Apprentice Mentorship Assignment & Progress Record (HR-F042) APPRENTICE MENTORSHIP ASSIGNMENT RECORD (HR-F042) Updates APPRENTICE MENTORSHIP ASSIGNMENT RECORD Apprentice Mentorship Assignment & Progress Record (HR-F042)Title- Select -MrMrsMissMsMxOtherStaff Member NameStaff_IDDate of BirthOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherApprenticeship Standard Enrolled UponLevel 2 Adult Care WorkerLevel 3 Lead Adult Care WorkerLevel 4 / 5 Leader in Adult Care (Management)Business Administrator Level 3 (Office Staff)Level 3 Senior Healthcare Support WorkerLevel 5 Nursing AssociateLevel 3 Team Leader / SupervisorAssigned Workplace Mentor NameType of Record- Select -Initial Pairing & Goal SettingWeekly Check-in (First 12 Weeks)Monthly Progress Review (Post-12 Weeks)Ad-hoc Pastoral SupportDate of Mentorship Check-InSECTION 2: THE SHADOWING & CLINICAL EXPOSURE LOG (Safe: QS6) Apprentices must not undertake tasks they are not competent in. Track observed versus supervised practice.Focus of Recent Shadowing Shifts: (Select primary activities observed/assisted with since last review)Basic Personal Care (Washing/Dressing)Continence CareMoving & Handling (Using Hoists / Stand-aids)Medication Prompting / Administration ObservationMeal Preparation & Hydration SupportCare Planning & Digital Documentation (Nourish)Complex/Delegated Healthcare Tasks (Observation strictly)Under-18 Safeguarding Verification: (If applicable) "I confirm that the apprentice, being under 18, was never left alone with a service user during the review period."YesNoN/A - Over 18Mentor's Clinical Assessment: "How is the apprentice bridging theory to practical domiciliary care?"Excelling - Confident, asks excellent questions, strictly follows boundaries.On Track - Developing at a normal pace, safe practice observed.Requires Focus - Struggling with specific practical tasks (Detail below).Safety Concern - Overstepping boundaries or failing to follow instructions.Specific Clinical Feedback / Goals for Next RotaGoal; Master basic hygiene routines, focusing on dignity and communication without prompting.Goal; Improve confidence and strict adherence to Moving & Handling plans (e.g., safe slide sheet/hoist use).Goal; Focus on accurate, timely digital documentation (Nourish/Birdie) immediately after tasks.Goal; Develop deeper understanding of infection prevention and dignified continence support.Goal; Prepare for formal Medication Prompting/Assisting practical competency assessment.Remedial; Must strictly observe the 'No Clinical Tasks / TDDI' boundary; immediate retraining required.SECTION 3: PASTORAL, WELLBEING & FTSU CHECK-IN (Well-led: QS2 & QS3)Emotional Resilience: "How is the apprentice coping with the realities of community care (e.g., witnessing cognitive decline, end-of-life care)?"- Select -Coping well - Shows healthy empathy and professional detachment.Finding it challenging but seeking support appropriately.Showing signs of distress/burnout.Fatigue Management: "Is the apprentice managing the physical demands of shift patterns alongside coursework?"- Select -Yes - EngagedNo - Reporting exhaustionReasonable Adjustments: "Are any agreed reasonable adjustments (e.g., dyslexia support, neurodiversity scheduling) working effectively?"- Select -YesNoN/AFreedom to Speak Up (FTSU) / Safeguarding Check: "Has the apprentice witnessed any practice by colleagues, families, or management that made them feel uncomfortable or concerned for a service user's safety?"- Select -No concerns raisedYes - Escalated to Registered Manager immediatelyMentor Action Taken (If Distress/Fatigue Identified)- Select -Adjusted upcoming rota to lighter/less complex calls.Approved immediate time off / rest break.Referred to Employee Assistance Programme (EAP).Escalated to Registered Manager.N/A - No concerns.Apprentice's Own Comments on Wellbeing & Support Needs- Select -I feel fully supported, confident, and have no current wellbeing or academic concerns.I am adjusting well but would appreciate more time shadowing complex manual handling or medication before attempting it.I am finding the emotional impact of the role challenging and would like to utilize the EAP or have a professional debrief.I am feeling fatigued balancing the rota with coursework; I am requesting a temporary reduction/review of my hours.I am experiencing severe stress/anxiety and require immediate pastoral support from the Registered Manager.SECTION 4: OFF-THE-JOB (OTJ) TRAINING & ACADEMIC ALIGNMENT (Effective: QS2)Protected Study Time: "Has the apprentice been able to take their statutory OTJ time (average 6 hours per week, or 20% if part-time) without rota interruption?"- Select -YesNoN/AMain Coursework Progress: "Is the apprentice on track with their vocational assignments/assessments?"- Select -Ahead or On TargetSlightly BehindSignificantly BehindFunctional Skills Progress (Maths & English): "If required, is the apprentice on track with their Functional Skills tutoring?"- Select -On TargetFalling BehindN/A - ExemptMentor Assessment of Core Values- Select -Outstanding EmpowermentOutstanding DignityOutstanding KindnessConsistent AlignmentDevelopment NeededValues MismatchDateAction for Rostering Team (Based on this review)- Select -Maintain current shadowing rota.Apprentice is ready to take the lead on Level 1 calls (with Mentor present in the property).Block from complex calls (Requires more basic practice first).Reduce hours temporarily due to fatigue/study demands.Apprentice Declaration- Select -I confirm this is an accurate record of our discussion. I feel supported in my role and understand who to speak to if I have any clinical or safeguarding concerns.Next External Tutor Visit DateNext Review Date:SUBMIT FORM
