Public Health Wales
All Wales Safeguarding Children Supervision Strategy
All Wales
Safeguarding Children
Supervision Strategy
2014
Version: Final January 2014
Authors: Developed by the
All Wales Named Nurses Forum
Date: 15.01.14
Page: 1 of 16
Ratified by: All Wales Safeguarding
Children NHS Network
Review Date: January 2017
Public Health Wales
All Wales Safeguarding Children Supervision Strategy
Table of Contents
Page No
Introduction
3
Background
3
Aim
3
What is Safeguarding Supervision?
4
Objectives
5
Principles Underpinning Safeguarding Children
Supervision
5
Roles and Responsibilities
6
The Function of Supervision
8
Types of Supervision
8
Safeguarding Children Supervision Framework
9
Quality Assurance
11
References
12
Appendix 1:
Example Safeguarding Supervision Agreement
Appendix 2:
Example Peer Review Agreement
Version: Final January 2014
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Date: 15.01.14
Page: 2 of 16
13
15
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Review Date: January 2017
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All Wales Safeguarding Children Supervision Strategy
Safeguarding Children Supervision Strategy 2014
This strategy was developed by the All Wales Named Nurses Safeguarding
Children Forum on behalf of the Safeguarding Children NHS Network.
Organisations wishing to use this document in the development of their own
Safeguarding Children Supervision Strategy have the permission of the Project
Group, subject to appropriate referencing.
The terminology used to describe safeguarding children supervision throughout
this document is supervision.
INTRODUCTION
Working to ensure children are protected from harm requires sound
professional judgements. This can be demanding and distressing work
therefore it is imperative that staff involved in this work have access to a
systematic framework to review their work. Safeguarding supervision offers a
formal process of professional support and learning for practitioners working
with children young people and/or their parents and/or carers.
Effective supervision is important in promoting good standards of practice and
to support individual staff members; it should assist in ensuring health
practitioners are competent and confident and provides a safe environment for
challenging practice.
BACKGROUND
The Clothier Report (1994) following the inquiry into the actions of Beverley
Allitt recommended the implementation of clinical supervision as set out in the
document “A Vision for the Future”. This was followed in 1997 (DOH) by the
introduction of clinical supervision in child protection.
The Lord Laming inquiry (2003) together with numerous recommendations of
serious case reviews have highlighted the requirement for professionals to
receive supervision specific to safeguarding children.
AIM
The aim of this strategy is to provide a safeguarding supervision framework
which can enable NHS organisations in Wales to develop and maintain a
confident and competent workforce in safeguarding and promoting the welfare
of children. Implementation of this strategy will assist organisations in
discharging their statutory responsibilities. This all Wales approach promotes
consistency and a reduction in variation across Wales allowing Welsh Health
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Boards and Trusts to have a benchmark against which performance can be
measured. Implementing safeguarding children supervision also fosters a
culture whereby the child’s welfare is placed at the centre of decision making;
a key requirement of the United Nations Convention on the Rights of the Child.
“UNCRC”
WHAT IS SAFEGUARDING SUPERVISION?
Safeguarding supervision is an essential requirement for the professional
development of health staff who work with children, young people and their
families. (Department of Health (DH) 1989; DH, 2008). It is seen as
dedicated time for the discussion of individual cases of concern. “Munro 2010”
Supervision should include scrutinising and evaluating the work carried out,
assessing the strengths and weaknesses of the practitioner and provide
coaching development and pastoral support. Supervisors should be available
to practitioners as an important source of advice and expertise and may be
required to endorse judgements at certain key points in child protection
processes. Supervisors should record all decisions made within case records if
possible. “Safeguarding Children Working Together under Children Act 2004
(WAG 2006)”
Supervision must enable and support workers to build effective professional
relationships, develop good practice, and exercise both professional judgement
and discretion in decision-making. For supervision to be effective it needs to
combine a performance management approach with a dynamic, empowering
and enabling supervisory relationship. Supervision should improve the quality
of practice, support the development of integrated working and ensure
continuing professional development. Supervision should contribute to the
development of a learning culture by promoting an approach that develops the
confidence and competence of managers in their supervision skills. It is
therefore at the core of individual and group continuing professional
development. “Providing Effective Supervision (Skills for Care & CWDC 2007)”
Peer review for paediatric medical staff involves doctors of the same ability or
expertise providing an impartial evaluation of the work of others. Paediatric
medical peer review is a form of reflective practice, as is clinical supervision.
