Policy for case supervision for Health Visitors, Public Health Nurses, School and Paediatric Nurses

Transcription

1 Policy for case supervision for Health Visitors, Public Health Nurses, School and Paediatric Nurses Date: May 2011 Version number: Version 2 Author: Julia Ferris, adapted from Grampian Child Protection Case Supervision Policy (August 2010) with permission from Phyllis Smart, Nurse Consultant, Child Protection, NHS Grampian Review date: May 2014 If you would like this document in an alternative language or format, please contact Corporate Services on Page 1

2 Contents Page no. Document Development Coversheet 3 1. Purpose of Case Supervision Policy 5 2. Introduction 5 3. Background 5 4. Current position 6 5. Definition of Case Supervision 6 6. Purpose of Supervision 7 7. The Case Supervision process 8 8. Roles and responsibilities within Case Supervision 8 9. Implementation of Case Supervision Governance Communication and Reporting Arrangements References Appendices 14 Page 2

3 NHS SHETLAND DOCUMENT DEVELOPMENT COVERSHEET* Name of document Policy for case supervision for Health Visitors, Public Health Nurses, School and Paediatric Nurses Registration Reference Number CSPOL008 New Review Author Executive Lead Julia Ferris Kathleen Carolan Proposed groups to present document to: Health visitors, public health, school and paeditric nurses ANMAC DATE VERSION GROUP REASON OUTCOME 04/11/ Health visitors, public health, school and paediatric nurses C/S MR 29/03/ ANMAC PO MR 17/08/ Clinical Governance Co-ordinating Group C/S PRO 20/09/ Clinical Governance Committee For approval See reverse 29/01/ Clinical Governance Committee For approval Approved Examples of reasons for presenting to the group Professional input required re: content (PI) Professional opinion on content (PO) General comments/suggestions (C/S) For information only (FIO) Examples of outcomes following meeting Significant changes to content required refer to Executive Lead for guidance (SC) To amend content & re-submit to group (AC&R) For minor revisions (e.g. format/layout) no need to re-submit to group (MR) Recommend proceeding to next stage (PRO) Page 3

4 DATE CHANGES MADE TO DOCUMENT 04/11/ /03/2011 Addition of section 11 Communication and reporting arrangements 29/01/ /04/2013 Unable to identify when this document was approved at Clinical Governance Committee in 2011 so presented at the meeting on 29 th January 2013 to ensure that the Committee have reviewed the Policy. Names and titles of people and roles amended to reflect change in structure of line management of health visitors from within Community Nursing Services to Child Health Team within Children and Families Directorate from April Also Nurse Advisor (Protection) role known as Protection Nurse Advisor from March 2013 so amended within the text. Page 4

5 1.0 Purpose of policy This document explains the principles of case supervision and the processes being introduced within NHS Shetland to implement and evaluate its effectiveness. The introduction of case supervision within NHS Shetland primarily aims to enhance the professional support to health visitors, public health nurses, school and paediatric nurses (HV/PHN/SN/RCN) employed by NHS Shetland in order for them to support the families and children with whom they work. This is a new policy and should be read in conjunction with Clinical Supervision Policy. 2.0 Introduction 2.1 Safeguarding children is a high priority for NHS Shetland and it is recognised that health workers who are directly involved with children and families are often the first to identify a child at risk of harm. It is a challenging area of work that needs to be managed by competent, confident, and well trained professionals. From national Significant Case Reviews a recurring recommendation is to provide case supervision for health visitors. In the Victoria Climbié Report Lord Laming commented that regular, high quality, organised supervision is critical, as are routine opportunities for peer learning and discussion. Supervision should be open and supportive, focusing on the quality of decisions, good risk analysis, and improving outcomes for children rather than meeting targets. 3.0 Background 33.1 The Inquiry into the circumstances surrounding the death of Kennedy McFarlane was a significant catalyst in developing child protection services across Scotland (Hammond, 2000). Along with a specific recommendation of supervision for health visitors other key themes that emerged included accountability, communication, and training. (Hammond, 2000). From this enquiry a national audit and review of child protection services in Scotland was undertaken resulting in the publication of the document It s Everyone s Job to Make Sure I m Alright (Scottish Executive, 2002). As a result of the audit and review, a national reform programme of child protection services was established to implement the wide ranging recommendations. These included the development of the following documents:- The Children s Charter (Scottish Executive, 2006) Page 5

