Essential Training Handbook

St Luke's Hospice Essential Training Handbook For Volunteers

Introduction Thank you for volunteering for St Luke’s Hospice. We really appreciate you giving your time to support our services, we know how precious your time is.

We work in a highly regulated environment so we are sure you will understand the requirement for this essential training. Some of this is a legal obligation, but all of it should be interesting and informative.

Please read each section of the handbook carefully and answer the questions on the assessment sheet. All answers can be found within the information in each section.

When completed, please return the assessment sheet to the Volunteer Coordinator in the HR Office or via email to volunteer@slhospice.co.uk If you experience difficulties in completing any section, please contact the Volunteer Coordinator for assistance.

All new volunteers will complete the training prior to starting in their role and thereafter every three years. A copy of the training handbook will be kept in each department at the Hospice for reference purposes.

After completing this training volunteers must ensure they implement the learning in their work with the Hospice.

Contents Fire safety Health and safety Manual handling Infection prevention and control Lone working, personal safety and security Safeguarding children and vulnerable adults Communication and customer service Information governance and data security Equality and diversity Working together

Page 2 Page 5 Page 10 Page 15 Page 18 Page 21 Page 27 Page 31 Page 38 Page 41

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Fire Safety

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What is fire?

Fire is a chemical reaction involving burning of a fuel. Three things must be present at the same time in order to produce fire: HEAT - sufficient heat energy must be applied to raise the fuel to its ignition temperature.

OXYGEN - sufficient oxygen must be present in the atmosphere surrounding the fuel for fire to burn.

FUEL - any combustible material - solid, liquid or gas.

Reducing the risks associated with fires In order to minimise fire risk there are a number of things we can do: Keep combustible materials away from heat sources.

Avoid clutter- particularly around walk ways and exit areas.

Don’t overload electrical sockets.

Keep areas such as linen rooms locked.

Store combustibles or fuels safely.

Check fire extinguishers regularly (DO NOT attempt to use a fire extinguisher unless trained).

Keep fire doors closed.

Fire doors Fire doors should be kept closed at all times unless fitted with an automatic release device.

All fire doors are designed to give at least 30 minutes protection against smoke and flames.

Some doors, usually in higher risk areas, are constructed to give one hour protection. Fire doors are therefore an essential and effective means of hindering the spread of a fire and should therefore be treated with respect.

DO NOT WEDGE FIRE DOORS OPEN! If it is necessary to wedge open a fire door, for example when moving furniture, somebody must take responsibility for ensuring it is closed again afterwards. If fire doors are wedged open over a prolonged period of time they can be damaged and are no longer effective. If a fire were to occur behind a damaged door, the smoke and flames would soon come round the bottom of the door and any protection offered by it would be eliminated.

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The fire alarm is tested in the Hospice every Thursday morning at 11:00am Signing in and out It is important that there is a clear record of who is in the building in the event of a fire.

All visitors, staff and volunteers must sign in and out of the electronic register.

Designated fire escape routes Designated fire escape routes are protected by fire doors and have directional signs located throughout the length of the escape route to direct people to the final exit door. It is important not to store anything on these escape routes, as they present a trip or fire hazard, particularly if the mains powered lighting fails.

Fire alarm call points may be located along these routes so the alarm can be raised without leaving a protected area. Emergency lighting may also be installed along these routes.

Think about it!

Look around your area and locate the fire alarm points, fire extinguishers and nearest escape routes.

Fire action 1. Raise the alarm.

2. Person in charge to dial 9 999 from Landline or 999 from a mobile, receptionists (or person in charge if none on duty) to take out the signing in books.

3. Close ALL doors and windows.

4. Evacuate by nearest available exit.

5. Proceed to the assembly point. (Entrance of main Hospice car park).

6. Person in charge to undertake a roll call.

7. Stand by and await further instructions.

8. Person in charge to meet Fire Service on arrival.

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Health and Safety

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The Hospice has a legal and moral obligation to protect patients, staff volunteers, contractors and the general public from risks to their health and safety posed by work activities. Ensuring health and safety is maintained is everyone’s responsibility.

Health and safety hazards

A hazard is something that has the potential to cause harm. Below is a list of some of the hazards and harm they may cause.

Harm

Hazard Manual handling hazard

Back of limb injuries Skin and eye irritation

COSHH hazard

Eye strain

Display Screen Equipment hazard

Upper limb injuries

Slip, trip hazard

Bruising, sprains and fractures

Think about it!

What hazards do you face in the course of your work?

In order to effectively reduce health and safety risk we need to identify the hazards we face in the course of our work. This can be done in one of two ways: REACTIVELY- recognising there is a hazard after someone has had an injury or developed ill health.

PROACTIVELY- recognises risks from inspections and risk assessments.

Who may be harmed and how?

It is important to consider who the hazards may harm and how, for example a spillage that has not been cleaned up could affect staff, volunteers and visitors who could slip, causing injury. The type of harm could be a minor bruise or in more extreme cases burns, broken bones and anxiety, as well as reputational damage to the organisation if a visitor is injured.

Incident reporting at St Luke’s Hospice Incident is a generic term which describes an event which presents a risk or potential risk to St Luke's and which needs addressing.

Report all incidents, accidents, near misses, concerns, information governance breaches or complaints to your Line Manager who will follow the Hospice reporting procedure.

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ALL staff and volunteers are legally obliged to report any hazards, incidents, near misses, damage to equipment or property to their Line Manager.

Slips, trips and falls Slips and trips are often seen as trivial, however one third of major injuries in the workplace are caused by slips and trips. Slips, trips and falls are one of the biggest causes of serious injuries at work, many result in broken bones or worse.

Everyone is at risk and it could happen anywhere!

