PROCEDURE FOR SUPERVISION AND PRECEPTORSHIP FOR PROVIDER SERVICES

PROCEDURE FOR SUPERVISION AND PRECEPTORSHIP FOR PROVIDER SERVICES First Issued Issue Version One Purpose of Issue/Description of Change To promote competent and safe practice through staff supervision and preceptorship across Provider Services Planned Review Date 2013 Named Responsible Officer:- Approved by Date Service Improvement Unit Multi-disciplinary Clinical Procedure CP14 Clinical Policy and Procedure Group Impact Assessment Screening Complete Date: Jan 2011 January 2011 Full Impact Assessment Required Y/N UNLESS THIS VERSION HAS BEEN TAKEN DIRECTLY FROM PROVIDER SERVICES WEB SITE THERE IS NO ASSURANCE THIS IS THE CORRECT VERSION 1/28

CONTENTS PAGE CONTENT PAGE Introduction 3 Overview of supervisory models 4 Principles of Clinical Supervision 4 Cross Reference to Policies 5 Responsibilities 5 Supervisory Models 6 Management Supervision(mandatory) 6 Professional Expert Supervision 8 Facilitated Group Supervision 8 Peer Clinical Supervision (mandatory) 9 Developmental Supervision 9 Safeguarding Children Supervision 9 Competencies for Clinical Supervision 10 Mentorship for students 10 Preceptorship (mandatory) 10 Benefits of preceptorship 11 Standard for preceptorship 12 Elements of preceptorship 12 Preceptorship programme 14 Training 15 Audit 15 References and further reading 15 APPENDICES Attributes of an effective preceptor Appendix One 16 Peer Supervision Contract Appendix Two 17 Record of Individual Clinical Supervision Appendix Three 18 Session Group Facilitated Clinical Supervision Appendix Four 19 Contract Group Facilitated Clinical Supervision Attendance Form and Record of Appendix Five 20 Session Preceptorship Contract Appendix Six 21 Preceptorship Meeting Record Appendix Seven 22 Preceptorship Final Review Form Appendix Eight 23 Example of Management Supervision Appendix Nine 24 Example of Supervisory Practice Appendix Ten 26 Monitoring Form Frequently asked Questions Appendix Eleven 27 228

Care Quality Commission Essential Standards of Quality and Safety (CQC, March, 2010) A structured support is in place for supervision which includes one-to-one sessions or group meetings. They are undertaken at a time and frequency agreed between the supervisor and the staff member, and they are recorded. This is in line with relevant guidance from professional regulators and/or professional bodies, and is monitored and reviewed. INTRODUCTION Clinical supervision forms part of the wider health and social care agenda, its focus is on quality, accountability and efficacy of practice. It supports the clinical governance and Essence of Care agenda, ensuring evidenced based, high quality and safe patient/client care, by encouraging practitioners to learn from experiences in their work place. Clinical supervision brings practising health care staff together to reflect on practice and encourages the development of professional skills. This enhances the quality of care through the implementation of an evidenced based approach to maintaining standards of best practice. Under Outcome 14 of the Care Quality Commission Essential Standards of Quality and Safety (2010), the organisation is required to ensure that supervisory arrangements are in place, monitored and reviewed for all staff involved in delivering care, treatment and support. Clinical supervision is distinct from managerial supervision, safeguarding children/safeguarding adults supervision, and other human resource processes such as Personal Development Review (PDR). However, it will complement and enhance these processes. It is a means of encouraging self-assessment, reflection and analytical skills. Clinical supervision is defined as a formal process of professional support and learning. It is a designated interaction between two or more practitioners within a safe and supportive environment. It enables practitioners to develop the knowledge and competence to assume responsibility for their own practice, to enhance patient care and the safety of care provided in complex clinical situations. On a personal level it allows practitioners to reflect on their clinical interactions, improve their practice and to identify their own learning and developmental needs. The models of supervision described in this document play an important role in the continuing improvement of effective and safe patient focused services. Supervision can also make a positive contribution towards Improving Working Lives and in achieving Care Quality Commission standards. This document is an overview of the models that can be used by all practitioners within Provider Services. Management Supervision Clinical Supervision for Registered Professionals: Professional Expert Supervision One to One Peer Supervision Or Facilitated Group Supervision 328

