Age Care certIV

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CHCAGE003CoordinateservicesforolderpeopleSABv3.0.docx

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STUDENT ASSESSMENT BOOKLET

CHCAGE003 Coordinate Services for Older People

Student Name: ___________________________

Suite 203, 11-15 Deane Street Burwood, NSW, 2134

Email: [email protected]

RTO Code: 45342

© 2020 Advance College

Advance College is a trading name of Australian Newtown College, RTO 45342.

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RECORD OF ASSESSMENT OUTCOMES: CHCAGE003

This section records the outcome of each task/assessment requirement so that the final assessment outcome can be determined for the unit CHCAGE003 Coordinate services for older people.

The table below shows all the assessment requirements for this unit. Once a student has satisfactorily completed all requirements related to the unit, they can be given a Final Assessment Result of ‘Competent’. A number of spaces have been provided to record multiple attempts. Final Assessment Results should only be recorded once all tasks have been attempted.

Assessment requirements/tasks

Task Outcome

Satisfactory (S) Not satisfactory (NS)

Date

Assessor initials

1. Written questions

2. Role play

3. Workplace project 1

4. Workplace project 2

5. Supervisor report

Final Assessment Results

Result (C/NYC)

Date

CHCAGE003 Coordinate services for older people

Student name:

Assessor name:

Assessor signature:

Date: / /

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ASSESSMENT OVERVIEW

This Student Assessment Booklet includes all your tasks for assessment of CHCAGE003 Coordinate services for older people.

ABOUT YOUR ASSESSMENTS

This unit requires that you complete four assessment tasks. You are required to complete all tasks to demonstrate competency in this unit.

Assessment Task

About this task

Assessment Task 1: Written questions

You must correctly answer all questions to show that you understand the knowledge required of this unit.

Assessment Task 2: Role play

You are to participate in a role play, providing support for a family member who cares for an elderly person.

Assessment Task 3: Workplace project 1

You are to document the coordination of services for three clients.

Assessment Task 4: Workplace project 2

You are to advise service providers how to give feedback on the effectiveness of services and activities.

You are also required to receive feedback from service providers and clients and report to their supervisor.

How to submit your assessments

When you have completed each assessment task you will need to submit it to your assessor.

Instructions about submission can be found at the beginning of each assessment task.

Assessment Task Cover Sheet

At the beginning of each task in this booklet, you will find an Assessment Task Cover Sheet. Please fill it in for each task, making sure you sign the student declaration.

Your assessor will give you feedback about how well you went in each task, and will write this on the back of the Task Cover Sheet.

Prerequisite

The prerequisite for this unit is NIL.

PERFORMANCE EVIDENCE

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

coordinated the service needs for at least 3 older people requiring varying levels or types of support

KNOWLEDGE EVIDENCE

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

the social model of disability

aspects of elder abuse, including:

· indications of neglect or abuse

· emotional impact of abuse

· appropriate management of issues surrounding abuse

manifestations and presentation of common health problems associated with ageing, appropriate actions in response to these problems and when to refer

role and function of various relevant health professionals

relevant community and support services

principles and practices of case management

organisation standards, policies and procedures

For all documentation on the performance criteria and assessment requirements of the unit CHCAGE003 Coordinate services for older people, please refer to the training.gov.au website with this link: https://training.gov.au/Training/Details/CHCAGE003.

ASSESSMENT TASK COVER SHEET

Students: Please fill out this cover sheet clearly and accurately for this task.

Student Name

Assessor Name

Unit: CHCAGE003 Coordinate services for older people

Assessment Details

Assessment Type

Written/Oral questions Role play Workplace Projects

Agreement by the student

Read through the assessments in this booklet before you fill out and sign the agreement below. Make sure you sign this before you start any of your assessments.

Have you read and understood what is required of you in terms of assessment?

Yes

No

Do you understand the requirements of this assessment?

Yes

No

Do you agree to the way in which you are being assessed?

Yes

No

Do you have any special needs or considerations to be made for this assessment? If yes, what are they? …………………………… ………………………… ………………… ……… … … .………………………………………….

Yes

No

Do you understand your rights to appeal the decisions made in an assessment?

Yes

No

None of this work has been completed by any other person.

