Reflective Essay Sample: Driscoll Model: A Challenging Safeguarding Conversation

Model Answer

This essay uses Driscoll’s (2007) What? So What? Now What? model to reflect on a difficult conversation from my second-year placement in a domiciliary care service, in which I raised a safeguarding concern about a service user with her adult son, who was also her primary informal carer. Driscoll’s model was chosen for its directness and its suitability for a single, bounded event of this kind, moving cleanly from a factual account of what occurred, through an analysis of its significance, to a concrete plan for future practice, without requiring a fixed number of predetermined stages that might not map neatly onto a conversation-based incident. Names and identifying details have been changed throughout in accordance with my placement provider’s confidentiality policy and the Health and Care Professions Council (2016) standards on maintaining service user confidentiality, and this account has been reviewed against those standards before submission to ensure no individual remains identifiable.

What?

During a routine morning visit, I noticed that the service user, referred to here as Mrs A, an 82-year-old woman with early-stage dementia and limited mobility, appeared thinner than at my visit the previous week, had bruising on her upper arm that she described only vaguely as “from getting up,” and became visibly anxious when her son entered the room partway through my visit, changing the subject and avoiding eye contact with him in a way I had not observed before. Mrs A had lived with her son for around eighteen months since her diagnosis, and previous visit notes, which I read as part of my routine preparation, described the arrangement positively, with no prior concerns recorded and the son generally described as attentive and cooperative with the care team, which is part of why the change in her presentation and demeanour stood out to me so clearly against that established, previously unremarkable baseline. I completed the visit as planned, recorded my observations factually and without speculation in the care notes, using descriptive rather than interpretive language as I had been taught during my induction, and, in line with my placement induction training, contacted my practice supervisor before the end of my shift to discuss what I had observed, rather than waiting until my next scheduled supervision session two days later. My supervisor advised that this met the threshold for a safeguarding referral under the local authority’s multi-agency safeguarding procedures, and asked me to be present, in a supporting rather than leading role, when she raised the concern directly and sensitively with the son later that same day, since I had built some rapport with the family over previous visits and my presence might help the conversation feel less abrupt and less like an unfamiliar official intervention. The conversation itself was tense: the son became defensive, denied any wrongdoing, attributed the bruising to a fall Mrs A had not mentioned to me, and asked, more than once, whether we were accusing him of hurting his mother, a question my supervisor answered calmly by explaining that a referral was a standard, non-accusatory process for ensuring Mrs A’s safety and wellbeing rather than a judgement of guilt, and by outlining, briefly, what the next steps of a multi-disciplinary assessment would actually involve.

So What?

Looking back on the conversation, I recognise that my own contribution was largely supportive and observational rather than central, which was appropriate given my role as a student on placement, but I still felt a considerable degree of internal conflict during the exchange: a wish to reassure the son, who was visibly distressed, set against an awareness that reassurance offered too readily, before any assessment had taken place, could undermine the seriousness of the concern or be misread as an early conclusion that nothing was wrong. This tension reflects a recognised challenge in safeguarding practice more broadly; the Care Act (2014) statutory guidance emphasises that safeguarding responses should be proportionate and should not automatically assume the worst of a family carer, many of whom are themselves under significant, under-supported strain, while simultaneously requiring that genuine indicators of possible harm, such as unexplained bruising alongside a marked change in the service user’s demeanour around a specific individual, are not minimised or explained away prematurely (Department of Health and Social Care, 2014). My supervisor’s handling of the conversation illustrated this balance in practice: she neither accused the son nor dismissed my observations, and instead framed the referral as a standard safety process, which the Social Care Institute for Excellence (2020) identifies as good practice for keeping a family engaged with, rather than alienated from, a safeguarding process that will likely need their continued cooperation. I also noticed, watching my supervisor rather than participating directly, that she was careful to keep some of her language provisional, saying that an assessment would establish what had happened rather than stating that harm had definitely occurred, which struck me on reflection as a deliberate and skilled choice rather than simple caution, since it kept the conversation focused on process and safety rather than tipping into an accusation the evidence at that early stage did not yet support either way.

