South Staffordshire and Shropshire Healthcare NHS Foundation Trust

Transcription

1 South Staffordshire and Shropshire Healthcare NHS Foundation Trust Document Version Control Document Type and Title: Authorised Document Category: New or Replacing: Supervision Policy (including clinical, managerial and professional supervision) YELLOW - CLINICAL Replacing C-YEL-gen-03 Clinical and Managerial Supervision: Promoting best practice in Health and Social Care delivery v8.1 (2011) Document Reference: C-YEL-gen-03 Version No. V1.0 Implementation Date: Document Owner: Approving Body: Mark Cardwell, Debbie Moores and Kenny Laing Quality Governance Committee Approval Date: 12 th February 2015 Ratifying Body: Board of Directors Ratified Date: 26 th February 2015 Committee, Group or Individual Monitoring the Document: Quality Governance Committee Review Date: March 2018 Key Words: Supervision, Managerial, Professional, Preceptorship, Mentorship

2 CONTENTS Section No. Content Page No. Overview 3 1 Introduction 4 2 Scope of the Policy 5 3 Roles and Responsibilities 5 4 Supervision Principles 8 5 Types of Supervision 9 6 Supervision Standards 11 7 Documenting Supervision 12 8 Supervision Training 12 9 Confidentiality of Supervision Evaluation of Supervision Equality Impact Assessment 14 Appendices Appendix 1 Example of Supervision Contract 15 Appendix 2 Example of Supervision Contract Review Form 18 Appendix 3 Example of Supervision Documentation Review Form 20 Appendix 4 Example of Supervision Aide Memoir 21 2

3 Overview South Staffordshire and Shropshire Healthcare NHS Foundation Trust is committed to delivering high quality, safe services and sees supervision as an essential mechanism contributing to this and will ensure all staff access supervision through a range of options, in line with the Trust Strategic vision, values and aims. This single supervision policy covers all Trust staff across all directorates and divisions. It covers managerial supervision, professional supervision and clinical supervision. To ensure all staff are supported to deliver this policy, local negotiation with the staff member and their line manager will take place, supported by other relevant clinical and professional leads to ensure that the supervision agreed is in line with their specific role, best practice, professional guidance and the service context. It remains the responsibility of all staff, supported by this policy, to have access to and to provide appropriate supervision in pursuit of excellence. The amount, nature and quality of supervision is appropriate to the individual and the role they are in, and must be balanced with the requirements of staff to deliver their objectives and perform well in their role. The agreed supervision arrangements must be documented and signed off by all those involved and all supervision sessions must document key discussions and agreements in line with this policy. The purpose of the Supervision Policy is to enable staff to be aware of o o o o The different types of supervision available. The expectation placed on staff at all levels in the organisation with regard supervision roles and responsibilities. The guiding principles behind the benefits of excellent supervision. The standards expected to be deployed to deliver excellence. thus ensuring that appropriate arrangements for their supervision will be agreed at induction, KSF appraisal, or job plan discussions. 3

4 1. Introduction Staff may wish to link this document with preceptorship, mentorship and professional guidance. 1.1 South Staffordshire and Shropshire Healthcare NHS Foundation Trust is committed to delivering high quality, safe services and sees supervision as an essential mechanism contributing to this and will ensure all staff access supervision through a range of options, in line with the Trust Strategic vision, values and aims. ult/general-information.aspx 1.2 All staff will be provided with equal opportunities to engage in supervision to ensure the appropriate level of support is in place. 1.3 Supervision, across all health and social care professions is about focusing on best practice; highlighting it, sharing it with others and practicing it. 1.4 All new staff members must be made aware of the supervision arrangements within their first week of employment, through local induction. 1.5 Supervision is essential to support and promote professional practice across all roles and disciplines. Professionally registered staff are bound by the appropriate code of conduct from their professional and/or regulatory body in order to maintain their professional registration and high quality care. Individual professional groups should refer to their own professional body guidance which should be considered in conjunction with this policy. 1.6 Supervision supports the clinical governance framework, Care Quality Commission standards, NHS Litigation Authority standards and risk management processes; by focusing staff and practitioners on their competence, standards of practice and Continuing Professional Development (CPD) requirements. 1.7 Supervision is essential for those working clinically with patients. Due to the interpersonal nature of staff-patient interactions, staff members are required to be engaged in supervision to reflect on, and understand, the impact they have on patients. Plus the impact working within a stressful clinical environment has on staff. This is particularly important when working with patients who present to services with interpersonal difficulties (e.g., as a result of earlier life trauma). 1.8 Supervision (clinical, managerial and professional) includes time for reflective practice and support; helping staff to manage his/her feelings is essential. This has been shown to lead to improved health outcomes for service users and reduced staff sickness rates. There are three subtypes of supervision: One: managerial supervision (including caseload management where appropriate). This will include ensuring that the supervisee is adhering to all Trust policies and standing operating procedures in their clinical work, for example regularity of care coordination reviews. 4

