dress code policy - Oct 08

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					                   DRESS CODE POLICY FOR
        (Policy required by the Infection Prevention & Control Health Act Code)

LEAD DIRECTOR :                    Martin Munro, Director of Human Resources and
                                   Organisational Development

POLICY APPROVED BY:                Executive Management Team

DATE POLICY APPROVED:              23rd October 2008

IMPLEMENTATION DATE:               October 2008

REVIEW DATE:                       November 2011

Equality Impact Assessment carried out on: 6th June 2008
                                                                           Policy No: HR041
                                                                                 Page 1 of 10

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                          Document Control Sheet
Policy Title
                                     Dress Code Policy for All Staff in NELMHT

Purpose of Policy                 This policy establishes the Trust’s position regarding
                                  standards of dress and appearance for all its staff.
                                  The policy applies to all staff, including those with
                                  honorary contracts, agency workers, and students
                                  when working on Trust premises.

Lead Director                       Martin Munro, Director of Human Resources and

Lead                                     Stephanie Bridger, Head of Nursing &
                                      Harjit K Bansal, Clinical Governance & Race
                                                   Equality Manager
Version (state if final                                  FINAL
 or draft)

             Date                                  11th January 2008

Circulated for Consultation to:   Local Clinical Governance Groups, Infection Control
                                  Nurse, Health and Safety Group, Service User and
                                  Carer Organisations, Lead Nurses, Equality and
                                  Diversity Group, OT lead, Practice Facilitation
                                  Team, Community Development Workers, Associate
                                  Director of Human Resources, Voluntary
                                  Organisations, Havering & Barking & Dagenham
                                  PCT Equality and Diversity Leads, JNCC
   If draft                                 [only complete remaining boxes]
Draft Number
                                                        2nd draft

Comments to
                                              Harjit K Bansal via email on:


                                                     30th June 2008

                                                                              Policy No: HR041
                                                                                    Page 2 of 10

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                                    Contents Page

     Assurance Statement                                             4

1    Introduction                                                      4

2    Aims and Objectives                                               4

3    Duties and Responsibilities                                      4-5

4    Infection Prevention and Control                                  5

5    General Guidelines
     5.1. Footwear                                                     5
     5.2. Clothing                                                    5-6
     5.3. Jewellery & Piercing                                         6
     5.4. Hair & Beards                                                6
     5.5. Tattoos                                                      6
     5.6. Nails                                                        6
     5.7. Neckties                                                     6

6    Religious Dress                                                   6
7    Head Dress                                                        6
8    Process of Implementation                                         7
9    Monitoring Arrangements                                           7

10   Equality Statement                                                7

11   Policy Number – HR041                                             7

12   Links to Other Policies/References                                7

     Appendix 1: Audit Tool                                            8

     Appendix 2: Equality Impact Assessment Screening Tool             9

                                                                   Policy No: HR041
                                                                         Page 3 of 10

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                               ASSURANCE STATEMENT

The purpose of this policy is to ensure that all staff (including agency staff), at all levels in
the organisation and working in NELMHT portray a positive image, both as individuals and
professionals, by behaving and dressing in a manner that is quite reasonable and
expected by service users, carer, visitors and our colleagues.

1.    Introduction

      This policy sets out the expectations of the Trust in relation to corporate dress code
      and is necessary in order to convey a professional image of the Trust and individual,
      give patient confidence, support infection control and have regard to health and
      safety consideration for staff.

      The Trust considers the way employees dress and their appearance is of significant
      importance in portraying a professional image to all users of its service, whether
      visitors, or colleagues.

      The policy applies to all staff, including those with honorary contracts, agency
      workers, volunteers and students when working on Trust premises.

2.    Policy Statement/Aims and Objectives

      The aim of the policy is to present a positive personal and professional image, in
      order to inspire public and service user confidence.

