Dress Code Policy For Uniforms & Workwear

Dress Code Policy For Uniforms & Workwear

DRESS CODE POLICY FOR UNIFORMS AND WORKWEAR Document Type Unique Identifier Document Purpose Document Author Target Audience Responsible Group Human Resources Policy HR-HACW-19 The purpose of this document is to set out the Trust s policy with regard to staff dress code, which includes uniforms and workwear. It is also to ensure the Trust complies with the Department of Health guidance on uniforms and workwear in order to support infection prevention & control measures, health & safety and promote public confidence and support staff comfort. Chris Nash, Associate Director of Human Resources and Workforce Transformation All Worcestershire Health and Care NHS Trust staff Quality and Safety Committee Date Ratified 24 th April 2013 Expiry Date 24 th April 2016 The validity of this policy is only assured when viewed via the Worcestershire Health and Care NHS Trust website (hacw.nhs.uk). If this document is printed into hard copy or saved to another location, its validity must be checked against the unique identifier number on the internet version. The internet version is the definitive version. If you would like this document in other languages or formats (i.e. large print), please contact the Communications Team on 01905 760020 or email communications@hacw.nhs.uk. 1

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Version History Version Circulation Date 1 August 2012 August 2012 2 August 2012 3 18 th December 2012 4 15 th April 2013 4 24 th April 2013 Accessibility Job Title of Person/Name of Group circulated to Human Resources Team EIA Scrutiny Group SDU Senior Management Teams JNCC Policy Group JNCC Full Committee Quality and Safety Committee Brief Summary of Change Worcestershire Health and Care NHS Trust has a contract with Applied Language Solutions to handle all interpreting and translation needs. This service is available to all staff in the trust via a free-phone number (0800 084 2003). Interpreters and translators are available for over 150 languages. From this number staff can arrange: Face to face interpreting Instant telephone interpreting Document translation British Sign Language interpreting Training and Development Worcestershire Health and Care NHS Trust recognises the importance of ensuring that its workforce has every opportunity to access relevant training. The Trust is committed to the provision of training and development opportunities that are in support of service needs and meet responsibilities for the provision of mandatory and statutory training. All staff employed by the Trust are required to attend the mandatory and statutory training that is relevant to their role and to ensure they meet their own continuous professional development. 3

WORCESTERSHIRE HEALTH & CARE NHS TRUST DRESS CODE POLICY FOR UNIFORMS AND WORKWEAR CONTENTS Page No 1. INTRODUCTION 4 2. SCOPE 4 3. DEFINITIONS 4 4. PRINCIPLES AND RATIONALE FOR THE DRESS CODE 4 5. ROLES AND RESPONSIBILITIES 6 6. BARE AND ELBOWS 7 7. REDUCING RISK OF CONTAMINATION 7 8. WEARING UNIFORM OUTSIDE OF WORK 8 9. NAME BADGES FOR STAFF 8 10. LAUNDERING 8 11. STANDARDS FOR STAFF GROUPS ON DRESS CODE 9 12. PROCESS FOR IDENTIFING STAFF GROUPS REQUIRED TO WEAR UNIFORM 12 13. PROVISION OF UNIFORM 12 14. CONCLUSION 12 15. REFERENCE AND BIBLOGRAPHY 12 16. ASSOCIATED DOCUMENTS 13 APPENDICES 1. 2. Note from DH 2010 - Advice from Muslim Spiritual Care Provision in the NHS (MSCP) Staff groups required to wear uniform. 14 15 4

