Clinical Supervision Policy

May 2013

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Table of Contents 1.

Introduction ................................................................................................................... 3

2.

Purpose of this Policy/Procedure .................................................................................. 4

3.

Scope ........................................................................................................................... 4

4.

Definitions / Glossary .................................................................................................... 4

5.

Ownership and Responsibilities .................................................................................... 5 5.1.

Role of the Managers ............................................................................................ 5

5.2.

Role of the Learning and Development Department .............................................. 5

5.3.

Role of Individual Staff ........................................................................................... 6

5.4.

Role of Supervisors/coaches ................................................................................. 6

6.

Standards and Practice ................................................................................................ 6 6.1.

Principles of Supervision ....................................................................................... 6

6.2.

Informal Supervision .............................................................................................. 7

6.3.

Group Supervision ................................................................................................. 7

6.4.

Process for requesting supervision........................................................................ 7

6.5.

Supervision for Nurses and Midwives at band 7 and above .................................. 7

6.6.

Confidentiality ........................................................................................................ 7

6.7.

Documentation and Reporting ............................................................................... 8

6.8.

Supervision and Development for Supervisors ...................................................... 8

7.

Dissemination and Implementation ............................................................................... 8

8.

Monitoring compliance and effectiveness ..................................................................... 9

9.

Updating and Review.................................................................................................... 9

10.

Equality and Diversity ................................................................................................ 9

10.1.

General Statement ............................................................................................. 9

10.2.

Equality Impact Assessment ............................................................................ 10

Appendix 1. Governance Information ................................................................................ 11 Appendix 2.Initial Equality Impact Assessment Screening Form ....................................... 13 Appendix 3. Process for requesting Individual Supervision ............................................... 15 Appendix 4 Process for requesting Group Supervision ..................................................... 16 Appendix 5 Record of Supervision Activity ........................................................................ 17 Appendix 6. Supervision Record ........................................................................................ 18

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1. Introduction 1.1. Clinical supervision is a process by which professionals are assisted to improve practice, develop both professionally and personally, and manage complex situations associated with the care and treatment of patients. It is a method of supporting and developing competence by providing practitioners with the opportunity to meet on either a regular or an ad hoc basis with an experienced colleague to discuss and reflect upon and learn from their experiences in clinical practice. 1.2. There are many definitions and models relating to clinical supervision. The following definition from the Nursing & Midwifery Council (2006) is useful in health care settings. 1.3. ‘A formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex situations’ (NMC 2006 p6) 1.4. The value of effective professional supervision is recognised by the majority of health associated bodies such as the Nursing and Midwifery Council, Chartered Society of Physiotherapists etc. 1.5. It is a statutory requirement for midwives to undergo annual midwifery supervision review at least once per year with a named midwifery supervisor. The purpose of Midwifery supervision is to provide a mechanism for support and guidance to every practising midwife in the United Kingdom and to protect women and babies by actively promoting a safe standard of midwifery practice. Supervisors of Midwives are appointed by, and are accountable to, the Local Supervising Authority (NMC 2012). 1.6. Therefore, clinical supervision as defined within this document is distinct and different to midwifery supervision. Midwives are required to continue with their formal professional supervisory arrangements but may choose to participate in additional supervision as identified in this document. 1.7. Coaching and mentoring are also recognised as an effective means of supporting individuals to develop both personally and professionally. Coaching and mentoring can be defined as ‘learning relationships which help people to take charge of their own development, to release their potential and to achieve results which they value’ (Connor & Pokora 2007 p11) 1.8. Whilst coaching and mentoring can be viewed as complementary and have many similarities, such as facilitating insight, learning and change through a one to one relationship, there are some more distinct differences between the two approaches. Mentoring is often undertaken by a more senior person who has experience or achieved success within the same field as the ‘mentee’ and may include a level of professional guidance direction and support. Coaching can be undertaken by an individual who does not have experience within the same field as the ‘coachee’ and is more focused on facilitating the coachee to find their own answers and potential. Clinical Supervision Version 2.0 May 2013

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1.9. Clearly, coaching and mentoring can be used to support individuals within any work setting whereas clinical supervision is aimed specifically at staff working in clinical settings. However many of the principles and outcomes are similar to that being achieved through supervision. Consequently, whilst accepting the differences between coaching, mentoring and clinical supervision, RCHT acknowledges that all these processes ultimately fulfil the requirements of staff for supervision and development. 1.10. Therefore, for the purpose of this document, the term ‘supervision’ and ‘supervisee’ are utilised. These are used as inclusive terms and could equally refer to coaching and mentoring processes. 1.11. This version supersedes any previous versions of this document.