6 Protecting Children and Young People: Framework for Standards (Scottish Executive, 2004) How well are children and young people protected and their needs met? Self evaluation using quality indicators (Scottish Executive, 2005a). This document includes indicators relating to:- - Professional competence and confidence - Staff development and training - Recognising and assessing risks and needs 3.2 From these developments it can be said that in order to provide staff with the necessary skills, capability, confidence, and competence to manage safeguarding issues effectively, robust supervision processes are fundamental as a foundation for developing professional practice in safeguarding children. Locally this position was supported by the HMIe Joint inspection of services to protect children and young people in Shetland 2009 which identified the need for supervision for health visitors and school nurses. 4.0 Current Position 4.1 Across NHS Shetland health professionals currently have some access to clinical supervision in a variety of formats and settings. Clinical supervision focuses on the personal and professional needs of the practitioner; safeguarding children case supervision by comparison focuses on the clinical care provided by the practitioner to individual children and their families, and the professional standards required for service delivery. This includes a management responsibility to ensure safe practice. The introduction of mandatory safeguarding children case supervision aims to enhance the establishment of support processes for health visitors and school nurses as recommended in the HMIe Report. 5.0 Definition of Case Supervision 5.1 Supervision in safeguarding children is a formal process of professional support and learning, which enables and empowers practitioners to: Enhance protection of children by assisting them to review, plan and be accountable for their work. Develop knowledge and confidence, Assume responsibility for their own practice 5.2 It is a process by which one worker is given responsibility by the organisation to work with another worker(s) in order to meet certain organisational, professional and personal objectives, which together promote the best outcomes for service users" (Morrison, 2006). Good Page 6

7 supervision adds to the capacity of the practitioner to undertake a complex task, often in difficult circumstances. 5.3 Supervision is a confidential process with the following exceptions: Information shared through the case management supervision process may need to be disclosed to another professional or agency in order to protect children from significant harm. The ongoing and future work with the family and child will be documented in the child s record kept by the supervisee and therefore those who acquire responsibility for the protection of the child in future will have access to that information. If there are issues with regard to professional competence, unsafe or poor practice which cannot be resolved within the supervisory relationship, this will be discussed with the supervisee and a decision taken as to how the issue can be resolved. This may involve consultation outside the context of supervision with the supervisee s team leader or Consultant Midwife. 5.4 Where the supervisee demonstrates poor or dangerous practice referral to management for investigation and assessment, in accordance with NMC Guidelines (2008) is essential. The supervisee will be kept informed regarding the process. 6.0 Purpose of Supervision 6.1 Supervision should be carried out in a supportive learning environment by employing a positive expectations approach. The key principles according to Morrison (2006) are that: Staff want to do a good job People work best when they have clear targets in view People can and will try to change if it makes sense to them 6.2 The purpose of case supervision is to: Ensure that the supervisee is clear about their roles and responsibilities and those of interagency colleagues in relation to safeguarding children Assess the supervisee s competency against NES Core Competency Framework for the Protection of Children which is closely aligned to the NHS Knowledge and Skills Framework (NHS KSF) Ensure that the best interests of the child(ren) and family are promoted Page 7

8 Assist and support professional development through evidence based practice and inform continuing professional development and training Promote anti discriminatory practice Develop a positive climate to aid the instigation of positive changes in practice to bring about better outcomes for children and their families. Increase confidence and competence of staff 7.0 The Case Supervision Process 7.1 The process of case supervision will involve: 1. Reviewing existing care plans for the child and family and the supportive packages provide. The aim is to ensure that plans are sensitive and relevant to the current needs of the child and family. 2. Assessing the supervisee s competency by reviewing practice and compliance with local and national guidance, policies and procedures relating to the protection of children. 3. Providing the supervisee with time to reflect on the case and give constructive feedback on practice. 4. Identifying gaps in the supervisee s knowledge and skills and give direction on learning opportunities that will meet the supervisee s identified needs. 5. Providing opportunity for the supervisee to become self aware and enable them to manage any emotive effects of working with vulnerable children. 6. Referring to the supervisee s line manager any issues that require additional or more formal support and guidance 8.0 Roles and responsibilities within the Case Supervision relationship 8.1 To gain the most benefit from case supervision there are responsibilities for both the supervisee and supervisor and these are described as follows. The Supervisee will be asked to: accept the mandate to be supervised and agree a contract for supervision be proactive in the selection of cases that will enhance their knowledge and skill relating to safeguarding practice implement any agreed actions and recommendations from supervision sessions be active in the pursuit of their own professional development give and receive constructive feedback Page 8

