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Professional supervision practice

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Topics: Conflict, Management
Professional supervision practice

1.1 Analyse the principle and scope of professional supervision
Supervisions within the care setting are a requirement to comply with the Health and Social Care Act 2008, essential standards of quality and care as set out by the Care Quality Commission (CQC).
Supervision supports the organisation to deliver positive outcomes for the service users. It is to develop a strong and professional workforce with a culture of growth and development, enabling monitoring and review of staff performance. Supervision is an accountable process which supports, assures and develops the knowledge, skills and values of an individual, group or team. With the purpose to improve the quality of their work and to achieve agreed objectives and outcomes. All staff are supervised on a continual basis with policy stating the care staff will receive six supervisions throughout the year, although this may be more if performance or practice dictates more regular. The supervision process will ensure that staff know the policies and procedures understanding the aims and objectives of the home. Ensuring individuals are clear on their roles and responsibilities and enable them to learn and develop their own skills and knowledge, offering constructive feedback so they can learn from their mistakes. Supervision should be a place in which individuals can talk freely.

1.2 Outline theories and models of professional supervision
A model of supervision is a theoretical framework to guide the delivery of a supervision, outlining the stage, functions and roles within the supervision. Such models include:

‘The Three-function interactive model’ (Cutcliffe and Proctor, 1998) is a process where supervisor and supervisee are jointly responsible for completing:
Formative supervision (educational, develops individuals to realize their potential through skills development and learning).
Normative supervision (Managerial, promoting and complying with policies and procedures, developing good standards of work and professional accountability).
Restorative supervision (Support that maintains harmonious working relationships and the sometimes emotional nature of the job).

‘Intervention Analysis’ (Sloan and Watson 2001) consists of two intervention approaches:
Authoritative interventions, the supervisor controls the process using prescriptive (advice, suggestions and explicit direction), informative (imparting knowledge and offering instruction), and confronting (direct feedback e.g. challenging behaviour and attitudes).
Facilitative interventions, control lies with the supervisee and the interventions are cathartic (enabling the release of tensions), Catalytic (encourages reflection and further self-exploration.) and Supportive (confirming values attitudes and actions).

Davys and Beddoe (2010) developed a functional model to integrate management and development aspects of the process. They represent it as a triangle. The centre of the triangle contains the conditions under which the supervision should take place:
Safe climate
Conflict management

Each corner of the triangle outlines the function of the supervisor:
1 Managing service delivery
Organisational policies and procedures
Quality and quantity of work
Decisions and priorities
2 Focusing on practitioners work
Reflection and exploration of the practitioners work with clients
Promote learning
3 Facilitating professional development
Ongoing professional development of skills knowledge and resources
Professional codes and best practice
Whichever perspective is adopted it is essential that there is a shared understanding about what and how services are delivered.

1.3 Explain how the requirements of legislation, codes of practice and agreed ways of working influence professional supervision.
The health and social care act 2008 (Regulations 2010) state that:
23. (1) The registered person must have suitable arrangements in place in order to ensure that persons employed for the purposes of carrying on the regulated activity are appropriately supported in relation to their responsibilities, to enable them to deliver care and treatment to service users safely and to an appropriate standard, including by:
1. (a) Receiving appropriate training, professional development, supervision and appraisal; and
2. (b) Being enabled, from time to time, to obtain further qualifications appropriate to the work they perform.
(2) Where the regulated activity carried on involves the provision of health care, the registered person must (as part of a system of clinical governance and audit) ensure that healthcare professionals employed for the purposes of carrying on the regulated activity are enabled to provide evidence to their relevant professional body demonstrating, where it is possible to do so, that they continue to meet the professional standards which are a condition of their ability to practise.
(3) For the purposes of paragraph (2), “system of clinical governance and audit” means a framework through which the registered person endeavours continuously to
(a) evaluate and improve the quality of the services provided; and (b) safeguard high standards of care by creating an environment in which clinical excellence can flourish.
The CQC provides guidance for providers to follow to ensure they comply with the regulations.

