Modern Matron_Quality Service Nurse

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Modern Matron_Quality Service Nurse Powered By Docstoc

1.0 1.1 1.2 2.0 2.1 3.0 3.1 3.2 3.3 3.4 3.5 4.0 4.1 4.2 5.0 6.0

Introduction Background About this Report Progress against last years Priority Actions Progress Report table Review of Matron Activities 2004 - 2005 Matron’s Charter Think Clean Day Clinical Leadership Forum National Modern Matron Conference and Developmental Group Patient Environment Action Teams Matrons Today What are Matrons in SLaM doing? Matrons Role and Impact Conclusion Recommendations




Introduction 1.1 Background The Modern Matron role was introduced to the NHS to improve the patients experience of health care. A key focus of the Modern Matron was to give a voice to front line staff which would enable them to meet the fundamentals of care for patients. The original guidance document outlined three key strands of the role. 1. Securing and assuring the highest standards of clinical care by providing leadership to the professional and direct care staff within the group of wards for which they are accountable. 2. Ensuring that administrative and support services are designed and delivered to achieve the highest standard of care. 3. Providing a visible, accessible and authoritative presence in ward settings to whom patients and their families can turn for assistance and support. South London and Maudsley NHS Trust introduced Modern Matrons in 2002. Since that date all service areas have access to individuals whose role encompass elements of the Modern Matron. The names of these individuals vary and include Modern Matron, Quality Service Nurse / Manager, Clinical Co-ordinator, Lead Nurse / Nurse Advisor. For the purpose of this report the term Matron will be used to include all these groups. 1.2 About this Report This report differs from its predecessors. In the previous two evaluation reports Matrons surveyed were asked to complete a self assessment tool and comments were sought from Service/Ward Managers and Directors. The information gained from this was used to identify where impact was being made and where further work was required. This report looks at the years 2004 - 2005 activities that Matrons have been involved in. It also contains information gained from discussions with twelve service users on one hospital site and 83 members of staff based on four different hospital sites, comments gained a from patient group in one service area. It also highlights examples of Modern Matrons diaries, providing some insight into the life of a Matron within SLaM.




Progress against last years Priority Actions The second year evaluation report identified six key Priority Areas. Over the past year Matrons have worked well with others to progress a number of the actions.


Progress Report Table Priority Action Progress

The Clinical Leadership Forum in partnership with the Clinical Governance Department to devise a strategy to roll out the Essence of Care Benchmarks across the Trust.

Head of Clinical Governance attended Clinical Leadership Forum to present Essence of Care. Matrons have participated in Essence of Care Benchmarks which have been rolled out across the Trust. Matrons with Ward Managers are leading the process at ward level. The Client Environment Board to devise A robust internal PEAT programme has an internal PEAT assessment been implemented. Matrons are involved programme. in assessments. Clinical Leadership Forum to identify Individual Matrons continue to work with examples of good practice in relation to carers in various ways. Good practice meaningful engagement with carers examples have not been posted on the post these on the good practice website. “Good Practice website. The Trust Executive to agree key Priorities have been set around PEAT priorities in relation to improving the assessment scores. patients environment agenda. To commission the Consultancy service The Consultancy service has continued to to do a piece of work which helps to work within Directorates and some of their clarify the key roles, responsibilities and work has included role clarity. Specific objectives of the Modern Matron and role work with Matrons will need to be Service Manager posts addressed. For each Matron to devise an action Clinical Leadership Forum is used as an plan to improve their self assessment. opportunity for Matrons to discuss particular areas of concern, obtain feedback and solutions.

3.0 3.1

Review of Matrons Activities 2004 - 2005 Matron’s Charter In October 2004 a new Chief Nursing Officer (CNO) was appointed to the Department of Health (DoH). The CNO‟s top priority was to improve hospital cleanliness and tackle the rising MRSA and other hospital infection rates. On her appointment the Health Secretary, John Reid, made it clear that the CNO role was vitally important and that her first concern was to ensure all NHS hospitals came up to the standards of the best when it came to cleanliness and infection control.