Developmental Supervision following learning from experience Safeguarding Children Supervision Mentorship for pre and post registration students Preceptorship OVERVIEW OF SUPERVISORY MODELS TYPE FREQUENCY SUPERVISOR TARGET STAFF Management supervision Every 4 8 weeks Line Manager Mandatory for all staff working in Provider services Professional Expert As required Professional Expert Case or context specific Supervision One to One Peer Clinical Supervision or Facilitated Group Sessions (group session must be agreed with line manager Developmental Supervision Safeguarding Children Supervision Minimum of 3, maximum of 8 sessions per year Professional Peer to meet patient need Mandatory for all registered clinical staff within Provider Services and those clinicians delivering clinical services e.g. assistant practitioners As required Professional Peer Following an incident or specific root cause analysis Refer to Safeguarding Supervision Policy for further details and documentation Principles of Clinical Supervision: Safeguarding Team Mandatory -all staff working with children who:- have a Child Protection Plan are Looked After Children are Children Causing Concern To safeguard standards of practice To develop the individual personally and professionally To promote excellence in healthcare To be practice focused To empower staff and patients/clients To facilitate professionally accountable practitioners To promote validation and support for colleagues through peer feedback Clinical Supervision will: Support and enhance practice for the benefit of patients/clients Maintain and improve standards of care Promote evidence based best practice Provide a practice-focused professional relationship Promote reflective practice Enable the practitioner to develop critical evaluation skills 428

Support and encouraged practitioners to engage in clinical developments and quality improvements Allow practitioners to develop self awareness, e.g. strengths/ limitations Enable practitioners to identify and understand own development needs and how to address them Be organised, planned and systematic Be conducted within agreed boundaries Organisational benefits from supervision: Improved service delivery Improved staff recruitment and retention Improved efficiency and effectiveness Reduced litigation Support innovation Encourage evidence based practice and responsiveness to relevant national, local and professional agendas ORGANISATIONAL POLICIES Always refer to most current versions of policies/procedures from the intranet as may be superseded at any time RESPONSIBILITIES Line managers: Provide management supervision to the staff for which they are responsible every 4-8 weeks Ensure adequate systems of support and supervision exist for staff they manage Incorporate clinical supervision into the development of individual personal development plans Monitor that each practitioner accesses clinical supervision with a clinical supervisor Support practitioners with other forms of clinical supervision which best meets the clinical needs of the patients in the practitioner s area of clinical practice and allow opportunities to attend, e.g. Safeguarding Children Supervision Monitor the attendance at clinical supervision via management supervision. Non-attendance should be discussed with the practitioner and an action plan put in place to monitor progress Encourage the practitioner to use their learning from whichever form of supervision they undertake to provide evidence of ongoing development for Personal Portfolios and Personal Development Reviews. Exceptionally, when managers cannot fulfil the expectations of this procedure, an action plan will need to be agreed and documented with own line manager to evidence a working strategy to provide staff with supervision to promote patient safety (Code of Conduct NHS Managers 2002). Supervision is a specific requirement set by the Care Quality Commission, Essential Standards of Quality and Safety (2010) and subject to external audit. 528

Responsibilities of Supervisee (not exhaustive) To attend a minimum of 3 and a maximum of 8 sessions per year Prepare for clinical supervision by identifying clinical/professional issues upon which you wish to reflect Keep an individual record of clinical supervision Protect time for supervision Be open to feedback and support and be willing to work on feedback obtained in each session Give feedback to the supervisor about their facilitation Attend sessions punctually and avoid cancelling if possible Agree and follow up any actions identified in clinical supervision sessions Supervisees are encouraged to make use of reflective learning and keep a reflective diary between clinical sessions. To ensure supervision is given appropriate priority among other workload commitments Responsibilities of Supervisor (not exhaustive) Complete supervision contract at first meeting To clarify limits of confidentiality between supervisor and supervisee Prepare for the supervision session, ensuring no interruptions Attend sessions punctually and avoid cancelling if possible Encourage the supervisee to seek specialist help or advice when necessary Challenge any behaviour that the supervisee displays which raises concerns about their practice, development or use of clinical supervision Ensure you have your own clinical supervision To ensure supervision is given appropriate priority among other workload commitments To ensure clinical supervision documentation is stored in a locked drawer or cabinet All registered practitioners will attend management supervision and clinical supervision SUPERVISORY MODELS There is no one model of supervision that meets the broad range of clinical needs within Provider Services, therefore, a summary of each model of supervision is outlined below:- MANAGEMENT SUPERVISION MANDATORY All practitioners and non registered staff working for the organisation will receive management supervision, using the suggested template for management supervision in this procedure (Appendix Nine) which can be adapted to suit individual needs of services. Management Supervision is applicable to all grades of staff working within Provider Services. It relates to levels of accountability and responsibility for work carried out by the post holder and includes elements of support, learning and performance review (Morton-Cooper & Palmer 2000). It should be interactive and used as a means of 628