You are unlikely to slip on a clean dry floor. Water, bodily fluids and dust can all lead to a slip or fall. To avoid risk, spillages must be cleared away immediately and a warning sign placed near to the wet floor.

Trips can happen when you catch your foot on something you didn't realise was there, for example: Leads and cables across walkways and corridors.

Broken or uneven flooring, or loose or uneven carpet.

Obstacles left in walkways and corridors.

Wearing sensible shoes with good grip will also reduce slips.

Ways of reducing risk It is important that risks are reduced as far as is reasonably practicable. This involves considering: 1. Can it be removed or done differently?

2. Can the risk be removed by transferring it to a person who has experience and knowledge of the situation?

3. Can we work differently to reduce the risk by taking frequent breaks from the computer?

4. Can equipment be used to reduce the risk, for example a trolley to move a large heavy box?

5. Is manual handling training needed to reduce the risk?

6. Can the environment be adapted to reduce the risk? E.g. moving shelves from over desks to prevent stretching.

7. Is maintenance required to reduce risks? E.g. gritting the car park and walkways in snow and ice.

8. Is personal protective equipment required to reduce risks? E.g. gloves when gardening or sorting donations.

What to do if you feel unwell If you have flu or sickness and diarrhoea please stay home for a minimum period of 24 hours after the symptoms have stopped to prevent the spread of infection at the Hospice and advise your line Manager you are unable to make your shift.

If you become unwell whilst carrying out your duties you must report to your Line Manager, who will assist you with your needs.

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Substances hazardous to health – reducing the risks COSHH (Control of Substances Hazardous to Health) During the course of your work you may be exposed to a variety of substances hazardous to health. These include chemicals and infections.

All chemicals that are used on the premises have been assessed for their impact on health.

There may be some products such as cleaning agents that can result in skin irritation. If these are used in your area there will be a file detailing the product, the harm it can cause and its safe use.

Hazardous and dangerous substances Some chemicals are legally classified as hazardous substances as they can cause ill health. Contact with the skin or eyes, swallowing them or breathing in the vapours may result in damage and irritation of the skin and eyes, respiratory problems, asthma and stomach upsets.

The Control of Substances Hazardous to Health Regulations (COSHH) cover the use of hazardous substances at work. The presence of an orange warning label on products will generally indicate whether they are hazardous.

CORROSIVE Will cause burns to skin, eyes and respiratory tract and can cause permanent damage.

TOXIC Will cause acute or chronic damage to health when inhaled or swallowed.

IRRITANT Will cause redness and irritation to skin, eyes and respiratory tract, but no permanent damage.

HARMFUL May cause temporary or permanent damage to your health if swallowed or inhaled.

FLAMMABLE Produces vapours which will burn at temperatures below 55 degrees Celsius, if they come into contact with a spark, flame etc.

HIGHLY FLAMMABLE Produces vapours which will burn at temperatures below 21 degrees Celsius, if they come into contact with a spark, flame etc.

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All hazardous or dangerous substances should be avoided wherever possible. If a substance cannot be eliminated, a risk assessment must be undertaken to reduce the risk as far as reasonably practicable. Environmental Health Officers (EHOs) would want to see such risk assessments on their visits.

All who work on the premises need to be informed about any hazardous and dangerous substances they may be exposed to, the risks they present, and the precautions to take.

The most commonly used chemicals in the Hospice are cleaning agents. If these are mixed with certain other chemicals they can create chlorine, a toxic gas. If drank it can cause serious ill health and even death. Since there are other proprietary cleaning products available that do the same job, the Hospice should be able to cope without using thick bleach that carries the orange warning label.

The manufacturers of hazardous and dangerous substances are obliged by law to provide safety data sheets. These contain first aid instructions that should be followed in the case of an accident. Two control measures commonly used by charities are to issue a list of products the Hospice is allowed to keep on the premises and to provide the Hospice with the safety data sheets.

All hazardous substances should always be kept in their original labelled containers and stored and secured out of the reach of the public, especially children.

Accidents and first aid As the Hospice is a clinical setting with clinicians in Day Hospice and on the InPatient Unit, we do not have trained first aiders on site. We do have first aid boxes located on all floors within the departments. With each box there is a procedure to follow for major and minor injuries.

Please advise your line manager if you use something from a box that needs replacing.

Do you know the location of the first aid box in the area where you help?

All accidents are to be reported to your line manager in the same way as incident reporting.

A form must be completed and emailed to incidents@slhospice.co.uk

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Manual Handling Including Working at Height

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Manual handling risks are recognised as being a major cause of injury to employees in all types of work environments. Legislation is in place that aims to reduce the risk of injury from manual handling activities.

What is manual handling?

Lifting

Pulling

Carrying By hand or bodily force

Pushing

Lowering

Causes of injury Poor handling technique This includes adopting poor postures e.g. stooping, twisting, bending and stretching.

Overloading This could include moving loads that are too heavy.

Cumulative This is damage occurring over a period of time, often years. This ‘wear and tear’ could be due to overloading, poor handling techniques e.g. Repetitive Strain Injury (RSI).

Static loading This includes where a posture is held for periods of time e.g. leaning forward or to the side. The individual may only be supporting a light load or the weight of their own body but injuries can still occur.

Assessing the risk Manual Handling Operations Legislation (1992) requires us to: Avoid – any hazardous manual handling tasks as far as is reasonably practicable.

Assess – any hazardous manual handling which cannot be avoided.

Reduce – the risk of injury to the lowest level reasonably practicable.

Where hazardous manual handling cannot be avoided a risk assessment should consider: Task - type of handling being undertaken, posture, frequency, recovery time.

Individual - factors affecting the handler's capability such as training, footwear, health.