Clinical supervision usually involves a senior supervisor providing a structured
format in a one-to-one setting and involves both reflection and direction. Peer
review involves a group of peers discussing and providing opinions which the
individual can accept or reject. “RCPCH 2012”
There is an expectation that doctors involved in child protection work will have
support, peer review and clinical supervision in order to be confident and
competent in this complex area of work. There is no formal definition of peer
review however, it will encourage paediatricians to meet the expected
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standards and prevent practitioners working in isolation, in out of date practice
with unacceptable interpretations or restricted to personal views. “Thomas
and Mott 2013”
Paediatricians involved in child protection work need access to emotional
support, peer review and clinical supervision in order to be competent and
confident in this stressful and demanding area of work. This should be
identified within job plans. “RCPCH 2013”
OBJECTIVES
The key objectives of this strategy are to provide guidance and supporting
tools which will allow NHS organisations to review their current arrangements
and consider how to utilise existing resources in the implementation of this
strategy. In order to inform the strategy staff opinion was explored and a
literature review conducted.
This will be done by:
 Providing a matrix which identifies differing staff groups linked to
recommended frequency and delivery method of Safeguarding
Supervision.
 Providing minimum standards for individual and group supervision.
 Providing supporting tools.
 Linking the safeguarding supervision matrix to the roles and
competencies identified in the Intercollegiate Document “RCPCH 2010”
 Recommending how the knowledge and skills of those providing
supervision should be developed and maintained.
PRINCIPLES UNDERPINNING SAFEGUARDING CHILDREN
SUPERVISION
The Children Act 1989 and 2004 (Section 28) place a duty on organisations
and individuals to ensure that their functions are discharged with regard to the
need to safeguard and promote the welfare of children and young people.
Safeguarding Children; Working Together under the Children Act 2004 (2006)
Section 14, clearly sets out the key principles underpinning safeguarding
children supervision:
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All staff involved in safeguarding children should have access to
supervision advice and support.
Effective supervision is important to promoting good standards of
practice and to supporting individual staff members.
Supervision should help to ensure that practice is soundly based and
consistent with LSCB and organisational procedures.
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All Wales Safeguarding Children Supervision Strategy
It should ensure that practitioners fully understand their roles,
responsibilities and the scope of their professional discretion and
authority.
It should help identify the training and development needs of
practitioners, so that each has the skills to provide an effective service.
Supervision should include scrutinising and evaluating the work carried
out, assessing the strengths and weaknesses of the practitioner and
providing coaching, development and pastoral support.
Supervisors should be available to practitioners as an important source
of advice and expertise and may be required to endorse judgements at
certain key points in child protection processes.
Supervisors should also record key decisions within case where possible.
“Working Together under Children Act 2004 (WAG 2006)”
ROLES AND RESPONSIBLITIES
The Chief Executive has the ultimate responsibility for safeguarding and
promoting the welfare of children within the Health Board/NHS Trust.
Safeguarding children supervision is an essential part of assisting staff in
safeguarding and promoting the welfare of children.
The Lead Executive Safeguarding Children - The Health Board/NHS Trust
must identify an executive lead as well as a non-executive lead member for
safeguarding children and young people. The executive lead is responsible for
ensuring that the overarching safeguarding supervision framework and policy
for the organisation are in place.
Designated Professionals within the Safeguarding Children Service provide
independent safeguarding advice and overarching support for child
safeguarding activity in NHS Wales.
Named/Lead Professionals are responsible for the development and
implementation of a Safeguarding Children Supervision Policy and a framework
within their organisation.
The Line Manager is responsible for the following:
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Promoting safeguarding children supervision by implementing the
strategy and ensuring training is provided for both supervisors and
supervisees.
Ensuring staff have access to and attend supervision.
Ensuring all relevant job descriptions include roles and responsibilities
relating to safeguarding children supervision.
Informing supervisors when staff enter or leave service so supervision
can be arranged or cancelled.
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All Wales Safeguarding Children Supervision Strategy
Informing supervisors when individual supervisees are on long term
leave so supervision sessions can be arranged.