ensuring that supervisees are able to do their job effectively and are assisted in their own personal development. Randomly selected patient health records will be reviewed by the line manager at management supervision. This supervisory relationship is ongoing for the duration of someone s employment in the particular post and takes place at least 4-8 weekly between the line manager and employee. A balance is achieved between the various aspects of supervisory issues, with the emphasis on each aspect (as in diagram) dependant upon the needs of the individual and service: Accountability MANAGEMENT SUPERVISION Support Development A template for management supervision (Appendix nine) covers topics relevant to the supervisees role and development. Processes may include:- reflecting on work experiences problem solving constructive feedback testing new ideas articulating expectations facilitating learning opportunities, if applicable implementation of new service initiatives audit activity to improve quality of service empowering and teaching The supervisor facilitates these processes through the application of a range of skills including active listening and questioning. Documentation is completed at the end of each meeting and held by both the line manager and the supervisee. In the event of poor performance being identified, the line manager should seek guidance from the current Managing Performance Policy and Procedure (or other workforce policies as relevant). Outcomes of Effective Managerial Supervision: Supervisee (in addition to those already listed): understands their value and contribution to the service has the opportunity to raise issues impacting on individual work patterns gains an overview of their work and expected outcomes has their Personal Development Review objectives meaningfully integrated into their work knows what is expected of them and understands their accountability has opportunity to access resources or advice to effectively carry out their role 728

will receive constructive feedback Manager: understands their supervisee and their performance ensures the supervisee is able to demonstrate changes in practice as a result of learning creates development opportunities appropriately delegates appropriately observes their supervisee grow and develop is aware of performance issues quickly and can prevent their escalation develops key leadership skills and behaviours, as required for the post is aware of patient related issues that may need addressing to improve quality of care PROFESSIONAL EXPERT SUPERVISION (case specific) This model of clinical supervision is practice focused, between a more experienced / expert clinician and an individual. This can be a short term arrangement or a single discussion, depending on the complexity of the clinical case/cases and the supervision support required. This usually involves specialist clinicians advising and supporting front line clinical staff e.g. tissue viability, palliative care, continence care and learning disability nurse specialists. Where the supervisor is not the supervisee s line manager, they will link with the line manager where poor practice performance issues are identified. Processes may include joint clinical sessions, teaching, review of complex cases, case studies, shadowing, problem solving, clinical reasoning and risk assessment. A formal contract is not required due to the expectation of specialist posts/ link roles to support and advise colleagues on evidence based practice. The same clinical standards of practice will apply in relation to confidentiality and adherence to current policies, procedures and professional codes of conduct. This style of supervision is mandatory for a specific area of work, which carries a higher level of risk e.g. safeguarding children. FACILITATED GROUP SESSIONS (peer led within the same service) This model of clinical supervision is a clinically focused, non hierarchical relationship and takes place for a minimum of 3 sessions to max of 8 sessions per year. The facilitator needs the same skill requirement as a clinical supervisor offering 1:1 sessions. Facilitation can be shared within the group on a rotation basis. Operational managers need to approve this type of supervision according to needs of the service area, as may not be the most effective supervisory model for the service. The group will work together using reflection to explore significant work experiences through active listening, questioning, problem solving and sharing each other s perspectives. Supervisees are empowered to learn and to take responsibility for own actions in order to develop their clinical practice. Actions and outcomes are reviewed at the subsequent session. 828

