Certification evidence

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Use this form to record your evidence that you have made and used playlists. You can enter information into the form then save it and return to it at a later date by using the link above. Once you submit the form we will review your evidence and get back to you if we have any questions or believe we need to see more detail.

It is best to choose one person to be responsible for filling in the form. That way they will have an overview of everything you’re submitting and can make sure it’s all consistent.

We think it should take you under an hour to fill in this form. And you can save time by simply copying information from the records you have been keeping as you get your playlist project up and running. But we know that a blank form can be quite daunting so take a look at this completed version of the form which shows what good evidence looks like.
About you
Please only change the information here if it is incorrect. 

Part 1: Making your playlist

As part of your implementation you will have created a playlist for one chosen resident. 

Please enter at least three songs that are on the playlist of your 'One' and tell us why they are on the playlist and what effect they have. You can add more than three songs if you like. To add an extra song just click the 'Add another song' link below.
Song 1

Song 2


Part 2: Using your playlist

It's not enough just to make a playlist for your 'One'. Different people have different care needs and respond in unique ways to their playlist.

This means that that it's important to consider the best way to use the playlist and record that information so that everyone who cares for them know how to use it and shares best practice.

In this section we want to see evidence that you have tried different ways of using the playlist and put in place a plan for your 'One'.
Evidence of use

Your One's care plan

Part 3: Embedding into care

Playlists work best when they are an integral part of your work throughout your organisation: where all residents are offered a playlist and all staff have been involved in the work. That creates a virtuous circle where the increased well-being of patients/residents translates into an increase in the job satisfaction of staff, which in turn is reflected back as increased quality of care to patients/residents. The best establishments take a 'whole home' approach to using playlists. In this section we want to see evidence that you have involved staff throughout your organisation and have a plan to embed playlists into your work. 
Involving staff

Feedback from staff
Please ask at least three of the people you have ticked above what they have got out of being part of your playlist project. Then tell us what role they perform and copy their answers in the boxes below. You can add more than three responses by clicking on the 'Add more staff feedback' link underneath the third response.

Your playlist plan