Learning outcome 1: Understand the purpose of professional supervision in health and social care or children and young people’s work settings
The purpose of supervision is to guide and support employees to work in accordance with their employer’s policies and procedures, while giving the employee the opportunity to learn and develop new skills. As a manager, it will be my responsibility to supervise all of my employees, a minimum of six times a year, in accordance with Standard 36 of the National Minimum Standards for Care Homes for Older People and Adults,which is the same asguidelines given by the Care Council for Wales.
Formal supervision has been in use for well over 100 years now and has developed over time, to reflect on the changing roles and needs of the practice.
In the late 19th century, American social workers used supervision as a way of discussing and reflecting on cases they had dealt with and by the 1920’s it had been introduced, some say for the first time, by Max Eitington, a doctor and psychoanalyst of Russian/German descent, as a compulsory part of psychoanalytic training. Over time more and more caring professions began to use supervision as a way of supporting their employees.
Moving on from the 1950’s and what was quite rigid forms of supervision, based on counselling and psychotherapy, the 1970’s saw the process evolve so that it centred around the job role and not the person carrying out that role. This caused a divide in the practice and employees needing support on a personal and emotional level sought counselling and other forms of therapy, whereas support and guidance concerning a person’s job role was given through formal supervision (Michael Carroll, 2001).
Britain caught on with the process in the late 1970’s and early 80’s with the British Association for Counselling and Psychotherapy making supervision compulsory for its workforce, a requirement still in force today (bacp, 2017).
The most detailed definition of supervision I have come across again comes from Carroll (2007) and is described as such:
At its simplest, supervision is a forum where supervisees review and reflect on their work in order to do it better. Practitioners bring their actual work-practice to another person (individual supervision), or to a group (small group or team supervision), and with their help review what happened in their practice in order to learn from that experience. Ultimately, supervision is for better quality service. In a relationship of trust and transparency, supervisees talk about their work and through reflection and thoughtfulness learn from it and return to do it differently. Supervision is based on the assumption that reflecting on work provides the basis for learning from that work and doing it more creatively.
The Care Council for Wales define supervision as:
Supervision is a regular one to one meeting between the supervisor (manager) and supervisee in order to meet organisational, professional and personal objectives. Supervision forms a key part of individual performance management. For newly appointed workers, it underpins the Social Care Induction Framework. It is the foundation on which appraisal is built.
As quoted in the Care Council for Wales’s guidebook ‘Supervising and Appraising Well’, supervision is:
A process by which one worker is given responsibility by the organisation to work with another worker(s) in order to meet certain organisational, professional and personal objectives (Tony Morrison, 2005).
Principles of supervision:
This is comparable with the list of aims of supervision given by The Care Council for Wales:
Employees should be given adequate notice that you intend to meet with them for supervision and set a mutually convenient date and time. The employee should be advised to make notes regarding what they would like to discuss in the supervision and it should be made clear that supervisions are a two-way conversation between employee and employer and as such are a useful tool towards ongoing personal development.
In my own experience, I have had colleagues who didn’t understand the purpose of supervision and didn’t utilise it to its full potential and dreaded their session, as they saw it as just an opportunity for the manager to reprimand them if they had done something wrong.
I have always tried to convey to employees, I have supervised, that it’s important for them to take ownership of their supervision and view it as an opportunity to have a frank and open discussion with their manager, which will enhance their working relationship and develop their abilities and responsibilities.
As a process for learning, three models are apparent.
These are:
Developmental models
The developmental model can be linked with the concept of lifelong learning, as it sees individuals as continually growing and developing. This is fundamental to the idea of person centred development.
Once the supervision session is over and a plan agreed on how the supervisee is going to move forward in their role, the process is an ongoing one.
Within a person centred development session, reflecting on previous experiences can be used to shape the future actions of the supervisee.
