Supervision Recorded (HR-F016) SUPERVISION RECORD (HR-F016) Notify Document Ref: HR-F016 (Supervision Record)Purpose: Staff Support, Performance & Well-being ReviewCQC Alignment: Well-Led (Quality Statement: Workforce well-being and enablement) SECTION 1: MEETING DETAILSStaff Member NameStaff_IDOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherDate of MeetingType of Supervision- Select -Induction / Probation ReviewQuarterly Standard SupervisionAd-hoc / Return to Work (Sickness)Post-Incident Debrief (Safeguarding/Complaint)Performance Management (Disciplinary related)Venue / Method- Select -Face-to-Face (Office)Remote (Video Call)TelephoneWalk-and-Talk (Wellbeing focus)SECTION 2: WELL-BEING & WORKLOADCurrent Stress & Well-being Level- Select -Excellent - I feel supported and highly motivatedGood - Busy but I am coping wellModerate - I am feeling some pressure but it is manageableHigh - I am feeling overwhelmed / Risk of burnout (Action Required)Caseload & Rota Management- Select -My hours and travel time are perfectManageable - Occasional tight schedules but okayStruggling - Too much travel / not enough gap between callsUnder-utilized - I need more hoursWork-Life Balance- Select -Good - My rota fits my personal lifeSatisfactory - Mostly works for mePoor - Work is impacting my home life (Review needed)Discussion Notes on Well-beingSECTION 3: SAFEGUARDING & PROFESSIONAL STANDARDSConfidence in Safeguarding Reporting- Select -High - I know exactly how to report abuse and to whomModerate - I know the basics but would like a refresherLow - I am unsure of the process (Training Booked)Whistleblowing Awareness- Select -I am confident I could report concerns externally if neededI am aware of the policy but unsure of the external contactsI need a refresher on WhistleblowingProfessional Boundaries- Select -No issues - Relationships with clients are professionalMinor Concern - Discussed specific client attachment issuesConcerns Raised - Gifts/Social Media use discussedSECTION 4: REFLECTIVE PRACTICEWhat has gone well since the last supervision? (Successes)What challenges have you faced? (Incidents/Difficult Clients)Review of Previous Actions- Select -All previous targets achievedPartially achievedNot achieved (Carried forward)N/A (First Supervision)SECTION 5: DEVELOPMENT & ACTION PLANTraining Status- Select -All Mandatory Training Up-to-DateSome Refreshers Due (Booked today)Significant Gaps in Training (Suspension of duties may apply)Identify Specific Training NeedsAgreed SMART Goal 1Deadline 1Agreed SMART Goal 2Deadline 2SECTION 6: DECLARATIONStaff Member CommentsSupervisor Electronic SignatureStaff Member SignatureDateNext Review Date:Submit Supervision Recorded