To coincide with her appointment and priority focus, the Department of Health in partnership with other key bodies published The Matrons Charter: An Action Plan for Cleaner Hospitals. Described as a „no nonsense‟ guide for hospital staff, the charter made it clear that all have a role to play in ensuring hospitals are clean. The document clearly states that Matrons must take the lead in setting standards. “Matrons must lead by example and by making changes when things aren’t up to scratch” (CNO 2004). Since the introduction of the Matron role it is clear that the public look to Matrons to uphold standards of cleanliness. The charter acknowledges their role in this but also recognises that cleanliness is everybody‟s business and not just the domestic staff. All individuals have a responsibility to work tidily and clean up after themselves. The Purpose of the Charter The Charter is aimed at all NHS staff and should also be shared with patients, carers and partners. It sets out ten broad commitments which should be:1. Discussed at all levels of the Organisation to provoke debate and encourage reflection on the importance of cleaning. 2. Used to encourage audits of practice in respect to inputs, output, culture and philosophy. 3. Used as a foundation for service ideals. 4. Used as a tool to enable local targets for improvement to be set. The Ten Broad Commitments are: Keeping the NHS clean is everybody‟s responsibility The patient environment will be well maintained, clean and safe Matrons will establish a cleanliness culture across their units Cleaning staff will be recognised for the important work they do. Matrons will make sure they feel part of the ward team 5. Specific roles and responsibilities for cleaning will be clear 6. Cleaning routines will be clear, agreed and well publicised 7. Patients will have a part to play in monitoring and reporting on standards of cleanliness 8. All staff working in health care will receive education in infection control 9. Nurses and infection control teams will be involved in drawing up cleaning contracts, and Matrons have authority and power to withhold payment 10. Sufficient resources will be dedicated to keeping hospitals clean 1. 2. 3. 4. The Matron‟s Charter sets out the demands Matrons will make of staff to ensure a culture of cleanliness is maintained.



Throughout the document thought provoking questions are asked of staff to support raising the cleanliness agenda and also to consider longer term impact for example:Does your Trust involve infection control nurses in refurbishment and new build projects? Before you buy new equipment do you have a system in place to ensure it can be cleaned? Do you have a rapid, reliable way of responding to patient comments? Do all staff promote the principles of a clean environment at all times? The document also provides good examples of practice and outlines the responsibilities of individuals from the Chief Executive to the Ward Housekeeper. For a summary of the Matrons Charter, (see Appendix One). The full document can be found on the Department of Health website. 3.2 Think Clean Day In February 2005 the Trust participated in Think Clean Day. This was an initiative between local Trusts and the Department of Health and other key bodies to raise the profile and importance of cleanliness. The purpose of the day was to focus attention on cleaning and demonstrate what could be achieved in a short time. In addition Trusts were asked to audit a ward or department and develop solutions to cleanliness problems. It was envisaged that everyone from Consultants to Cleaners would be involved. As part of the preparation for Think Clean Day a presentation was made to the Senior Leaders Group by the Client Environment Board which included information about the Matrons Charter. A representative from the Think Clean Campaign informed Senior Leaders about the initiative and the types of activities others across the country would be conducting. Senior Leaders were split into service area and corporate area groups. These groups were led by Matrons and Estates and Facilities staff. The purpose of this was to enable groups to begin to plan their days. Each group was asked the following:What do you want 28th February 2005 to look like? Who will you involve? How will you involve service users? What needs to happen from today? Who will lead the work? How will you incorporate the ICNA Audit tool kit?