The three stages of the developmental model:
It’s of vital importance that the supervisor is always fully aware of what stage the supervisee is at, in order to give the appropriate and suitable amount of support, a process known as scaffolding (Kendra L Smith, 2009).
Stage 3: Advance or Expert
Knowledge & Skills
Stage 2: Intermediate
Stage 1: Beginning or Novice
Time
Awareness, motivation and autonomy are the key processes in the above stages;
The beginner has to have an awareness of what is expected of them in order to develop the necessary skills to carry out their job role.
There has to be motivation for the learner to continue to develop themselves, during stage 2, as their confidence and knowledge increases.
The expert becomes autonomous in their work and is responsible for their own decisions and working practices (Kendra L Smith, 2009).
Conclusion: A developmental approach to supervision is intuitively appealing, for most of usbelieve that we will get better with time and the right training (Bernard and Goodyear 1998).
Integrative models
As the word suggests, integrative models of supervision bring together and incorporate many different methods, theories and models of supervision, in order to tailor make the approach for each individual supervisee and the stage they are at in their practice.
Bernard’s Discrimination Model: One of the most commonly used and researched integrativemodels of supervision, originally published by Janine Bernard in 1979. This model comprises of three different purposes of supervision:
These are used in conjunction with three possible supervisor roles:
The supervisor has the scope to respond in one of nine ways based on the 3 purposes of supervision and the 3 supervisor roles.
For example, the supervisor may take on the role of teacher while concentrating on a particular intervention used by the supervisee and teaching ways of improving their skills.
The role of counsellor can be used when discussing issues, the supervisee may be having, while dealing with a person in their care, where there are issues with counter-transference.
As the response is always specific to the supervisee’s individual needs, it can change with every session. Caution is advised to supervisors not to respond using the same purpose or role out of personal preference, comfort, or habit, but instead to ensure the purpose and role used meet the most significant needs of the supervisee at the time (scie, 2017).
Integrated Development Model: Developed by Stoltenberg (1981) and Stoltenberg andDelworth (1987)
The IDM describes three levels of counsellor development:
As noted earlier, the IDM stresses the need for the supervisor to utilise skills and approaches that correspond to the level of the supervisee. So, for example, when working with a level 1 supervisee, the supervisor needs to balance the supervisee’s high anxiety and dependence by being supportive. The same supervisor when supervising a level 3 supervisee would emphasise autonomy. If a supervisor was to consistently mismatch his or her responses to the developmental level of the supervisee, it would likely result in significant difficulty for the supervisee to satisfactorily master the current developmental stage.
For example, a supervisor who demands autonomous behaviour from a level 1 supervisee is likely to intensify the supervisee’s anxiety.
Systems Approach: In the systems approach to supervision, the heart of supervision is therelationship between supervisor and supervisee, which is mutually involving and aimed at bestowing power to both members (Holloway, 1995).
Holloway describes seven dimensions of supervision, all connected by the central supervisory relationship. These dimensions are: the functions of supervision, the tasks of supervision, the person in care, the supervisee, the supervisor, and the setting.
The function and tasks of supervision are at the forefront of interaction, while the latter four dimensions represent unique contextual factors that are, according to Holloway, covert influences in the supervisory process. Supervision in any particular instance is seen to be reflective of a unique combination of these seven dimensions.
Orientation Specific models
The orientation specific model centres on a firm belief that the supervisor and supervisee should share the same theoretical model of therapy and subsequently, base their supervision on the therapy that is used on their clients, in order to get the most from their working relationship.
It makes perfect sense that the supervisee should have a good understanding of that therapy, for effective supervision to occur. As the roots of the supervision method stem from a particular type of therapy, orientation specific methods of supervision frequently utilise the language, techniques and focus of that particular therapy (Smith, 1996 – 2011).
Methods of therapy used;
Psychoanalytic Supervision
Behavioural Supervision
Utilises cognitive behavioural strategies. The problem is identified and the appropriate technique to resolve the problem is selected. Supervisor models the technique and selectively reinforces the supervisee, utilising behavioural rehearsal with the supervisee.
