AGENCY WORKER COMPLIANCE & VETTING CHECKLIST (HR-F037) Subscribe AGENCY WORKER COMPLIANCE & VETTING CHECKLIST Agency Worker Compliance, Vetting & Local Induction Checklist (HR-F037)SECTION 1: AGENCY & WORKER IDENTIFICATIONTitle- Select -MrMrsMissMsMxOtherStaff Member NameStaff_IDOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherWorker Job Profile- Select -Care Worker / Support WorkerComplex Care WorkerSenior Care Worker / MentorField SupervisorCare Coordinator / Rota SchedulerClinical LeadQuality Assurance / Compliance OfficerHR / Recruitment AdministratorImplementation ResearcherDeputy Care ManagerRegistered Care ManagerAgency / Supplier NameSECTION 2: PRE-DEPLOYMENT COMPLIANCE VERIFICATION & COMPETENCY MATCHINGPhoto Identification: Have you visually verified the worker's original Photo ID (Passport/BRP/Driving Licence) against the person standing in front of you?- Select -YesNoN/ARight to Work in the UK: Does the Agency Profile confirm a valid Right to Work, and have hour restrictions (e.g., Student Visa 20-hour limit) been checked against today's rota?Verified - No restrictionsVerified - Visa restrictions checked & compliantNot Verified (Do not deploy)Enhanced DBS & Barred List- Select -Checked via DBS Update Service today (Clear & Matches ID).Original Enhanced DBS Certificate sighted (Issued within last 12 months - Clear).Positive Disclosure (Requires immediate Registered Manager review via HR-F033).No valid DBS confirmed (Do not deploy).Fatigue Management & WTR: Has the worker confirmed they have had an adequate rest period (minimum 11 hours) since their last shift, compliant with Working Time Regulations?- Select -YesNo (Do not deploy)Transit & Insurance Verification: How is the worker travelling between calls?- Select -Public Transport / WalkingDriving Own VehicleValid UK Driving Licence visually verified?- Select -YesNoValid Business Class Motor Insurance verified?- Select -YesNoMandatory Training Certification: Has the agency provided evidence of in-date training for the following? (Select all verified)Safeguarding Adults (Level 2+)Moving and Handling (Practical assessment within last 12 months)Medication Administration (Level 2)Basic Life Support / First Aid (Practical)Infection Prevention & Control (IPC)Mental Capacity Act (MCA) & DoLSWill the worker be required to use specialised equipment?- Select -No specialised equipment needed.Yes - Ceiling Track Hoist / Mobile Hoist.Yes - Stand Aid / Sara Stedy.Yes - Profiling Bed / Slide Sheets.Will the worker be undertaking Delegated Healthcare Tasks or Complex Care?- Select -No complex tasks assigned.Yes - Catheter Care / Stoma Care.Yes - PEG / Enteral Feeding.Yes - Prompting/Administering Controlled Drugs.Competency Verification: I confirm I have reviewed the worker's specific training profile and they are explicitly signed off as competent for the equipment/complex tasks selected above.- Select -YesNoN/APrevents deployment- Select -Deployment to those specific service users preventedSECTION 3: DAY ONE LOCAL INDUCTION, BRIEFING & POST-SHIFT EVALUATIONCommunication & Language Check: Can the worker clearly communicate in spoken English and read written instructions (e.g., MAR charts, Care Plans)?- Select -YesNo (Do not deploy)Local Induction Briefing CompletedIssued Mutima Care ID Badge / Uniform verification.Set up on Electronic Call Monitoring system (e.g., Nourish / Birdie) with temporary login.Briefed on Lone Worker Policy & Emergency Out-of-Hours Office Contact.Briefed on Safeguarding Reporting procedures (Who to call immediately).Briefed on Medication Policy (e.g., MAR chart completion, missed dose protocol).Provided with specific Service User Care Plans & Risk Assessments for today's rota.Introduction Protocol- Select -Worker will shadow a permanent staff member for their first shift (Best Practice).Worker will be met at the first visit by a Field Supervisor.Worker is being deployed alone (Requires justification below).Justification for Lone Deployment (if applicable)- Select -Low AcuityPrior ExperienceEmergency Cover (Mitigated)N/AReliability & Timekeeping- Select -Excellent - Logged into all calls on time.Adequate - Minor delays but communicated well with the office.Poor - Late/Missed calls without communication.Documentation & Clinical Quality (Reviewed via Nourish/MAR charts)- Select -Excellent - Notes detailed, person-centred, MARs accurately signed.Adequate - Basic notes, no medication errors.Poor - Sparse/missing notes, poor English, or medication recording errors.Feedback from Service Users / Permanent Staff- Select -OutstandingGoodAdequatePoor (Attitude)Poor (Clinical)No specific feedback received / No complaints logged.Final Agency Worker RatingApproved for Future Shifts (Add to preferred locum pool).Use Only in Emergencies (Requires closer supervision).Do Not Use Again (DNU) - Block from future Mutima Care rotas.If DNU, state the factual reason to be formally fed back to the supplying agency- Select -Clinical Safety BreachSafeguarding/Conduct BreachReliability/PunctualityDocumentation FailureMisrepresentation of SkillsN/ADate & Time of Pre-Deployment CheckDate of Post-Shift EvaluationNext Review Date:SUBMIT FORM