2. Purpose of this Policy/Procedure This policy aims, firstly, to provide a clear understanding of supervisory processes at RCHT that focus on the personal and professional development of staff (excluding medical and dental staff). Secondly, it provides a framework for reporting of supervisory activity undertaken at RCHT which can then be reported for governance purposes.

3. Scope 3.1. This policy applies to all health professionals, (excluding doctors and dentists), and clinical support staff employed at The Royal Cornwall Hospitals NHS Trust. 3.2. Clinical supervision does not seek to replace managerial supervision. The role of the line manager in providing supervision for their staff is an important part of ensuring effective performance is maintained. Clinical supervision is an additional means of support and development to that of line management.

4. Definitions / Glossary Term Clinical supervision

Meaning ‘A formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex situations’ (NMC 2006 p6)

Coaching/Mentoring

‘Learning relationships which help people to take charge of their own development, to release their potential and to achieve results which they value’ (Connor & Pokora 2007 p 11) Mentoring is often undertaken by a more senior person who has experience or

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achieved success within the same field as the ‘mentee’ and may include a level of professional guidance direction and support. Coaching can be undertaken by an individual who does not have experience within the same field as the ‘coachee’ and is more focused on facilitating the coachee to find their own answers and potential. The body designated in the Nursing and Midwifery Order (2001) as responsible for exercising general supervision over all midwives practising within its area. Managerial supervision refers to the support and guidance provided by a line manager to a direct report that enables them to undertake the day to day operational aspects of their role. A statutory responsibility which provides a mechanism for support and guidance to midwives with the aim of protecting women and babies by actively promoting a safe standard of midwifery practice (NMC 2009) . A person receiving support and help to develop through supervision, coaching or mentoring A person working with another individual to help them develop personally and professionally through the processes of supervision, coaching or mentoring

Local Supervising Authority

Managerial supervision

Midwifery supervision

Supervisee/coachee/mentee

Supervisor/coach/mentor

5. Ownership and Responsibilities 5.1. Role of the Managers Line managers are responsible for:   

Recognising the benefits that clinical supervision provides for staff and highlighting staff for whom this would be a particularly useful mode of personal and professional development. Providing time for clinical supervision within working hours Providing on-going managerial supervision for all their staff

5.2. Role of the Learning and Development Department The Learning and Development Department is responsible for: 

Ensuring that the Trust website contains an up-to-date list of recognised supervisors available for the supervision of others.

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   

Ensuring that supervisors are aware of reporting arrangements to collect data relating to supervisory activity Collect data regarding supervisory activity at RCHT Provision of training, development and support for current and future supervisors/coaches Supporting staff to access a supervisor if required

5.3. Role of Individual Staff All staff members are responsible for:     

Actively engaging in clinical supervision activities in accordance with the requirements from their professional body. Ensuring that they take up supervision to meet their personal and professional development needs Recognising that supervision is a positive and effective means of improving performance and supporting development. It is not solely aimed at improving poor performance. The direction of their supervision and identification of areas of practice that could be explored in a supervisory session. Maintaining a record of learning from supervision/coaching in their personal professional portfolio

5.4. Role of Supervisors/coaches      

Providing an environment in which the supervisee feels safe to explore potentially difficult situations, behaviours and attitudes Ensuring that they focus on the developmental needs of the supervisee and maintain a non-judgemental approach. Utilise appropriate skills to ensure that supervision sessions are effective and purposeful. Agree with supervisee at the outset regarding any communication that will take place with the supervisee’s line manager Maintain supervision/coaching records Complete a record of supervisory activity and return this to the Learning and Development Department quarterly

6. Standards and Practice 6.1. Principles of Supervision The Chartered Society of Physiotherapy (2005) define the principles of supervision as follows:     

Support and enhance practice for the benefit of patients Develop skills in reflection to narrow the gap between theory and practice Involve a supervisor and practitioner/group of practitioners reflecting on and critically evaluating practice Be distinct from formal line management supervision and appraisal Be planned and systematic and conducted within agreed boundaries Be explicit about the public and confidential elements of the process

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Define an outcomes based action plan. The outcomes can then be more broadly developed to assist the practitioner’s professional development through the Performance Development Review (PDR) process with their line manager/reviewer.