Rogerian Supervision
The supervisor models the three primary Rogerian interventions:
Systemic Supervision
The supervision should closely follow the theory. For structural supervision, clear boundaries between supervisor and therapist must be maintained. For strategic supervisors, the supervisor manipulates the supervisee’s behaviour and once it is altered, the supervisor discusses it, with the goal of the supervisee gaining insight.
The residential home I am work at is in Wrexham, North Wales, and as such falls under the jurisdiction of the Care and Social Services Inspectorate in Wales.(CSSIW)
Their National Minimum Standards for Care Homes and Domiciliary Care Agencies policy states that the National Minimum Standards for staff supervision are as follows:
Staff have regular, recorded supervision meetings at least once every two months (3 months for domiciliary care) with their senior/manager in addition to regular contact on day to day practice (fortnightly supervision where there is no regular contact; pro rata for part time staff), covering:
Line managers must ensure that supervision takes place in line with these standards for all staff for whom they have responsibility. It is the responsibility of the manager to ensure that sessions are planned and prepared and that there is an auditable record of these sessions.
National Minimum Standards for Care Homes for Older People
STANDARD 36
Staff Supervision:
36.1 The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice.
36.2 Care staff receive formal supervision at least 6 times a year.
36.4 All other staff are supervised as part of the normal management process on a continuous basis.
36.5 Volunteers receive training, supervision and support appropriate to their role and do not replace paid staff.
These are the minimum requirements and as a manager, you will need to supervise staff on other occasions, as and when are necessary, either to deal with a crisis, or to respond to a member of staff who feels they cannot wait until their next scheduled supervision session (Welsh Assembly Government, 2004).
As the manager you are responsible for the effectiveness of the team and for the quality of their work. It’s important that as a manager to remember that supervision isn’t just about these areas but through supervision you will improve communication between you and your staff team, which in turn can motivate them to work more productively and effectively and help with staff retention.
The Care Council for Wales Code of Practice for Employers of Social Care Workers states:
Section 2: As a social care employer, you must have written policies and procedures in place toenable social care workers to meet the Care Council’s Code of Practice for Social Care Workers. This includes:
Section 2.2: Effectively managing and supervising staff to support effective practice and goodconduct and supporting staff to address deficiencies in their performance.
Effective supervision in a variety of settings Guide 50 (SCIE 2013)
Recommendations: Supervisors’ expertise and training
Supervisors need to continually update their expert clinical and practice knowledge and their clinical intervention skills for the specific populations of people with whom their supervisees are working.
Further to guide 50 as above, SCIE Guide 1: Managing Practice gives advice and guidance on Supervision and Team Leadership.
To view the guide visit:
www.scie.org.uk/publications/guides/guide01/files/guide01.pdf
1.4 How can changes in legislation, findings from research and critical reviews, be used within professional supervisions
As new legislation, laws and policies are implemented, within the ever changing world of health and social care, it’s essential that as a manager, you keep up with these changes and ensure you cascade these changes down to your staff.
We are legally bound to provide safe and practical care to all of our residents, based on legislation from CSSIW, Care Council for Wales, Contract Monitoring and the company’s policies and procedures which are based on government guidelines and requirements. It’s vital that as managers we ensure all our care staff are working in the same way and providing safe and adequate care to our residents.
There are a number of ways we can pass the required standards and ways of working to staff; staff meetings, training, practical demonstrations, observation, supervision.
Whatever the method we use it is vital that all staff work in the same safe, responsible way, as the manager is ultimately the one that will be held responsible and accountable should there be an omission or an error in the way care is delivered at their home.
Enquiries are always held when there is a tragic and inexcusable failing in the care given to a child or adult and over the last few years there have been several high profile cases that have been brought to light:
The Health Department made some recommendations following the inquiry on the death of Victoria Climbie and stated that “skilled and competent frontline staff, adequate managerial support and professional supervision are crucial elements in child protection” (Department of Health, 2003).
