Dress Code Policy ICP019

Dress Code Policy ICP019 Table of Contents Dress Code Policy ICP019... 1 Why we need this Policy... 3 What the Policy is trying to do... 3 Which stakeholders have been involved in the creation of this Policy... 4 Any required definitions/explanations... 4 NHFT... 4 PPE... 4 Key duties... 4 Chief Executive... 4 Managers including Matrons... 4 All Staff employed by NHFT... 4 No Smoking Policy... 4 In line with the Smoke Free Environmental Policy staff must not smoke in public when in uniform or wearing Trust badges which identify them as an NHFT employee.... 4 Common to all Staff... 4 Professional Appearance:... 5 Identification:... 7 Hair:... 7 Jewellery:... 8 Tattoos:... 9 Nails:... 9 Personal hygiene/cosmetics:... 9 Religion:... 10 Shoes... 11 Clothing not considered appropriate at work/in the workplace:... 12 Page 1 of 16

Washing Uniforms and clothing worn at work... 12 Tax Relief... 13 Requests for variations to the uniform policy... 13 Purchase of uniform... 13 Leaving the Trust... 13 Failure to comply with the Policy... 14 Training requirements associated with this Policy... 14 For further information... 15 Equality considerations... 15 Reference Guide... 15 Document control details... 16 Appendix 1... 16 Page 2 of 16

Why we need this Policy In the Department of Health publications, Uniforms and Work Wear: An evidence base for developing local policy 2007 and Guidance on Dress code policies for NHS employees 2010, there is a requirement for Trusts to satisfy various criteria regarding work attire, specifically uniforms. The Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance states that Dress code policies should ensure that clothing worn by staff when carrying out their duties is clean and fit for purpose. It also states that particular consideration should be given to items of attire that may inadvertently come into contact with the person being cared for. Work wear should be easily washable, and aprons and gloves should be available for staff if they carry out personal care tasks. What the Policy is trying to do To meet infection control guidelines, withstand decontamination and minimise crossinfection risks. Effective hygiene and preventing infection are absolutes in all healthcare settings. The clothes that are worn by staff should facilitate good practice and minimise any risk to patients. Uniforms and work wear should not impede effective hand hygiene, and should not unintentionally come into contact with patients during direct patient care activity. Uniform should be comfortable and allow mobility for safe moving and handling. Similarly, nothing should be worn that could compromise patient or staff safety during care. To promote a corporate image to encourage public trust and confidence in Healthcare workers. The public may use appearance as a proxy measure of professional competence and hygiene standards. Patients and the wider public should have complete confidence in the cleanliness and hygiene of their healthcare environment. The way staff dress is an important influence on peoples overall perceptions of the standards of care they experience. Uniforms and work wear should be clean at all times, and professional in appearance. In addition, public attitudes indicate it is good practice for staff either to change uniform at work, or to cover their uniforms as they travel to and from work. Patients, carers and visitors also like to know who is who in the care team. Uniforms and name badges can help with this identification. Community or inpatient staff not required to wear uniform should adhere to the work wear policy to demonstrate a professional appearance and a consistent approach to standards of care. To contribute to the professional image that all staff wish to present. All staff will present themselves in a clean, smart and appropriate manner, ensuring that the professional image presented to patients, public, other organisations and each other is of a standard that promotes confidence and trust in NHFT. There is an expectation that all staff who have been identified as needing to wear a uniform and who undertake clinical contact with a patient must wear a NHFT provided uniform and/or PPE. This policy also details the dress code for patient facing staff that do not undertake clinical contact and/or wear uniform. This policy does not cover PPE worn specifically to protect staff against one or more risks to their health or safety, e.g. face protection, heavy duty gloves etc. For further guidance on this please refer to the Standard Precaution Policy. Staff undertaking clinical contact should be provided with sufficient PPE to ensure that Infection Prevention and Control guidelines are followed. Page 3 of 16