Yes

No

I have not cheated or plagiarised the work or colluded with any other student/s.

Yes

No

I have correctly referenced all resources and reference texts to complete these assessment tasks.

Yes

No

I understand that if I am found to be in breach of policy, disciplinary action may be taken against me.

Yes

No

STUDENT DECLARATION

I, , certify that the statements I have attested above have been made in a good faith, are true and correct. To the best of my knowledge and belief, these tasks are my own work.

Student Signature: …………………………… Date: ............... /................./...................................

ASSESSMENT TASK COVER SHEET – Attempt 1

Result

Satisfactory (S)

Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor signature: Date:

ASSESSOR FEEDBACK (Assessment Task 3 to Task 4)

Assessor signature: Date:

ASSESSMENT TASK COVER SHEET – Attempt 2

Re-assessment Result

Satisfactory (S)

Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor signature: Date:

ASSESSOR FEEDBACK (Assessment Task 3 to Task 4)

Assessor signature: Date:

ASSESSMENT TASK COVER SHEET – Attempt 3

Re-assessment Result

Satisfactory (S)

Not Yet Satisfactory (NYS)

ASSESSOR FEEDBACK (Assessment Task 1 to Task 2)

Assessors: Please return this cover sheet to the student with assessment results and feedback.

Assessor signature: Date:

ASSESSOR FEEDBACK (Assessment Task 3 to Task 4)

Assessor signature: Date:

ASSESSOR DECLARATION

I declare that I have conducted a fair, valid, reliable and flexible assessment with this student, and I have observed the student demonstrate unit outcomes through consistent and repeated application of skills and knowledge over a period of time and provided appropriate feedback.

Signature: ________________________

Date: ______/_______/_____________

STUDENT FEEDBACK AND ASSESSMENT APPEALS

You can make an appeal about an assessment decision by putting it in writing and sending it to us. Refer to your Student Handbook for more information about our appeals process.

I have received my assessment result and I am satisfied with the given feedback for this assessment.

I am not satisfied about my result and I would like to appeal regarding my result.

Student Signature: …………………………… Date: ......... /.........../..................

ASSESSMENT TASK 1: WRITTEN QUESTIONS

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Task summary:

This is an open book test – you can use the Internet, textbooks and other documents to help you with your answers if required.

You must answer all questions correctly.

Write your answers in the space provided.

If you need more space, you can use extra paper. All extra pieces of paper must include your name and the question number/s you are answering.

You may like to use a computer to type your answers. Your assessor will tell you if you can email them the file or if you need to print a hard copy and submit it.

What do I need in order to complete this assessment?

Access to textbooks and other learning materials.

Access to a computer and the Internet (if you prefer to type your answers).

When do I do this task?

You will do this task in your own time.

what do I need to do if I get something wrong?

If your assessor marks any of your answers as incorrect, they will talk to you about resubmission. You will need to do one of the following:

Answer the questions that were incorrect in writing.

Answer the questions that were incorrect verbally.

Instructions to students:

Question 1

In one to two paragraphs, describe how the social model of disability has changed the way in which care is provided to older people in Australia.

Question 2

What are the roles of the following health professionals in relation to elderly patients?

Health professional

Services for the elderly

General practitioner

Podiatrist

Physiotherapist

Audiologist

Speech pathologist

Dietitian

Psychologist

Oncologist

Dermatologist

Orthopaedic specialist

Urologist

Neurosurgeon

Ophthalmologist

Radiologist

Cardiologist

Rheumatologist

Thoracic Surgeon

Nephrologist

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Question 3

In the table below, list five common health problems associated with ageing. Include the symptoms of these health problems and when referral to services would be appropriate.

Common health problem in the elderly

Common symptoms

When would referral to specialist services be appropriate?

Which services may a person with this health condition be referred to?

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Question 4

Provide a definition of ‘case management’.

Describe the steps involved in a typical case management process.

Question 5

Rebecca has a number of aged related conditions which require her to access a number of different services. She has a case manager who coordinates these services.

Rebecca’s conditions include:

Arthritis

Chronic pain

Difficulty walking

Isolation

No longer able to drive

Difficulty dressing and manipulating objects

1. Make a list of services that will assist Rebecca to meet her needs.

Make a list of 10 activities that Rebecca could engage in to make her less isolated.