A formal record of attendance and record of the session is kept by the facilitator (Appendix five), a contract is agreed during the first session (Appendix four) and group members maintain their own reflective diary (Appendix three). Membership changes would require a revisiting of the contract. Where any serious risk or poor practice, nonadherence to professional codes or current policies and procedures is identified, the supervisee is asked to take action through their own line manager as outlined in the contract. The issue needs to be reported to the line manager if the supervisee fails to take the action agreed. Clinical supervisors need to have supervision themselves, so their practice is supported and developed. PEER CLINICAL SUPERVISION (same service / same profession) This model of clinical supervision is clinically focused and takes place between two professionals of the same profession with a minimum of 3 and a maximum of 8 sessions per year. They may have similar levels of experience and expertise or with a clinical peer who is more experienced, depending on the supervisory needs of the supervisee. The supervisee can select their own clinical supervisor from the list kept by the Service Improvement Unit. Processes may include review of complex cases, case studies, problem solving and clinical reasoning. A contract is agreed during the first session (Appendix two) and a written record (Appendix three) is completed for each subsequent meeting, the supervisee is encouraged to share relevant issues with line manager during management supervision as appropriate e.g. if training needs arise. Where any serious risk of poor practice, non-adherence to professional codes or current policies and procedures is identified, the supervisee is asked to take action through their own line manager as outlined in the contract. The issue needs to be reported to the line manager if the supervisee fails to take the action agreed Monitoring CLINICAL SUPERVISION Support Development DEVELOPMENTAL SUPERVISION This model of supervision is specifically following an incident or a specific root cause analysis with recommendations for learning from experience. There will be specific learning outcomes, agreed jointly with manager and supervisee. In this model, the manager will allocate a clinical supervisor who has the skill, knowledge and clinical experience to best meet the needs of the supervisee. The number of sessions will be specified, within a specific time frame. Outcomes of the developmental supervision will be shared with the supervisee s line manager. SAFEGUARDING CHILDREN SUPERVISION This model of supervision is mandatory refer to current Safeguarding Supervision Policy 928

COMPETENCIES FOR CLINICAL SUPERVISION The following knowledge and skills enables a registered practitioner to undertake the role of clinical supervisor, not all are essential, but are readily transferable into a clinical supervisory context:- Nursing Staff who have successfully completed a Learning and Assessing Module at degree level, registered nurses need to comply with Nursing and Midwifery Council (NMC) Standards Allied Health Professionals do not have to complete Learning and Assessing Module as it is not a requirement of the Health Professions Council. Staff who are classified as a Mentor and are on the organisations database of Mentors (essential for registered nurses to comply with NMC standards) Have a working knowledge and understanding of current policies and procedures Have been working in their area of practice for 12 months (essential) MENTORSHIP FOR STUDENTS The organisation has a specific post of Practice Education Facilitator whose role is to co-ordinate and provide a system of mentorship for pre and post registration student nurses placed in the organisation (NMC 2006). There is a register of named nurse mentors for students, who have mandatory yearly updates. Educational placement standards are subject to ongoing self audit in partnership with Higher Educational Institutes, students and mentors. PRECEPTORSHIP (Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals, Department of Health, 2010) From the moment they are registered, practitioners are autonomous and accountable. Preceptorship should be seen as a model of enhancement, which acknowledges new registrants as safe, competent but novice practitioners who will continue to develop their competence as part of their career development and continuing professional development. Preceptorship is designed for: - Newly registered practitioners Staff new to their role or the organisation Practitioners returning to practice Practitioners entering a new part of their professional register Overseas practitioners who have satisfied the requirements of, and are registered with, their regulatory body Within this procedure newly registered practitioner refers to anyone eligible for preceptorship. Preceptor:- Registered practitioner Minimum of 12 months experience within the same or associated field of practice as the preceptee Nurses need to comply with Nursing and Midwifery Council (NMC) Standards and to have completed a level 6 mentorship module 1028