5 1.8.2 Two: professional supervision. If you are receiving supervision from someone other than your Professional Lead then professional supervision should be accessed. For example, to ensure supervisees are performing the duties expected of their profession maximising their contribution to the Trust Three: clinical supervision. This provides an opportunity for a supervisee to review the quality of their clinical work provided. For example: clients with particular difficulties, for use of specific interventions, opportunity for learning/consolidating skills. This is different from caseload management as there will not be time in clinical supervision meetings to review all cases. It is expected that the supervisor and supervisee will devise a system to ensure that all clients are considered in supervision over an agreed timescale, where applicable. For example in line with the Code of Practice, Preceptorship. 2. Scope of the Policy 2.1 This policy includes all employees of South Staffordshire and Shropshire Healthcare NHS Foundation Trust. Clinical practice supervision specifically applies to all those who deliver or participate in the delivery of a health and social care service. 2.2 It is recognised that informal supervision arrangements are necessary in certain circumstances. This policy however covers formal supervision arrangements only. 2.3 Staff may additionally access specialist safeguarding children supervision from the Named Nurses for child protection. This is a separate process to provide essential support and guidance for staff dealing with complex child protection cases. Safeguarding children supervision can be provided to individuals or teams. Arrangements for this specialist supervision should be agreed with the Named Nurses for Child Protection. See the Trust s Safeguarding Children Policy for more information. Ref: C-YEL-sg Roles and Responsibilities 3.1 The Chief Executive is ultimately responsible for the Trust s supervision policy arrangements and must therefore ensure that mechanisms are in place to: Ensure that this policy is observed by all staff and that resources are available to ensure effective implementation. 3.2 Executive Directors will be responsible for ensuring that: The policy is implemented and operated effectively within the sphere of their control. Staff will be encouraged, supported and released to attend supervision - clinical, managerial and professional on a regular basis. 5

6 3.3 Clinical Directors will be responsible for ensuring that: Appropriate systems and processes for supervision are in place across all professional groups within the sphere of their responsibility. A register of supervisors is developed, maintained across the Divisions/Directorates. Links are made to triangulate supervision with Professional Leads and managers in line with KSF appraisal. The policy is effectively and fairly implemented and operated within their sphere of control. Staff will be encouraged, supported and released to attend supervision - clinical, managerial and professional on a regular basis. 3.4 Professional Leads will be responsible for ensuring that: Appropriate systems and processes for supervision are in place across the professional group including systems for supervising trainees and accountability for their work. This may need to be agreed in consultation with training institutions. Links are made to triangulate supervision with Clinical Directors and managers where appropriate. The policy is effectively and fairly implemented and operated within their sphere of control. Supervisees or employees provide evidence of documentation for the purposes of ensuring quality record keeping e.g. supervision records and health records. 3.5 Line Managers and Team Leaders will be responsible for ensuring that: There is agreement with employees of the level, amount and nature of the supervision required. This should be reviewed as a minimum yearly at KSF/Appraisal and documented and best practice is at the 6 month appraisal review. Appropriate systems and processes for supervision are in place across the professional group. Links are made to triangulate supervision with Clinical Directors and Professional Leads where appropriate. The policy is effectively and fairly implemented and operated within their sphere of control. Employees with a disability are afforded the equal access to supervision, making necessary adjustments as required. Employees are informed of this policy and its operation. Employees are informed of the requirement to participate in supervision and encouraged to engage. Employees are supported to be released to attend sessions and this will be reviewed as part of appraisal process. Where managers and Team leaders are aware of an issue in practice they will discuss and agree with staff increased supervision as necessary and involve Professional Leads where appropriate to support clinical and professional issues. 6