9 participate in problem solving and critical analysis of selected cases be accountable for their own practice maintain safe and appropriate records make relevant records available to the supervisor prepare for the session by identifying an agenda for discussion and exploration take responsibility for making effective use of the time be punctual. ensure that there will be no interruptions, except in an emergency complete an evaluation of the supervision session as required 8.2 The Supervisor will:- provide a professional supervision relationship for safe, reflective practice promote an open, supportive and respectful working relationship review case records along with the supervisee be accountable for their own practice and development ensure confidentiality except in those circumstances already outlined be punctual ensure that there are no interruptions except in an emergency. be open to constructive criticism and reflect on ways to improve supervision for the supervisee give constructive feedback to the supervisee sensitive to their level of training and experience identify a supervisor to maintain own standards of practice and continuous learning maintain appropriate records refer to the supervisee s line manager or escalate to Consultant Midwife as appropriate in instances where the supervisee is unable to make practice changes resulting in poor or dangerous practice in accordance with NMC Guidelines (2008) 8.3 The case supervisor is line managed by Consultant Midwife. The case supervisor is offered monthly peer group supervision and professional direction from the Consultant Midwife. 9.0 Implementation of Case Supervision 9.1The principles of case supervision will be consistent across NHS Shetland. The implementation of case supervision will be regularly evaluated and developed in response to evaluation findings. Page 9

10 9.2 Cases taken to supervision by health visitors, public health nurses and school nurses are in the Additional health visiting programmes as defined by Health for All Children 4 (Scottish Executive, 2011). Those taken to supervision by the community children s nurse will fall into similar categories, for example: Children on the child protection register Looked After Children Children/families where practitioners have identified needs, risks or concerns Vulnerable families where there is difficulty in assessing the level of risk, either by poor uptake of services or difficulty in accessing families Children identified through the weekly multi-agency GIRFEC meeting 9.3 Each supervisee is offered a preliminary introduction session followed by one to one supervision sessions six to eight weekly lasting approximately one hour. It is understood that newly qualified health visitors and those with a large number of cases require case supervision more frequently. At the preliminary session all paperwork is provided for the supervisee, discussed and the contract signed. The documents are also sent electronically (templates are included within appendices 1-6). 9.5 Supervision sessions follow a structured format with agreed standardised contracts and documentation. Supervisees will be asked to bring individual family/children s records to the session. 9.6 Evaluation forms are given to all supervisees before their first case supervision session. Thereafter they will receive follow up evaluation questionnaires at regular intervals. Evaluation of findings will be used to assist managers in developing a standard approach to case supervision to make best use of limited resources to improve outcomes for children. The Supervisor will provide an initial report on supervision 6 months after introduction, and annually thereafter for the Consultant Midwife. 9.7 During a supervision session it may become evident that serious misconduct has arisen. The supervisor will end the session and report her concerns to the Consultant Midwife. The supervisor will notify the line manager responsible for the supervisee informing them of the concerns and support them to take appropriate action. When actions have been agreed, the outcome will be shared with the supervisee. 9.8 In the event that these issues relate to the practice of a third party discussed during supervision the following action is recommended: Page 10

11 If the information points to mild/moderate issues these can be resolved within supervision for the third party and followed up within the supervision process. In the event of serious misconduct, or unresolved mild/moderate issues, the information regarding the third party will be passed on directly to the Consultant Midwife, as outlined above Governance 10.1 Line of accountability in supervision Consultant Midwife Team Leader Health Visitors, Public Health Nurses, School Nurse, Paediatric Nurses 11.0 Communication and reporting arrangements 11.1 An information session was held in November 2011whereby staff were informed of the intent to provide case supervision and the first draft of this policy was shared. Discussion regarding the implementation of this policy also took place. Since February 2011 each staff member to whom this policy applies has received an individual session with the Nurse Advisor (Protection) to share the process of case supervision Records are kept for each individual staff member receiving case supervision including supervision dates are reviewed to ensure all staff receive supervision. In the event a staff member does not make themselves available for supervision, their line manager will be informed. Page 11