Allied Health Professionals do not have to complete above module as it is not a requirement of the Health Professions Council. The period of time following registration as a health care professional, whether on completion of an education programme or following a break from practice can be a challenging time. Preceptorship aims to facilitate a change in role and status. Newly Registered Practitioners, who manage the transition successfully, are able to provide effective care more quickly, feel better about their role and are more likely to remain within the profession. (DH 2010) Preceptorship is within the spirit of the staff pledges made in the NHS Constitution (Department of Health, 2010), and the value and importance is recognised in A High Quality Workforce: NHS Next Stage Review (DH 2008), where it states: A foundation period of preceptorship for practitioners at the start of their careers will help them begin the journey from novice to expert. This will enable them to apply knowledge, skills and competences acquired as students, into their area of practice, laying a solid foundation for life-long learning Effective preceptorship arrangements can be used by employers as part of the processes in place or evidence that is submitted against regulatory and other standards, e.g. Care Quality Commission Essential Standards of Quality and Safety (DH, 2010) requires providers to take all reasonable steps to ensure that workers are appropriately supported, thereby enabling them to deliver care and treatment to service users safely and to an appropriate standard including appropriate training, professional development, supervision and appraisal. Benefits of preceptorship Preceptee will: Develop confidence Have a facilitated professional introduction into the clinical environment Have formal support in order to feel valued and respected by their employing organisation Feel invested in and preceptorship has the potential to enhance future career aspirations Feel committed to the services business plan and objectives Develops understanding of the commitment to working within current organisational policies and procedures relating to clinical practice Support their personal responsibility for maintaining up-to-date knowledge Employer: Enhanced quality of patient care Enhanced recruitment and retention Reduced sickness and absence as staff are valued and supported Reduced risk of potential clinical errors Registered practitioners who understand the regulatory impact of the care they deliver and develop an outcome/evidenced-based approach 1128

Preceptor: Develops appraisal, supervision, mentorship and supportive skills Engenders a feeling of value to the organisation for newly registered practitioners and those new to a clinical area Identifies commitment to their profession and the regulatory requirements Supports their own lifelong learning Enhances future career aspirations Professions: Providing a high standard of practice and care at all times Making care the priority, treating service users as individuals and respecting their dignity Working with others to protect and promote the health and well-being of those in their care, their families and carers and the wider community Being open and honest, acting with integrity and upholding the reputation of the profession Enhancing the image of health care professionals Standard for Preceptorship Evidence and experience suggests that it is important to adopt a clear standard for preceptorship. This will ensure that the benefits of preceptorship can be most effectively delivered for all newly registered practitioners. Organisations have a responsibility to ensure: systems are in place to identify all staff requiring preceptorship systems are in place to monitor and track newly registered practitioners from their appointment through to completion of the preceptorship period preceptors demonstrate the attributes outlined in appendix one and are identified from the workforce within clinical areas there are sufficient numbers of preceptors in place to support the number of newly registered practitioners employed preceptors are appropriately prepared and supported to undertake the role and that the effectiveness of the preceptor is monitored through appraisal newly registered practitioners understand the concept of preceptorship and engage fully there is an internal audit framework in place to demonstrate take up rates and quality of the period of preceptorship; this will also be available for external monitoring bodies as required a Preceptorship Handbook will be available on the intranet. Preceptorship operates within a governance framework Elements of Preceptorship NEWLY REGISTERED PRACTITIONER: Preceptorship should provide the opportunity for preceptee s to: apply and develop the knowledge, skills and values already learned develop specific competencies that relate to the preceptee s role access support in embedding the values and expectations of the profession 1228

document a personalised programme of development that includes postregistration learning, e.g. leadership, management and effectively working within a multi-disciplinary team reflect on practice and receive constructive feedback take responsibility for individual learning and development by learning how to manage self continue life-long learning embrace the principles of the NHS Constitution (DH, 2010) PRECEPTOR: Preceptorship should provide the opportunity for the preceptor to: develop others professionally to achieve potential formalise and demonstrate continued professional development discuss individual practice and provide feedback share individual knowledge and experience have insight and empathy with the newly registered practitioner during the transition phase act as an exemplary role model receive preparation for the role embrace the principles of the NHS Constitution (DH, 2010) EMPLOYER: The Preceptorship process should: be quality assured promotes and encourage an open, honest and transparent culture among staff support the delivery of high quality efficient healthcare demonstrate the employer s delivery of the NHS Constitution and other key policies indicate the organisation s commitment to learning 1328