The Code of Practice for Social Care Workers is a list of statements that describe the standards of professional conduct and practice required of social care workers as they go about their daily work.

The General Social Care Council (GSCC) produced codes of practice for social care workers.
As a social care employer, you must have written policies and procedures in place to enable social care workers to meet the GSCC’s Code of Practice for Social Care Workers, and this includes:

Effectively managing and supervising staff to support effective practice and good conduct and supporting staff to address deficiencies in their performance;
As an employee the code of practice states that you should.
Be accountable for the quality of their work and take responsibility for maintaining and improving their knowledge and skills.
All of the above set a standard by which the performance of an individual can be measured. Supervision aims to develop the individual’s professional practice in line with these expectations.

1.4 Explain how findings from research, critical reviews and enquiries can be used within professional supervision.
Findings from research, critical reviews and inquiries are used to provide structural reforms aimed at improving services. They are used to provide guidelines, protocols and standards to which we are expected to conform. These can be used within supervision to highlight standards expected and also offer clear expectations to care staff.

1.5 Explain how professional supervision can protect the individual, supervisor and supervisee.
Professional supervision serves as a strong source of information, motivation and growth for new employees thus protecting and securing the position of new workers and what is expected. For a supervisor it increases professional accountability and also risk avoidance by increasing surveillance of the workforce. Supervision is a means of reflection of practice and is a way of identifying continual professional development needs.

2.1 Explain the performance management cycle.
Performance management is a holistic process bringing together many of the elements that make up the successful practice of people management including, in particular, learning and development. It is a process which should contribute to the effective management of individuals and teams in order to achieve high levels of organisational performance, establishing shared understanding about what is to be achieved and an approach to leading and developing people which will ensure that it is achieved. It is a continuous cycle that involves:

Planning: setting performance expectations and goals for groups and individuals to channel their efforts toward achieving organisational objectives. It also includes the measures that will be used to determine whether expectations and goals are being met. Involving employees in the planning process helps them understand the goals of the organisation, what needs to be done, why it needs to be done, and how well it should be done.
Monitoring: consistently measuring performance and providing ongoing feedback to employees and work groups on their progress toward reaching their goals. Ongoing monitoring provides the opportunity to check how employees are doing and to identify and resolve any problems early.
Developing: increasing the capacity to perform through training, giving assignments that introduce new skills or higher level of responsibility, improving work processes, or other methods. Development efforts can encourage and strengthen good performance and help employees keep up with changes in the workplace.
Rating: evaluating employee or group performance against the elements and standards in an employee's performance plan, summarising that performance, and assigning a rating of record.
Rewarding: providing incentives to and recognition of employees, individually and as members of groups, for their performance and acknowledging their contributions to the company's mission.

2.2 Analyse how professional supervision supports performance.
Professional supervision supports performance in a number of ways:

Supervision helps staff members gain competency and makes them feel supported and valued.
Supervision explains the requirements and responsibilities of staff members’ positions, and what is expected of them, so that expectations are clear from the beginning. This can prevent problems later, or if they arise, provide a standard against which performance, behaviour, and relationships can be measured.
Supervision can not only catch poor performance, but prevent it, by identifying areas of concern and working on them with staff and volunteers.
Adequate supervision can help to recognize and address potential problems before they become actual problems.
Good supervision keeps staff, It makes them feel that someone cares whether or not they do a good job, and that there’s a solid structure supporting them if they run into problems. These are factors that keep people happy with their jobs, and encourage them to stay.
Supervision, coupled with constructive feedback, can result in better employees who feel they are a more fully integrated part of the group. Again, the end result of this is a stronger, more effective organisation.

2.3 Analyse how performance indicators can be a measure of practice.
Performance indicators are used to measure performance against standards, objectives, or quality targets agreed in the supervision, for example, attendance record and absenteeism. These can be used to provide feedback within the supervision process. The most common types of performance indicators are:
Out put, e.g. case load
Impacts: standards, behavior, completion of work objectives.
Reaction: customer satisfaction, judgments by colleagues.
Time: speed of response, service delivery times.