28th February 2005: Think Clean Day. Most clinical sites took part in the Think Clean Day and so did a number of corporate departments. Below are examples of what took place. i. Education and Training Centres Hand washing posters were displayed in all centres and the poster stating “Cleanliness is everybody’s business” was also displayed. Staff were encouraged to be extra vigilant about the overall environment. Lambeth A series of posters were displayed across Lambeth sites. Each ward demonstrated a particular theme related to cleanliness. In addition wards were encouraged to de-clutter and tidy bed areas and office spaces. Lewisham Led by Billy Govinden (Modern Matron) and Sue Fisher (Facilities Manager) a series of activities took place. The day commenced with an infection control audit. A display board was set up in the Ladywell Unit reception detailing NVQ courses in cleaning, posters on hand washing and food hygiene. Staff joined patients on the wards for lunch. A competition was held titled „who has the tidiest room‟ which was won by Wharton Ward service users. Bethlem Hospital A Think Clean roadshow was held in the Community Centre and services were encouraged to display information and also collect information to share with ward staff and service users. Monks Orchard House Housekeeper, Ann Allen, worked with service users on the day. They generated ideas about what would make a difference, made posters and displayed these around the unit. They made good use of a photograph to show litter in a bedroom to encourage service users to use the bin. They also produced before and after photos of an unmade bed and some untidy workspaces to show how these are a hazard and obstruct cleaning.





Overall the day proved successful and demonstrated that with concerted effort that much can be achieved in one day to improve the environment. 3.3 Clinical Leadership Forum The Clinical Leadership Forum continues to provide an opportunity for Matrons across the Trust to meet. The meetings have focussed on improving the patients experience / environment and the Matrons role within this, i.e. Essence of Care, PEAT, Housekeepers. In addition, presentations have been delivered demonstrating where Matrons and Estates and Facilities staff have worked well to improve the patient environments and the challenges which exist within the role delivery.




National Modern Matron Conference and Developmental Group Six Matrons attended the first National Mental Health Matrons Conference. The conference provided Matrons with the opportunity to review the different perspectives of the role, obtain information about the national picture and develop terms of reference for the developmental group. Some of the objectives of the national group include:    

Responding to Legislative drivers Influence national policy Inform local policy development Plan and facilitate national events Create an environment which supports opportunities for growth and development


Patient Environment Action Teams (PEAT) Matrons continue to be involved in PEAT activities across the Trust. Over the past year in order to raise the importance of the PEAT process, Matrons, Estates and Facilities and other clinical and non clinical staff were invited to participate in PEAT training. Three training days were provided which concentrated on understanding the PEAT documentation and agreeing on what was an acceptable standard. Individuals were asked to consider what they expect whilst a patient in hospital. It is envisaged that internal PEAT assessments will be conducted by one clinical and one non clinical member of staff. Internal PEAT inspections were conducted in July and action plans were devised by clinical services. At the time of writing this report the Trust is preparing for the next round of internal PEAT assessments scheduled for December 2005.

4. 4.1

Matrons Today What are Matrons in SLaM doing? In order to obtain a flavour of what types of things our Matrons are involved in over a period of one week, Matrons were asked to provide a weeks diary activity. Below are examples. Matron 1 Week of 17th October


Tuesday Wednesday Thursday Friday


Reviewing clinical cases, CPA meeting Planning national conference via conference call Supervision of staff Training day (KSF) Research meeting Carers skills workshop 7pm - 9pm Teaching session for team members Available for support / respond to emergencies Provided advice and support to another Trust re: treatment. Spoke with a relative. Lunch with residents at off site Trust facility E-mails - no time in the week available



Matron 2 Monday am pm

Week of 24th October

Tuesday am pm

Wednesday am


Thursday am pm

Chaired site security meeting Supervised site service managers meeting about cost of CCTV Meeting re: swipe cards Meeting with infection control Check beds. E-mail On call 17.00 - 09.00 Walked the site, checked emergency log book, phone calls, e-mails Chaired service user liaison meeting Meeting to agree complaints training OPS meeting On call 17.00 - 09.00 Bed management meeting Chaired environmental meeting Meeting with Health and Safety advisor Meeting with Clinical Governance Ward managers forum Phone calls, e-mails On call 17.00 - 09.00 Project board meeting - 2 hours Scheduled PEAT walk round with Estates and Facilities, identify concerns On call 17.00 - 09.00 Phone calls, e-mails Meeting re: smoking policy Walk the wards with Health and Safety checking windows, ligature free bedrooms Meeting with ISS Mediclean, walk wards

Friday am pm



Matron 3 Monday Case review meeting providing advice to team re: care Meeting with team to discuss record keeping Benchmark re: Essence of Care Meeting with client to discuss complaint Pan London meeting reviewing respite care in the capital Contract meeting at local commissioners Interviewing for team member PCT including presentation to




