Restoring
Supervision Hub
The Restorative function of the A-EQUIP model focuses on restoring staff wellbeing. It refers to ways in which we can restore, re-energise and rejuvenate our health and social care workforce.
It is about developing resilience in all our health and social care professionals, the teams that we work in and the wider organisations we are part of through restorative healthcare.
Engagement with stakeholders as part of the development of the Supervision Hub highlighted the importance of psychological safety and wellbeing, and the development of a culture of supervision to help improve the retention of the workforce. Some stakeholders indicated a preference for the term 'restorative' over 'clinical' supervision.
The Restoring pages aim to support the restorative approach to supervision throughout the health and social care workforce.
The restorative approach "promotes reflection of personal emotions and practice, has a positive impact on emotional wellbeing, provides a strategy to mitigate workplace stress, enhances retention and assists with the management of personal and professional demands" [1]Professional nurse advocate A-EQUIP model: a model of clinical supervision for nurses 
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Reflective and restorative supervision is essential, The BASW state in their UK Supervision Policy that "the over emphasis in recent years on the managerial aspects of supervision, has led to the reduction in the reflective aspects of supervision, loss of professional autonomy in decision making and a poorer service for service users" [2]UK Supervision Policy .
In New Zealand "restorative responses involve honest dialogue in a psychologically safe environment and are guided by a concern to address harms, meet needs, restore trust, mitigate repetition, and promote repair" [3]He Maungarongo ki Ngā Iwi: Envisioning a Restorative Health System in Aotearoa New Zealand .
Restorative supervision was first developed by Sonia Wallbank who identified that "focusing supervision and support on the needs of the individual, not just the work they deliver reduces stress, burnout and improves the pleasure people derive from their work" [4]Dr Sonya Wallbank .
Writing for the HCPC, Dr Noreen Tehrani states that "by providing a safe space, restorative supervision allows a supervisee to reflect and express feelings of failure or concerns about their decision-making. This enables them to access support and guidance and develop strategies to manage those feelings, building resilience and integrating learning from their experiences" [5]The benefits of supervision - an employer’s perspective .
Reflecting the ways in which restorative cultures go beyond our own wellbeing the following dropdowns explore ways of relating this restorative approach to individuals, teams and organisations. This also emphasises the needs for compassionate cultures within teams and organisations rather than just the building of individual resilience.
Reflecting the ways in which restorative cultures go beyond our own wellbeing the following dropdowns explore ways of relating this restorative approach to individuals, teams and organisations. This also emphasises the needs for compassionate cultures within teams and organisations rather than just the building of individual resilience.
Restoring IndividualsFor many professions there is an implicit focus on the restorative aspect in supervision.
In the Professional Advocate role that is underpinned by the A-EQUIP model, Restorative Clinical Supervision (RCS) is explicitly restorative. In Wales RCS has been mandated for all registered Nurses to be offered a minimum of 4 times a year for 1.5 hours [6]Welsh Health Circular .
The findings from the Restorative Supervision Programme review showed it reduced burnout by 43% (from 42.81 to 24.71) and stress by 62% (from 43.35 to 16.86) from regional baselines [7]A healthier health visiting workforce: Findings from the restorative supervision programme .
For more information about RCS search for "000 NHS Wales - Restorative Clinical Supervision Programme for Nursing" on ESR.
Restoring OrganisationsA common challenge to the idea of restoring resilience is that it suggests that for those staff struggling to cope "that fault lay with their own coping skills, rather than a response to their working conditions [9]Learning from NHS Staff Mental Health and Wellbeing Hubs 
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Yet rather than understood in the engineering sense as a measure of the load that can be placed on an object, instead, resilience should be seen as ecological and about the ability of communities and relationships to adapt and spring back.
Individual resilience therefore "should be developed as part of a community that shares a critical dialogue, offers supportive relationships and enables reflective discussion’… …resilience “…doesn’t lie in individuals, it lies between individuals" [10]Building Resilience and Compassion .
Restorative supervision can have a role in the development of compassionate cultures and the restoration of caring organisations, that also improves recruitment and retention of staff. Compassionate Leadership Hub provides more information.
Restoring TeamsResilience-based Clinical Supervision (RBCS) [8]Resilience-based Clinical Supervision is a form of restorative clinical supervision delivered in a group.
RBCS is a facilitated reflective discussion, characterised by:
- Co-creating a safe space
- Integrating mindfulness-based stress-reduction exercises
- Focusing on the emotional systems motivating our response to a situation
- Considering the role of our internal critic in sustaining or underpinning our response to a situation
- Maintaining a compassionate flow to self and consequently to others
For more information about RBCS see Resilience-Based Clinical Supervision (FoNS) .
The potential for healing, learning and improving is enhanced within a restorative just culture where people feel safe to raise concerns and talk openly about a harmful event or experience without a fear of being judged.
Should you require any further information, please contact HEIW.MentalHealthWorkforcePlan@wales.nhs.uk 
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