THE OBSERVATION COMPETENCY FORM

To Be Used For ALL AWP STAFF

The Observation Competency assessment form must be completed with an RMN with a
minimum of 6 months post registration experience. There is the opportunity to complete a
Theory Record on the back.

Name:

Date of Assessment:

Name of Assessor:

Date of Assessed Observation period:

Skill for Assessment Theory Practical

Obtained Ability
through determined
reading / through
discussing supervised
observation
Tick Initial Tick Initial
Knowledge and understanding of Trust Observation
Policy

Skills of engagement with distressed / disturbed

Patients

Understanding of empathy and demonstrates this

To the patient.

Ability to observe and describe mood, speech content

And presentation.

Alert to the need for assistance, and how to obtain it.

Understands and can demonstrate how to summon

Assistance.

Awareness of possible impact of own behaviour on

The patient being observed.
Understanding of the need to maintain patient dignity
And privacy whilst carrying out observations.
Understanding responsibilities as an individual
Practitioner under the observation policy

Signature of Assessor:

Signature of Staff Member

Created July 2008 Page 1 of 2

Adapted from the Elizabeth Casson House Competency Form by Jacqui Parham,
Review date; January 30th 2009
 COMPETENCY TO CARRY OUT OBSERVATION COMPENTENCY FORM,
THEORY RECORD

Trust Observation Date Knowledge Signature of Comments

Policy, Confirmed Assessor
Paperwork
Assessment
Observation record
Observation rota
Observation
allocation sheet

Trust Risk
Assessment
Care Plans

Interpersonal
effectiveness
Verbal & non verbal
Communication
Reading Material
(list)

Training Courses
(list)

OTHER

Created July 2008 Page 2 of 2

Adapted from the Elizabeth Casson House Competency Form by Jacqui Parham,
Review date; January 30th 2009