12 REFERENCES Hammond, H. (2000) Child Protection Enquiry into the circumstances surrounding the death of Kennedy McFarlane, dob. 17 April Dumfries and Galloway: Dumfries and Galloway Child Protection Committee. Hawthorn, J and Wilson, P. (2009) Significant Case Review: Brandon Lee Muir. Dundee: Scottish Police Services Authority. Lord Laming (2003) The Victoria Climbe Inquiry. Report of an inquiry by Lord Laming. HMSO, London. Morrison, Tony (2006) Staff Supervision in Social Care, Making a real difference for staff and service users. Pavilion Publishing Brighton NHS Education Scotland (2010) Core Competency Framework for the Protection of Children. Scotland Nursing and Midwifery Council. (2008) Code of Professional Conduct: Standards for Conduct, Performance and Ethics. London: NMC. Scottish Executive. (2002) It s everyone s job to make sure I m alright: Report of the Child Protection Audit and Review. Edinburgh: Scottish Executive. Scottish Executive. (2004) Framework for Standards: Protecting Children and Young People. Edinburgh: Scottish Executive. Scottish Executive. (2005a) How well are children and young people protected and their needs met? Self evaluation using quality indicators. Edinburgh: Scottish Executive. Scottish Executive. (2006) Protecting Children and Young People: The Charter. Edinburgh: Scottish Executive. Scottish Executive. (2006) Visible, Accessible and Integrated Care Report of the review of Nursing in the Community in Scotland. Edinburgh: Scottish Executive. Scottish Executive. (2011) Health for All Children (Hall 4) Edinburgh: Scottish Executive Page 12

13 Appendix List: Supervision documentation 1.Case Supervision Contract The supervisor will discuss the contract with the supervisee. The supervisee and supervisor will sign the contract. The supervisee will keep the contract and the supervisor will keep a copy for reference. 2 Record of Case Supervision This document is completed by the supervisor for each family discussed. The record details information or actions relating to the supervisee e.g. recommended reading, training or other learning event. It is the responsibility of the supervisor to store this record securely. The supervisee can keep their own copy 3. Case Review Record This document will be filed in a separate section in the Family and Child Health (FCHR)/School Nursing Record (SNR)/Child s Record (CR). This document will be completed by the supervisee at or after the supervision session to summarise the case discussion and plan. Only information or actions relating to the case will be recorded. It will be placed after the family/children s section of the FCHR/SNR/CR and the supervisee should write Case Supervision on this tab. 4 Supervisees Record Form This form can be used as part of a Personal Development Plan. As a tool it may assist with reflection. It s use is not mandatory. Patient identifiable information should not be included in this form. 5. Example of Evaluation of Case Supervision initial questionnaire This questionnaire will be sent out to all health visitors, public health nurses and paediatric nurses at the outset for completion before the first formal case supervision session. The questionnaire is printed off, completed and sent to the Team Leader or Protection Nurse Advisor. 6. Example of Evaluation of Case Supervision follow up questionnaire This follow up questionnaire will be sent out for completion as above at regular. A supervision record held by the supervisee and the supervisor will record information or actions relating to the supervisee e.g. recommended reading, training or other learning event. Page 13

14 Appendix 1 CASE SUPERVISION CONTRACT Supervisee: Role: Supervisor: I agree to receive supervision sessions 6-8 weekly These sessions will:- Last one hour Be protected; supervisee and supervisor will adhere to the agreed appointments, time boundaries, punctuality and ensuring privacy with no interruptions Be recorded and documentation maintained securely within the child s/family s record Have an agenda set by me which can be changed if needed Have times and dates of the sessions made available to management if and when requested Will be open to feedback including, constructive criticism on the management of the case supervision sessions Will promote anti-discriminatory practice and behaviour Adhere to NMC Professional Codes of Conduct regarding accountability and confidentiality As a Supervisee I agree to:- Prepare for the session and will be responsible for having an agenda prepared Make all relevant records available for each session Be willing to learn, to develop my clinical skills and be open to receiving support and challenge Ensure a copy of the supervision record is retained within the Child s/family Record Agree to complete the evaluation tool As a Supervisor I agree to:- Page 14 Offer you advice, support and challenge to enable you to reflect in depth on issues affecting your practice. Consider the issues raised and maintain confidentiality as per NMC guidelines.