Load - size, shape, weight of the object being handled.

Environment - space available, flooring, obstacles, temperature, stairs or slopes.

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Principles of safer handling For any roles where manual handling is required, volunteers need to attend specific ‘Moving and Handling’ training. E.g. in the Warehouse.

When undertaking any handling activity (lifting, lowering, carrying, pushing and pulling) the principles of safer handling should be used even with light loads.

Good techniques for Lifting Plan the manual handling activity Where is the load going to?

Consider distance, route and obstructions.

Can you use equipment?

Consider if the equipment available is suitable and well maintained.

Don’t lift more than can be easily managed according to your capability.

Do you need help? If unsure seek help or advice.

Adopt a stable position Place feet apart with one leg slightly forward. If the load is to be moved from the floor the forward foot should be placed alongside the load.

Wear clothing that allows movement and footwear that is stable.

Secure hold If possible, hug the load into the body. This may be better than tightly gripping with only your hands. Start in a good posture, with your back in a natural upright position. Slight bending of the back, hips and knees is preferable to stooping or squatting at the start of the lift.

Don’t flex the back further while lifting.

Keep the load close Where possible, loads should be held close to the body between hip and shoulder height. The heaviest side of the load should be towards the body. Avoid handling loads at arm’s length as much as possible and store loads on shelves between hip and shoulder height for easy access.

Avoid twisting Twisting or leaning should be avoided, particularly if the back is bent. Do not twist whilst lifting, use feet to turn. Shoulders should be level and face in the same direction as the hips.

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Keep the head up when handling When the load is securely gripped, look forward and not at the load. Move smoothly, jerking or snatching the load can increase the risk of injury or loss of control over the load.

Put down then adjust When lowering the load it should be put down then slid into the desired position. Avoid lifting the load to the back of surfaces/shelving or over obstacles. Avoid changing grip during the move, put it down to readjust.

Personal Protective Equipment (PPE) Employers are obliged by law to provide free protective clothing or equipment for staff/ volunteers where risks cannot be adequately controlled by other means. Cuts and puncture wounds can be caused by broken or sharp items. Diseases can be picked up from contaminated materials, blood and bodily fluids.

Heavy-duty gloves will provide a degree of protection for those who have to lift heavy items. Lighter-weight gloves would be more appropriate for lighter items. Gloves containing latex should be avoided due to the risk of an allergic reaction.

Footwear with protective toe-caps will provide extra protection for those who have to move heavy items. High visibility and waterproof clothing may also be required for those involved in outside work or in the Warehouse.

Please ensure if you have been provided with PPE to wear whilst working that it is worn; it’s for you own safety!

Working at height

The government regulations for working at height apply to work at any height where a fall is liable to result in injury.

Safe use of kick stools Kick stools should be used sensibly for low risk tasks where a person would spend short periods on the equipment. This would need to be justified in a risk assessment.

If you cannot comfortably reach where you intend to lift, ask for support from your line manager. The Hospice prohibits the use of ladders unless specifically trained.

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Points to consider: 1) The kick stool needs to be used in such a way that it is prevented from slipping on the surface.

2) The surface must be level and clear to allow the kick stool to keep good contact with the floor.

3) Any items that are carried should be relatively small and lightweight.

4) Staff should know how to use kick stools safely (refer to manufacturer’s instructions) and when not to use them.

5) Check kick stools regularly to ensure they are in good condition.

6) Are all the wheels present and do they rotate freely?

7) Is there any material clogging the mechanism?

8) Are there any cracks or other signs of damage?

9) Is the surface of the platform free from contamination by dirt or fluids?

10) Keep both feet on the kick stool at all times.

11) Do not attempt to over-stretch when trying to reach up or out.

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Infection Prevention and Control

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All volunteers working within the Hospice have the responsibility to ensure that they adhere to procedures related to infection prevention and control in order to safeguard the health and safety of patients, visitors and staff, and other volunteers.

Mode of spread Infection may be transmitted in the following ways: Indirect or direct contact - contact is the main way in which infection is transmitted therefore hand hygiene is the most important method of avoiding cross infection.

Vectors such as cockroaches, fleas, flies and other insects that may harbour infections.

Airborne Faecal-oral contact - poorly prepared or contaminated food or water.

Hand hygiene The transmission of micro-organisms via contaminated hands is recognised as a major cause of healthcare associated infections. Adherence to good hand hygiene practice is an essential part of any infection prevention and control strategy. Studies have shown that some areas tend to be missed when performing hand hygiene. The diagram below demonstrates which areas these are: Front

Back

The white areas are those least frequently missed.

The darker areas are those less frequently missed.

The darkest area is those most frequently missed.

Hand sanitiser These dispensers are located around the Hospice in various areas leading from Reception to the InPatient Unit and Day Hospice. Hand sanitiser is a good way of reducing the hand bacteria where it is difficult or there are no hand washing facilities. The bactericidal foam should, as a guideline, be used only twice before hand washing is required (this is due to a consistent buildup of bacteria).

Soap and water hand wash Hand washing at a sink with liquid soap and water is the preferred method for hand decontamination if the hands are visibly soiled or potentially contaminated with dirt:· 1) Wet the hands with tepid running water.

2) Apply one dose of liquid soap from the pump dispenser into a cupped hand.

3) Rub firmly and thoroughly all surfaces of the hands and fingers, paying particular attention to the tips of fingers, the thumbs and the areas between fingers (for 10-15 seconds) before rinsing the hands thoroughly under tepid running water, holding hands down.

4) Dry the hands thoroughly by blotting/gentle rubbing with a disposable paper towel, paying particular attention to the skin between the fingers. Damp hands can encourage bacteria to adhere to hands and be transmitted more readily.