WORCESTERSHIRE HEALTH & CARE NHS TRUST DRESS CODE POLICY FOR UNIFORMS AND WORKWEAR 1.0 INTRODUCTION The purpose of this document is to set out the Trust s policy with regard to staff dress code, which includes uniforms and workwear. It is also to ensure the Trust complies with the Department of Health guidance on uniforms and workwear in order to support infection prevention & control measures, health & safety and promote public confidence and support staff comfort. 2.0 SCOPE This policy applies to ALL employees, to those who are required to wear uniform and to those who wear their own clothes for to work. It also applies to ALL students on placement, work experience students and volunteers. It equally applies to ALL visiting healthcare personnel who provide clinical services on Trust sites, such as visiting doctors, GP s and other healthcare professionals. 3.0 DEFINITIONS For the purpose of this policy the following definitions apply; Uniform is where the Trust provides an appropriate range of corporate uniform for staff to wear. Workwear is where staff wear their own clothes to work. NB. Uniform provided remains the property of the Trust and should be returned to the departmental manager at the end of employment with the Trust. 4.0 PRINCIPLES & RATIONALE for the DRESS CODE In indicating standards of dress code for staff the following key principles will be applied; Patient Safety Effective hygiene and preventing infection are absolutes in all healthcare settings. The Trust expects the Department of Health s Bare Below Elbow recommendation for work wear (DH, 2010a) to be fully complied with at all times. Although there is no conclusive evidence that uniforms and workwear play a direct role in spreading infection, the clothes that staff wear should facilitate good practice and minimise any risk to patients. Uniforms and workwear should not impede effective hand hygiene and should not unintentionally come into contact with patients during direct patient care activity. Similarly, nothing should be worn that could compromise patient or staff safety during 5

care, for example false nails, rings, earrings, other than studs, and necklaces. Departmental policies may allow a plain ring, such as a wedding ring. Public Confidence 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 people s overall perceptions of the standards of care they experience. The RCN have endorsed the importance of this and Patient Surveys also evidence how important the way staff dress is to the patient. As a public service, the Trust expects all staff to present a positive professional image in order to inspire public confidence and to enhance the profile of the service provided. This applies to all employees irrespective of whether they are in uniform or not. Extremes of fashion are not acceptable in the work setting and this includes hair styles and hair colours. Where there is any disagreement on whether something is an extreme, the Deputy Director of Nursing will have the final decision. A uniform, where provided is a means of easy identification and promotes a professional appearance and must be worn. Uniforms should be clean and professional in appearance. In addition, although there is no evidence that wearing uniforms outside work adds to infection risks, public attitudes evidenced from complaints received indicates it is important to public perception. It is also good practice for staff either to change at work, or to cover their uniforms as they travel to and from work. Patients and visitors like to know who is who in the care teams. Uniforms and name badges help with this identification and staff must be easily identifiable by name badge or photo identification. Staff Comfort As far as possible, subject to the overriding requirements of patient safety and public confidence, staff should feel comfortable in their uniforms. This includes being able to dress in accordance with their cultural practices. For example, although exposure of the forearm is a necessary part of hand and wrist hygiene during direct patient care activity, the uniform code should allow for covering of the forearm at other times. Where uniform is provided, the Trust will, within the budget available, purchase quality clothing to enhance staff comfort but also to reduce replacement costs. Staff in senior clinical roles It is important that staff in senior clinical roles and therefore have a particular responsibility to act as role models, comply with this Dress Code Policy at all times. All senior clinical staff who are required to wear uniform, such as community hospital matrons or specialist staff, must wear uniform at all times if they are spending any of a working shift in a clinical environment. Health & Safety Every member of staff has a responsibility to minimise the risk of injury and ill health to patients, other persons and themselves whilst at work. Therefore health & safety and control of infection risks associated with items of clothing or accessories must be considered in relation to activities being carried out whether clinical or non-clinical. 6

Equality & Diversity The policy applies to all employees irrespective of age, colour, disability, nationality, gender, sexual orientation, marital, social and employment status, gender assignment, political affiliation, trade union membership or any other status. Whilst the Trust recognises the diversity of cultures, religions and disabilities of its employees, and will endeavour to take a sensitive approach when this affects dress and uniform requirements, priority will be given to health and safety, security and infection control considerations. All employees will be treated in a fair and equitable manner recognising any special needs of individuals where adjustment may need to be made. No member of staff will suffer any form of discrimination, inequality, victimisation, harassment or bullying as a result of implementing this policy. The policy accommodates personal and cultural diversity where this does not compromise the safety of patients or staff, or damage the professional standing of the individual or the Trust. Adjustments to accommodate disability will be determined on an individual basis, with advice and support from Occupational Health and Human Resources. However it is recognised that whilst priority must be given to Health and Safety, security and infection control issues, managers are required to implement the policy sensitively and take in to account relevant cultural differences. Please refer to appendix 1. 5.0 ROLES & RESPONSIBILITIES Individual employees All staff must comply with this policy. If a member of staff has a particular issue or requirement that needs to be taken into consideration that must be raised directly with the line manager. By not adhering to this policy and the standards set formal disciplinary action may be taken. Line managers All line managers have a responsibility to make sure the staff complies with the requirements of this policy. Line managers are required to manage and report any concerns they have around adherence to the policy and escalate if necessary to the senior manager at the level above them. Decisions on how to manage any issues related to compliance with this policy may be influenced by the following: Whether the overall image presented is professional and positive. The degree of personal care delivered to patients and infection prevention & control issues. The degree of lifting and handling necessary within the job. Any risk of violence or aggression towards staff. Any concerns regarding dress code and appearance of staff including clothing, footwear, jewellery, tattoos or body piercing, should be discussed directly with the 7