Teaching at local University Research group meeting Meeting with voluntary groups to discuss patient needs Client appointments Attend outpatient appointment with client Meeting with service manager of an external service provider


Other Matrons described involvement in:           

Formulating recovery plans re: overspending Business planning Chair ward based meetings Chasing referrals Following up complaints Staff management issues Recruitment Supporting / advising staff re: care and risks Staff supervision Chasing up maintenance works and liaising with Estates and Facilities Highlighting poor physical environments to management Attending community meeting - dealing with complaints locally as required

Further examples can be found in Appendix Two 4.2 Matrons Role and Impact Matrons or Quality Services Nurses were intended to be high profile figures, visible to patients and visitors and to more junior staff. Their role was to encompass significant involvement in ensuring a cleaner and more therapeutic clinical environment and help to drive up standards of care and treatment. In practice, the matron‟s role has developed in diverse ways across the Trust. In order to see what impact was being achieved a decision was made to go out on to the wards.



In practice, this involved visiting twenty-four units on the four major hospital sites (BRH, Maudsley, Ladywell and Landor Road) over a two day period and talking to a random sample of staff on duty at the time. (Wards were informed that visits would be taking place but not precisely when). In total 83 people (a mean of about 3.5 per unit) ranging from ward managers / team leaders to Health Care Assistants and ward clerks and domestics were met. It was originally intended to ask a selection of both staff and patients whether they knew who their matron (or local equivalent term) was and then to ask about their impact on environmental and clinical issues. In practice, initial attempts at asking patients about matrons resulted in much confusion and, apart from the odd reference to Hattie Jaques, no useful information was gained. It was therefore quickly decided to restrict the survey to staff. A further complication developed in that significant numbers of people were unable to tell, immediately, who their matron was, but knew of the person when the name was given to them. Staff were then asked whether they recognised the name and, if so, whether they could describe the role that individual played. The subject was then further explored by specific questions on their visibility to / involvement with patients and clinical issues and their impact on the ward/unit environment. The results obtained were as expected. Almost 90% of staff asked did indeed recognise the name of their matron and 11% did not (see Appendix 3). When asked to describe the role, less than three quarters (71%) were able to do so in any detail. The responses given could be questioned as to whether what was described was actually „Matron duties‟ for example:“Wearing many hats and I thought the role would be more practical, the role is not what I expected” “Involved in drug errors, reports and investigations”. “Collecting Data for external sources “ “Role to broad and has no authority Too much bureaucracy and meetings” “Workload wise where do I start? Getting bogged down in management issues” Although the figures were not analysed by grade, it appeared that the more senior the staff the better they were informed and the more contact they had with the Matron, which challenges the “highly visible” aspect of the original role description. In the follow up questions, less than half (48%) of respondents considered the “matron” to have significant patient contact (or to be known to the client group). This is particularly significant as it includes areas where the matron was based on a unit or had a joint role as either the ward / unit manager or nurse advisor. Given that these scored between 80 and 100% on this question. There were other areas where the matron was not seen to have a clinical role at all. 10

The figures are clearer on the environment questions, with only a third (33%) of those asked agreeing that the matron had a significant impact on living and working conditions on the unit. Only one service area scored higher than fifty per cent on this question and one area came in at 7% and zero respectively (see appendix 4). It should be said that on virtually all the areas visited, staff were clear about who was responsible for environmental issues. Most felt that these concerns were best managed in house, whether by a dedicated charge nurse on one ward or by ward housekeepers on another. It should also be noted that some respondents explicitly cited help they had received from the “matron” in delivering major improvements or refurbishments and it may be that the value of the role is indeed in these major and relatively unusual events. It should also be said that the overall impression received from staff was that where people did know the “matron” they were generally quite positive about the role that person played in the unit. The concern, however, is that that role is too broad which was not the intention when they were established, having been diluted by other elements of service management. 5.0 Conclusion Over the past year Matrons have made progress on their priority actions and have been involved in a number of national initiatives. The Think Clean Day was a great success and demonstrated how team work can achieve great results for patients, carers and visitors and enabled staff to recognise their role in the cleanliness agenda. The revamped internal PEAT process has provided an opportunity for clinical and non clinical staff to get involved in assessments and ensure that our environments are fit for purpose. This report identifies that there is little commonality between Matron roles across the Trust. The examples of Matrons diaries demonstrated that most have significant managerial responsibilities, which are time consuming. This can often leave little time to concentrate on the array of Matron related issues which may arise and also impacts on their visibility on wards. The visits to the ward proved useful and clearly showed that the Matron role has variable impact on the environment and visibility to patients. Most staff did not know who their Matron was but recognised the name of the individual when this was provided. Most staff viewed the Matron as a manager and as such described management tasks when asked about the role. The environmental issues appeared to be dealt with locally and the Matron‟s involvement requested when progression is halted.