This policy will be reviewed to ensure that the principles are current and relevant to healthcare standards. Which stakeholders have been involved in the creation of this Policy Trust-wide consultation including Procurement, HR, E&D, Infection Prevention and Control Assurance Group, the Patient Safety & Experience Group, Service User Reference Group & Staff Side Trust Policy Board attendees Any required definitions/explanations NHFT PPE Hijab Niqab Northamptonshire Healthcare NHS Foundation Trust Personal Protective Equipment a head covering worn in public by some Muslim women a veil worn by some Muslim women in public, covering all of the face apart from the eyes Key duties Chief Executive Has ultimate accountability for ensuring the provision of high quality, and safe and effective services within NHFT. Managers including Matrons Must ensure that all staff are aware, have access and adhere to this policy. They are also responsible for ensuring there are adequate supplies of appropriate protective equipment available and that any deviations from the policy are investigated in the correct manner, according to the Policy for the Management of Incidents. All Staff employed by NHFT All staff and students, both clinical and non-clinical are responsible for applying the principles contained within this policy. They should report any deviations on an Incident Form as outlined in the Incident and Near Miss Policy. No Smoking Policy In line with the Smoke Free Environmental Policy staff must not smoke in public when in uniform or wearing Trust badges which identify them as an NHFT employee. Common to all Staff The Trust will employ staff in a wide variety of work settings which require them to perform a broad spectrum of duties. Staff working in clinical areas may or may not wear a uniform. Similarly, staff working in nonclinical areas may or may not wear a uniform. Page 4 of 16

There are standards that apply to all staff irrespective of whether they wear a uniform or wear their own clothes to work. People may use appearance as a proxy measure of professional competence. Patients and visitors may equate untidy appearance with low professional competence and poor hygiene standards. All employees, including student nurses, apprentices, and agency staff and volunteers must adhere to the following standards: Dress Code Standards for all staff Professional Appearance: Staff must dress in a manner which inspires patient and public confidence. Work wear must be smart, professional and appropriate in appearance at all times. It is the responsibility of each individual to ensure that the clothing they wear to work is clean and well maintained. Staff must not dress untidily and/or in an unprofessional manner. Staff must not wear neckties during direct patient contact. Staff must not carry pens, keys, scissors or other sharp or hard objects outside of the breast pockets. These may cause injury or discomfort to patients during care activity. They should be carried inside pockets either at the breast or in hip pockets. Staff must present to work in a clean uniform/work wear at the start of every shift. A clean uniform presents a professional appearance. Uniforms must not restrict movement at the shoulders, hips and waist. Incorrectly fitting uniforms must be replaced. Staff must change as soon as possible if uniform or work wear becomes visibly soiled or contaminated. Visible soiling may present an infection risk and will be disconcerting for patients. Ties have been shown to be contaminated by pathogens, and can accidentally come into contact with patients. They are rarely laundered and play no part in patients care. Neck ties, scarves, cravats etc. (other than bow ties) must not be worn in any care activity that involves patient contact unless approved wear, as specified, for religious/cultural reasons. If a tie is worn this must be secured away (tucked inside your shirt) or removed when delivering any clinical contact/patient care. Dresses/ Tunics or Polo shirts, each professional group should wear the agreed colour scheme designated for their role and Smart/casual clothing should be appropriate for the area of work and employees should appear clean and tidy. Staff should maintain a degree of modesty by ensuring that tops are not low cut, skirts are not too tight or short, underwear is not visible above trouser tops and that belly buttons are not on display. Jeans may be permitted according to local protocol (see your manager regarding this) and excessive jewellery should not be worn if staff members work in a frontline position or in clinical areas, i.e. come into contact with patients/public/clinical staff. Page 5 of 16