member of staff in the first instance. It is good practice to provide a letter to the individual confirming this informal discussion with a copy kept in the staff s personal file. If the manager is concerned that this poses a health and safety risk the individual will be required to make the appropriate changes immediately. All staff must understand that not adhering to this policy may result in action under the Disciplinary Procedure. 6.0 BARE BELOW ELBOWS The Trust has adopted the Department of Health s Bare Below Elbows recommendation for work wear (DH, 2010a). This means that ALL staff required to cleanse their hands regularly as part of their role MUST wear short sleeves. This includes ALL clinical staff providing DIRECT care, e.g. nursing staff, therapists and medical staff if conducting examinations or other similar clinical interventions. Evidence indicates that if long sleeves are worn, hand hygiene will not be as effective and there is further evidence to indicate that cuffs may become contaminated. The traditional white coat for clinical staff will not be allowed for the same reason and any long sleeved garments must be removed prior to any direct contact patient intervention. Where, for religious reasons, members of staff wish to cover their forearms or wear a bracelet when not engaged in patient care, they must ensure that sleeves or bracelets can be pushed up the arm and secured in place for hand washing and direct patient care activity. In a few instances, staff have expressed a preference for disposable over-sleeves elasticated at the wrist and elbow to cover forearms during patient care activity. Disposable oversleeves can be worn where gloves are used, but strict adherence to washing hands and wrists must be observed before and after use. Over-sleeves must be discarded in exactly the same way as disposable gloves. Hand hygiene is paramount please refer to appendix 1. Cardigans, jackets and coats may be worn with uniforms if necessary in cold weather conditions but they must be removed prior to undertaking any direct contact patient intervention or task where hand hygiene is required. Catering staff who provide meals for patients are provided with clothing with long sleeves for health & safety reasons. Housekeeping, catering and portering staff are provided with cardigans, jumpers and outdoor clothing. However, they must remove cardigans, jumpers or outdoor clothing prior to undertaking any duties where there is direct patient contact. 7.0 REDUCING RISK OF CONTAMINATION Aprons a clean disposable single use plastic apron of the designated colour must be worn for every direct contact and clinical intervention and including when undertaking tasks where actual or potential splashing of blood, body fluids or substances that are hazardous may occur and also worn when handling food and 8

at patient mealtimes. To maintain compliance with infection prevention control requirements the following colours will apply across the Trust. White aprons must be worn for direct clinical care or personal care. Green aprons must be worn when serving food. Green aprons must be worn for food preparation. Headwear - catering and hostess staff must wear suitable head covering or hair net when handling or serving food. 8.0. WEARING UNIFORM OUTSIDE WORK Whilst there is no evidence of any infection risk from travelling in uniforms, it is acknowledged that public confidence in the NHS may be undermined by seeing staff shopping in uniform for example. This is evidenced by complaints received and comments in Patient Surveys. Therefore the following will apply: Travelling to and from work or undertaking any non-work related activity such as shopping in uniform is not permitted where adequate changing facilities are available. Where uniforms have to be worn to travel to and from work or to undertake a non-work related activity, uniform must be kept covered by outdoor clothing. In the case of community staff who are expected to wear uniform whilst travelling between patient visits, this must be the standard uniform outerwear provided by the Trust. 9.0 NAME BADGES FOR STAFF All employees must be able to identify themselves and their discipline during their work shift. It is important for patients and the public to be able to identify who they are dealing with. Employee identity may be either by a name badge and/or a photo ID fixed to clothing or via a lanyard worn around the neck. Where teams opt to wear lanyards, this must be risk assessed in terms of the area they are working in to ensure it does not present a safety risk. All employees must carry this form of identification at all times during working hours, and be able to produce it on request. For clinical staff who may wear a lanyard, this must be tucked in to clothing when carrying out clinical procedures where they could become contaminated or cause problems such as trauma. No other badges should be worn other than for professional qualifications/affiliations. 10.0 LAUNDERING If uniforms or clothing become visibly soiled or contaminated they must be changed immediately. Where non-uniformed staff are undertaking a procedure 9