5) Remove jewellery/wrist watches to allow effective hand hygiene.

6) Do not use nail brushes.

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When should you wash your hands?

After using the toilet.

After cleaning up any spillage.

Before handling food.

When hands look or feel dirty.

After counting or handling money – especially coins.

Before and after entering patient areas.

Clinical waste disposal It is the responsibility of nursing staff to segregate and dispose of clinical waste correctly, not volunteers.

General waste General waste will include waste food stuffs, paper, tins, plastic containers and aerosols and flowers. Place this waste in black bin bags. Any cardboard should be flattened and placed in the wooden storage unit next to the industrial waste bins in the staff garden.

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Lone Working, Personal Safety and Security

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A lone worker is defined as a person who works by themselves without close supervision, in any environment where there are no other workers present who are available to respond quickly and effectively to unusual occurrences or emergencies. At St Luke’s this includes Befrienders and Day Hospice patient drivers.

A generic risk assessment will be carried out for lone working roles. This risk assessment will be carried out by our Estates and Facilities Manager in collaboration with department managers. All volunteers will be supplied with a copy of relevant risk assessments.

Dynamic risk assessment will be undertaken for certain roles, for example before a Volunteer Befriender visits a client at home the Befriending Service Coordinator will visit the possible client's home and carry out a dynamic risk assessment, ensuring that during that visit the home environment is seen to be acceptable for the service to be offered. If not acceptable the service will not be offered. If there is some risk, but this risk is seen to be acceptable, then measures will be put in place to reduce the risk, for example, if the client smokes, they will be asked not to smoke during the volunteer's visit. Volunteer Befrienders are then required to carry out their own Dynamic Risk Assessment each time they visit their client.

Hazards faced by lone workers Environmental - there are many potential hazards in people’s homes that lone workers may encounter. These include: fire, slips, trips, falls, obstructed access and exit, infections, pet allergies or attack, smoking.

Transport - many lone workers rely on their own vehicle in order to offer services in the community. This can present hazards such as breakdown or road traffic accidents.

Manual handling - Hospice volunteers should not physically assist patients and should seek guidance if they are unsure about a situation. Volunteers should ensure any manual handling is avoided whilst working alone.

Challenging behaviour - although uncommon, there is the potential that lone workers will be exposed to unpredictable behaviours from others including aggression and violence. This may be from members of the general public or service users and their families. Some situations are more hazardous than others. In circumstances where there is substance or alcohol abuse or mental health problems, people’s behaviour is more unpredictable and therefore potentially causes a greater hazard. If you feel that someone’s behaviour could compromise your own safety, remain calm and make your way out of the premises. You should contact your line manager immediately to inform them of the situation.

Lone worker responsibilities All those working alone are required to carry out their own Dynamic Risk Assessment, each time they undertake their role. If risk is identified they are not to carry out their normal volunteer role, they must remove themselves from the situation and report what they have seen to their line manager.

All those working alone must make themselves familiar with the Lone Working Policy and specific role induction and/or your role guidelines.

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Tell someone where you are going, what time you are leaving and when you expect to return home. If possible carry a mobile phone and check its fully charged.

Maintain any personal owned vehicle used for lone working in good working order with MOT and relevant insurance.

Do not carry large sums of cash, medicines or expensive items.

If you experience any difficulties with the role, or you require support or advice, contact your line manager, or the InPatient Unit out of hours, who will contact the on-call manager. If it is an emergency ring 999.

Report all incidents and near misses encountered in the course of your duties to your line manager.

Attend any meetings or events arranged to provide support and information to lone workers.

Personal safety and security General security Report all security-related or suspicious incidents to the person in charge.

Wear your identification at work. If safe to do so, challenge those who are not wearing identification, who do not appear to have any rightful authority to be where they are or who are acting suspiciously.

Don’t allow ‘tailgating’. Be aware of anyone trying to gain access to a secure area by closely following as you enter.

Put valuable Hospice equipment in secure storage areas when not in use.

Ensure you do not bring valuable personal property to work with you.

Protect your personal property at all times by locking it away and using lockers where offered, or by not taking/wearing anything of value when working alone.

If unsure about tasks you are asked to undertake, or equipment you are asked to use, then do not undertake the tasks. For example, if you are asked to mow a client’s lawn, but feel the mower is unsafe, do not mow the lawn.

If you are asked to loan money, you must say no.

If you are offered money, personal possessions or expensive gifts, you must not accept them.

Protecting property Shut/lock windows, doors, cabinets and cupboards in unoccupied areas. Protect property and assets and lock personal valuables away.

If accessing a client’s property requires you to have access to a key safe, be very mindful of your environment when doing so.

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Safeguarding Children and Vulnerable Adults

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We all have a duty of care to others, we need to treat every individual with dignity and respect to ensure they feel safe and are empowered to make independent choices and decisions.

Safeguarding is a collection of measures that ensure groups such as children, young people, and vulnerable adults are protected from abuse, harm and neglect. It is particularly important because the groups in question - children, young people and vulnerable adults - are those most at risk. This is because they have a lessened ability to keep themselves safe, which means that it is the responsibility of others to ensure they are safe. As a result, anyone who works with or is otherwise responsible for these individuals, needs to understand what safeguarding is, and how they can play a part in it.

Types of abuse and neglect Physical abuse is deliberately physically hurting a child. It might take a variety of different forms, including hitting, pinching, shaking, throwing, poisoning, burning or scalding, drowning or suffocation a child.

Emotional abuse is the persistent emotional maltreatment of a child. It is also sometimes called psychological abuse and it can have severe and persistent adverse effects on a child’s emotional development.