At first it would seem that supervision is only for the benefit and protection of the supervisor and supervisee, or the manager and staff member. However, it stands to reason that the individual, or in my setting, the resident is the one who is protected by the process.
Without supervision staff would muddle along and do their job how they think it should be done and without professional input and guidance every staff member will have a different opinion on how to do their job, which would lead to variations in working practice and potential drops in standards, which will ultimately affect the resident the most, as they are the ones at the receiving end of the care.
Protections afforded by professional supervision:
Staff have always reported to me that when they receive regular quality supervision, they feel respected and valued, as they are given the opportunity to discuss any concerns or queries and that their manager is taking the time to give guidance and support to staff, on their job role.
Learning Outcome 2: Understand how the principles of professional supervision can be used to inform performance management in health and social care or children and young people’s work settings
2.1 Explain the performance management cycle
The performance management cycle is a very useful four stage tool in the setting of tasks and review of staff performance, based on tasks given (The Happy Manager, 2017).
Stage One: Plan
The first stage of the cycle is to meet with the employee; this could be at the induction stage, at the beginning of their employment, during a supervision or appraisal, or to implement a new way of working.
It is the responsibility of the manager to make clear the purpose of the meeting, whether it is to set new goals or evaluate performance. The manager and employee must them discuss what is expected of the employee over a clearly defined period of time.
I like to use the acronym SMART in instances like this.
Specific: Who? What? Where? When? Which? Why?
Setting the above specifics will tell everyone involved who is doing what, where they will do it, how much time they have to do it in, any requirements or limits they have to take into account and probably the most important aspect of all why they are doing it. Everyone likes and needs to know why they have to do something; it is a great motivator knowing why a task has to be done, especially if there is a timescale involved.
Measurable: To make sure the task at hand is measurable you need to be able to quantify goals,such as how many or how much so staff are fully aware of the task they are undertaking.
Achievable: The manager and the employee need to agree that the task is both necessary andachievable or the employee will struggle to find the motivation to complete the task. The manager should also assist the employee in compiling an action plan to help complete the task.
Realistic: The manager has to ensure that the employee(s) chosen to complete the task arecapable of doing so. If they have no previous experience of such a task they will need guidance and support or there is a good chance they will feel out of their depth and either fail to complete the task or complete it to a poor standard.
Timely: Everyone performs better when working to a target. A small amount of stress can be agood motivator to complete a task and if there is no set time scale to finish a job, it can lose its urgency and is difficult to work to an action plan.
Stage Two: Develop
In order to assist the employee(s) to develop in their role, or undertake a new task, you must be able to see their strengths and weaknesses and identify any training needs they have and give them the opportunity to meet these needs by providing them with the necessary skills and training. Continuing personal development is a very important aspect of anyone’s job role and the manager must be seen to be supporting this.
Stage Three: Perform
It is not enough to set an employee on their way with a task and let them get on with it until completion. It is encouraging for anyone to have their manager take the time to get a progress report and see how the task is coming along. There could be unforeseen obstacles or a lack of resources that are hampering the task at hand and it is productive for the employee to be able to report this to their manager so they can work together to overcome these issues. It is unfair to expect the employee to do this alone and this could be where they lose their motivation, job satisfaction will decrease and the task will suffer as a result.
Stage Four: Review
Once the set period of time has elapsed and the task has been completed it is important that there is a thorough review between the manager and all employees involved.
The need for a review is not just to check that the task has been completed to a high standard but also to be better prepared when at the beginning of the cycle again and the planning stage comes around again. We learn from mistakes and any obstacles that we came across the first time can be pre-empted and eliminated at the planning stage the next time to make for a more efficient process.