6.2. Informal Supervision Whilst this policy focuses on the provision of supervision in a formal setting, it is acknowledged that some staff participate in informal supervision with colleagues outside the work setting. This can be a valuable learning experience; however, RCHT encourages staff to engage in formal supervision to ensure that it remains a meaningful and constructive process and to gain maximum benefit for patient care. Episodes of informal supervision are not recorded as supervision activity at RCHT.

6.3. Group Supervision Supervision can be undertaken as an individual practitioner or with a group of practitioners. A group can consist of singular or mixed professional/occupational groups. The principles of group supervision are the same as that of individual supervision. However, greater consideration needs to be made to the establishment of ground rules at the start of the process and there should be a shared common purpose between the group members.

6.4. Process for requesting supervision The processes for requesting individual and group supervision are outlined in a flow chart in appendices 3 and 4 respectively.

6.5. Supervision for Nurses and Midwives at band 7 and above 6.5.1 The Nursing and Midwifery Strategy 2013 encourages the participation of all nurses and midwives in clinical supervision. However, the strategy identifies a mandatory requirement for all nurses and midwives at band 7 or above to undertake clinical supervision. 6.5.2 It is the responsibility of each individual nurse/midwife to make arrangements for their supervision which can be undertaken on an individual basis or as part of a group. Nurses/midwives who are undertaking a coaching programme need not also participate in clinical supervision unless they specifically choose to do so. Nurses/midwives at band 7 or above are expected to undertake a minimum of two clinical supervision sessions per year.

6.6. Confidentiality 6.6.1 The supervision process is confidential between the supervisor and the supervisee. Any discussion of the content of a supervision session should not be discussed outside of the session without the agreement of both parties. 6.6.2 However, should a situation arise where maintaining confidentiality would put patients or others at risk of harm, the supervisor is required to take appropriate action. Clinical Supervision Version 2.0 May 2013

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6.7. Documentation and Reporting 6.7.1 As a minimum the supervisor must record the date, time name and workplace of supervisee on the supervision record sheet (appendix 5) for all supervision sessions. Before starting supervision with an individual or group the supervisor must explain that this type of record of their supervision will be maintained and used in reports to demonstrate levels of supervision activity at RCHT. These reports do not include the names of individual supervisees nor do they contain any detail of the content of a supervision session. They simply record that the activity has taken place. 6.7.2 Supervisors are encouraged to maintain records of their supervision session although this should be agreed with their supervisee at the start of the process. Supervisor records are encouraged as they form a useful reference point for future session, are helpful in the evaluation of progress and are a reminder regarding the agreement of actions. Supervisors may develop their own record template or utilise the one found at appendix 6. 6.7.3 Supervisees are encouraged to keep records of supervision for their personal professional portfolio. In this instance any reference to patient care/ colleagues/visitors etc should be anonymous. Written reflections on learning that has taken place as a result of supervision are encouraged.

6.8. Supervision and Development for Supervisors 6.8.1 Supervisors for registered professionals will have a minimum of two years post registration experience and will undertake a form of taught preparation for their role. This could be a coaching course (or equivalent) with external accreditation but may also be an internal preparatory programme. 6.8.2 Supervisors for non-registered professionals will have a minimum of 5 years experience within a healthcare setting (or related field) and will have completed a form of taught preparation for their supervisory role. This could be a coaching course (or equivalent) with external accreditation but may also be an internal preparatory programme. 6.8.3 Supervisors are accountable for their own development and support. However, they are advised to meet formally with a fellow supervisor at least once yearly for personal development and reflection upon their supervisory skills. Supervisors should hold a personal record of this meeting. 6.8.4 A learning needs analysis for supervisors is carried out by the learning and development department on a bi-annual basis. Bespoke training programme to meet identified needs will then be developed and implemented.

7. Dissemination and Implementation 7.1. This policy will be disseminated via the document library on the RCHT Intranet site. 7.2. Implementation of the policy is undertaken by individual staff members in partnership with named supervisors and the Learning and Development Clinical Supervision Version 2.0 May 2013

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Department.

8. Monitoring compliance and effectiveness Element to be monitored

The amount of supervision that is undertaken by staff at RCHT will be monitored quarterly

Lead

The Learning and Development Department will collate reports detailing the amount of supervision undertaken utilising information submitted quarterly by supervisors The reporting form included in this policy at appendix 5 will be used to collect data for monitoring purposes. Reporting on supervision activity is completed quarterly and a report compiled.