What are five supports that Rebecca may need to assist her to access these services and activities?

List five ways in which having a case manager will help Rebecca?

Question 6

1. In the table below, list at least three indicators you may observe in a person who is subject to abuse.

Type of abuse

Indicators of abuse

Financial

Sexual

Physical

Psychological / Emotional abuse

Neglect

What are some of the emotional impacts of elder abuse?

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What steps would you take if you suspected a client was being abused?

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ASSESSMENT TASK2: ROLE PLAY

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Task Summary:

You will participate in a role play and provide support for a family member who cares for an elderly person.

What do I need in order to complete this assessment?

Your assessor will play the role of the family member

Environment set up for a meeting with the family member

When do I do this task?

· You will do this role play during your assessor’s workplace visit.

· There is almost some research that you will need to do in your own time before you do this role play

what do I need to do if I get something wrong?

If your assessor sees that you have not shown appropriate skills or knowledge, they will give you some feedback and you will need to do the specific task again.

What do I need to submit?

· Copies of any policies and procedures followed and any documentation completed as part of these policies and procedures

Instructions

Jelma has asked to see you to talk about options for support for her father, Alfred.

She currently cares for her father in her home.

You know Alfred, as he has personal care services provided at home. He has Parkinson’s Disease with dementia, which is worsening.

Currently a personal care worker attends her father three times a week to shower and dress him. Jelma provides all other care.

To prepare for this role play you must research services and community groups that can assist families and carers when caring for elderly people.

Bring a list of these services and groups with you to the role play so you can discuss them with Jelma.

Your assessor will play the role of Jelma. You are to meet with Jelma to find out her challenges in caring for her father and provide support by letting her know what services she and her father could access.

[Assessor to Complete]

Your assessor will be looking to see that you:

Comments

Attempt 1 Yes/No

Date:

Attempt 2 Yes/No

Date:

Attempt 3 Yes/No

Date:

Recognise how providing support to an elderly person with complex needs can impact on family members

Recognise and respond appropriately to signs of abuse

Provide appropriate support to Jelma.

Refer the client and Jelma to relevant services

Provide information on the relevant support services

Please add any feedback to the student about this task on the Assessment Cover Sheet. Keep a copy of the completed Assessment Task Cover Sheet.

ASSESSMENT TASK 3: WORKPLACE PROJECT 1

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Task Summary:

You need to fill out the attached template to document the coordination of services for three older people.

What do I need in order to complete this assessment?

Access to three clients requiring coordination of services

Approval from your supervisor to work with each client

Individual development plans for each client

Resources in order to complete your work (such as referral forms, feedback forms, case notes and so on).

When do I do this task?

· You will do task in during your workplace

what do I need to do if I get something wrong?

If your assessor marks any part of template as having insufficient detail, they will give you some feedback and talk to you about resubmission.

Instructions

In this assessment you are required to work with three clients to coordinate services and support activities.

You will need to do the following:

Choose three clients who require coordination of various types and levels of support.

Get approval from your supervisor to work with these clients (see permission note below).

Identify and prioritise your clients’ needs, goals and preferences by accessing their individual development plans and consulting with the clients, their family and your colleagues.

Make a plan for each client to document services and activities to be provided for the coming fortnight. The plan will document each service/activity, time and location, service provider, resources and arrangements

Support the clients to arrange and access services, activities and support agencies.

Monitor if services and support workers can provide the level of services required and take action if services are no longer sufficient or relevant.

You must obtain permission from your supervisor to work with each client.

You will be supervised at all times during your work. Complete the following permission form for each client.

ASSESSMENT TASK 4: COORDINATE SERVICES and support activities

Complete this template for each of the clients that you work with. You must complete each part of the template. As you complete the tasks, ask your supervisor to sign off each entry to indicate that it is a true account and that you followed workplace policies and procedures. Your assessor may ask you questions about your project during a workplace visit.

Note: Make sure that you do not disclose any personal information that would identify the client. Do not use names, contact information or any other identifying information.