which might result in soiling or contamination, a single use plastic apron must be worn and then disposed of. Workwear including uniforms/clothing worn to work in care areas should be washed at the hottest temperature suitable for the fabric which is indicated on the clothing label. A wash at 60c removes most micro-organisms but use of biological detergents means that these can be removed at lower temperatures if the fabric cannot withstand a 60c. Washing with detergent at lower temperatures down to 30 c eliminates MRSA and most other organisms. Heavily soiled uniforms should, where possible, be washed separately at the highest recommended temperature. It is advised that uniforms are separated from other clothes. 11.0 STANDARDS FOR STAFF GROUPS ON DRESS CODE All staff wearing uniform must adhere to the dress code at all times and be aware of the need to comply with health and safety and cross infection risks. Uniform should be clean and presentable to maintain a professional image with a clean uniform being worn on each shift. The following sections sets out specific guidance that all staff must follow 11.1 Uniformed staff working in clinical roles Uniform is provided by the Trust as protective clothing for use on duty and remains the property of the Trust at all times and when wearing uniform, members of staff should remember that the image of their professional group, as well as the Trust, is influenced by their appearance and behaviour. The following specific criteria will apply; Jewellery Hand and wrist jewellery including watches can harbour micro-organisms and reduce compliance with hand hygiene. Therefore only one plain ring should be worn and wrist watches must not be worn. Necklaces should not be worn. A small stud in one or both ears is acceptable but several studs or large earrings are not. With the exception of a small ear stud(s) visible body piercing jewellery must be removed whilst on duty. Nails Nails must be kept short and clean. False nails, nail varnish and nail art should not be worn by staff providing direct patient care or contact. Hair Hair should be tidy and neat. If hair is longer than collar length it must be tied back and off the collar. 10

Footwear Footwear must be appropriate to ensure a safe environment for staff and patients. Staff working in clinical areas must wear shoes that are soft soled to reduce noise and be non-slip. Enclosed shoes must be worn by all clinical staff as they offer protection against spillages and injuries. Any footwear that leaves areas of the foot exposed is not acceptable as this presents a health and safety risk from spillages or items dropped onto the foot. This is in compliance with Department of Health (2010a) guidance and must be adhered to. Neckties/Lanyards Neckties, other than bow ties, must not be worn in clinical areas. Evidence indicates they can become colonised by pathogens if worn in clinical areas Lanyards must be tucked in to clothing when carrying out clinical procedures where they could become contaminated or cause problems such as injury. Belts and buckles Wearing of a belt and buckle is optional where uniform dresses are worn, but if there is any possibility of the belt buckle causing an injury to a patient when carrying out moving and handling tasks, they should be removed. The belt and buckle must be cleaned regularly. Wearing scrubs In very hot weather i.e. temperatures at 27 0 and above for 2 days or more consecutive days, it is permissible for clinical staff who work all of their shifts in an indoor environment, to wear scrubs. These will be supplied via the individual clinical area stock and purchased by that department. Other Wherever possible tattoos must be covered at all times. Staff must not carry pens, scissors or other sharp objects in outside breast pockets as they may cause injury or discomfort to patients during care activity. They should be carried inside clothing or hip pockets. Where a headscarf or a veil is worn, as part of religious observance, staff must ensure that the flow of the garment does not interfere with work practice. This must be changed on a daily basis to minimize cross infection and to reduce the risk of personal injury. Similarly if any member of staff who has a need for special consideration to be given to their appropriate clothing due to a disability, they should bring this to the attention of their manager, seek support and guidance from the Occupational Health department and the Infection Prevention & Control team as necessary. 11.2 Non-uniformed staff working in clinical roles Some clinical staff are not required to wear uniform but are still required to comply with all the requirements in para 11.1 when carrying out clinical tasks that involve direct patient contact. This will also apply to neckties and lanyards. Bare Below Elbows applies equally regardless of whether uniform is worn. Jeans or casual clothes are not appropriate in most areas where employees come into contact with patients, visitors or members of the public. In some services they may be deemed appropriate for clinical reasons but they must still be clean 11