The Trust has a significant number of senior staff whose role encompasses that of the Matron. This report has shown that due to the way posts have been configured and the increasing demands made by DOH, Trust and Local services the Matron role has been diluted. Even in some of the services where the Matron role follows the guidance „responsible for a group of wards‟ the Matron focus has been diverted. At a time when the National Health Service is concentrating on Standards for Better (PEAT, hospital cleanliness, better hospital food, evidenced based care and refurbishment of patient environments). The Trust has the potential through the Matron role to ensure that standards are high and that the patient‟s experience of care is improved, but instead we may be creating another tier of service management and duplication of effort. 6.0 Recommendations 1. Re-focussing the Matrons role in order to release service management aspects and strengthen the original Modern Matron principles. 2. Consultancy service to work with Matrons around role clarity. 3. Nursing Directorate to create a development programme for clinical leaders. 4. Repeat the review in six months time. 5. Report to the Board in six months to 1 years time.

Report Compiled by Elaine Rumble Deputy Director of Nursing November 2005




MATRONS CHARTER SUMMARY  The public look to Matrons to uphold standards of cleanliness.  Cleanliness is everybody‟s business.  The Charter is aimed at all NHS staff. It sets out 10 broad commitments, which should be:1. 2. 3. 4. Discussed at all levels within the Organisation Encourage audit activity - culture/philosophy development The foundation for service ideals Act as a tool to enable local targets for improvement to be set

The Charter should be shared with patient, carers and partners Ten Commitments are 11. Keeping the NHS clean is everybody‟s responsibility 12. The patient environment will be well maintained, clean and safe 13. Matrons will establish a cleanliness culture across their units 14. Cleaning staff will be recognised for the important work they do. Matrons will make sure they feel part of the ward team 15. Specific roles and responsibilities for cleaning will be clear 16. Cleaning routines will be clear, agreed and well publicised 17. Patients will have a part to play in monitoring and reporting on standards of cleanliness 18. All staff working in health care will receive education in infection control 19. Nurses and infection control teams will be involved in drawing up cleaning contracts, and Matrons have authority and power to withhold payment 20. Sufficient resources will be dedicated to keeping hospitals clean Everybody’s Responsibility Everyone should clean up after themselves. Matrons have a clear role in improving cleanliness standards. Questions to ask self:(a) (b) (c) Do you take active steps to keep your work area clean and tidy? Do you pick up odd pieces of litter, for instance in corridors and public places? What could you do to make it easier for cleaning staff to do their job?

Leadership Leadership is important. The Charter suggests that the campaign should be led by the Chief Executive. The Charter asks all NHS staff to be more vigilant to the environment they work in, for example, clear away clutter, and ask do I have adequate storage? 13