7 Supervisees or employees provide evidence of documentation for the purposes of ensuring quality record keeping e.g. supervision records and health records. Employees are supported with protected time and space for professional growth. 3.6 Employees and Supervisees will ensure that: Agreement is reached with the manager or team leader as to the level, amount and nature of the supervision required in line with this policy. This should be reviewed (as a minimum) yearly at KSF/Appraisal and documented. For staff delivering clinical services, they will attend a minimum of six managerial supervision sessions and twelve clinical supervision sessions annually. The latter should last at least one hour on a monthly basis. More intensive clinical supervision may be recommended to support the direct delivery of psychotherapy or to enable people to develop new clinical skills. If appraisal identifies that the staff member is working regularly with those with more complex difficulties expressed interpersonally, for example those suffering the after effects of trauma (who may meet criteria for a diagnosis of personality disorder) then discussions should occur as to whether more frequent supervision that could be weekly, is needed. This is usually recommended by relevant bodies. Many benefits of clinical supervision have been documented showing the improved outcomes for patients, reduction of staff stress levels etc. Arrangements for and frequency of Individual Performance Reviews (IPR) should be agreed at the individual review. For all three types of supervision this should be provided by someone that is fitting to the clinical area and roles, (pro-rata for part time employees) spaced at regular intervals and should adhere to professional and/or regulatory body guidance or service standards. It is the responsibility of individuals at review to state the requirements of their professional bodies if it differs from the above and agree adherence, for. These will include BACP, UKCP, HCPC, GMC, NMC and GPhC. This would also involve enabling and maintaining accreditation. Supervision is compulsory and non attendance will be pursued/addressed under performance policies. This applies both to supervisees and supervisors. Supervisee s seek out additional/more timely supervision in order to help them deal with or respond to specific circumstances. For instance when working regularly with those with more complex difficulties expressed interpersonally, e.g., those suffering the after-effects of interpersonally based trauma (who may meet criteria for a diagnosis of personality disorder) then weekly clinical supervision is recommended. Managerial and clinical supervision may be provided by the same supervisor and combined as one session if this is negotiated and agreed with the supervisor and supervisee. Or alternatively split to safeguard clinical supervision. Professional and clinical supervision may be provided by the same supervisor and combined in one session. This should be provided by 7

8 the relevant profession in line with regulatory requirements and best practice. If supervisees become concerned about the quality of supervision, discussions should be held locally with their line manager to find a way to address the issues. On request, the supervisee is required to provide evidence of supervision sessions attended. (Appendix 3 supervision documentation review form). Clinical supervision sessions should be recorded through discussion and accurate record keeping. The record should include the date and name of the supervisor and their designation. Main recommendations or actions suggested as well as any risks noted should be entered. Staff who are responsible for supporting students, trainees or locums will ensure those staff are supervised in line with professional guidelines. 3.7 All Supervisors and Managers will ensure that: They are able to identify, through appraisal, staff members in whom they have confidence, and in sufficient numbers, to undertake the supervisor role. Supervisory training will be provided clinical, managerial and professional as required for supervisee and supervisor. There may be a need locally for supervisors to seek supervision themselves whilst undertaking this specific role. Supervisees or employees provide evidence of documentation for the purposes of ensuring quality record keeping e.g. supervision records and health records. 4. Supervision Principles Supervision supports best practice, enabling practitioners to maintain and improve high standards of safe health and social service delivery, supporting improved outcomes for individuals, carers and their families. Supervision is a practice-focused professional mechanism guided by a skilled supervisor or manager. Supervision is an open and supportive process that is a mandatory (essential) part of practice. There is equitable access for all staff through a range of supervision activities. Staff will be offered training to ensure they are skilled and competent to support others in supervision activities. Evaluation of supervision will happen systematically through annual clinical audit to assess its impact on performance, risk management, clinical governance and service user outcomes. There is an expectation that there will be a triangulation of all supervision activity between supervisee, supervisor, manager or team leader. It is recognised that each professional group will have its own defined approaches to supervision as outlined from their professional bodies. Indeed some staff groups, particularly multi-disciplinary teams, may 8