Sexual abuse is any sexual activity with a child. You should be aware that many children and young people who are victims of sexual abuse do not recognise themselves as such. A child may not understand what is happening and may not even understand that it is wrong. Sexual abuse can have a long-term impact on mental health.

Safeguarding children Safeguarding children from harm is everybody’s business. A child is anyone who has not yet reached their 18th birthday (Children’s Act 2004). If you have concerns about the welfare of any child you encounter whilst at work, you have a duty to act upon your concerns. This brief overview outlines how to recognise abuse and neglect of children and how to act on your concerns. There are 4 defined categories of abuse as outlined in ‘Working together to safeguard children’ (2006).

Child sexual exploitation is a form of sexual abuse where children are sexually exploited for money, power or status. It can involve violent, humiliating and degrading sexual assaults. Child sexual exploitation doesn’t always involve physical contact and can happen online.

Hidden from view and going unnoticed, vulnerable children and young people are groomed into exploitative situations and relationships. They may receive gifts, money or less tangible goods such as affection or status as a result of performing sexual activities, or others performing sexual activities on them.

They are often tricked into believing they are in a loving, consensual relationship. They may be taken to parties and offered drugs and alcohol.

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They can be groomed and exploited through mobile phones and online too. They may be persuaded or forced to send or post sexually explicit images of themselves, take part in sexual activities via a webcam or smartphone or have sexual conversations by text or online.

Abusers may threaten to send images, videos or copies of conversations to the child or young person’s family and friends unless they take part in other sexual activity.

Neglect is a pattern of failing to provide for a child’s basic needs, whether it be adequate food, clothing, hygiene, supervision or shelter. It is likely to result in serious impairment of a child’s health or development.

Some common signs that there may be something concerning happening in a child’s life include: • unexplained changes in behaviour or personality.

• becoming withdrawn.

• seeming anxious.

• becoming uncharacteristically aggressive.

• lacks social skills and has few friends, if any.

• poor bond or relationship with a parent.

• knowledge of adult issues inappropriate for their age.

• running away or going missing.

• always choosing to wear clothes which cover their body.

What to do if you suspect a child is at risk of, or has suffered, significant harm (child abuse): Discuss with your line manager as appropriate who will…

Inform the safeguarding lead – Wendy Wilson (St Luke’s Director of Care) Who will refer to the appropriate social services child protection team Who decide on the action to be taken.

Safeguarding adults ‘There can be ‘no secrets’ and no hiding place when it comes to exposing the abuse of vulnerable adults’. The Government’s White Paper, ‘Modernising Social Services’, published at the end of 1998, signalled our intention to provide better protection for individuals needing care and support. This is being taken up through the Care Standards Bill.

Every adult has a right to respect, dignity, privacy, equity and a life free from abuse. However some adults are vulnerable and can’t protect themselves from abuse.

A Vulnerable Adult is a person over 18 years of age, who is, or may be, in need of community care services, by reason of mental or other disability, age or illness, and who is, or may be, unable to take care of him or herself, or unable to protect him or herself; against significant harm or exploitation. This may be because of age, illness, physical disability or impairment, mental health problems or learning disabilities. Their need for additional support may be complicated by other factors, such as social or emotional problems, homelessness, sensory impairment, drug or alcohol problems, challenging behaviour, chronic illness or physical frailty. (Department of Health 2000).

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Types of abuse Abuse may take many forms and its impact on the person concerned is what matters.

Abuse may include: Physical abuse – including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.

Domestic abuse – including psychological, physical, sexual, financial, emotional abuse or so called ‘honour’ based violence.

Sexual abuse – including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting to.

Psychological abuse – including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.

Financial or material abuse – including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.

Modern slavery encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.

Discriminatory abuse – including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.

Organisational abuse – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment.

It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

Neglect and acts of omission – including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health care, support or education.

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Confidentiality Sharing information is essential in protecting adults from harm. In some circumstances it will be necessary to exchange or disclose personal information which will need to be done in accordance with the Data Protection Act 2018. If a service user makes a disclosure of abuse, care must be taken to explain to them the procedure that will be followed and they should be told that it might not be possible for the Hospice to maintain confidentiality.

Justification for sharing information When a vulnerable adult is believed to be at serious risk of harm.

When there is evidence of serious harm or risk of harm to others.

Where there is evidence of a serious health risk to an individual.

For the prevention, detection or prosecution of a crime.

When instructed to do so by a court.

If you suspect abuse – report it!

There is a duty to report a concern if: You have a suspicion that someone is being abused.

You believe that poor standards of care, a breach of professional conduct or misuse of authority, are making conditions in which there is a risk to vulnerable adults.

In all cases of concern, allegations or disclosure of abuse, you must inform your line manager, the Director of Care or social workers as soon as possible and complete an incident form.

What is prevent?

Prevent aims to stop people becoming terrorists or supporting terrorism. It is part of the Government’s Counter Terrorism Strategy.

What is terrorism?

Terrorism is the unlawful use of violence or a threat of violence to support a belief or ideology.

What is extremism?

Extremism is the use of extreme behaviour to support a belief or ideology. Not all extremism is harmful or criminal, but sometimes those who behave in an extreme way, can go on to become terrorists.

Prevention is better than the cure The Cheshire Constabulary Prevent Team, in partnership with local authorities and other partnership agencies, is working to stop people becoming or supporting terrorists. They are doing this by building stronger, safer communities who feel empowered to reject extremism and terrorism in all its forms.

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The threat The communities of Cheshire can be threatened by a minority of people who encourage or glorify violence in the name of a political ideology or a religion. The most severe threat to the UK is currently from people returning from international warzones such as Syria and Iraq.

Other threats include people who espouse racist or Islamaphobic views such as white supremacists and EDL supporters.