11.3 Uniformed staff working in non-clinical roles There are a number of staff groups in the Trust that are required to wear uniform but who are not carrying out clinical roles such as housekeeping staff, catering staff, trainers etc. It is equally important that these staff comply with the Dress Code when wearing uniform, and that they should remember that the image of their professional group, as well as the Trust, is influenced by their appearance and behaviour All staff in these groups, if they are required to undertake hand hygiene as a regular task within their role, must be aware of the need to comply with the standards within this policy. Uniform should be clean and presentable at all times. Housekeeping staff, catering staff and portering staff must remove cardigans or jumpers prior to commencing their duties. Appropriate headwear must be worn by catering staff when handling or serving food. Flat shoes, that are covered and with a non-slip sole should be worn. 11.4 Non-uniformed staff working in non-clinical roles For the remainder of employees in the Trust who are not required to wear uniform, and who are not in clinical roles, they must still be aware that appearance at work must conform to acceptable standards. Extremes of fashion including hair styles and colour are not acceptable. There may be some variation between areas and in all cases the line manager is responsible for making the judgement on what is acceptable in line with this policy. For example jeans or casual clothes would not be appropriate in most areas where employees come into contact with patients, visitors or members of the public. In all cases, the following criteria must apply: Skirts or dresses should be an appropriate length with no extremes of fashion and style. Trousers should be smart. No denim to be worn unless agreed appropriate to the work area. Midriffs should not be exposed and necklines discreet. Shirts, polo shirts and t-shirts should be smart in appearance. All clothing should be of a type that promotes dignity and professionalism and is not provocative, or could be construed as such. There should be no inappropriate writing, logos or designs visible. This will be decided on a case by case basis. No shorts to be worn. Footwear must be appropriate to ensure a safe environment for staff and patients. In clinical areas shoes must be soft soled to reduce noise, low heeled, non-slip and enclose the foot. Footwear in non-clinical areas must ensure safety although not necessarily enclose the foot. Flip flops are not allowed however as they expose the foot to spillages or items that might be dropped. However, open toed sandals may be worn. Jewellery worn must be present a professional image and reduce any health and safety risks. Visible body piercing jewellery must be removed other than earrings. 12

12.0 PROCESS FOR IDENTIFING STAFF GROUPS REQUIRED TO WEAR UNIFORM A process is in place to determine which groups of staff are required to wear uniform at work. This will broadly be determined by the nature and scope of the work required or the service areas within which staff are working. A list will be kept updated on which staff groups are required to wear uniform (appendix 2). Service managers are responsible for identifying any new staff groups who are required to wear uniform or for any decisions made over changing uniform requirements within existing staff groups. This should then be discussed in conjunction with the Quality Directorate (currently delegated to the Deputy Director of Nursing). Once agreed this will be communicated to the Facilities department who are responsible for the management of the uniform ordering and supply process. As part of the recruitment process all new employees with the Trust complete a uniform order form if their role requires that they wear uniform. 13.0 PROVISION OF UNIFORM The Trust will supply uniform to staff which is of a suitable quality to ensure comfort for the wearer and reduce replacement costs. Uniform suppliers will be kept under review both in terms of cost and quality to ensure maximum benefit from available resources. Clinical staff required to wear uniform will be allocated items dependent on their working hours and to allow sufficient items to enable a clean uniform dress/tunic/polo to be worn on each shift. For example a clinician working 5 days a week would receive 5 dresses/tunics/polo shirts and 3 pairs of trousers if worn. Non-clinical staff will be allocated uniform items dependent upon their individual work role, e.g. administrative staff working 5 days a week would receive 3 work blouses/shirts. Replacement uniforms should normally be ordered after a period of two years. 14.0 CONCLUSION This policy provides general guidance and cannot cover all situations. If managers have any queries or issues they wish to seek clarification on the issue should be raised initially with the appropriate senior manager. If there are still unresolved issues the HR Team will be pleased to advise. 15.0 REFERENCES AND BIBLIOGRAPHY Department of Health (2010a) Uniforms and workwear: Guidance on uniform and workwear policies for NHS employers. 13