9 have a mixed approach. Therefore it is expected that this policy is implemented and adhered to support best practice across professional groups, recognising that there may be some professional variation in terms of approach. Staff have protected time and space within the session to reflect on practice and professional growth (clinical and professional supervision). Where service delivery is underpinned by NICE guidance, technologies or best practice, more intensive clinical supervision may be necessary and delivered by accredited supervisors. 5. Types of Supervision 5.1 This policy relates to three types of supervision. This is in recognition that there are different forms of supervision that take place such as separate Managerial Supervision and Clinical Supervision, where the line manager may be from a different professional background to the supervisee. Professional supervision will be delivered by a Professional Lead or representative of the relevant professional body working within same/similar field. 5.2 It may be necessary to access a mixture of all three types of supervision according to professional need and as agreed with the line manager. 5.3 It may also be appropriate, depending on local circumstances, for a staff member to receive all three types of supervision from one supervisor. Alternatively, it may be necessary according to individual or service circumstances that supervision could be accessed by three different supervisors. 5.4 An aide memoir is included in Appendix 4 outlining key areas that should be discussed through managerial supervision. Supervision addresses formative, normative and restorative functions. 5.5 Clinical Supervision: - clarity on 1:1 and group supervision benefits to team, service and practice Clinical supervision is a reflective support process for all staff groups who are delivering direct care to service users to develop their knowledge, skills and competence. It enables them to critically review their practice, take responsibility for their work and promote quality in their field of expertise. It is central to quality improvement and safer working practice and a key additional outcome is to improve service user experience of health and social care services. It is intended to support staff to develop their skills and knowledge relating to their professional practice. Through reflection, it enables individuals and groups to identify issues concerning patient care and find ways of improving results and outcomes. It is an integral part of Continuing Professional Development (CPD) and lifelong learning and seeks to bring together staff and skilled supervisors to improve and innovate practice and standards of care. 9

10 5.5.2 Clinical Supervision should include structured debate about specific service user care. The agenda in clinical supervision may be determined by the supervisee and may include areas such as; The current provision of clinical input, including any evidence/ theoretical base from which the care/intervention is drawn. Any proposed amendments/changes to care. Risk assessments and management plans. Care planning. Patient reported outcome measures. Professional reported outcome measures. Safeguarding issues. Reviewing case notes (joint task with managerial supervision (see below section 5.6)). Case Management/capacity and demand. Discharge planning. Clinical reasoning. Identified training needs if gaps identified in clinical skills/ knowledge Clinical supervision is not a substitute for day to day support and guidance from line managers/team leaders/supervisors therefore managerial supervision should be accessed by all members of staff and offered by their manager. 5.6 Managerial Supervision: Managerial supervision is delivered by the supervisee s line manager and can be used as an effective way of: Management of workload/caseload of supervisee including annual leave, sickness absence and discipline. The regular monitoring and review of a staff member s performance towards achievement of clear case work, practice and team objectives. The giving of constructive feedback on practice and performance. The planning of new tasks, setting standards and reviewing health and safety issues. The identification of individual training and development and resource needs relating to tasks. Completion of KSF/Appraisal and objectives and personal development planning. Identifying and address training needs of supervisees and feeding these into the annual team training needs analysis/plan. Reviewing of the health care record for the purposes of ensuring quality record keeping. Reviewing case notes (joint task with clinical supervision (see above section 5.5.2)). 10

11 5.7 Professional Supervision: Professional supervision can be delivered by a Professional Lead/Practioner of the same professional group within same or similar field/specialism Where clinical supervision is not provided by the same professional group it will be necessary to access some sessions throughout the year by a supervisor of the same specialism. This arrangement will need to be determined and negotiated locally. 6. Supervision Standards 6.1 Supervision can be delivered in a number of ways. There are other models of clinical and managerial supervision that services and individuals may choose according to their requirements; for example those using family interventions may require a specific model to suit their therapy, or professionals from a social care background. 6.2 Supervision is a two way process and staff have a responsibility to ensure they participate in regular supervision. Those conducting supervision need to ensure they respond to staff requests for supervision in line with this policy. If the specialism requires external support for supervision, the organisation will ensure appropriate provision is made for those practitioners. This should be negotiated and agreed between the manager and Professional Lead and a review process put into place. 6.3 There are a range of activities which may constitute supervision and staff should demonstrate a variety of employed methods rather than a single type of supervision. In order for these activities to be considered as supervision, some reflection of practice needs to have taken place and notes recording conclusions should be made. 6.4 Suggested methods of delivering supervision include: One to one sessions with manager (managerial supervision). One to one meetings with supervisor and/or Professional Lead: supervisees will, through negotiation with their manager, identify an appropriately experienced supervisor, to meet on a one-to-one basis to reflect on an individual s practice with a view to gaining a greater understanding of the issues, an improvement in practice, assessment of risk or to identify a training or development need. Group/team supervision: staff come together in small groups (can be uni-professional, same grade/discipline, multi-disciplinary team, operational teams or special interest groups) to discuss practice and issues arising from it, using a specialist speaker or facilitator. The topics may be wide and varied, including issues such as standards, workload management, work-related training, safeguarding children and vulnerable adults and planning and health and safety issues. 11