Tool Frequency

Reporting arrangements

The report will be shared with the HR Governance group, the Senior Nurse/Midwifery Committee and the Divisional Quality and Learning Group.

Acting on All line managers, supervisors and the learning and development recommendations department will work collaboratively to ensure tat and Lead(s) recommendations/actions are completed in a timely manner Change in practice and lessons to be shared

Any changes to practice /lessons learned will be shared through senior nurse /midwifery meetings, Learning & Development Departmental meetings and supervisors training sessions. Where applicable email communication will also be utilised.

9. Updating and Review 9.1. This policy will be reviewed three yearly or in line with any specific changes to Professional Body standards/guidelines. Additionally it will be reviewed in line with any changes to required standards by NHS Monitoring bodies such as NHSLA, CQC etc.

10. Equality and Diversity 10.1. General Statement Royal Cornwall Hospitals NHS Trust is committed to a Policy of Equal Opportunities in employment. The aim of this policy is to ensure that no job applicant or employee receives less favourable treatment because of their race, colour, nationality, ethnic or national origin, or on the grounds of their age, gender, gender reassignment, marital status, domestic circumstances, disability, HIV status, sexual orientation, religion, belief, political affiliation or trade union membership, social or employment status or is disadvantaged by conditions or requirements which are not justified by the job to be done. This policy concerns all aspects of employment for existing staff and potential employees. This document complies with the above statement.

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10.2. Equality Impact Assessment The Initial Equality Impact Assessment Screening Form is at Appendix 2.

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Appendix 1. Governance Information Document Title

Clinical Supervision

Date Issued/Approved:

10th February 2014

Date Valid From:

10th February 2014

Date Valid To:

1st February 2017

Directorate / Department responsible (author/owner):

Helen Lewis, Learning & Development Department

Contact details:

01872 255148 This policy outlines a process for staff who wish to undertake supervision to support their personal and professional development. It identifies a means of recording supervision activity at RCHT Supervision Coaching Mentoring Clinical supervision RCHT PCT CFT  Director of Human Resources and Organisational Development /Interim Nurse Executive

Brief summary of contents

Suggested Keywords:

Target Audience Executive Director responsible for Policy: Date revised:

May 2013

This document replaces (exact title of previous version):

Clinical Supervision Policy & Framework Senior Nurse/Midwifery Committee Heads of HR Meeting JPRG Coaching, Mentoring & Supervision Working Group

Approval route (names of committees)/consultation:

Divisional Manager confirming approval processes

Interim Nurse Executive

Chair of JCNC Suzanne Grice- Renault or nominated deputy Signature of Executive Director giving approval Publication Location (refer to Policy on Policies – Approvals and

Original copy signed Internet & Intranet

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 Intranet Only

Ratification): Document Library Folder/Sub Folder

Clinical -General

Links to key external standards

Care Quality Commission Outcome 14 Chartered Society of Physiotherapy. (2005) A Guide to Implementing Clinical Supervision Connor M, Pokora J (2007) Coaching and Mentoring at Work: Maidenhead. Open University Press

Related Documents:

Nursing and Midwifery Council. (2006) Clinical Supervision

Training Need Identified?

Nursing and Midwifery Council. (2012) Midwives Rules and Standards Nursing and Midwifery Council.(2009) Modern Supervision in Action, a practical guide for midwives Yes – supervisors need to undertake a programme of training to develop a supervisory role. Following this they may need further refresher training and supervision themselves

Version Control Table Date

Version No V1.0

May 2013 V2.0

Summary of Changes

Changes Made by (Name and Job Title)

Clinical Supervision Policy and Framework

Sandra Arnold Practice Development

Clinical Supervision reviewed

Helen Lewis, Learning & Development Department

All or part of this document can be released under the Freedom of Information Act 2000 This document is to be retained for 10 years from the date of expiry. This document is only valid on the day of printing Controlled Document This document has been created following the Royal Cornwall Hospitals NHS Trust Policy on Document Production. It should not be altered in any way without the express permission of the author or their Line Manager. Clinical Supervision Version 2.0 May 2013