profession. Guidance on the correct colour scheme for uniform is referred to in appendix 1. Cardigan/Fleece Wear/sweatshirts, where cardigans/fleeces are worn they must be black, navy or green. They must not be worn during the delivery of clinical care. Long sleeves must be rolled up before giving direct patient care. Please refer to the Hand Hygiene procedure. Staff must be bare below the elbow during direct patient care activity. Cuffs at the wrist can become heavily contaminated and are then likely to come into contact with patients. Where for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not in the clinical environment and engaged in patient care, they must ensure that sleeves or bracelets (including medical alert bracelets) can be pushed up the arm and secured in place for handwashing and direct patient care activity. Trousers/Shorts should be either black, navy or green or in the agreed colour scheme for the role/ profession. Jeans may be permitted according to local protocol (see your manager regarding this) Dark or neutral hosiery should be worn with dresses. During the summer months when experiencing extremely hot temperatures, uniform dresses, skirts, etc. may be worn without tights. Plain, dark or neutral socks should be worn with trousers. Maternity Wear, uniform will be supplied if available and as required. Where changing facilities are provided staff must change into and out of uniform at work, or cover uniform completely when travelling to and from work. Staff must not go shopping or engage in other activities (including eating in cafes/restaurants) in uniform/workwear outside work, without the uniform being covered. Name badges and lanyards must also be removed. There is no evidence of an infection risk from travelling in uniform, but many people perceive it to be unhygienic. It is recognised that for some patients undertaking therapeutic activates outside the Trust it may not be appropriate for accompanying staff to wear uniform. Any decision not to wear uniform should be made in consultation with the Ward/ area Manager and the rationale documented. Guidance on the correct colour scheme for uniform is available on the Staff Room: Page 6 of 16

http://thestaffroom.nhft.nhs.uk/purchasing?smbfolder=156 Identification: Patients/members of the public like to know the names and roles of staff that are caring/talking to them. Staff must wear clear identifiers, unless a local health and safety risk assessment specifies this is not appropriate. Staff must not wear numerous badges. Staff should ensure that lanyards are kept clean. Lanyards should not be worn when engaging in direct patient care. Lanyards can be contaminated and accidentally come into contact with patients. Research suggests that they should be laundered on a regular basis, (at least once a month). Lanyards can be contaminated and accidentally come into contact with patients. Research suggests that they should be laundered on a regular basis, (at least once a month). A maximum of two badges denoting professional qualifications or memberships is acceptable. Any more looks unprofessional and may present a safety hazard. Hair: Staff must ensure hair is neat, tidy and well-groomed, tidy and off the collar. Good standards of care and cleanliness must be maintained. Hair accessories should be kept to a minimum. Beards and moustaches must be kept clean, neat and tidy. Hair pieces/extensions must not be excessive or pose potential health & safety risks. Hair should be clean, well-groomed, tidy, and Hair should be clean, well groomed. This applies off the collar, to reduce the incidence of to all hairstyles and types, including extensions, bacterial growth around the collar. wigs, etc. Uniformed staff should have their hair tied back (male and female staff), if it falls below the collar. A long fringe should be fastened back and prevented from swinging across the face. Hair Page 7 of 16

should be worn in a style that does not require frequent readjustments. This applies to all hairstyles and types, including extensions, wigs, etc. Jewellery: Jewellery should not be excessive or unconventional, or breach infection control guidance. Jewellery and watches can harbour microorganisms and make effective hand hygiene more difficult. Conspicuous jewellery can be a distraction and at odds with presenting a professional image, affecting patient/public attitude and confidence in their care team. Pierced facial jewellery is not permitted. This does not just refer to ear piercings but includes other piercings such as eyebrow, nose, lip and tongue, and this list is not inclusive. These should be removed, unless worn for religious purposes when they must be taped or pinned to skin or the inside of the dress/tunic. In clinical care areas no jewellery is to be worn with the exception of one plain ring, such as a wedding ring and one pair of plain stud earrings. Necklaces, long or hoop earrings and rings present possible hazards for patients and staff. Conspicuous jewellery can be a distraction and at odds with presenting a professional image Wristwatches and other wrist jewellery must not be worn in any setting where a clinical procedure will be performed as they impede effective hand washing. If watches are required for clinical practice, they should be pinned inside the pocket or worn as a fob watch style. The wearing of an activity tracker by staff involved in a direct patient care activity would contravene the Bare Below the Elbows standard that all staff, non-clinical and clinical MUST adhere to whilst in clinical areas. There may be instances for cultural or social reasons where staff request to meet the requirements of a certain belief / religion in the workplace. Such requests should be discussed with an individual s line manager and should not compromise Bare Below the Elbow guidance. Jewellery should be discreet and appropriate and not cause offence or harm to patients/clients. Page 8 of 16