Informing supervisors when staff are under additional pressure and may
require extra supervision.
Facilitating the training and development of staff when learning needs
have been identified in supervision, incorporating it into the competency
framework, and monitoring through appraisal processes.
Respecting the confidential nature of supervision, yet responding
appropriately to any concerns shared formally by the supervisor.
Informing the supervisor and Named Professional if aware of any issue
that undermines the safeguarding of children or the promotion of their
welfare.
If acting as a group supervisor for their team, service or discipline, take
responsibility for their own competence level and seek appropriate
advice, education, training and development to ensure safe practice.
The Safeguarding Children Supervisor:Supervision should only be carried out by an experienced competent
supervisor. The trained safeguarding children supervisors are responsible for
the following:
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Providing advice and support.
Promoting good standards of practice and adherence to the All Wales
Child Protection Procedures 2008.
Identifying the training needs of the supervisee.
Recording key decisions.
Where areas of poor practice have been identified the supervisor will
inform the supervisee and his/her line manager.
Auditing and evaluating supervision by providing regular reports through
the organisations governance framework.
Identify own learning needs through appraisal.
The Supervisee will be responsible for the following:
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Accessing advice and support when required.
Preparing for the supervision session in advance.
Keeping clear records of the supervision session.
Taking responsibility for the quality of their own work and should prepare
for and make a positive contribution to the supervisory process.
Escalating to the named/lead professional when a difference of opinion
occurs.
Understanding and accessing training re purpose of safeguarding children
supervision.
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THE FUNCTION OF SUPERVISION
Effective supervision is a complex relationship between the different
stakeholders who have both shared and different needs which can be assessed
through its functions.
The major functions of supervision can be summarised as:
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Management – where there is accountability for agency policies,
procedures, practice and services.
Educational - the professional development of staff.
Supportive - helping staff to recognise and deal with the stresses the
work entails.
Assessment - assessing and evaluating competencies by focusing on staff
performance.
These 4 functions form the basis of the supervision model. Morrison’s 4x4x4
Model of Supervision is an integrated framework that brings together the 4
functions of supervision, the 4 stakeholders in supervision namely service
users, staff, organisation and partners with the 4 elements of the supervision
cycle namely experience, reflection, analysis, plans and actions. “Morrison T.
(2005) Staff supervision in social care: making a real difference to staff and
service users, 3rd edn. London: Pavillion”
Supervision should also be part of the agency’s performance management
framework to ensure it is embedded within the organisation with relevant
policies to promote this. It cannot be the only tool but without other
performance management elements will never fulfil its potential when
confronted with major competency and poor performance issues. We all need
to look in our agencies to ensure policies exist to address these issues and
know how to use them. Recognising the different roles and needs that
supervision may be asked.
TYPES OF SUPERVISION
There are 4 types of recognised supervision in health organisations:
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
One to one supervision with an experienced supervisor.
Group supervision involving a team, or a group of different disciplines
with an experienced supervisor.
Peer review.
Ad hoc supervision either by telephone or other electronic means seeking
clinical and non clinical advice and guidance.
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SAFEGUARDING CHILDREN SUPERVISION FRAMEWORK
The Inter Collegiate Document Safeguarding Children & Young People Roles
and Competences (2010) describes six different levels of staff groups that
require different levels of competence depending on their role and degree of
contact with children, young people and their families, the nature of their
work, and their level of responsibility. In line with this competency framework,
it is suggested that different staff groups will require different levels of
safeguarding supervision dependant on their role and degree of contact with
children and young people.
Morrison (2005) suggests that the supervisory relationship must be established
in a clear and secure manner therefore an agreement is an essential prerequisite. The agreement has three elements, administrative, professional and
psychological. All three elements need to be in place for the process to work
although the nature and level of each element may change over time. An
example of a Supervision Agreement can be found at Appendix 1, with an
example of a Peer Review Agreement at Appendix 2.
At the first session of supervision the supervisor and supervisee will complete
a supervision agreement. The supervision contract agreement include:
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Frequency of supervision
Expectations of both supervisor and supervisee
Confidentiality
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Types of Supervision
Type of
Supervision
One to one
Group
Eligibility Criteria
Content of Supervision
For practitioners who manage
a case load and have direct
contact with children on a daily
basis.
