Delegation - learning

The allocation of work from a registered SLT to another member of the SLT workforce (registered SLT, student SLT, SLT assistant (job titles may vary for this position see Glossary of terminology).

As the registered practitioner you have a legal responsibility:

• to have determined the knowledge and skill level required to perform the tasks within the work area
• to assess the competence of the person to whom you are delegating
• to ensure that an appropriate level of supervision, support and feedback mechanism is in place related to the task(s)

You retain accountability for the delegation, monitoring and ensuring that the outcome of the task is up to standard.

The SLT assistant is responsible for working within their level of competency and is accountable for accepting the delegated task and for his/her actions in carrying out the task.

This is providing that:

• the SLT assistant has the skills, knowledge and judgement to perform the assignment.
• the delegation of task falls within the guidelines and protocols of the workplace.

For more information go to: What is delegation

If a task is assigned to someone both the responsibility and accountability for the activity passes from one individual to another.

Being accountable not only means being responsible for something but also ultimately being answerable for your actions.

What is my responsibility for tasks delegated to them?

This may include accountability for training, support and monitoring of the reablement workers and liaising with direct supervisors to ensure that appropriate support and guidance is provided to complete those tasks delegated.

Am I professionally liable and will my insurance cover it?

As the registered practitioner you are professionally accountable for the activities of support staff to whom you have delegated. They will have responsibility for ensuring they are working within their own scope of practice.

Where an issue of inadequate competence arises the SLT has a duty to follow this up with the support worker and their line manager through their line management arrangements and other organisational procedures. Further training may be deemed suitable or it may be that the support worker is given another task where competency is not in doubt / assured.

RCSLT insurance provides full cover against 3rd party actions and legal defence costs, for all members whether a fully certified therapist or associate member providing appropriate support and supervision is available and accessed regularly. See here for more information.

However:

• Students who are members of RCSLT do have professional indemnity insurance as part of their membership.
• NQPs working in their first SLT job will also have insurance cover as part of their RCSLT membership.
• Graduates working as SLT assistants, in a paid role, will have insurance if they hold associate membership of RCSLT.
• Graduates undertaking voluntary work will not have professional indemnity insurance cover and should ensure this is in place through the volunteer agency prior to working.

How can I justify prioritising supervision for an SLT assistant over seeing service users?

This has been highlighted in a number of recent health service reviews, for example, the Winterbourne View Hospital final report includes a recommendation that service providers “should provide effective and appropriate leadership, management, mentoring and supervision” (DH, 2012, p. 54). As the registered practitioner you are responsible for ensuring adequate supervision is in place, and ultimately are accountable for the tasks undertaken. The RCSLT Supervision guidelines recommend the frequency and duration for all practising SLTs and assistants are the same, regardless of experience – every 4 – 6 weeks together with managerial supervision and ongoing support as required.

Can a teaching assistant be expected to perform the job of a therapist?

The registered therapist retains accountability for any tasks delegated and ongoing monitoring and support of the TA to ensure that any changes to treatment are addressed as required.

On returning to school to outcome the therapy, I find that they have not completed the task at all, and have not informed me.

What can I do?

Then if it not possible to resolve a matter between yourself and the LSA directly, you can contact those responsible for management and supervision to discuss the matter further and try to overcome any barriers to effective implementation

• Negotiate and work jointly with SENCO and/or class teachers to identify staff members (and/or parents) who are willing to and have the time to carry out therapy tasks.
• Arrange demonstration sessions (at least one plus observation and feedback on the other person’s delivery of the task) with the staff member/parent.
  • Ensure they understand the aims and reasons for the tasks, and expectations for how often to complete them.
• Review/monitor the staff member/parent’s completion of tasks, whether with a record sheet, home-school therapy book, or observations.
• Provide routes to access support/advice if concerned Link to relevant case studies when available.

What is my responsibility for tasks that they undertake?

RCSLT recognises that role emerging placements may challenge the traditional approach to supervising a student as the student may have day-to-day support and management by a non-SLT or non-AHP.

The supervising SLT retains responsibility for the caseload.

In cases of role-emerging placements where there may not be an SLT on site, the supervising SLT, service provider and higher education institute need to establish clear lines of accountability and supervision prior to the placement taking place. Any agreements need to include consideration of:

• delegation of duties specific to that setting
• any risk management and safeguarding matters
• how competency is to be evidenced and assessed

What should I expect in terms of tasks delegated to me?

The appropriateness of delegation will depend on your level of training and will typically be addressed in University placement documentation available to you and your supervising clinician.

If you have concerns around delegation – either being given too little or too much – you should address this with your University and the supervising clinician.

I don’t feel confident to delegate tasks to them.

What should I do?

You may wish to increase your confidence by undertaking a CPD activity e.g. complete the Flying Start module on delegation.

Discuss their levels of skills, knowledge and experience with the staff themselves.