Tattoos: Staff must not display tattoos that contain language or imagery that could be considered offensive. If deemed offensive they must be covered appropriately whilst on duty. Tattoos on the forearms and hands must be left uncovered for hand hygiene during direct patient care activity. If deemed offensive they must be covered appropriately whilst on duty. Nails: Clean nails are hygienic and look professional. Long nails are harder to keep clean and are a potential hazard. False nails, infills or nail gel harbour microorganisms and make effective hand hygiene more difficult. The Hand hygiene policy is to be adhered to at all times. Nails should be natural, short (not protruding Nails should be kept clean and well-manicured. beyond fingertip) and clean. French manicured nails/nail varnish / acrylics / gels / shellac /nail art and nail extensions are not permitted in any setting when a clinical procedure will be performed. Excessive nail length should be avoided. Personal hygiene/cosmetics: Staff are expected to maintain an acceptable level of personal hygiene. Staff wearing make-up, perfume or after shave should ensure application is minimal. Hygiene is paramount at all times, to ensure Hygiene is paramount at all times, to ensure not not to cause embarrassment to work to cause embarrassment to work colleagues or colleagues or patients. patients. Staff wearing make-up, perfume or after shave should ensure application is not over powering so to cause embarrassment to work colleagues or patients. Staff wearing make-up, perfume or, after shave should ensure application is not over powering so to cause embarrassment to work colleagues or patients. False eyelashes must be removed in clinical practice where there is a risk of them becoming detached. Page 9 of 16

Religion: Where for religious reasons members of staff wish to cover their forearms or wear a bracelet they may do so within the prescribed requirements detailed below. The niqab is not permitted to be worn in clinical practice but may be worn in an office environment. Hand hygiene is paramount, and accidental Hand hygiene is paramount, and accidental contact of clothes or bracelets with patients is contact of clothes or bracelets with patients is to to be avoided. be avoided. Where for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not in the clinical environment and engaged in patient care, they must ensure that sleeves or bracelets (including medical alert bracelets) can be pushed up the arm and secured in place for hand washing and direct patient care activity Staff wearing religious articles, such as wedding necklaces should be worn underneath the uniform to avoid contact with patients when providing care. Religious and other cultural jewellery must not be worn in any setting where a clinical procedure will be performed but may be pinned securely inside the uniform. Bracelets such as metal Kara (metal bangle worn by Sikhs) are deemed to be admissible in the clinical setting subject to overriding health care and safety consideration. Fabric bracelets will not be permitted due to high risk of infection etc. Consultations throughout the NHS have identified that the niqab would significantly interfere with communication and should not be permitted on these grounds. Hijabs / turbans worn for religious purposes are permitted and should be changed frequently, as are uniforms and laundered as per recommendations for uniforms. However, managers must take each case on its own merit and undertake a risk assessment as well as seeking advice and guidance from Human Resources/ Equality Team. Page 10 of 16

Shoes Staff must wear footwear that is appropriate for the environment(s) and work activities they undertake. Staff must wear soft-soled shoes, closed over the foot and toes. Shoes must be plain black, for nursing staff with a fully enclosed upper and heel and nonslip soles. Backless and/or open toe shoes or sandals must not be worn as these constitute a hazard. Casual trainers/plimsolls, clogs & croc style shoes must not be worn; incidents have been reported in which the soles of this type of footwear were penetrated by sharp objects such as shards of broken glass. Closed shoes offer protection from spills and dropped objects. Staff need to be aware that open and nonenclosed shoes e.g. flip flops risk injury. Managers will need to specify to staff appropriate footwear for their area of work. Closed shoes offer protection from spills and dropped objects. Open shoes e.g. flip flops/crocs risk injury or contamination for staff. Soft soles reduce noise in wards. Not wearing any heel/ankle strap provided increases injury risk. Clogs or Croc style shoes are only permissible in a theatre/kitchen setting. Steel toe capped shoes must be worn by porters/transport. Black trainer style shoes are permitted but not training shoes/plimsolls. Managers will need to specify to staff appropriate footwear for their area of work. Page 11 of 16