Matrons Role Matrons are asked to take the lead in establishing a cleanliness culture across organisations. The Matrons must have the authority, credibility, drive to communicate a vision of cleanliness, challenge poor practice and recognise good practice. The Charter cannot be delivered without good working relationships with Support and Estates and Facilities staff. Cleaning staff need to be viewed as part of the ward team. In order to achieve this, regular domestic staff should work on wards. This will help them to feel part of the ward team. Roles and Responsibilities  The Chief Executive is responsible for standards across the whole Trust.  Trust Executive Directors are responsible for: (a) allocating budgets with due attention to infection control and cleanliness (b) understanding the implications of the funding decisions they make  Matrons are responsible for: (a) leading and driving a culture of cleanliness in clinical areas (b) setting and monitoring standards in conjunction with others  Infection control teams are responsible for: (a) advising on contracts for cleaning (b) educating staff about the need for good hygiene standards  Nurses in charge of wards and departments are responsible for: (a) agreeing cleaning standards for their area (b) making sure that standards are met (c) working with local cleaning staff to help them fulfil their roles  Contract managers are responsible for: (a) making sure that contracts (including in-house SLA‟s) deliver high standards, and value for money (b) establishing a spirit of partnership and teamwork with service providers  Cleaning service managers are responsible for: (a) ensuring there are enough staff, with the right skills to do the job (b) making sure there is an appropriate supply of equipment, including cloths and chemicals



Some things regularly slip through the cleaning net, with no-one taking responsibility. Patient equipment (for example, drip stands and commodes) is a case in point. Who cleans such items is a local decision - but whatever the solution, Matrons need to ensure that someone knows that this is their job, and takes it seriously. Patient Involvement Local feedback mechanisms need to be organised in relation to the environment. First port of call for concerns will be ward/unit managers, Matrons, estates staff. Infection Control This is everyone‟s business. All staff, whether clinical/non clinical staff need regular, on-going education re: infection control. Records of updates should be kept. Cleaning Contracts Nurses, Matrons and Infection Control teams need to be involved in the drawing up of/review of cleaning contracts. Clarity re: expectations important. Resources Adequate resources need to be spent in order to achieve/maintain cleanliness standards. The Housekeeper role can assist with this. An NHS model contract contains relevant information re: this. Support Trust to plan how to invest in cleanliness and to make sure that investment delivers real improvements in standards. This is a summary of the Matrons Charter. Full copies can be obtained from the NHS Estates website:-



APPENDIX TWO Matron 4 Monday am Week of 24th October


Tuesday am


Wednesday am

7 Borough Commissioning meeting 9-12 BRH. Presented all the activity, answered queries on the contracts and service provision for the 3 units to all 7 borough joint commissioners and dat coordinators. Presented 2 new bids for inpatients. One for increasing the establishment of the admissions team to cope with the demands of 2 week wait target and one for a physical liaison team on the AAU. Laid some seeds for increasing the establishments for all 3 units for 2007/8 Checked emails, Oh dear! Too Many to count! 12-45. Leak on WPH and staff were getting no joy from works. Clients getting agitated re the laundry room having to be closed. Team Leader at WPH on leave. Called works met with the clients to explain what was happening. 1pm-3pm. Penny Brown visiting the Bethlem units to look at action plans arising from PEAT. Shown round WPH and Alex and given the paper trail of reqs and risk logs to show that we had assessed ourselves and raised the alarms but had failed to get any works completed. 4pm. Called works again re the leak on WPH. Told to get a laundry assistant by works! Had a heated discussion. Plumber arrived eventually at 5pm! Sent emails to everyone re the leak! Arranged for clients to use Alex One laundry facilities until leak fixed. 6ish. Late shift staff member impromptu clinical supervision following a difficult group 9.30 -1.30 Clinical Leadership Meeting Maudsley Popped into AAU to see staff. Impromtu supervision with acting team leader. Checked data with unit administrator. Checked bathrooms as floor had collapsed and builders in attendance. Found three builders smoking in said bathroom. Had a lovely heated discussion with them about how smoking is extremely bad for their health in more ways than one, called Mr Reynolds to let him know. Drove back up to Bethlem….. 2-4pm. Admission Team Leader Appraisal Checked WPH laundry, staff updated me re the failure of the plumber to fix the problem. Called Barry Reynolds, left messages and emails with every relevant party. Arranged the next addictions no smoking policy meeting. Spoke with Recruitment re the last of the Band 5 awaiting start dates Admissions needing some advice re the difficult referral. Miscellaneous: couple of calls from VJ and Matt, long discussions re standards for better health, recruitment and EoC meetings. 9-11ish Completed the Healthcare Commission Improvement Review Forms for all three units. Checked through the post numbers/ management accounts with Alex One Team Leader. Met with Martin Brown who at last agreed to fix the laundry room on WPH. Went through a new design for the laundry facilities with him. Met briefly with clients to inform them. Administered some methadone on WPH, as other qualified was in group. Drove to Maudsley



