1. Triadic Clinical Supervision Ronnie Mitchell Senior Charge Nurse Directorate of Forensic Mental Health & Learning Disabilities

2. Why? As supervision is mandatory there was a need for standardising supervision provision across the directorate Provide increased support to clinical supervisors, many of which were new supervisors. Ensure that supervision sessions remain focused on clinical practice

3. Triadic Approach First implemented across the directorate in 2011 Initially a small number of Band 6 and 7 nurses trained as Triadic Consultants Following this, there was a roll-out of additional Clinical Supervisor training across the directorate

4. Triadic Model Involves three people taking part in a supervision session –Supervisor –Supervisee –Triadic Consultant

5. Role of Triadic Consultant To advocate the benefits of clinical supervision within their area of responsibility To attend (at least) the first three supervision sessions delivered by new supervisors. Thereafter attend regular supervision sessions with each supervisor in order that standards are maintained.

6. Role of Triadic Consultant Main source of support for clinical supervisors during sessions Ensure that the focus of each supervision session remains on clinical practice Is able to provide constructive feedback to the clinical supervisor at the end of each session

7. In Practice Supervisor can seek advice from Consultant on up to 3 occasions during a supervision session, (typically lasting 1 hour) If deemed necessary, the Consultant can interrupt the session no more than twice. Supervisee cannot interact directly with the Consultant

8. Challenges Supervisees can initially feel uncomfortable having a third person in the room. The Consultant has to endeavour to remain as unobtrusive as possible. Maintaining a regular calendar of supervision for each nurse (typically every 6 weeks)

9. Benefits Uniformity of supervision delivery across the directorate. Regular, timeous sessions provide staff with an ongoing source of clinical support. Supervisors are able to seek advice/feedback from Consultants almost at the point of delivery.

10. Audit A record of attendance for each supervision session is kept at individual ward level Monthly Audits are submitted by SCNs to Lead Nurse detailing number of sessions delivered

11. What’s Next? Additional Clinical Supervisors can be trained as required. Triadic Consultants will continue to take part in sessions with each of their supervisors Refresher training (if required) for supervisors is available.