To help and prevent people being drawn into terrorism or extremist violence, the Police are supporting those people who are vulnerable to becoming extremists by working with sectors and institutions and also by challenging extremist ideologies, ensuring that the individual is protected so that our communities remain safe.

Contact details:Â if you have any concerns about an individual, please call the Cheshire Constabulary Prevent Team on 01606 365986. Â Extremist material online - the internet is used by some people to promote terrorism and extremism. Cheshire Constabulary is committed to protecting citizens but they rely on people to tell them about it. www.direct.gov.uk/reportingonlineterrorism is a dedicated webpage where you can report online content you think might be illegal or which you find offensive.

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Communication and Customer Care

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Communication is essential to every role. It enables the accurate transference of information, generates mutual understanding, encourages reflection and questioning and strengthens relationships. We communicate in a variety of ways such as letters, e-mails, conversations, meetings, and the telephone to a variety of individuals including colleagues, volunteers, patients, professionals and the general public.

How do we communicate?

Verbal 45% Words used Volume Tone of voice Intonation

Non verbal 45%

Facial expressions Gestures Posture Positioning

Good communication involves: Availability - both parties have to want to communicate, if one party is distracted or unwilling to discuss the issue communication is harder.

Active Listening - active listening is not simply hearing what someone has said but is understanding the meaning, picking up on feelings and reflecting these back for clarification that you have fully comprehended.

Acceptance - accepting what someone is communicating to you even if this is not what you want to hear or if it conflicts with your own views is essential to good communication.

Top tips for good communication: Be polite and courteous at all times.

Call people by their preferred title.

Be positive in your approach- how can you help them, how can you resolve the problem?

Connect with them on a personal level.

Set expectations (ground rules).

Keep people informed.

Avoid jargon.

Observe how people react to your communication and respond appropriately.

Listen actively.

Acknowledge what is important to them and you.

Discuss a mutually acceptable way forward.

Summarise what has been agreed.

Communication in a palliative care setting Communication in a palliative care setting is special. The people you come into contact with may be ill, upset, bereaved, confused and vulnerable therefore it is important that all volunteers are confident and competent in communicating in these circumstances. In your role you may come across relatives who are distressed or bereaved, people who are anxious or nervous about visiting the Hospice for the first time, people who want to discuss illness or death.

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Remember: Good communication is essential to everyone’s role.

Be aware of how you communicate to get the desired impact.

Use the tips for good communication to enhance your communication skills.

Difficult conversations are to be expected in a palliative care setting - be prepared.

As volunteers, patients and visitors may wish to talk to you about personal concerns, issues and feelings. These need to be kept confidential; however if they say something that you feel needs to be passed on please ask the person concerned for permission to mention a particular or general concern to the nurses.

Handling conflict Despite our best efforts to communicate effectively conflict can occur. Conflict occurs when two individuals disagree. It can result in a heated discussion, an argument, verbal aggression or even physical assault. Conflict can occur between colleagues or from service users. It is important that we learn how to deal with conflict in a positive way.

Keep calm.

Be objective.

Be open and honest.

Don’t make it personal.

LEAPS: Listen actively.

Empathise, understand the situation.

Ask for information.

Paraphrase, summarise the issues.

Search for an agreement.

Responding to verbal complaints: If you receive a verbal complaint it is important that you follow the steps below: 1. Accept the complaint with courtesy.

2. Immediately refer the complaint to your line manager.

The Manager will: Acknowledge receipt of the complaint.

Listen to the person and clarify that you understood the nature of their concern.

Apologise to the person for any distress caused.

Establish how they want the complaint resolved.

Complete an incident report.

If the complaint cannot be resolved at this stage it will be referred by the manager to a senior manager. The complaint will be acknowledged, investigated and a response provided.

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Professional boundaries Professional boundaries are limits that are placed on the relationship between a volunteer and patient to protect the physical and emotional well being of the patient and the volunteer.

Boundaries are essential to keep these relationship professional. They provide ground rules and protect the patient from becoming too dependent on us. They protect us from becoming too personally involved.

It is Hospice policy that staff and volunteers should not: Accept money from or lend money to a patient, their relatives or carers.

Accept personal gifts from a patient, relative or carer. See Gift Acceptance policy.

Give personal gifts to a patient, relative or carer.

Seek to establish ‘social’ contact with patients, their relatives or carers, outside of Hospice services. This includes contact via social media sites such as Facebook or Twitter.

We ask that you do not share your personal information with patients or their visitors including your address or phone number.

Discuss your personal life with a patient, relative or carer. It is alright to talk about interests you share but not to discuss, for example, your own health problems; an argument you had with your spouse, or other personal problems.

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Information Governance and Data security

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Information governance is concerned with the rules and regulations for handling patient information of a personal and/or sensitive nature and how that information is kept safe and confidential.

Confidentiality All our departments handle personal information, and this training will guide you to deal with it appropriately. Misuse of patient and other personal information can cause distress and St Luke’s can be fined up to 30% of our income for any breaches of information security.

How can you help us to stay on the right side of the law by doing the right thing?

All employees and volunteers of the Hospice have a duty to protect and maintain privacy of personal information and to use it only for the purposes for which it was intended. Access must only ever be allowed on a need to know basis.

You must: Be aware of your legal responsibilities in protecting the confidentiality and security of information you handle.

Keep any information you handle secure (both paper and electronic records).

Comply with your role specific guidelines and if unsure refer any queries you receive regarding personal information to your line manager – if in doubt ask!

All volunteers sign a Confidentiality Declaration at induction when starting their volunteer role. Any breach of confidentiality may result in you being ask to leave.

What is personal information?

Any information relating to a living person who can be directly or indirectly identified by that information.

Personal information Name.

ID Number.