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Appendix 2.Initial Equality Impact Assessment Screening Form Name of service, strategy, policy or project (hereafter referred to as policy) to be assessed: Clinical Supervision Directorate and service area: Is this a new or existing Procedure? Directorate of Human Resources An update of a previous policy Learning & Development Department Name of individual completing Telephone: assessment: Helen Lewis 01872 255148 1. Policy Aim* This policy aims, firstly, to provide a clear understanding of supervisory processes at RCHT that focus on the personal and professional development of staff (excluding medical and dental staff). Secondly, it provides a framework for reporting of supervisory activity undertaken at RCHT which can then be reported for governance purposes. 2. Policy Objectives* As above 2. Policy – intended Outcomes*

4. How will you measure the outcome?

Staff understand the process to access supervision to support their personal and professional development Staff recognise the availability of supervision at RCHT RCHT can clearly define the amount of supervisory activity that is taking place Quarterly reports will demonstrate the number of staff who have undertaken supervision

5. Who is intended to benefit from the Policy?

Patients, carers and relatives All staff members

6a. Is consultation required with the workforce, equality groups, local interest groups etc. around this policy? b. If yes, have these groups been consulted? c. Please list any groups who have been consulted about this procedure.

Consultation has been undertaken with the following groups of staff/individuals: Senior Nurse/Midwife Committee HR Heads of Service/Governance Group Trust Lead for Leadership and Management development Coaching, Mentoring and Supervision working group Learning and Development Administrative team leader JPRG

*Please see Glossary 7. The Impact Please complete the following table using ticks. You should refer to the EA guidance notes for areas of possible impact and also the Glossary if needed. Where you think that the policy could have a positive impact on any of the equality group(s) like promoting equality and equal opportunities or improving relations within equality groups, tick the ‘Positive impact’ box. Clinical Supervision Version 2.0 May 2013

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Where you think that the policy could have a negative impact on any of the equality group(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box. Where you think that the policy has no impact on any of the equality group(s) listed below i.e. it has no effect currently on equality groups, tick the ‘No impact’ box. Equality Group Age

Positive Impact

Negative Impact

No Impact X

Disability

X

Religion or belief

X

Gender

X

Transgender

X

Pregnancy/ Maternity Race

X

Sexual Orientation

X

Marriage / Civil Partnership

X

Reasons for decision

X

You will need to continue to a full Equality Impact Assessment if the following have been highlighted: A negative impact and No consultation (this excludes any policies which have been identified as not requiring consultation). 8. If there is no evidence that the policy promotes equality, equal opportunities or improved relations - could it be adapted so that it does? How?

Full statement of commitment to policy of equal opportunities is included in the policy

Please sign and date this form. Keep one copy and send a copy to Matron, Equality, Diversity and Human Rights, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Chyvean House, Penventinnie Lane, Truro, Cornwall, TR1 3LJ A summary of the results will be published on the Trust’s web site. Signed ___Helen Lewis_____________________________________ Date ___May 2013______________________________________ Clinical Supervision Version 2.0 May 2013

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Appendix 3. Process for requesting Individual Supervision Individual identifies need for supervision

Need for supervision is agreed between Line Manager and Individual

Individual approaches a supervisor directly and agrees for supervision to commence or Individual Line Manager approaches Learning and Development to request support in finding a supervisor

Supervision Commences

Records of supervision episodes are returned to Learning and Development quarterly

Records of group supervision are maintained by the supervisor and evaluation is undertaken as agreed

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Appendix 4 Process for requesting Group Supervision Individual identifies need for supervision

Need for supervision is agreed between Line Manager and Individual

Individual approaches a supervisor directly and agrees for supervision to commence or Individual Line Manager approaches Learning and Development to request support in finding a supervisor

Supervision Commences

Records of supervision episodes are returned to Learning and Development quarterly

Records of group supervision are maintained by the supervisor and evaluation is undertaken as agreed

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Appendix 5 Record of Supervision Activity Name of Supervisor____________________________________ Date of Activity from_________________________to ____________________

Date of supervision session

Time of supervision session

Duration of supervision session

Name of supervisee

Workplace of supervisee

Evaluation of supervision process undertaken Y/N

This form should be returned to the learning and development department by the following dates each year

For Learning and Development Dept use only

30th June 30th September 31st December 31st March

Data entered onto database ___________date Name___________________

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Appendix 6. Supervision Record

Confidential between the supervisor and supervisee

Name of Supervisor

Name of Supervisee

Date of Supervision session

Supervisee job role & workplace

Start time

Finish time

Session number

Location

Agreed Goals for Session

Summary and context of discussion

Action Points

Reflection on original aims for supervision

Supervisee Feedback/comments

Signature of Supervisee

Signature of Supervisor

Date

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