12 6.5 Non attendance of supervisee or supervisor: Supervision is required to ensure effective service delivery and non attendance by the supervisee can be addressed under Trust performance policies. Equally, for supervisors who consistently cancel and do not rearrange the session, this is also recognised as a performance issue. 7. Documenting Supervision 7.1 It is important to have a clear working arrangement for supervision activities and to formalise this. Both the supervisor and the supervisee/s will evidence these arrangements via a written supervision contract form which is signed, copied and retained in the personal file (Appendix 1). 7.2 This contract should be reviewed at least annually to ensure that supervision arrangements continue to be effective via a supervision contract review form which should be signed, copied and retained (Appendix 2). 7.3 In all episodes of supervision, general notes should be made around the issues that occur during supervision and any reflections related to individuals practice should be recorded in all cases (Appendix 3). 7.4 It is the responsibility of the line manager and supervisee to keep a record of all managerial supervision undertaken (see Appendix 3). 7.5 When a service user s care has been discussed in a supervision session an agreed entry will be recorded by the supervisee in the service user s case notes. Any decisions regarding care made during supervision should be discussed with other involved professionals as necessary. 7.6 If as a result of discussions reflections and suggestions arise for changes to the whole package of care then it is the supervisee s responsibility to raise such issues for discussions with other care providers in team meetings or professionals meeting or similar. 7.7 There is an expectation that any concerns from the supervisor will be passed to the line manager when any concern over fitness to practise arises. 7.8 When a member of staff, either supervisor or supervisee leaves the organisation, a copy of the supervision notes and records should be retained in the supervisee s personal file. 8. Supervision Training 8.1 In order to undertake the role of supervisor, training can be accessed via the Learning and Development Department or individuals should have prior supervisor training approved by the Trust. Training provides a level of quality assurance across the organisation. 12

13 Supervisor training: can be accessed through the Learning and Development Department (L&D). Supervisee training: a basic level module via video describing the process and is offered as part of the introduction to supervision, or via the Learning and Development Team. This is to ensure all staff operate with a consistent, base level of understanding and can gain access to information about supervision if they require it. Training programmes through local education providers: for those requiring more information it may be possible to access more advanced training programmes through the Learning and Development Department when this is identified as part of an individual s Personal Development Plan. 8.2 The concept of supervision should be introduced to all new team members as part of their induction and guidance should be given on how to get the most from supervision sessions. 8.3 Newly qualified staff will initially require a period of support through the early transition from student to a qualified professional. This process is known as a period of preceptorship and is detailed in the Trust s Preceptorship Policy (Ref). 9. Confidentiality of Supervision 9.1 The normal codes of conduct relating to confidentiality apply to supervision and professionals are expected to operate within their code of practice at all times. Due to the nature of supervision it is imperative that confidentiality is observed by all parties however, if some form of malpractice, negligence, misconduct or dangerous practice is revealed, it should be recognised that this will be acted upon in line with Trust policies and procedures. 9.2 All issues discussed as part of a supervision session or activity will be in confidence, unless there is anything disclosed that may affect the wellbeing or safety of the supervisee, their patients, professional practice, the team or the organisation. Themed learning will be anonymised, collated and cascaded as part of continuous improvement. 9.3 There may be occasions where supervision records may be requested to be accessed for the purposes of audit, inspection and evaluation. 10. Evaluation of Supervision 10.1 The implementation of this policy will be evaluated systematically through the Trust s annual clinical audit programme to determine: Staff compliance with Trust standard. Evidenced supervision included in individual s CPD portfolio. Cascade of learning themes from the audit to ensure the process is working effectively. 13

14 11. Equality Impact Assessment 11.1 All policies must have the completed Equality Impact Assessment Tool form which is included in Appendix 5. 14

15 Name of Supervisor/s Title Professional Training Qualifications in Supervision Contact Details Internal/ External to Directorate/ External to Trust Reason/ Remit for External Arrangements APPENDIX 1 Example of Supervision Contract Name of supervisee: Job Title/Role: Professional Body: Statutory Registration Required: Yes / No Type of supervision: clinical/ managerial/ professional Clinical Managerial Professional Name of Line Manager: Contact details: Agreement from line manager for obtained : regarding supervision arrangements Yes/No Date: Cost (if external) or quid pro quo arrangements. Arrangements for supervision: (including frequency, time allocated, venue): Supervision note-keeping arrangements: 15