Thursday am


Friday am pm

1pm-3pm. AAU Charge Nurse Appraisal Checked on bathrooms while there, work in progress will need to close 2 beds temporarily to find where the long standing problem leak is! Informed service manager, admissions team and commissioners re wait time target being effected. Drove back to BRH, checked emails! BIG mistake….left late 10-12. Addictions User Involvement meeting Maudsley Chaired this strategy meeting. Mostly looked at organising an event for Southwark addiction services. Meeting changed to monthly as the group would like to map the needs of service users and staff in relation to improving user involvement in every borough. Finished off 2 bank staff management cases for disciplinary hearings which had come from formal complaints from clients. Sent them off to HR for proof reading 2-3pm. AAU Unit Meeting 3-4pm. Supervision with AAU Team Leader Brief chat with late shift before leaving AAU, checked progress of bathrooms. Left message with Barry Reynolds re rest of the AAU refurb Drove back to BRH 5-6pm. Supervision with Charge WPH Nurse Checked emails. Will I never learn? Stayed late. 10-11 Management Supervision with senior band 5 on WPH. Sickness and lateness. Responded to 7 Dat Co-ordinators re improvement reviews and DoH returns 12-2pm WPH Unit Administrator Appraisal Wrote a report re service user involvement for the Addictions Clinical governance meeting for Monday. Checked and responded to emails. Left the unit at 4, attempting to take some time back! Off to Plymouth for the weekend! This diary does not include the impromptu visitations from staff at my office for a “ quick chat” nor the numerous calls to and from HR, my line manager, finance, payroll, nurse advisor, consultants, management accounts, contracts, referrers, an x client wishing to re open an old complaint, complaints office, SUI Office, requests from other addiction services re protocols, service provision, advice re the regimes, staffing numbers, dat co-ordinators looking for impromptu info re activity



Matron 5 Monday Tuesday am

Week of 12th October

9:30-16:00 Facilitation: tissue Viability Audit and Link worker Training 9:30-11:30 Meeting with Service Director BRH Review and Feedback Nursing Exec Agenda and MHOA Nursing Issues 13:30-16:30 HR Maudsley- Bullying and Harassment investigation: interview of witnesses (This matter has been ongoing for one year, as victim was dissatisfied with preliminary investigation. In addition victim and perpetrator had long periods of sickness which also prolonged the investigation. Management report expected after interviews of 4 potential witnesses 10:00am-12pm Chair: MHOA Clinical Team Leaders Forum Feedback from Nurse exec and discussion of topical issues that impact practice 13:00hrs-14:00hrs Facilitation of Band 5 Peer Supervisions on AL2 15:00hrs MHOA SUI Panel review of outstanding SUI and recommendations. 9:30-12pm MHOA Executive Monthly meeting Administration: And completing a lengthy LMI(into the 3rd week of the investigation and interview of witnesses and reading patients case notes dating back over 10 years) Answering Telephone Adhoc queries 9:30 am Should have attended the Modern Matron steering group this morning but have to complete LMI report which is part of a joint Social and health investigationdeadline end of September before I go on leave. Above ongoing . Break to plan diary for next week for supervision and clinical visits, any action expected from other forum meetings, End of life policy development, addressing adhoc Telephone queries And Drop-in clinicians who have queries This list is by no means exhaustive as built into is being able to respond as a matter of urgency to any untoward clinical event, serious complaint as well as providing advice supporting managers with staff development programmes. As a Senior Nurse my diary should include Research time for literature searches and reflective practice .I‟m working on including this in my diary.


Wednesday am


Thursday am pm

Friday am





Overall Results for Each Question

Visibility to Patients

Impact on Environment

Awareness of Role

Name Recognition






50% Yes No









Comparison by anonymised area (% respondents agreeing)
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 Area 7 Overall

Name recognition

Awareness of Role

Impact on Environment