15 Ensure the case holder is aware of her roles and responsibilities. Facilitate the supervisee to manage risk with individual cases. Be committed to continually developing my competencies as a professional and Nurse Advisor(Protection) Supervisee Signature Date Supervisors Signature Date Page 15

16 Appendix 2 RECORD OF CASE SUPERVISION To be retained by Supervisor Child s/children s CHI(s) Name of Case Supervisor Date of Supervision Name of Case Holder Areas of Current Concern Child s/children s Developmental Needs Parenting Capacity Details Family/Environmental Factors Other Locations/Activities currently being undertaken by HV/PHN/SN/CCN Clinic Activities Home Family Centre Nursery Other Page 16

17 Other agencies involvement Social Work Details Children s Reporter Education Health Other On CPR LAC Supervision Plan Date Signature of Supervisor Signature of Case Holder Page 17

18 Professional Development Record NHS Shetland (Retained by supervisor and supervisee) Date Identified/Agreed Tasks Date Completed Page 18

19 Date NHS Shetland Professional Development Date completed Other Issues Page 19

20 Appendix 3 CASE REVIEW RECORD (For inclusion within appropriate FCHR/SNR) Family Surname: Names(s)/CHI(s): Also known as: Date Summary of case supervision Plan Review date Page 20

21 Date Summary of case supervision Plan Review date Page 21

22 Appendix 4 SUPERVISEES RECORD FORM To be kept by supervisee. Can be used for Personal Development Plan and appraisal or to assist supervisee with evaluation of project at a later date Name of Supervisor: Date: Name of Supervisee: What was the issue? Action taken. What have I learned? What will I do differently? Further agreements. Page 22

23 Appendix 5 EVALUATION OF SAFEGUARDING CASE SUPERVISION CASE SUPERVISION EVALUATION QUESTIONNAIRE: KNOWLEDGE, SKILLS AND CONFIDENCE We are seeking the views of all staff who will have case supervision in child protection. Once you have completed the evaluation questionnaire, please return it to either of the two nurses below within the next two weeks. Clare Stiles Team Leader (Child Health) Breiwick House South Road Lerwick Telephone: clare.stiles@nhs.net Janice Irvine Nurse Advisor (Protection) Breiwick House South Road Lerwick Telephone: janiceirvine@nhs.net Many thanks for taking the time to complete this questionnaire. Your help is very much appreciated and will inform the future provision of case supervision. Page 23

24 Section 1: Information about you NHS Shetland 1. How long you have worked as a health visitor/public health nurse/school nurse/community children s nurse? (delete as appropriate) years... Months 2. HV s only - when did you complete your health visitor course?.../...(month/year) 3. Do you work full time or part time? Full time Part time No of hours 4. Your current caseload profile: (please complete all relevant boxes) a. What is the size of your current case load? b. How many under 5s do you have? c. How many school age children do you have? d. How many children on the at risk child protection register do you have? e. How many antenatal clients do you have? f. How many vulnerable antenatal clients do you have? g. How many Looked After Children do you have? h. How many children are on the: Core Programme Additional Programme Intensive Programme 5. What training on child protection have you received since coming into post? None 2.5 day mulit-agency 1 day refresher Other Page 24

25 Please give details of any additional training. 6. Currently, how confident are you in managing child protection cases? (please tick one box only) Very confident Quite confident Not very confident Not confident Page 25

26 Section 2: Your knowledge, skills, competence and confidence in identifying and responding to child protection issues On a scale of 1-7 how would you rate your current practice with regards to the following competencies around child protection: (1 being poor practice and 7 being excellent practice) Competencies Grade Comments 1. Professional practice a. Identifying children in need or at risk b. Taking appropriate action after identification of risk c. Taking appropriate action when faced with the unexpected d. Responding to complex ethical and professional issues e. Responding to challenges to your decision-making and judgements f. Utilising a range of strategies to instigate agencies to take action g. Sharing information with appropriate agencies h. Knowing when to seek guidance e.g. through supervision i. Making complex decisions about level of risk j. Being aware of vulnerability and risk k. Knowing own and others responsibilities Page 26

27 2. Communication and record keeping a. Recording accurate information b. Differentiating between fact and opinion c. Presenting information in informal circumstances (team meetings) d. Presenting information in formal circumstances (case conference) e. Communicating with other professions and agencies 3. In relation to your knowledge, skills and competence in managing child protection issues, what would you regard as your strengths? 4. In relation to your knowledge, skills and competence in managing child protection issues, what would you regard as your weaknesses? Page 27