Preceptorship Programme Preceptee will receive a preceptorship handbook at Induction (provided by inducting line manager) The preceptee will be allocated a preceptor by their line manager prior to commencement of employment or within their first week Within 10 working days Preceptorship contract is completed (appendix three) Identify learning needs Agree monthly meeting dates Monthly Meetings Review progress Continue to set objectives to be achieved Inform preceptee s line manager if any concerns with progress Monthly meeting record will be completed at each meeting(appendix four) Final Meeting Review progress Ensure preceptee has list of clinical supervisors Complete Preceptorship Final Review Form (appendix eight) 1428

TRAINING Supervision and Preceptorship Workshops are facilitated by Advanced Practitioners, Service Improvement Unit, Old Market House. All Registered Clinical Staff within Provider Services, which includes other clinical professions such as exercise physiologists, will attend mandatory training every three years. The concept of Preceptorship is inclusive and includes a range of health professionals e.g. assistant practitioners AUDIT Uptake of Clinical Supervision and Preceptorship will be subject to ad hoc audit. REFERENCES AND FURTHER READING Care Quality Commission (March 2010) Essential Standards of Quality and Safety Department of Health (2008) A High Quality Workforce: NHS Next Stage Review Department of Health (March 2010) Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals Department of Health (March 2010) The NHS Constitution Health Professions Council (July, 2008) Standards of conduct, performance and ethics Morton-Cooper A, Palmer A. (2000) 2 nd Edition. Mentoring, Preceptorship and Clinical Supervision. Blackwell Publishing. Nursing & Midwifery Council (2009) The NMC code of professional conduct: standards for conduct, performance and ethics 1528

ATTRIBUTES OF AN EFFECTIVE PRECEPTOR APPENDIX ONE The attributes required of a registered practitioner who supports newly registered practitioners through preceptorship include: Giving constructive feedback Setting goals and assessing competency Facilitating problem-solving Active listening skills Understanding, demonstrating and evidencing reflective-practice ability in the working environment Demonstrating good time-management and leadership skills Prioritising care Demonstrating appropriate clinical decision-making and evidence-based practice Recognising their own limitations and those of others Knowing what resources are available and how to refer a newly registered practitioner appropriately if additional support if required Being an effective and inspirational role model and demonstrating professional values, attitudes and behaviours Demonstrating a clear understanding of the regulatory impact of the care that they deliver and the ability to pass on this knowledge Providing a high standard of practice at all times 1628

PEER SUPERVISION CONTRACT APPENDIX TWO Name of Supervisee (Print) Designation Name of Supervisor (Print) Designation Duration/Frequency of session s Agreed Venue/s (NHS site only) Date_ Ground Rules for Both Parties: 1. Supervision is confidential both verbally and when written, except for explicit exceptions i.e. breaching current organisational policies or relevant codes of professional conduct 2. In cases of non adherence to professional codes, breach of current organisational policies and procedures, breaches of law or in case of potential harm to others the line manager needs to be informed. This should be done by the supervisee, where practical. Otherwise, the supervisor will need to share the information with the line manager. 3. Both supervisee and supervisor can request for the contract to be cancelled. This is envisaged if either the relationship is irretrievable, or following a review the relationship has come to a natural ending, necessitating a change of supervisor/supervisee. 4. Time keeping and avoiding the cancellation of sessions is a priority. 5. Shared responsibility for ensuring the highest standards are maintained 6. Completing of relevant documentation at the end of each session 7. Supervision will take place on NHS premises in a private room 8. The date, time and venue for the next session will be arranged at the end of each session Role of the Supervisee Prepare for clinical supervision by identifying clinical/professional issues upon which you wish to reflect Make and follow through action plans that arise from your reflection To maintain and update supervision documentation To be committed to fully participating in supervision and jointly finding solutions to issues that arise to continually sustain and develop high quality and safe patient care Topics may include: Caseload management Specific client cases Critical Incidents Personal development Training issues Clinical effectiveness Any changes to this agreement will necessitate the completion of a new contract. SUPERVISEE SUPERVISOR Supervisor and Supervisee to keep a copy of the contract 1728

RECORD OF INDIVIDUAL CLINICAL SUPERVISION SESSION (Either professional expert supervision or peer clinical supervision) APPENDIX THREE Date: Time: Venue: Supervisor (Print): Supervisee (Print): Phone Face to Face Issues/Actions raised at last session (if relevant) Key Issues of Discussion (do not use patient identifiable information on this form): Agreed Actions: Date and Time of Next Supervision Session: Supervisee Signed: Date: Supervisor: Signed: Date: Form to be retained for a period of two years as evidence of the supervision process 1828

