 - Speech & LanguagePrimary Spoken Language- Select -EnglishOther (Translation support required)Speech & Communication Methods Clear verbal communication Speech is slurred or difficult to understand (e.g., Post-stroke) Non-verbal (Cannot speak) Uses Makaton / Sign Language Uses picture cards / Communication board Uses electronic text-to-speech deviceDetail specific non-verbal cues or gestures usedSECTION 4 - Accessible Information Standard (AIS) & Sign-offHow must official agency documents (e.g., Care Plans, Complaints info) be provided to the service user? Standard Print Large Print (Font size 16+) Easy Read (Pictures with simple text) Braille Audio format Sent directly to Next of Kin / Legal RepresentativeSpecific Instructions for Care WorkersAssessor NameDate of AssessmentSave Sensory Assessment