Supervisors and supervisee have
protected time to discuss child
protection cases/vulnerable children
and families, to assess concerns
and levels of risk to the child and
assist in the development of an
action plan.
Level 3
The supervisee’s learning needs
may be identified and an action
plan agreed if appropriate.
Suitable
for
caseload
management
holders
and
practitioners
who
do
not
caseload manage, but have
direct regular contact with the
same child.
Group supervision
additional to one
supervision.
Protected time for the supervisor to
engage in supervision with a group
of staff, to discuss and reflect on
cases, or emerging themes/topics
brought by the group, and to
consider how best to protect
children and promote their welfare
can be whilst supporting staff in their role.
to one
Level 2 and Level 3
Ad hoc
advice and
support
All staff
There will be a record of the
supervision, whether face to face or
by telephone, outlining concerns
and agreed action plan. Record to
be sent to the practitioner.
Pre and Post child protection
conference
preparation
and
discussion.
Level 1, Level 2 and Level 3
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Support
at
child
protection
conference or Court attendance,
including advice for writing a
statement for Court.
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Frequency of Supervision
Role
Designated
and
Named
Professionals and Safeguarding
Children Leads.
Frequency and method of supervision
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Other
members
of
the
Safeguarding Children Team.

Staff who carry caseloads and
have
direct
contact
with
children and their families e.g.
Midwives, HVs, Primary care
team, Paediatricians, CAMHS
Teams and Paediatric Therapies.

Staff who are not caseload
holders but who deliver/offer
client/patient
care.
e.g.
Paediatric Nursing staff, MIU
and A&E Staff.
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Three monthly one to one supervision with
nominated supervisor.
Day to day case discussion.
Ad hoc advice and support from more
senior member of Safeguarding Team.
Group supervision within own peer group.
One to one as required with Named or
Designated Doctor or Nurse.
Group peer supervision as required.
One to one supervision on a three to six
monthly basis with the Safeguarding
Children team, Named Nurse/Midwife/
Safeguarding Lead for Service.
Peer review meetings, minimum monthly.
Group supervision to be offered on a need
led basis with either the Safeguarding
Children Team or Named Nurse/Midwife for
Child Protection.
More frequent supervision should be offered to staff who are:
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Newly appointed;
Returning to work after a career break or long term sick;
Have responsibility for significant numbers of children and young people
with safeguarding issues;
Where practice issues have been identified;
QUALITY ASSURANCE
In recognition of the evidence (Morrison 1998) that poor child protection
supervision is at risk of being more dangerous than no supervision, the
Safeguarding Children Supervision Strategy includes a strong governance
framework and is included in the new Quality Outcomes Framework
implemented across NHS Wales. This demonstrates the commitment to
supporting health professionals in the participation of safeguarding children
supervision.
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REFERENCES
CWDC (2007) Providing Effective Supervision Skills for Care
Department of Health (1989) Children Act 1989 London: DH
Department of Health (2008) Analysing childhood deaths and serious
injury through abuse and neglect: what can we learn? A biennial
analysis of serious case reviews 2003-2005. University of East Anglia
Department of Health (1993) A Vision for the Future HMSO London
Department of Health (1994) The Clothier Report HMSO London
Department of Health (1997) Child Protection Guidance for Senior Nurses,
Midwives, Health Visitors and their Managers HMSO London
Laming (2003) The Victoria Climbiè Inquiry The Stationery Office London
Morrison T (2006) Staff Supervision in Social Care. Making a real
difference for staff and service users. Pavilion Brighton
RCPCH (2010) Intercollegiate Document Safeguarding Children & Young
People Roles and Competences for Health Care Staff
RCPCH (2012) Peer Review in Safeguarding May 2012 www.rcpch.ac.uk
RCPCH (2013) Child Protection Companion 2013
Thomas A and Mott A (2013) Child Protection Peer
Paediatricians in Child Abuse Review Vol 22 60-66 (2013)
Review
for
United Nations Convention on the Rights of the Child 1989
All UN member
states except for the United States and Somalia have approved the Convention. The UK signed it on 19 April 1990 and
ratified it on 16 December 1991. It came into force in the UK on 15 January 1992.