APPENDIX FOUR GROUP FACILITATED CLINICAL SUPERVISION CONTRACT (Guidance may be adapted for the groups use, usually no more than 6/8 supervisee s) Name of Supervisor (Print): Designation: Duration/Frequency of Sessions: Agreed Venue/s (NHS site only): Date: Ground Rules for Group Sessions: 1. Supervision is confidential both verbally and when written, except for explicit exceptions i.e. breaching current organisational policies or relevant codes of professional conduct. 2. In cases of non adherence to professional codes, breach of current organisational policies and procedures, breaches of law or in case of potential harm to others the line manager needs to be informed. This should be done by the supervisee, where practical. Otherwise, the supervisor will need to share the information with the line manager. 3. Time keeping and avoid cancellation of the sessions is a priority 4. Group members to prepare for the sessions by identifying clinical/professional issues upon which to reflect 5. Shared responsibility for ensuring the highest standards are maintained 6. Completing of relevant documentation at the end of each session 7. Supervision will take place on NHS premises in a private room 8. The date, time and venue for the next session will be arranged at the end of each session. Supervisee Print Name Supervisee Signature Supervisee Designation Supervisor and Supervisee to keep a copy of the contract 1928

APPENDIX FIVE GROUP FACILITATED CLINICAL SUPERVISION ATTENDANCE FORM AND RECORD OF SESSION (Guidance may be adapted for groups use) Date: Venue: Time of Session: From: To: Name of Supervisor: Print Name: Signature: Name of Supervisee: 1) 2) 3) 4) 5) 6) 7) 8) Key Issues of Discussion (do not use patient identifiable information on this form): Agreed Action (if applicable) Date and Time of Next Supervision Session Form to be retained by Facilitator for two years as evidence of supervision process 2028

APPENDIX SIX PRECEPTORSHIP CONTRACT Name of Preceptee (Print) Designation Name of Preceptor (Print) Designation Duration/Frequency of sessions_ Agreed Venue/s (NHS site only) _Date_ Ground Rules for Both Parties: 1. Preceptorship is confidential both verbally and when written, except for explicit exceptions, i.e. breaching current organisational policies and procedures, standards or relevant codes of professional conduct. 2. In cases of non adherence to professional codes, breaches of current organisational policies and procedures breaches of law or in case of potential harm to others, the preceptee s line manager needs to be informed. This should be done by the preceptee, where practical, otherwise the preceptor will need to share the information with the preceptee s line manager. 3. Time keeping and avoiding the cancellation of sessions is a priority. 4. Shared responsibility for ensuring the highest standards are maintained. 5. Completing of relevant documentation at the end of each session. 6. Preceptorship will take place on NHS premises in a private room. 7. Preceptor and preceptee agree to meet once a month for six months. Role of the Preceptee: Arrange monthly meeting with preceptor Ensure documentation is available for the preceptor to complete Undertake mandatory training requirements and identify personal learning needs. Preceptee and Preceptor Signature PRECEPTEE PRECEPTOR Preceptor and Preceptee to keep a copy of the contract. 2128

APPENDIX SEVEN PRECEPTORSHIP MEETING RECORD Name of Preceptee (Print): Name of Preceptor (Print): Clinic/Base: Preceptorship Meeting Number (please state): Date: Record summary of discussion: Comments from Preceptor: Comments from Preceptee: Summary of Action Points: Date of Next Meeting: Preceptee to retain a copy in portfolio 2228

APPENDIX EIGHT PRECEPTORSHIP FINAL REVIEW FORM Name of Preceptee: Base: Date: 1) Did you have a preceptorship contract? Yes/No 2) Were you able to attend all the agreed meetings with your preceptor? Yes/No If no, please explain: 3) Were your individual learning needs identified at the beginning of the preceptorship period? Yes/No 4) Were your individual learning needs reviewed at each meeting? Yes/No 5) Were your individual learning needs met during the preceptorship period? Yes/No If no, please explain: 6) Were you given a list of clinical supervisors for your practice area at the end of the preceptorship period? Yes/No 2328