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/docu ments/digitalasset/dh_114754.pdf Department of Health (2010b). The Health and Social Care Act 2008 Code of Practice for health and adult social care on the prevention and control of infections and related guidance. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalass et/dh_110435.pdf The Health and Safety at Work etc Act 1974 1 sections 2 and 3. Section 2 covers risks to employees and Section 3 to others affected by their work, eg patients. The Control of Substances Hazardous to Health Regulations 2002 2 (as amended) (COSHH). Further information about COSHH and its applicability to infection control can be found at http://www.hse.gov.uk/biosafety/healthcare.htm. Management of Health and Safety at Work Regulations 1999 (Management Regulations), that extend the cover to patients and others affected by microbiological infections, and include control of infection measures. Securing Health Together 4, the Health and Safety Executive (HSE) long term strategy for occupational health that commits HSE/Health and Safety Commission and their fellow signatories (including the Department of Health) to a 20 percent reduction in ill health caused by work activity by 2010. 16.0 ASSOCIATED DOCUMENTS Health and Safety Policies Infection Prevention & Control Guidelines Disciplinary Policy and Procedure Maternity, Paternity and Adoption Leave Policy Uniform ordering & returns procedures 14

Appendix 1 DEPARTMENT of HEALTH GUIDANCE (2010 A) Advice from Muslim Spiritual Care Provision in the NHS (MSC)) Exposure of the forearms is not acceptable to some staff because of their Islamic faith. In response to these and other concerns, the MSCP convened a group including Islamic scholars and chaplains and multi-faith representatives as well as Department of Health policy-makers and external experts in infection prevention. Based on these group discussions, the MSCP prepared a list of recommendations to ensure that local dress code policies are sensitive to the obligations of Muslims and other faith groups whilst maintaining equivalent standards of hygiene. Recommendations therefore include: Uniforms may include provision for sleeves that can be full length when staff are not engaged in direct patient care activity or have three-quarter length sleeves. Any full or three-quarter length sleeves must not be loose or dangling. They must be able to be rolled or pulled back and kept securely in place during hand- hygiene procedures and when providing direct patient care activity or tasks where sleeves may become contaminated or reduce ease of hand hygiene. Strict procedures for washing hands and wrists must still be observed. Use of hand disinfection gels containing synthetic alcohol does not fall within the Muslim prohibition against natural alcohol (from fermented fruit or grain). 15

Appendix 2 STAFF GROUPS REQUIRED TO WEAR UNIFORM Please note, a Colour ways and Styles List is kept updated by the Facilities department this lists in detail which groups of staff are required to wear uniform and in which styles and colours. The following list is not exhaustive and is continually updated but is included as a guide to which staff are currently required to wear uniform in the Trust. STAFF GROUPS WHO WEAR UNIFORM *** Nursing physical Community hospital nurses and Matrons health services Community nurses/community matrons/care managers Nursing physical Clinical nurse specialists/ Offender Health nurses / Children s nurses (Orchard health services Service)/Ludlow Road/Nursery Nurses / Creche staff Nursing physical health services Nursing mental health services Therapists physical health services Pharmacists Housekeeping and Catering Portering Administrative staff Community Equipment Service Corporate Sexual Health nurses / Community Neurological Nurses / Dental Nurses Intermediate care / Community Stroke Service Nurses working in older adult mental health in-patient areas. Occupational Therapy / Physiotherapy / Podiatry/Speech & Language Therapist in Community Stroke & Rehabilitation Team/Psycho-social therapists (HMP Oakwood) Pharmacy technicians (Offender Health) Housekeeping staff. Catering staff. Linen staff, courier and estates Portering staff Reception staff / Ward Clerks / Clinic staff ( all front of house) / Medical Secretaries Drivers MAPA trainers. Resus trainers. *** As at August 2012. 16