Welsh Assembly Government (2006) Safeguarding Children Working
Together Under the Children Act 2004 Cardiff WAG
Welsh Government (2010) ‘Doing Well, Doing Better Standards for Health
Services in Wales’
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APPENDIX 1
Safeguarding Children Supervision Agreement (Example)
Between ……………………………………………………………………….................. (Supervisee)
And ………………………………………………………………………........................ (Supervisor)
Date of Supervision………………………………………………………………..........
It is expected that practitioner will access supervision at 3 monthly intervals.
The key areas to be addressed are:
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To appraise the existing package of care being delivered to the family
and child.
To enhance problem solving and decision making.
To clarify roles and responsibilities within interagency working.
To give and acquire feedback.
To facilitate reflective practice.
To provide support and challenge.
To be a source of support and address issues relating to staff care.
To develop a consistent and robust approach to safeguarding children.
To identify areas for staff development.
To identify areas of risk for the organisation.
As a supervisee I agree to:
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Bring to child protection supervision current cases of children and/or
young people subject to the child protection plan or and of concerns.
Be punctual and prepare for sessions by having an agenda, preparing
notes.
Take responsibility for any outcomes and actions as a result of the
supervision session.
Be willing to learn to be open to receiving support and challenge.
To inform the supervisor if needs to cancel supervision and be prepared
to negotiate another date within the supervision guidelines.
As a supervisor I agree to:
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Offer support and challenge which facilitate reflective practice.
To make records of the supervision session.
To take responsibility for any outcomes and actions as a result of the
supervision session.
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All Wales Safeguarding Children Supervision Strategy
To inform the supervisee if needs to cancel supervision and be prepared
to offer another date within the supervision guidelines.
To maintain details of the supervision confidential and can only discuss
clinical issues of concerns to the supervisee’s line manager following
prior discussion with the supervisee.
Confidentiality:
The supervision session will be confidential with the exception of the disclosure
of any unsafe, unethical or illegal practice. In the rare event of an exception it
may be necessary to inform the line manager.
Frequency of meetings: To be agreed by both the supervisor and supervisee
Venue: To be agreed by both the supervisor and supervisee
Comment: ...........................................................................................
...........................................................................................................
...........................................................................................................
...........................................................................................................
...........................................................................................................
Name and Signature of Supervisor: .......................................................
Date: ..................................
Name and Signature of Supervisee: .....................................................
Date: ...................................
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APPENDIX 2
PAEDIATRIC MEDICAL PEER REVIEW TERMS of REFERENCE (Example)
Purpose:
To develop a proactive culture of learning about procedures, process and
evidence base underpinning diagnosis and in so doing provide support
regarding opinions reached and benefit from the experience of peers who are
doing the same work.
Objectives:
 To provide time for discussion of difficult cases in a relaxed, non
threatening atmosphere.
 To provide support through the sharing of experiences of others.
 To review cases seen to ensure appropriate evidence based
management.
 To view photo documentation accompanying the case presentation.
 To provide opportunity for emotional support.
 To provide training for inexperienced paediatricians.
Membership:
All paediatricians conducting child protection examinations.
Process:
 The Chair will be drawn from amongst the group and should rotate.
 The peer review should meet a minimum of once a month.
 Attendances should be recorded on a sign in sheet kept within the
department for 18 months.
 Where possible the group will seek consensus in forming a view on the
case and it is the lead consultant for each case who is responsible for
ensuring any actions, changes of opinions and recording related to case
management.
 Individuals will keep a log of their attendance/certificates to present in
their annual appraisal.
 Where the process is the only method of clinical supervision in cases
more detailed documentation of case management and self reflection will
be required as well as consideration of production of minutes of the
meeting.
 If a case is presented for second opinion/expert opinion purposes,
agreement should be reached in advance by all involved parties on
reporting arrangements and case leadership. Names of specific individual
doctors should be recorded in the file or in any subsequent reports
derived wherefrom with the permission of that individual only after
she/he has seen the notes and agreed the content of the opinion and
report.
 Examining doctors should be present for the discussion of their case.
 All photographic evidence should be produced.
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All Wales Safeguarding Children Supervision Strategy
Photographic evidence should be reviewed prior to case information
being shared (to avoid bias in interpreting the findings.
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