Clothing not considered appropriate at work/in the workplace: Sweatshirts or t-shirts with inappropriate slogans/logos; Low cut t-shirts, blouses or revealing/transparent clothing; Cropped tops showing midriff; Tight fitting tops, skirts and trousers; Leggings; unless worn with a dress or long tunic; Jogging trousers(however, exception for certain posts will be permitted)e.g. gym instructor; Casual shorts/hot pants (however, tailored shorts, culottes are permitted but must be knee length, only if the piece of clothing does not cause a health and safety risk); Vests top; Combat trousers (however, exception for certain posts will be permitted i.e. estates staff/porters); Scruffy/torn clothing; Micro or very short miniskirts/dresses for dignity and modesty reasons; Sports clothing for example: track suits (however, exception for certain posts/ activities will be permitted); Football and rugby shirts; Excessive or unconventional jewellery; Fashion/any trainers (unless stated otherwise or for certain posts/ activities); Studded belts; Strapless dresses/tops/cold shoulder/string tops/vests and spaghetti tops must not be worn, sleeveless shift style dress are acceptable. This list is not an exhaustive list. The above are examples of clothing that is inappropriate for work wear. Please note staff do not need to wear their uniform on study days. However, staff are representatives of NHFT and study days constitute a working day. Therefore staff must present as per requirements for non-uniformed staff detailed within this policy. Washing Uniforms and clothing worn at work It is highly recommended that staff involved in direct patient care observe the following guidance on laundering uniforms and clothing worn at work. Scientific observations and tests, literature reviews and expert opinion suggest that: Standards Washing Instructions: Staff should wash contaminated uniforms and work wear at the hottest temperature suitable for the fabric. All other uniform and work wear should be washed at the highest temperature the fabric Why A wash for 10 minutes at 60ºC removes almost all microorganisms. Washing with detergent at lower temperatures down to 30ºC eliminates MRSA and most other microorganisms. Separate washing will eliminate any possible Page 12 of 16

will tolerate, (see manufactures washing instruction label) but this should be at least 30ºC. Clothing/Head wear that cannot be washed at 30ºC should not be worn. cross-contamination from high levels of soiling, and enable the uniform to be washed at the highest recommended temperature. Wash heavily soiled uniforms separately. Tax Relief Tax relief is applicable as laundry facilities are not available. Nurses and AHP s can claim tax relief in respect of laundry costs where they have to pay for laundering their uniform. Copies of the form and more information is available your local Inland Revenue Office. Requests for variations to the uniform policy If a Staff member feels that on the grounds of religious, cultural or special needs that a variation to this policy is required in any clinical setting, where a procedure will be performed and should be taken into account; this must be raised with their line manager and a Human Resource Business Partner. Purchase of uniform The Purchasing Department has a list of approved suppliers. Please contact them for guidance before obtaining quotations. The Purchasing Department has the right to veto orders for uniform to enable standardisation of colour and styles and reduce disproportionate requests for uniform across the Trust. Minimum Levels of uniform issue: Full time staff 4 dresses or tunic tops or polo shirts / 3 trousers Part time staff 3 dresses or tunic tops or polo shirts / 2 trousers 1 day per week staff 1 dress or tunic / 1 trouser Leaving the Trust Staff members who leave the Trust must return their uniform, together with their identity badge. Page 13 of 16