CLIENT 1

Comments

Supervisor initials

1. Access the client’s individual development plan (IDP) and consult with client, family and colleagues as appropriate

1. What are the goals of this client?

What needs does this client have for services and support activities?

c) Does the client have any particular preferences that need to be taken into account when coordinating services and support activities?

d) What are three priorities for this client?

1. Make a plan and document at least four services and activities to be provided (an example has been provided for you)

Day

Date

Service or activity

Time

Location

Service provider

Resources required

Arrangements

1

1/12/2015

Podiatrist

District nurse

10 am

2pm

Clinic

Home visit

Tammy Smith, Podiatrist

Jenny Jones

Wheelchair Transport

None

Client to be picked up at 9.40am by community service driver to podiatrist. Client to be picked up at 10.30 to be taken home.

Jenny has all the information required and has confirmed visit

2

3

4

5

Obtain supervisor’s initials to confirm your fortnightly plan

For each of the services and activities identified, confirm with the service provider that they understand the client’s needs and preferences and confirm their roles and responsibilities (An example has been provided for you)

Name of service or activity

Service provider

How did you confirm that they understood the client’s needs and preferences

Roles and responsibilities of service provider

Supervisor’s initials

Podiatry

Tammy Smith

Phoned Tammy and discussed client’s needs – has been experiencing pain in feet over past week

Let them know that client prefers to have a morning appointment rather than afternoon as she likes to nap after lunch

To manage foot problems caused by diabetes and lack of circulation.

To provide information about foot care to district nursing service.

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For each of the services and activities identified, list the support that the client will need to arrange and/or access the services, activities and/or support agencies. If you need extra space either add lines electronically to this template or provide an attachment

(An example has been provided for you)

Name of service or activity

Service provider

What support will the client need to arrange or access? (an example has been completed for you)

Supervisor’s initials

Podiatry

Tammy Smith

Make appointment on client’s behalf

Arrange community services transport to pick up at 9.40am

Arrange for home care to provide personal care services early so that she is ready to be picked up at 9.40am

Remind client the day before by phone call

How will the effectiveness of each service, activity and support worker/agency be monitored? What action will be taken?

(An example has been provided for you)

Name of service or activity

Service provider

How will effectiveness be measured?

What action will be taken if services are found to be ineffective

Supervisor’s initials

Podiatry

Tammy Smith

Feedback from Tammy

Consultation with client

Feedback from district nurse

District nurse to discuss with podiatrist, client and medical practitioner

CLIENT 2

Comments

Supervisor initials

1. Access the client’s individual development plan (IDP) and consult with client, family and colleagues as appropriate

1. What are the goals of this client?

What needs does this client have for services and support activities?

f) Does the client have any particular preferences that need to be taken into account when coordinating services and support activities?

g) What are three priorities for this client?

1.

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1. Make a plan and document at least four services and activities to be provided (an example has been provided for you)

Day

Date

Service or activity

Time

Location

Service provider

Resources required

Arrangements

1

1/12/2015

Podiatrist

District nurse

10 am

2pm

Clinic

Home visit

Tammy Smith, Podiatrist

Jenny Jones

Wheelchair Transport

None

Client to be picked up at 9.40am by community service driver to podiatrist. Client to be picked up at 10.30 to be taken home.

Jenny has all the information required and has confirmed visit

2

3

4

5

Obtain supervisor’s initials to confirm your fortnightly plan

For each of the services and activities identified, confirm with the service provider that they understand the client’s needs and preferences and confirm their roles and responsibilities (An example has been provided for you)

Name of service or activity

Service provider

How did you confirm that they understood the client’s needs and preferences

Roles and responsibilities of service provider

Supervisor’s initials

Podiatry

Tammy Smith

Phoned Tammy and discussed client’s needs – has been experiencing pain in feet over past week

Let them know that client prefers to have a morning appointment rather than afternoon as she likes to nap after lunch

To manage foot problems caused by diabetes and lack of circulation.

To provide information about foot care to district nursing service.

For each of the services and activities identified, list the support that the client will need to arrange and/or access the services, activities and/or support agencies. If you need extra space either add lines electronically to this template or provide an attachment

(An example has been provided for you)

Name of service or activity

Service provider

What support will the client need to arrange or access? (an example has been completed for you)

Supervisor’s initials

Podiatry

Tammy Smith

Make appointment on client’s behalf

Arrange community services transport to pick up at 9.40am

Arrange for home care to provide personal care services early so that she is ready to be picked up at 9.40am

Remind client the day before by phone call

How will the effectiveness of each service, activity and support worker/agency be monitored? What action will be taken?