28 Section 3: Your case supervision NHS Shetland 1. Which groups of colleagues are most aware of your role and skills in dealing with child protection issues? Which groups of colleagues are least aware of your role and skills in dealing with child protection issues? Do you feel you have an adequate support network, outside case supervision? (please tick one box only) Yes No 4. Where do you take issues in practice if a problem arises with regard to working with other professionals, outside case supervision? Section 4: Your reflections Thinking of your own experience of case supervision for child protection to date, what do you see as the main strengths and weaknesses? Strengths Weaknesses Page 28

29 2. If you have any other comments please add them below. Thank you for taking the time to fill in this questionnaire. Your help is very much appreciated and will help to inform future support for health care professionals dealing with child protection. Page 29

30 Page 30

31 Appendix 6 EVALUATION OF SAFEGUARDING CASE SUPERVISION CASE SUPERVISION EVALUATION QUESTIONNAIRE: KNOWLEDGE, SKILLS AND CONFIDENCE This is a follow-up questionnaire for Health Visitors, Public Health Nurses, School Nurses and Community Children s Nurse who are currently having case supervision. Once you have completed the evaluation questionnaire, please return it to either of the two nurses below within the next two weeks. Clare Stiles Team Leader (Child Health) Breiwick House South Road Lerwick Telephone: clare.stiles@nhs.net Janice Irvine Nurse Advisor (Protection) Breiwick House South Road Lerwick Telephone: janiceirvine@nhs.net Many thanks for taking the time to complete this questionnaire. Your help is very much appreciated and will inform the future provision of case supervision. If you would like more information on this evaluation, please do not hesitate to contact me directly. Page 31

32 Section 1: Information about you NHS Shetland Since you completed the last evaluation questionnaire, has your workload e.g. caseload profile, health visitor team [size and skill mix]) altered significantly in any way? If not, please go to Section 2. If yes, please give details of any changes. Are these changes affecting, positively or negatively, your experience of identifying and managing child protection issues? If yes, please give details below. Page 32

33 Section 2: Your knowledge, skills, competence and confidence in identifying and responding to child protection issues On a scale of 1-7 how would you rate your current practice with regards to the following competencies around safeguarding children: (1 being poor practice and 7 being excellent practice) Competencies Grade Comments 1. Professional practice a. Identifying children in need or at risk b. Taking appropriate action after identification of risk c. Taking appropriate action when faced with the unexpected d. Responding to complex ethical and professional issues e. Responding to challenges to your decision-making and judgements f. Utilising a range of strategies to instigate agencies to take action g. Sharing information you should with appropriate agencies h. Knowing when to seek guidance e.g. through supervision i. Making complex decisions about level of risk j. Being aware of vulnerability and risk k. Knowing own and others responsibilities 2. Communication and record keeping a. Recording accurate information b. Differentiating between fact and opinion Page 33

34 c. Presenting information in informal circumstances (team meetings) d. Presenting information in formal circumstances (case conference) e. Communicating with other professions and agencies 3. Currently, how confident are you in managing child protection cases? (please tick one box only) Very confident Quite confident Not very confident Not confident 4.In relation to your knowledge, skills and competence in managing child protection issues, what would you regard as your strengths? 5. In relation to your knowledge, skills and competence in managing child protection issues, what would you regard as your weaknesses? Page 34

35 Section 3: Your case supervision NHS Shetland 1. Do you feel that your case supervisor gives you sufficient support to improve your clinical competencies around the area of safeguarding children? (please tick one box only) Yes No 2. Please indicate whether you agree or disagree with the following statements about your case supervisor. Statements There is enough time to improve my competencies There is a lack of available opportunity to discuss cases The case supervisor is available when required The case supervisor arranges an alternative date and time to meet when necessary The case supervisor does not help to identify requirements to achieve competencies The case supervisor helps me to further develop decision making skills Having a case supervisor is invaluable to my practice The case supervisor does not understand the requirements of case supervision Agree Disagree Don t Know 3. Do you feel you have an adequate support network, outside case supervision? (please tick one box only) Yes No Page 35

36 4. Where do you take issues in practice if a problem arises with regard to working with other professionals, outside case supervision? Section 4: Your reflections 1. Thinking of your own experience of case supervision to date, what do you see as the main strengths and weaknesses? Strengths Weaknesses 2. If you have any other comments please add them below. Thank you for taking the time to fill in this questionnaire. Your help is very much appreciated and will help to inform future support for health care professionals dealing with child protection. Page 36