2.2 Analyse how professional supervision supports performance and can be used to challenge poor practice
As mentioned earlier too many employees see supervision as a disheartening occurrence they either dread being involved in or can’t see the point of. Thankfully, due to several of the regulatory bodies in care insisting on the need for regular professional supervision, many are now seeing supervision for what it is; the opportunity for a two-way discussion with your line manager to discuss your job role, performance and finding ways to make your job role more enjoyable and productive.
Effective performance management and supervision can promote good quality service delivery and result in a more highly motivated staff (scie, 2017)
Speaking personally, I prefer to have regular supervision as it gives me the chance to meet with my line manager and discuss my performance and I can identify areas where there is room for improvement and I get to find out what my strengths are. I don’t see supervision as a negative; I see it as a chance to further develop my personal portfolio of skills and training, working on areas that need it and using my strengths to fulfil my job role to the best of my ability, working to the company’s high standards.
I encourage my staff to see supervision in the same light as myself and several of my employees are now embracing their supervisions and coming prepared to discuss certain aspects of their job role. As a result, staff sickness has reduced by more than 80% in the last 3 months and the residents and employees of the home have all reported a lift in the atmosphere of the home. Even some visitors have said there is a nicer atmosphere in the home and one of our training consultants has commented on how the employees seem more receptive when carrying out training with them.
2.3 Describe the use of performance indicators as a measure of performance and how you use performance indicator
When I took over as trainee manager at springwood I noticed that the staff training matrix was badly in need of updating and many of the staff were seriously overdue training. I ensured all mandatory training was given to who needed it and also implemented training courses for other aspects of the job, such as dementia, skin integrity and medicine management.
Staff tend to feel more confident to carry out their job role when they have had the required training and in the company training policy it states that all staff will be given the necessary training to carry out their role effectively.
As the manager of the home it is vital that I communicate to all staff what is expected of them in their role, which is why I ensured everyone was given an up to date copy of their job description and this was discussed with them in the first supervision we had together after undertaking the role as manager.
I also explained the usefulness of the SMART acronym to staff, that is detailed in section 2.1, some of the employees who had worked in care previously were familiar with the tool but others found it helpful and said they would probably use it next time they were given a specific task to complete. I encouraged them to incorporate it into their job role and said it would be effective when staff appraisals came around next April.
Learning Outcome 3: Be able to undertake the preparation for professional supervision with supervisees in health and social care or children and young people’s work settings
3.1 Explain factors that may result in a power imbalance in professional supervision
It is too common to have a power imbalance between employee and employer as, straight away, the employer is seen as superior due to their experience in the job and their qualifications.
If the supervisor is the person who employed the supervisee they will also feel pressure, as the person who gave them the opportunity of the job is giving them their supervision and the employee will want the supervision to go well, to prove to the employer that they made the right decision in giving them the job. The expectation to live up to will also put a great amount of pressure on the employee, in their quest to be a good employee.
As the employer you are responsible for upholding standards at work and your employees are working to guidelines that you have set, which again puts you at an advantage over your staff as they are having to work to your way of doing things. They have to trust in your knowledge and they will think twice about questioning you, whether they wish to or not as you are the manager.
3.2 Explain how to address power imbalance in own supervision practice
As a new manager I wanted to get to know my staff, so I could identify their strengths and decide how to utilise these strengths and address any training needs, as I quickly discovered that the previous manager had been extremely lax and hadn’t kept up with training. I contacted the training company we use and arranged a six-week intensive training programme to catch up with the all the mandatory training that was out of date.
I put up a notice giving the dates of all the upcoming courses and the names of the staff that had to attend and very quickly I was inundated with complaints from staff about having to give up some of their days off to come in for training.
As I explained to them; as the manager, it is my responsibility to ensure all staff have the required training and that I have to email a copy of the staff training matrix to Wrexham Council and my area manager to prove we are complying with requirements as set by CSSIW, Care Council for Wales and Contract Monitoring. I went on to say that if staff were not compliant and failed to attend training courses they would be unable to work as if anything was to happen and the staff didn’t have the necessary training I would be the one held accountable for not ensuring my staff had adequate training. I thought it necessary to explain the seriousness of the situation and that, as the manager, it is my responsibility.