3.1 Explain factors which result in a power imbalance.
Power is often perceived as some form of control or influence exerted over someone or something. Supervisory relationships are full of differing sources of power that can emerge. Davy’s and Beddoe (2010) stated that power balances are likely to come from three sources:
1) The legitimate role of the line manager as supervisor
2) The authority derived from professional knowledge and skill
3) The perceived personal attributes of the supervisor to exercise their authority in issues of unsafe practice
As the Manager you are already in a position of power. There are two main types of power personal and organisational. Personal refers to the knowledge, skills and competence associated with an individual, which makes them an expert. As an expert the individual can exert a certain amount of power in various situations.
Organisational power can be one of four types:
Reward power, as in pay, promotion or praise.
Coercive power is a negative form of the above-punishment, disciplinary procedures.
Legitimate power, when the individuals has a position of authority,
Information power, has special knowledge which is valued by the other staff or supervisees.

3.2 Explain how to address power imbalance in own practice
To minimize the possible detrimental effects of power imbalance within supervision it is important to maintain a healthy relationship with the supervisee. Build a rapport with all supervisee's to establish good working relationships and set boundaries. Have a clear set of expectations and clarify with each supervisee. I must acknowledge that as the supervisor there will inevitably be a power imbalance in my favour, but I must ensure that I use this wisely and ethically.

3.3 Agree with supervisee confidentiality, boundaries, roles and accountability within the supervision process.
All employers have a duty of care, which means that as a supervisor you also need to be concerned with regard to the supervisee’s physical, emotional and social well-being. This means creating a safe, positive climate for supervision to allow it to be:
Person centred focus practice to services users and staff.
Agreed agenda, relating to set objectives.
Private, free from distractions.
Ethical, based on professional values
Free flow of information, data is available and accessible
Recorded, confidential, unless deemed otherwise.
The supervisee should be aware of the supervision policy, which will out line their role within the supervision and what is expected of them. e.g. that they are accountable and it is a formal and regular occasion.

3.4 Agree frequency and location of supervision
Policy states that care workers should receive six supervisions per year, these can be group supervision, individual supervision, peer supervision or observation. The frequency (individuals may need more than six) and the type of supervision will take into account a number of factors:
The experience of the worker, new employees may need more frequent supervision.
Length of time in the job, those who have undertaken a new role may need more support initially.
Complexity of their work.
Individuals support needs
Part time/full time
This will be agreed in advance with the supervisee unless circumstance dictate or issues arise.

3.5 Agree sources of evidence that can be used to inform professional supervision.
The focus of supervision should be person-centred, whether it is from an organisational, service user or professional perspective. Therefore information used should be directly related as well as concentrating on any personal issues the supervisee may be experiencing. Evidence used should be linked to the supervisees practice objectives e.g.:
Workload management
Monitoring of quality of service
Reflection on and in practice
Team working assessments
User satisfaction surveys
Performance measurements
Observation of practice.

3.6 Agree with supervisee actions to be taken in preparation for professional supervision.
Supervisees should prepare for each meeting by reviewing their notes from previous meetings, and planning and thinking about things they wish to raise and discuss. Be ready to share thoughts and ideas and be open and honest about what has gone well or been difficult. Be ready to plan and undertake training and other development activities. They should be prepared to bring with them anything they are responsible for e.g. care plan, and also evidence that they have carried out previously agreed actions.

4.1 Support supervisees to reflect on their practice.
To reflect on their practice supervisees need to be open and honest about their experiences and the thoughts and feelings connected with those experiences. As a supervisor I need to give supervisees the encouragement to analyse their own work and its implications, allowing them to answer their own questions or offering support or knowledge to guide their decision-making. Reflection empowers staff to assess their own performance allowing them to make corrections that feel natural and unforced.

4.2 Provide positive feedback about achievements
Positive feedback increases motivation and reinforces commitment. It needs to be given in open dialogue within the professional relationship to ensure it is received appropriately. The positive feedback given needs to be sincere and specific e.g. focus on the events or actions.