Failure to comply with the Policy Managers should ensure that all staff are aware of and have access to this policy. Where there are instances of employees failing to comply with the policy Managers will remind the employee of the contents of the policy and the expectation that they will comply with it. Where possible, changes will be made to an employees dress/appearance for that 'shift' which enables them to comply with the policy. If an employee having failed to comply with the policy on a previous occasion fails to do so on a second occasion, then they may be sent home from that particular 'shift' and not receive pay for the period of time that they did not work due to their failure to follow policy. Disciplinary action may also be considered and in cases of repeated failure to abide by the policy may result in an individual s dismissal from employment with the Trust. Training requirements associated with this Policy Mandatory Training There is no mandatory training associated with this policy but the Uniform Policy will be discussed on Induction to the Trust. Specific Training not covered by Mandatory Training None required. However this Policy will be monitored for compliance and effectiveness. The table below outlines the Trust s monitoring arrangements for this document. The Trust reserves the right to commission additional work or change the monitoring arrangements to meet organisational needs. Aspect of compliance or effectiveness being monitored Duties Uniform and appearance patient facing staff to meet the standards outlined in this policy Method of monitoring Individual responsible for the monitoring Monitoring frequency To be addressed by the monitoring activities below. Monthly audit for inpatient services, quarterly audit for community services, biannual audit for physiotherapy & other noninvasive therapy services. Managers, team leads and Infection Prevention & Control team As stipulated in method of monitoring Group or committee who receive the findings or report Infection Prevention and Control Assurance Group Group or committee or individual responsible for completing any actions Lead Nurse Infection Prevention and Control. If there is There is no mandatory training associated with this policy. It will be referred to in Page 14 of 16

mandatory training associated with this document state the mandatory training here: Trust Inductions. For further information Please contact the Lead Nurse Infection Prevention & Control. Equality considerations The author has taken account of the quality considerations and specific conditions required to meet the religious and cultural needs of staff. The primary concern of this policy is to ensure that infection prevention & control standards are not compromised. Due consideration will be given to requests not taken into account by the policy e.g. injury requiring limbs to be in plaster, to any needs relating to disability & injury in relation to the policy. Managers & staff will be expected to contact HR & the Trust s Quality team for advice with regard to these matters. Reference Guide DH 2010 Uniforms and work-wear: Guidance on uniforms and work-wear for NHS employers, Department of Health http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digit alasset/dh_114754.pdf Health and Safety at Work Act (1974) Accessed online [18.03.2010] at http://www.hse.gov.uk/legislation/hswa.htm National Institute for Clinical Excellence (NICE), (2003) Infection Control: Prevention of Healthcareassociated infection in primary and community care. RCN (2009) (Second edition) Guidance on Uniforms and clothing worn in The delivery of patient care DH (2007) Essence of Care-care environment benchmark, Department of Health http://www.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidance/d H 080058 DH (2006) Essential Steps to Safe, Clean Care: Reducing Healthcare Associated Infections: Department of Health. http://.dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidance/dh4136 212 Page 15 of 16

DH Health and Social Care Act (2009): Code of Practice for the NHS on Healthcare Associated Infections and Related Guidance Nursing and Midwifery Council (2008) The Code: Standards of Conduct, performance and ethics for nurses and midwives. London NMC The Health and Social Care Act (2008) Code of Practice on the prevention and control of infections and related guidance, Department of Health, December 2010. Royal College of Nursing, Guidance on Uniforms and work wear, 2013 Document control details Author: Lead Nurse Infection Prevention & Control Approved by and date: 01/08/2017 Trust Policy Board Any other linked Policies: HR032 Smoke Free Environmental Policy HSC001 Health & Safety Policy HSC013 Personal Protective Equipment Policy HSC021 Food Hygiene Policy & Guidelines ICP001 Hand Hygiene Policy CRM002 Incident Policy including near miss and SI Policy number: ICP019 Version control: 9 Version No. Date Ratified/ Amended Date of Implementation Next Review Date Reason for Change (e.g. full rewrite, amendment to reflect new legislation, updated flowchart, minor amendments, etc.) 8.0 04.03.2014 01.04.2014 04.03.2017 New governance of trust policies template. 9.0 01.08.2017 02.08.2017 01.08.2020 Page 16 of 16