MANAGEMENT SUPERVISION BASED ON PRINCIPLES OF KSF, DEVELOPMENT, SUPPORT AND MONITORING STAFF NAME:- BASE:- DATE:- APPENDIX NINE Strategic aims of service (specify own aims) :- Below is just an example 1. IMPROVE PATIENT SAFETY AND RELIABILITY OF CARE 2. IMPROVE PATIENT EXPERIENCE 3. IMPROVE STAFF WELL BEING 4. IMPROVE PRODUCTIVITY EXAMPLE ONLY Training CURRENT OBJECTIVES Details of Action Plan & monitoring arrangements MEASURABLE OUTCOME Evidence Based practice Patient Safety Audit Activity Case Note Review Other matters for discussion HR issues Annual Leave 24/28

Personal Training/Education completed or identified :- Internal Learning and Development External Learning and Development Is there any other support you need at this time to carry out your role? Additional Comments:- If applicable Clinical Supervision, dates attended and dates booked. Signature of Manager: Signature of Staff: Date of Next Meeting: This record to be kept for two years on staff personal file copy for staff to help build portfolio. APPLY SMART OBJECTIVE SETTING / Specific, measurable, achievable, realistic, timely APPENDIX TEN 2528

EXAMPLE OF SUPERVISORY PRACTICE MONITORING FORM Time period annually Jan to Dec Each Year Total Number of Staff Total Number Registered Staff Specify the Team/Service for which the audit is being completed: C/S Clinical Supervision M/S Management Supervision B = Both in any one month NAME OF STAFF JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC Total C/S Total M/S Keep a copy for your records 2628

FREQUENTLY ASKED QUESTIONS APPENDIX ELEVEN Does this procedure apply to all registered clinical staff within Provider Services? Yes, this procedure is mandatory. Do all staff who are mentors (registered nurses only to comply with NMC Standards) undertake the role of a clinical supervisor? Yes Do all staff who are mentors (registered nurses only to comply with NMC Standards) undertake the role of Preceptor? Yes, if they have worked in their area of practice for 12 months. Do all Allied Health Professionals undertake the role of clinical supervisor? Yes Do all Allied Health Professionals undertake the role of Preceptor? Yes, if they have worked in their area of practice for 12 months. What qualifications do I need to be a clinical supervisor or preceptor (registered nurses only to comply with NMC Standards)? You need to have completed ENB998, Level 6 Teaching and Assessing module or completed a Mentor Portfolio of Development What supervision is there for clinical supervisors? All supervisors have their own supervision Does clinical supervision link to appraisals? No, the only link is the record of attending clinical supervision on the management supervision form. Can I choose a clinical supervisor? Yes, from the register of clinical supervisors in your clinical service Can I choose a preceptor? No, a preceptor will be allocated to you prior to commencement of employment or within your first week of work Is the time for clinical supervision/preceptorship protected? Yes. Supervision/Preceptorship will be in working hours What is the difference between management and clinical supervision? Management supervision is provided by the line manager and is performance focused. Clinical supervision is supervisee focused. What records do I keep? All documentation for clinical supervision/preceptorship are in this procedure. Records will be kept and stored in a manner which maintains integrity and confidentiality. What do I do if I am unhappy with my clinical supervisor/preceptor? 27/28

Discuss issues with the clinical supervisor/preceptor initially. If this does not resolve the issue, discuss with own line manager. Can I arrange group supervision with peers? Yes, if you have a group of peers willing to commit to the group and share facilitation. The facilitator would need to demonstrate a working knowledge of group processes and dynamics to their line manager. What if the clinical supervisor/preceptor is concerned about poor practice or the mental/physical ill health of a colleague? The issues would be raised with the clinical supervisee/preceptee firstly. If the supervisee/preceptee will not address in an appropriate manner, the supervisor/preceptor needs to inform the supervisee/preceptee that the information will be shared with the line manager, including documentation of the process How do I find a supervisor? By requesting a copy of the clinical supervisors register for your clinical area from any of the Administration Team in the Service Improvement Unit, Old Market House What if I only work a few hours a week? All health care is delivered within the organisations clinical governance framework, so standards of practice apply equally to part time staff. The minimum number of clinical supervisory sessions per year is recommended at 3. Discuss any concerns you may have with your line manager so they can be resolved at an early stage. 28/28