16 Summary of learning/development needs identified by supervisee at appraisal: Supervisee s responsibilities Initiation and organisation of their own personal, professional and practice development and relevant supervision arrangements. Awareness of National, Professional or local codes of conduct and or practices where relevant. Identification of practice issues for exploring and improvement of practice. Exploration of interventions that are useful. Be open to feedback and develop an ability to use this constructively. Accountable for his/her work and informing their manager and Clinical Supervisor of any difficulties. Ensure that they fulfil their supervision contract with their Clinical Supervisor. Keep their manager informed of their Clinical Supervision arrangements. Keep notes on the outcome of each session. Supervisor s responsibilities Understands the purpose of supervision. Can explain the purpose of supervision. Understands the functions of supervision i.e. formative, restorative and normative. Can negotiate a mutually agreed contract. Can prepare a structured approach for each session. Is clear about the documentary process required for supervision. Can set a supervisory climate that is effective and sets the boundaries of confidentiality. Can give and receive constructive feedback. Can develop an effective supervisory relationship utilising appropriate interpersonal skills. Understands the Trust Framework and approach to Clinical Supervision. GROUP SUPERVISORS Can lead and effectively apply the supervisory process to group situations. Have knowledge of group processes and manage group dynamics, including conflict and competitiveness. 16

17 Additional information: (e.g. any other supervision received) Date of review (at least annually; please use supervision contract review form at next review): Signed: Supervisee: Supervisor Dated: Dated: Original Completed form retained by: Location: Copy: Supervisee/Supervisor Copy: Personal file Copy: Line Manager 17

18 APPENDIX 2 Example of Supervision Contract Review Form Name of supervisee: Job Title/Role: Professional Body: Statutory Registration Required: Yes / No Type of Supervision: clinical/ managerial/ professional Name of Supervisor: Title: Contact details: Internal / External to Directorate / External to Trust: Name of Line Manager: Contact details: Summary of review (to include how supervision is working, supervisory relationship, learning or development achieved, concerns or issues) : Changes made to supervision contract: YES / NO Details of changes: Line manager informed: YES / NO Reason: 18

19 Additional information: (e.g. any other supervision received) Date of next review: Signed: Supervisee: Supervisor Dated: Dated: Original Completed form retained by: Location: Copy: Supervisee/Supervisor Copy: Personal file Copy: Line Manager 19

20 APPENDIX 3 Example of Supervision Documentation Review Form Name Date Discussion topic Comments Action Signed Supervisor: Signed Supervisee: Date Date Date of next session Copy retained by: Location: 20

21 APPENDIX 4 Possible areas for discussion: Example of Supervision Aide Memoir Formative Functions promoting development of the supervisee s skills and knowledge 1. Professional development 2. Professional issues Restorative Functions recognises affects of work, and stresses upon the supervisee 3. Time management 4. Personal issues which may impinge on work 5. Dealing with stress Normative Functions ensuring safe working within frameworks for practise and Trust and professional standards 6. Work needs and responsibilities 7. Resource/Budget management 8. Clinical issues 9. Other issues 1. Professional development New innovations Research Courses (external) In-service training Work based learning opportunities- shadowing, secondments 2. Professional issues Role and Responsibilities - Appraisal objectives Core Skills Knowledge and understanding Team work/issues Capacity 3. Time management Demand for delivery Individual/departmental time keeping Prioritising Balance Problem solving Decision making Access to resources Flexible working options 21

22 4. Personal issues which may impinge on work Work/Life balance Professional boundaries Orientation to job 5. Stress health and well being issues Identify/review stress work /home 6. Work needs and responsibilities Goals of service and directorate/business plan Team objectives Caseload management Record keeping, IT, Nominal Roll, Care plans etc Managerial/Supervisory Administrative Policies and Procedures adhered to/disseminated Attendance at professional meetings including Away Days/Journal Clubs/ Practice Placement/CPD 7. Resource/budget management Posts vacancies, recruitment Budget management Timely access to right equipment e.g. IT 8. Clinical/practice issues Any proposed amendments/changes to care Risk assessments/risk management plans/positive risk management Care planning Patient Reported Outcome Measures Professional reported outcome measures Evidence based practice Safeguarding Reviewing case notes Discharge planning Clinical reasoning Reflective practice 9. Other Issues 22