Adult support and protection: learning review guidance

Guidance for Adult Protection Committees to use when considering or undertaking learning reviews. Reviews/reflective learning exercises with the same purposes - meeting the criteria for a learning review - should use this guidance, including protocol for submission to the Care Inspectorate.


Annex 6

Facilitating and shaping practitioner and first line manager events and strategic manager events

Learning Reviews are a collective endeavour to learn from what has happened in order to improve systems and practise in the future and thus better protect adults at risk of harm. Bringing together practitioners and their first line managers in a facilitated event is an opportunity for them to reflect on practice and also to ensure that their voice directly contributes to the review. A sensitively facilitated event can also generate immediate learning at both an individual and a group level; learning which can be applied directly to current practice. For strategic managers, meeting together in a facilitated group is an opportunity to understand the learning from a particular situation in order to consider the implications from both a single agency and a multi-agency perspective.

However, reviewing complex situations where an adult has been harmed or been at risk of harm can raise anxiety in organisations and individuals. This anxiety can block learning by generating defensiveness, with a consequent inability to review and reflect, or to acknowledge the need for change and development in processes and practice. It is essential, therefore, that careful consideration is given to the shape and structure of group events and that they are well facilitated.

Careful preparation is essential if the events for practitioners and their first line managers and events for strategic managers are to be effective and make a meaningful contribution to the Learning Review. Preparation includes identifying participants so that the relevant people attend, selecting an appropriate venue, and thinking about the duration of the event.

At this preparation stage all participants need clarity about the purpose of the group session and a sense of how it will be conducted. They also need a framework to help them prepare and for participants and their first line managers, this will consist of asking them to revisit their involvement with the situation under review and to think about the assessments they completed, the decisions they made, the actions they took and their interaction with other professionals and services. They should also be asked to identify areas of effective practice and areas where, in retrospect, they realise that something could have been done better.

Review Team members have an important part to play in preparing participants and should be the link with those staff from their service area or organisation to ensure that they are well briefed and understand the purpose. Review Team members should also be prepared to answer any queries prior to the event.

Group sessions may vary in duration depending on the situation under review, but for practitioners and first line managers it is advisable to set aside a full day. Sessions for strategic managers can usually be completed in half a day.

The venue, as well as the structure of the day, must facilitate the process and so needs to be comfortable and fit for purpose. The layout of the room is an important factor and it is helpful if participants are able to see another in order that they can develop a conversation together. Rooms laid out in boardroom style or horseshoes or circles should assist this, together with space to move in and out of small groups and sub-sets if required. If the event is to be held for the duration of a day, then it is preferable to provide lunch. This will help participants to continue thinking together in a less formal way and avoid disruption to the process.

The discussions at this group event do need to be captured as they will directly contribute to the overall learning and to the review report. A note taker should be identified before the events and this will usually be the Review Team Administrator. It should be noted that what they will produce are not formal minutes, but working notes to assist the Reviewer(s) and the Review Team in identifying key learning and recommended actions.

Practitioner/first line manager events and strategic manager events require the facilitators to work in the moment with the material generated by the group and cannot be rigidly structured. However, in order that they have some coherency and provide a framework in which participants can work productively they need some shape with carefully crafted beginnings, middles and endings.

However well-prepared participants are there will still be some apprehension as they gather for the group session and so a careful introduction is essential. This should cover:

  • introductions to everyone in the room and why they are there
  • reiteration of purpose and process
  • an acknowledgement of the apprehensions and anxiety within the room
  • setting out working principles for the sessions
  • a brief overview of the situation under review

For practitioner and first line manager events the next stage is the exploration of their involvement in the situation under review. This is best done chronologically and, as the story unfolds, it will be important to remind participants to differentiate between their thoughts and actions at the time, and the wisdom of hindsight afforded by a retrospective reflection. In other words, it is about exploring the question 'why did we do that then?' and following this up with the question 'could we have done it differently and what would have helped us to do so?'

As the discussions and thinking develops within the group, the Reviewer(s) should ensure that the following areas are covered:

  • were the risks in the situation identified and understood?
  • how were the family members engaged with?
  • How did the professionals work together?
  • What went well? This is about identifying effective practice and what facilitated that practice
  • What could have been done better and why did it not happen at the time?

To help participants make sense of the emerging issues and learning it is essential that the Reviewer(s) pause from time to time to summarise the discussion.

How the practitioner/first line manager event is brought to a close is important if it is to have some ongoing value and should not be rushed. This final session of the day should include:

  • A summary of the key learning
  • An outline of the next steps
  • An opportunity for participants to think about their personal learning from the day and how to take it forward
  • Checking out how participants feel about the process they have been through

The events for strategic managers also need a careful and thorough introduction similar to the one for practitioner events. However, they will need to input on the circumstances leading to the review so that they have material to work with for the rest of the session. The session will then cover:

Small group work to think about:

  • Challenges and missed opportunities in this situation
  • What worked well and why?

Followed by careful feedback to identify themes and issues, feedback from the practitioners and frontline managers event, with an opportunity for discussion;

  • Input on the views of the family, again with an opportunity for discussion
  • Discussion on 'what needs to change' to think about:
  • o what changes have already been made?
  • o what else can be done?
  • Summary and agreement on the emerging recommendations/future actions
  • Setting out next steps in terms of the process of the Learning Review

For the reviewer(s) these group events will bring to the fore their facilitation skills. This includes managing the group dynamic but also working sensitively with the individuals within the group. It is about creating an atmosphere of safety and trust, which encourages participants to openly and honestly express their views and reflect on their involvement in the situation. It is about opening up discussion, allowing people to consider and debate but also knowing when to intervene and lead from the front so that the event does not lose its focus.

Contact

Email: Kristy.adams@gov.scot

Back to top