4.3 Provide constructive feedback than can be used to improve performance.
Constructive feedback also again needs to be specific and focus on the facts. With the practice being described rather than evaluated and the focus on the behavior rather than the person. Give the supervisee the time reflect on their practice.

4.4 Support supervisees to identify their own development needs.
A key to enabling supervisees to identify their own development needs is to support them in reviewing and reflecting on their own practice. Evaluating the outcomes of their work and identifying areas of their practice where they feel less confident or where improvements could be made and agreeing sources of professional development whether that be additional training or further support.

4.5 Review and revise professional supervision targets to meet the objectives of the work setting.
Supervisees need to be active participants within the supervision. When reviewing targets related to their work they need to consider:
How workload is managed and priorities set.
Why professional policies and procedures should be used
Which service users planned outcomes they are expected to achieve and by when
When practice risks are identified and how they are addressed
Their recording, how daily records are of the expected standard
What continuing professional development has been completed and further learning or development they require.
Supervisees need to understand how these targets promote the objectives of the work setting by attaining the essential standards of quality and safety for the services users within out care.

4.6 Support supervisees to explore different methods of addressing difficult situations.
In order to learn from challenging situations the supervisee needs to be able to reflect upon the situation in an open an honest manner. Enabling them to examine the effect of the event, the consequences and the interactions that occurred. They should also consider how their actions may have caused or influenced the situation and how to modify their actions or reactions for future situations to encourage a more positive outcome.

4.7 Record agreed supervision decisions.
Records of supervision should be made in a timely manner and signed by both the supervisor and the supervisee, both understanding and agreeing on the content and decisions. The supervisee retains a copy and the original is filed adhering to the confidentiality policy with only management able to access this.

5.1 Give examples in own practice of managing conflict situations within professional supervision.
A conflict situation in supervision is any context in which there is opposition to the professional behavior values and goals. Thomas’s (1992) five-stage model of conflict can be applied to supervision as follow:

An awareness of practice or performance problems
An expression of thoughts or emotions\
The perceived intentions of the supervisee
The observed or reported behavior
The resulting practice outcome

Bower and Bower (1991) DESC model for giving corrective feedback intends not to devalue the supervisee but help them to learn by focusing on the behavior and not the person as follows:

Describe: the behavior/performance that creates problems
Express: your emotions and feelings about the behavior/performance
Specify: what you want the supervisee to do
Clarify: the consequences for failing to change or alternatively changing.

On an occasion where I encountered conflict I asked the supervisee to reflect on their actions. I described the actions as I had witnessed them, stating only the facts relating to this particular situation and I stated how the situation had made me feel. I asked the supervisee to consider how she would feel if she was subjected to these actions. Upon reflection the supervisee agreed that her actions were below what is expected of her within her role and she herself provided a more acceptable approach, which she would adopt in the future.

5.2 Reflect on own practice in managing conflict situations experienced during professional supervision practice.
The aim of conflict management is to empower both parties to reach a solution on how the dispute can be resolved. Involving understanding the rights and interests of each party while at the same time acknowledging their respective responsibilities in the process. All communications depend on the situation and content in which they occur. As a supervisor I need to be sensitive to the power dynamic within supervision as this process can provide the conditions under which conflict may arise. By handling conflict appropriately and quickly it will stop any potential damage or breakdown in the supervisory relationship. Each supervisee will behave differently when confronted with a conflict situation. Buliding a rapport with staff members will assist me in identifying how each person deals with this situation and will enable me to modify my approach to each person to enable us to come to an agreed resolution. After occasions where conflict has been encountered I can reflect on how I approached the situation and analyse if this could have been improved in any way.

I feel within my work setting that the supervision process is lacking in structure and there is not enough emphasis on the importance it plays within the organisation. I have highlighted this to my manager and am currently creating a new supervision policy and regime, whereby the supervisees take a more ownership approach to the process. I will reflect on the supervisory process throughout consider aspects of the process which went well, or those that need to be changed and any development needs that I may have.

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