Steering the Ship
In my last post I began talking about the chaos that came with the first wave of covid-19 and lockdown back in March 2020 and all the fun* it brought (*sarcasm, it really wasn’t fun!).
Rules and regulations were coming in everyday, where and when to wear PPE, where to clean and how often, what to do if staff feel ill, what to do if residents feel ill (remember, this was before regular testing was introduced so every little cough would send shivers down our spines). Activities and emotional support took up more time than ever before, food shopping and meal planning was a struggle. Fitting all these daily tasks into the day felt like playing Tetris with the staff’s time, making sure every minute was being used effectively.
And so, our casual, laid-back routine would have to be replaced with military precision. First thing to change was our approach to supervisions.
Working as a team
As a staff team, we have always worked very closely with one another and there is an open-door policy fully in effect. It is a rare moment when there isn’t at least one resident or staff member in the office with me. Staff will pop in to report issues, add items to the shopping list, discuss individual residents or just chat about their weekend. I, as their manager, get to spend at least half an hour talking to each member of staff on every shift, giving them updates, feeding back on their practice, or just letting them know how far I have got with the latest Resident Evil game. Staff members are in contact with me and each other, by phone, text messages and social media. I have no doubt that this culture is what got us through the pandemic, and I am so grateful for the efforts made by all the staff, residents, students, families, and friends.
All good stuff, except when it comes to recording supervisions.
Recording our teamwork
Before the pandemic, 99% of our formal (i.e., recorded) supervisions went like this –
Me: Do you have any issues?
Staff member: Nope
Me: Do you remember what we discussed this morning about (insert work-related topic here)?
Staff member: Yep
Me: Great, sign here
Not exactly evidence of a “clear and transparent processes for staff to account for their decisions, actions, behaviours and performance” (to quote CQC’s Key Lines of Enquiry).
One of my biggest worries as a manager is that by pushing too hard for professionalism in the home, I would upset the thing that made Castlerea special, the atmosphere of a family home. That atmosphere is important not only to the residents but to the staff. When the staff feel like they work in a supportive and caring environment, they will pass that support and care on to the residents. So many care settings suffer when the staff do not feel cared for and supported and the feeling of “what’s the point?” creeps in. I had never seen formal supervision as part of a truly supportive environment as it always felt like they reinforced a hierarchically structure of “manager-worker” rather than a supportive “all-in-this-together” team structure. Is it worth jeopardising such a valuable culture for sake of paper evidence that at best only benefits inspectors and at worst could negatively impact the care we deliver? This perceived dilemma meant I had never pushed to formalise our supervisions, leaving them more as a necessary evil we got round to after the important work of supporting the residents was done. Had it not been for Covid-19, I’m not sure I would have ever changed that mind set.
The catalyst for change
Covid-19, if nothing else, gave us plenty to talk about! The regulations, rules and guidance were changing on an almost daily basis, not to mention 10 individual residents’ risk assessments to discuss. There was a lot of information that needed to be passed on to all members of the team, and it was vitally important I made sure I knew who what, and so we made sure we had regular, formal supervisions, all written up and recorded.
As the year went on, the regulations started to remain pretty much the same and so there was not as much to report. It would have been really easy to let the supervisions slip. However, they carried on, and when there wasn’t something covid-related to discuss, we would pick another subject. How do we make the menu healthier? What makes a good activity? What examples of holistic care can we think of? How are you coping with the current situation? What we found was the supervisions didn’t replace our informal chats or close relationships, instead it enhanced them by giving us an opportunity to focus on improving our practice. At first, I would pick a topic to prompt a discussion, but it wasn’t long before everyone was bringing something to the table. Now our supervisions go a bit more like this –
Manager: Do you have any issues?
Staff member: Actually, I have been thinking about (insert work related topic here) and I’ve had a few ideas….
1 Hour later…
Manager: Great, we’ll put that in place, sign here.
A new approach to recorded supervision
One of my favourite examples of this new style of supervision was when I asked a staff member a simple open question of “is there anything you can think of that would improve the care we give?” to which they replied with “Well, they say laughter is the best medicine, could we do something around that?”. After a long discussion we decided to hold a fund-raiser for Comic Relief (we had missed the official date for Red-Nose Day but that wasn’t going to stop us), with games, tombola, family and friends joining us via Zoom and one of the residents performing a stand-up routine that went down a storm! This discussion also ignited my mild obsession with Patch Adams (the man, not the film), something I will no doubt be writing more about at a later date.
On New Year’s Eve 2020, I was doing a sleep in, and in the evening, I thought I would get a head start on the new year by typing out the time sheets for the year (a job usually left to the last minute) while I watched TV with the residents. Once I had finished (it didn’t take long, about one episode of ‘Allo ‘Allo) I thought I would have a go at writing a training schedule, and then timetabled monthly discussions around the Care Certificate. As I was putting these new schedules into the staff members’ files, I noticed just how many more supervisions had been recorded during 2020, almost as many as the previous 5 years combined. This was the point I realised how far we had come in the last twelve months and much more professional our ways of working had become.
Now we are over halfway through 2021, I am proud to say we have stuck to our schedule. There is a whole world of information out there regarding supervisions and I am slowly trying to work my way through as much of it as I can. Making sure I ask open questions, give praise, ask for feedback, all things that are helping turn supervisions from something that makes staff members roll their eyes to an integral part of our service delivery.