I also recognise, on reflection, that my anxiety in the moment was heightened by uncertainty about my own role and authority as a student; I was unsure whether it was appropriate for me to speak during the conversation at all, and I said very little beyond a brief, calm acknowledgement when the son turned to me directly and asked whether I too thought something was wrong. In hindsight, this hesitancy was probably the right instinct given my supervisory relationship and my limited experience, but it also highlights a gap in my own preparation: I had not discussed with my supervisor, before the conversation began, what my role should be if I were addressed directly, which left me improvising a response under pressure rather than having thought it through calmly beforehand. Beauchamp and Childress’s (2019) principle of non-maleficence, avoiding harm, is relevant here in a way I had not fully appreciated until reflecting afterwards: harm in a safeguarding conversation can come not only from failing to raise a legitimate concern, but also from raising it clumsily in a way that damages trust and makes future engagement with services harder, which is part of why the careful, non-accusatory framing my supervisor used mattered as much as the fact of raising the concern at all. Skills for Care (2021) similarly stresses that support workers and students are often the first to notice subtle changes of exactly this kind, precisely because of the regularity and informality of home visits compared with periodic clinical appointments, which reinforces to me that my initial noticing, even though the conversation itself was led entirely by my supervisor, was a genuinely meaningful part of the safeguarding process rather than a minor, incidental detail.

Now What?

Going forward, I intend to raise questions about my expected role in advance whenever I know I will be present for a sensitive or safeguarding-related conversation, rather than discovering my role, or lack of one, once the conversation is already under way; this is a specific, concrete change directly attributable to reflecting on this episode. I also plan to revisit my placement provider’s safeguarding policy and the relevant sections of the Care Act (2014) guidance in more depth, so that my understanding of thresholds and proportionality is grounded in the formal guidance rather than only in the single example I observed, and I have already booked myself onto my university’s optional safeguarding update workshop next term with this specifically in mind. More broadly, this episode has reinforced for me that safeguarding practice sits in genuine tension between protecting a vulnerable adult and respecting the family relationships around them, and that resolving this tension well depends less on a fixed rule and more on the kind of calm, proportionate, non-accusatory communication my supervisor modelled; I intend to note specific phrases and framing techniques she used, such as describing the referral as routine and safety-focused rather than as an allegation, in my reflective log, so that I can draw on them directly the first time I am required to lead a similarly difficult conversation myself once qualified. I also plan to discuss with my personal tutor whether a short placement debrief specifically for students who witness safeguarding conversations, rather than only those who lead them, would be useful more widely, since I found that processing the emotional weight of the exchange, on top of its practical and procedural content, took real, deliberate effort, and a structured space to do that soon after the event, rather than only in a written assignment weeks later, would likely have helped me consolidate the learning more quickly and with less lingering anxiety about whether I had responded appropriately.

References

• Beauchamp, T.L. and Childress, J.F. (2019) Principles of Biomedical Ethics. 8th edn. New York: Oxford University Press.
• Care Quality Commission (2022) Safeguarding Adults: Roles and Responsibilities in Health and Social Care. London: CQC.
• Department of Health and Social Care (2014) Care and Support Statutory Guidance: Issued Under the Care Act 2014. London: DHSC.
• Driscoll, J. (2007) Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. 2nd edn. Edinburgh: Baillière Tindall.
• Health and Care Professions Council (2016) Standards of Conduct, Performance and Ethics. London: HCPC.
• HM Government (2024) Care and Support Statutory Guidance. London: DHSC.
• Social Care Institute for Excellence (2020) Safeguarding Adults: Sharing Information. London: SCIE.
• Skills for Care (2021) Safeguarding Adults: A Guide for Support Workers. Leeds: Skills for Care.