(An example has been provided for you)

Name of service or activity

Service provider

How will effectiveness be measured?

What action will be taken if services are found to be ineffective

Supervisor’s initials

Podiatry

Tammy Smith

Feedback from Tammy

Consultation with client

Feedback from district nurse

District nurse to discuss with podiatrist, client and medical practitioner

CLIENT 3

Comments

Supervisor initials

1. Access the client’s individual development plan (IDP) and consult with client, family and colleagues as appropriate

1. What are the goals of this client?

What needs does this client have for services and support activities?

i) Does the client have any particular preferences that need to be taken into account when coordinating services and support activities?

j) What are three priorities for this client?

1. Make a plan and document at least four services and activities to be provided (an example has been provided for you)

Day

Date

Service or activity

Time

Location

Service provider

Resources required

Arrangements

1

1/12/2015

Podiatrist

District nurse

10 am

2pm

Clinic

Home visit

Tammy Smith, Podiatrist

Jenny Jones

Wheelchair Transport

None

Client to be picked up at 9.40am by community service driver to podiatrist. Client to be picked up at 10.30 to be taken home.

Jenny has all the information required and has confirmed visit

2

3

4

5

Obtain supervisor’s initials to confirm your fortnightly plan

For each of the services and activities identified, confirm with the service provider that they understand the client’s needs and preferences and confirm their roles and responsibilities (An example has been provided for you)

Name of service or activity

Service provider

How did you confirm that they understood the client’s needs and preferences

Roles and responsibilities of service provider

Supervisor’s initials

Podiatry

Tammy Smith

Phoned Tammy and discussed client’s needs – has been experiencing pain in feet over past week

Let them know that client prefers to have a morning appointment rather than afternoon as she likes to nap after lunch

To manage foot problems caused by diabetes and lack of circulation.

To provide information about foot care to district nursing service.

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For each of the services and activities identified, list the support that the client will need to arrange and/or access the services, activities and/or support agencies. If you need extra space either add lines electronically to this template or provide an attachment

(An example has been provided for you)

Name of service or activity

Service provider

What support will the client need to arrange or access? (an example has been completed for you)

Supervisor’s initials

Podiatry

Tammy Smith

Make appointment on client’s behalf

Arrange community services transport to pick up at 9.40am

Arrange for home care to provide personal care services early so that she is ready to be picked up at 9.40am

Remind client the day before by phone call

How will the effectiveness of each service, activity and support worker/agency be monitored? What action will be taken?

(An example has been provided for you)

Name of service or activity

Service provider

How will effectiveness be measured?

What action will be taken if services are found to be ineffective

Supervisor’s initials

Podiatry

Tammy Smith

Feedback from Tammy

Consultation with client

Feedback from district nurse

District nurse to discuss with podiatrist, client and medical practitioner

ASSESSMENT TASK 5: WORKPLACE PROJECT 2

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Task summary:

Part A: You are to advise service providers how to give feedback on effectiveness of services and activities.

Part B: You are to obtain feedback from at least one of the service providers from each of the clients in Assessment Task 4.

Part C: You are to obtain feedback from each client in Assessment Task 4.

Part D: You are to prepare a report to your supervisor on the feedback for each client and provide recommendations for the Individual Development Plan.

What do I need in order to complete this assessment?

Access to the three clients from Assessment Task 4

Access to obtain feedback from one service provider for each client

Individual development plans for each client

Resources to complete work (such as feedback forms)

Access to relevant organisational policy and procedures

Coordination of services and activities for clients

Obtaining feedback from service providers.

When and where do I need to do this?

You will do this task in your workplace

what do I need to do if I get something wrong?

If your assessor identifies that your documentation is not clear or you have not provided sufficient detail, they will give you some feedback and talk to you about resubmission.

Instructions:

This assessment follows on from Assessment Task 4.

You are required to work with three clients to coordinate services and support activities.