I thought the staff would respect me more for telling them the truth and as I had hoped, they attended every course and I now have an up to date training matrix. I was actually reprimanded by my staff for missing the manual handling training course as I was in a meeting.
I think it is important that you are honest with your staff and not blame others for a thing you have to do as a manager; after all that is your job, having the responsibility for the home, the residents and the staff.
I found myself in a similar situation 4 weeks ago; we had several vacant rooms and I had to reduce the staff working hours, as instructed by the owner of the home. Revised rotas were put up and once again there were some very unhappy staff. I tried to reassure them that the reductions wouldn’t be in place for long and that it was up to me to ensure the empty rooms were filled as soon as possible. Staff complained that they were not getting their contracted hours but as I explained to them; it states in their contract that if the business requires it, short time working will be implemented. Staff weren’t very happy for a day or two but because they could see I was making phone calls and being productive trying to get empty rooms filled up there wasn’t a problem for long. Three weeks later, I had filled five of the empty rooms and now that the summer holiday season has started I have got staff complaining that they are doing too many hours now.
I believe that as long as you are honest with your staff and don’t promise things you can’t deliver, you will earn their respect and they are more likely to do things for you when asked.
In supervision I like to keep the atmosphere relaxed and friendly but my staff have got to know that I will not tolerate gossip or causing trouble with colleagues. There has to be a line that you don’t cross as a manager, it is all very well being one of the team but I tend not to get too involved with my staff personally. I won’t talk to them on Facebook or socialise with them outside of work. I think you have to set an example and be professional.
I have an open door policy at work and staff can come to me with concerns or problems but I won’t sit and gossip with them, as this will encourage a culture of gossiping in the workplace and although you will never stop gossip completely I don’t see the point of joining in with it (scie, 2017).
Learning Outcome 5: Be able to manage conflict situations during professional supervision in health and social care or children and young people’s work settings
5.1 Give examples from own practice of managing conflict situations within professional supervision
Recently I had a situation to deal with following several complaints that arose during routine supervisions concerning a member of night staff. It seemed that several members of staff felt the need to complain about the member of staff and her attitude to her work, that she wasn’t pulling her weight when at work and her attitude towards her seniors in charge of the shift. I made a list of the issues that were raised and asked the member of staff if I could talk to her before her next night shift commenced. When I informed her of the issues raised by her colleagues she became very aggressive and defensive and denied all the allegations. I asked her to calm down and asked her why all of her night staff colleagues would make up allegations about her that weren’t true? She then demanded to speak to her colleagues and discuss with them why they all complained about her. I said I didn’t think it was a good idea as she was very agitated and I didn’t think it would be a productive meeting.
I suggested that in a day or two once she had taken on board what had been discussed and she had calmed down, if her colleagues were prepared and comfortable to have a meeting with her, then I would arrange it.
I then informed her that due to the number and nature of the allegations I felt the need to supervise her at work and to do that I would need her to work day shifts for a week or two. She said that there was no way would she work day shifts and I could sack her. With that she got up and stormed out of the office, leaving the building and has not returned to work since.
5.2 Reflect on own practice in managing conflict situations experienced during professional supervision process
I regret the situation that happened, as detailed above, in that I was unable to completely resolve the situation for everyone. I tried to offer a solution for everyone, taking the complaints raised seriously and trying to take steps to resolve the matter, offering a mediation meeting between all staff once all parties had calmed down, but unfortunately one staff member wasn’t happy with the solution and wouldn’t co-operate.
However, I would rather have attempted to solve a problem and keep the majority of staff happy, so they feel that their complaints were listened to, rather than ignore issues raised and staff feel their supervisions are pointless.
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