NHS Number.

Passport.

Driving Licence.

National Insurance Number.

Location indicator.

Home Address.

Email address.

Sensitive personal information Race.

Ethnicity.

Politics.

Health Information.

Sex life or sexual orientation.

This could include the fact that they are receiving Hospice treatment.

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Collection of personal information Everyone has the right to be informed about the collection and use of their personal information.

We will provide the following information: Why we collect their information.

How long we keep their information.

Who it will be shared with.

We do this using: A ‘Privacy notice’ on the Hospice Website.

A Communication Preferences form on the Hospice Website.

‘Keep in Touch’ Postcards for Supporters.

Details must be accurate and everyone has the right of erasure – if a patient or supporter asks for their details to be updated or removed, then please ensure they are directed to the clinical teams or communications team respectively.

Disclosing information Confidential information must not be shared unless permission has been given by the individual concerned or the need to protect the individual from harm, for example with safeguarding.

However if a patient on the ward or clinic complains about an aspect of their care and tell you about it, you are not breaching confidentiality by advising a member of staff, you are helping the patient. It also gives the opportunity for the staff to improve standards of care.

If a patient confides in you that they are abused or hurt in any way by someone, you must report it to your line manager or nurse in charge regardless of whether the patient has asked you to keep it secret or not. This is a safeguarding issue and will be passed to the relevant member of staff to take action.

If you were to overhear staff members talking about a patient or you read information about a patient, you must not repeat any of this information to anyone outside the Hospice, to family or friends. If you were to do so, this would be a breach of confidentiality and could have serious consequences.

You must also be careful not to talk to acquaintances you meet by chance in the Hospice or clinic unless they speak to you first. They may not wish anyone to know they are in the Hospice.

If you believe there has been a breach of confidentiality, you should report it to your line manager who will use the Hospice’s incident reporting procedure, so that it can be investigated.

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What can I tell people?

Patients' condition

Types of care we offer

Hospice email address and fax number

Patients' presence

Patients' names

Staff names, roles, Hospice contact details

Personal staff/volunteer details e.g email address, phone number

Fundraising activities

Duty of Confidence Be careful and cautious when answering the telephone: Callers request information under false pretences.

Requests for information need to be verified.

If possible, always obtain requests in writing.

Good quality record keeping: Can everybody else read them?

Complete them as soon as possible.

Make sure they are dated, timed and signed.

When you are handling information, please ensure it is used correctly, securely and confidentially.This means on a computer where possible, but when on paper, securely stored away and placed in secure disposal as soon as possible.

Data Protection Act (2018) came into force in UK law on 25th May 2018. It sets standards which must be satisfied when obtaining, recording, holding, using disclosing or disposing of personal information, on paper and on computer systems. It also includes images such as CCTV and X-rays etc.

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There are eight principles of data protection: 1) Processed fairly and lawfully.

2) Obtained for specified and lawful purposes.

3) Adequate, relevant and not excessive.

4) Accurate and up to date.

5) Not kept any longer than necessary.

6) Processed in accordance with the rights of the individual or ‘data subject’.

7) Kept securely.

8) Not transferred to any country outside the EU without adequate protection in place.

Processed fairly and only for specified purposes Why are you collecting the information, what you are going to do with it, and who you may share it with. Personal information MUST NOT be shared for reasons other than those it was collected – if you need information to do your role effectively in the Hospice, you must not share that information with the outside world – e.g. friends, partners, neighbours.

Adequate, accurate and relevant Only collect and keep information you need, and do keep it up to date. Dispose of documents when they are no longer needed, any personal information MUST be disposed in the confidential waste containers found in each department.

Keep security in mind Keep confidential papers locked away, always lock your computer when you’re away from your desk. Lock your computer, even if it’s just for a short time. If information has to be passed to others, ensure it is passed securely. Please look at the following scenarios –think about which of the above principles was breached, what harm it could cause and how it could be done differently the next time.

Please look at the following scenarios – think about which of the above principles was breached, what harm it could cause and how it could be done differently the next time.

Scenario 1: Receptionist Sarah starts her shift, and sees that her friend (Jane) is an inpatient at St Luke’s.

She thinks a mutual friend of her and Jane should know, so she calls her. Should she have done this?

No, it’s information only learned from her work at St Luke’s, and was shared for the reason of ensuring the right people are admitted. This is a clear misuse of information. Complaints and patient distress have been the result of this kind of misuse.

Scenario 2 A volunteer finds a sheet of paper on the corridor floor. It’s a leaflet showing the opening times of the hospice shops. On the back is written a name, address and phone number which she doesn’t recognise. She pins the leaflet to a nearby notice board where it might be found. Why might this be a problem?

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The details on the paper are personal information and must be disposed of in the confidential waste immediately. Please report this to your line manager, and they will use our incident reporting system.

Scenario 3 Robert, a volunteer, goes into his local supermarket. He bumps into a friend, who asks him what the Hospice visiting times are, as her uncle was admitted to the Hospice that morning. He tells her he cannot say, as this is confidential information. Is this correct?

No, we can give out any information that is “freely available” – e.g., telephone or fax numbers, visiting times, staff names, etc… that are available on the internet, on leaflets, signs, etc…

Scenario 4 A member of shop staff takes Gift Aid details for a new donor. The customer leaves the shop and the staff member goes to help another customer, leaving the details out on the counter–top. Is this a data breach?

Yes, anyone could come in the shop and see this information. It contains personal details, and so should be stored away securely.

A source requires two or more pieces of ‘personal identifying’ information to become sensitive, i.e. a name and a phone number. Either on their own are not a huge risk, but when there are two or more together, this becomes information we must protect.