You will need to do the following:

Provide information to service providers to explain feedback methods regarding the effectiveness of services and activities provided to clients

Obtain feedback from service providers

Obtain feedback from clients and/or their family and carers

Provide a report to the supervisor.

Note: You will need to observe privacy and confidentiality while completing this assessment. Do not use any information that would identify clients. Refer to clients as ‘Client 1’, ‘Client 2’ and so on.

Part A: Advise service providers how to give feedback on effectiveness of services and activities

For this task you must prepare information that can be given to all service providers to let them know how they can provide feedback on the services and support activities that they provide to clients.

You must read your organisation’s policies and procedures on obtaining feedback from service providers and discuss with your supervisor or other colleagues to find out how feedback is obtained in your service.

Your advice to service practitioners may be prepared in the following formats:

Email

Printed information sheet

Other mechanism specified by organisational policies and procedures.

The advice must include the following information:

How your organisation will ask for feedback

How the service provider can provide feedback at other times

What the feedback will be used for

Contact information for your organisation.

Hand in your completed advice to your assessor.

Part B: Obtain feedback from service providers

For Part B you are required to obtain feedback from at least one service provider for the three clients you worked with in Assessment Task 4.

You must obtain the feedback under the supervision of your supervisor or a work colleague nominated by your supervisor.

The feedback method will depend on procedures, but may include such things as:

Case management meeting

Service provider’s report

Phone call

Email.

Complete the following template to record the feedback you receive for each client.

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Feedback from service providers

CLIENT 1

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the needs of the client – provide information?

Does the service provider recommend any changes to service provision?

Feedback from service providers

CLIENT 2

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the needs of the client – provide information?

Does the service provider recommend any changes to service provision?

CLIENT 3

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the needs of the client – provide information?

Does the service provider recommend any changes to service provision?

Part C: Obtain feedback from clients

For Part C you are required to obtain feedback from each of the three clients you worked with in Assessment Task 4.

You should obtain feedback about one of the services that the client is receiving.

You must obtain the feedback under the supervision of your supervisor or a work colleague nominated by your supervisor.

The feedback method will depend on procedures, but may include such things as:

Face-to-face meeting

Phone call

Feedback form.

You may obtain the feedback directly from the client or, if more appropriate, you may seek feedback on the client’s behalf from family or carer.

Complete the following template to record the feedback you receive for each client.

Receive feedback from clients

CLIENT 1

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the client’s needs/ Provide details

Is the client satisfied with services? Are there any changes recommended?

CLIENT 2

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the client’s needs/ Provide details

Is the client satisfied with services? Are there any changes recommended?

CLIENT 3

Date feedback received

Service/s provided

Service provider

How long have services been provided?

Are services meeting the client’s needs/ Provide details

Is the client satisfied with services? Are there any changes recommended?

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Part D: Report feedback to supervisor

For Part D you are required to analyse the feedback you received from each of your three clients and write down any recommendations for changes to services.

Use the templates provided.

FEEDBACK REPORT TO SUPERVISOR

Client 1

What service did you receive feedback on?

Name of service provider

What feedback and recommendations were received from service provider?

Who did you obtain client feedback from? (Tick appropriate box.)

· Client

· Family member __________________________________

· Carer/Advocate __________________________________

What feedback and comments were received from the client or their representative?

What recommendations do you have for changes to services (if any)?

FEEDBACK REPORT TO SUPERVISOR

Client 2

What service did you receive feedback on?

Name of service provider

What feedback and recommendations were received from service provider?

Who did you obtain client feedback from? (Tick appropriate box.)

· Client

· Family member __________________________________

· Carer/Advocate __________________________________

What feedback and comments were received from the client or their representative?

What recommendations do you have for changes to services (if any)?

FEEDBACK REPORT TO SUPERVISOR

Client 3

What service did you receive feedback on?

Name of service provider

What feedback and recommendations were received from service provider?

Who did you obtain client feedback from? (Tick appropriate box.)

· Client

· Family member __________________________________

· Carer/Advocate __________________________________

What feedback and comments were received from the client or their representative?

What recommendations do you have for changes to services (if any)?

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July 2020 Version 3.0

CHCAGE003 Coordinate Services for Older People

© Advance College