Scenario 5 You are a Day Hospice patient driver. Your patient confides in you that they don’t always like going home, as their son shouts at them for forgetting things and their daughter-in-law now ‘looks after’ their bank books. You’re concerned about what the patient has told you. Are you able to share this information with the Day Hospice manager?

Yes. If information sharing is due to a ‘Safeguarding’ concern, then this is a legitimate use of it.

The Caldicott Guardian A Caldicott Guardian is the person responsible for protecting the confidentiality of patient information and enabling appropriate information-sharing. Our Caldicott guardian is: Wendy Wilson, St Luke’s Director of Care: wendy.wilson@slhospice.co.uk The Caldicott guidelines are: Justify the purpose of using confidential information.

Only use it when absolutely necessary.

Use the minimum required.

Allow access on a strict need-to-know basis.

Understand and comply with the law.

If you have any questions regarding information governance, please ask any staff member – we are always happy to help. If in doubt, always check!

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Data security Information security is about ensuring information is: Protected and secure.

Reliable.

Available to authorised users only.

Your responsibilities are to ensure: Records are correctly stored.

Passwords are kept secure.

You use secure printing.

You lock your computer when leaving your desk.

You report any inappropriate disclosures or overheard conversation.

You delete any spam mail without opening it.

You don’t download unauthorised software.

You use IT equipment correctly.

Any breaches of data security, must be reported to your line manager.

Looking at your area of work. Answer Yes or No to each question. If you answer No to any question please raise the issue with your line manager.

Secruity and confidentiality of information

Yes

No

Is your work area clear of any personal identifiable information when not attended?

Is personal information locked away in cabinets, drawers or in a locked room?

Do you log out when your PC is left unattended?

Are passwords kept secure and never shared?

Do you identify callers requesting personal indentifiable information?

When emailing more then one person do you use BCC (Blind carbon copy) so they don't see each other's email addresses?

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Equality and Diversity

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Equality Equal means to have the same value. It does not mean that things need to be the same. Equality means that everyone in society is valued as an individual, with equal rights.

Diversity Diverse means different. People are different and varied in the way they look, dress, behave, what they believe in, their gender, sexual orientation, age, culture and personalities. We serve a diverse community.

Equal opportunities Equal opportunities mean that there is equal access to life chances. This includes access to employment, education, buying goods or accessing services. Equal opportunity is guaranteed under legislation. Everyone should have equal opportunity to access Hospice services.

Stereotyping Stereotyping means to generalise, to make things the same for example ‘all women are bad drivers’. Of course this is not true there are many very good women drivers. People stereotype because: It helps them deal with difference and ignorance.

It makes them feel superior.

Stereotyping leads to oppression, dis empowerment, discrimination, exploitation and the denial of people’s rights. Stereotyping is not acceptable.

Discrimination Discrimination means unfair or unequal treatment of individuals or groups.

Institutional Discrimination – policies exclude certain groups e.g. all staff must work Saturdays is discriminatory against practising Jews who keep the Sabbath sacred.

Direct discrimination – individuals are treated less favourably because of whom they are e.g.an employer stating no women need apply – this is direct sex discrimination.

Indirect discrimination – rules and conditions apply to all but affect one group more than another e.g. only access to the cinema is via stairs – this discriminates against disabled people.

Age - refers to a person having a particular age (for example, 35 year olds) or being within an age group (for example, 18-30 year olds). This includes all ages, including children and young people.

Disability - a person has a disability if s/he has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day to day activities.

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Gender reassignment - this is a process of transitioning from one gender to another, whether proposing to undergo, undergoing or having already undergone a process (or part of a process) to reassign sex by changing physiological or other attributes of sex.

Marriage - the legally or formally recognised union of two people as partners in a personal relationship. Historically a union between a man and a woman however since 2013 the Marriage (Same Sex Couples) Act 2013 has brought this definition up to date and refers to marriage for same-sex couples in England and Wales. The legislation is in place so that religious organisations can marry same-sex couples and to enable civil partners to convert their civil partnership into marriage and transsexual people to change their legal gender without necessarily having to end their existing marriage.

Civil partnerships - refers to (Civil Partnership Act 2004) civil partnerships of same-sex couples with rights and responsibilities identical to civil marriage.

Pregnancy and maternity - pregnancy is the condition of being pregnant or expecting a baby.

Maternity refers to the period after the birth and is linked to maternity leave in the employment context. In the non-work context, protection against maternity discrimination is for 26 weeks after giving birth and this includes treating a woman unfavourably because she is breastfeeding.

Race - refers to a group of people defined by their colour,nationality (including citizenship), ethnic or national origins.

Religion or belief - religion means any religion,including a reference to a lack of religion. Belief includes religious and philosophical beliefs including lack of belief (for example, Atheism). Sex Someone being a female or a male.

Sexual orientation – this is where a person’s sexual attraction is towards their own gender, the opposite sex/gender or to both sexes/genders. All volunteers must avoid discrimination, stereotyping and respect people’s diversity and individuality.

All volunteers must avoid discrimination, stereotyping and respect people’s diversity and individuality.

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Working Together

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We would like all volunteers to embrace our values and help to keep St Luke’s the wonderful Hospice it is; providing quality care and services to hundreds of people in our community each year.

St Luke’s values Value the individual – we recognise that people are our greatest asset. We treat those we care for, volunteers and colleagues with respect, dignity & compassion.

Embrace Change – we promote a culture where innovation and new ideas are encouraged, whilst valuing our heritage and past.

One Team – we work together collaboratively, we share ideas and we support each other to ensure that we achieve our common goals, both within the hospice and within our wider community.

Strive for Excellence – we strive for excellence in everything that we do and we celebrate our successes.

‘Thank you for your continuing support’ Neil Wright CEO

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