      There are specific principles underlying particular elements of the dress code. These

      •    To avoid unintentional injury to service users (e.g. from wristwatches or
           jewellery worn by staff involved in the personal care or handling of service
      •    To reduce risk of cross-infection (e.g. improved hand hygiene if no jewellery or
           false nails).
      •    To reduce likelihood of injury to staff (e.g. assault – neck chains).
      •    To avoid offence to people of different cultures or beliefs (e.g. unduly “skimpy”

3.    Duties and Responsibilities

  •   The Trust’s Chief Executive, Chief Operating Officer and Director of Human
      Resources are responsible for promoting and supporting the aims and objectives of
      this policy.

  •   Borough Directors and line managers are responsible for implementing this policy
      and ensuring that all clinical staff are aware of this policy and supported in enforcing
      the policy and adhered to at all times in respect of their staff.

  •   All supervisors managing junior staff, students, locums, agency staff and students on
      placements in clinical areas, are responsible for ensuring that these groups of people
      are informed of this policy and adhere to the requirements.

  •   Staff are individually responsible for their general presentation, appearance and
      personal hygiene in accordance with the Dress Code policy in clinical areas and
      have a responsibility to consider how their appearance may be perceived by others.

                                                                                  Policy No: HR041
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     All staff are also responsible for following this policy and must understand how this
     policy relates to their working environment, health and safety, infection control,
     particular role and duties and contact with others.

 •   The Director of Human Resources and Organisational Development is responsible
     for notifying all employments agencies of this policy.

     Failure to adhere to this policy may constitute misconduct and result in formal
     disciplinary proceedings.

4.   Infection Prevention and Control

     All staff must comply with the Trust Standard Infection Prevention and Control Policy
     at all times. Clothing must be suitable to enable application of standard infection
     control measures while providing clinical care.

     Clinical care or contact is defined as follows:
     • Contact with intact skin
     • Manipulation of clinical equipment or devices used in the clinical environment

     There is no conclusive evidence that uniforms or work clothing poses a significant
     risk of cross infection in the clinical setting. Tests have identified that a small number
     of Clostridium difficile spores remained on uniforms after laundering. Washing at 60
     degrees will remove most microrganisms, (DH 2007).

     Clinical staff undertaking clinical procedures where there is a risk of contamination of
     clothing with body fluid or other potentially infectious material should wear
     appropriate personal protective equipment e.g. aprons, (Prevention of Blood-Borne
     Viruses Policy).

     Uniform or work clothing should be laundered separately daily. Change immediately
     if uniform or clothes become visibly soiled or contaminated. Wash uniforms at the
     hottest temperature suitable for the fabric. When purchasing uniforms consideration
     should be given to providing fabric that can tolerate high temperatures. Clean
     washing machines and tumble dryers regularly and maintain according to the
     manufacturer’s instructions, (DH 2007).

     Short sleeved shirts/blouses should be worn during clinical care to facilitate effective
     hand hygiene and to prevent cuffs becoming contaminated. Cuffs are more likely to
     come into contact with patients.

     Fleeces and cardigans must be removed prior to patient contact. Ties should be
     pinned or tucked to prevent draping on to wounds and sterile fields during aseptic

     Head/neck scarves must be secured to the head/neck to prevent draping on wounds
     and clinical equipment. Hair should be neat and secured off the collar.

5.   General Guidelines

     5.1.   Footwear

     It is the responsibility of all staff to wear footwear that is appropriate for the duties
     undertaken and to ensure a safe environment for staff and service users. Footwear
     should be of a “sensible” nature and worn appropriate, particularly in areas involving
     direct delivery of care. “Sensible” includes no flip-flops which will impede safer lifting

                                                                                Policy No: HR041
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and handling issues and occasions when the use of restraint is required. Footwear
that might cause injury to others during normal working duties should be avoided.

Shoes should be cleaned immediately if contaminated with body fluids, using
general-purpose detergent and hot water – disposable gloves should be worn
(Aylliffe and Collins; 1989; Brewer; 1996 & Walker and Donaldson; 1993).

For specific areas of work, footwear should be worn in accordance with health and
safety regulations.

Injury associated with wearing inappropriate footwear will invalidate any claim
against the Trust.

5.2.      Identification

All staff working in the Trust properties must wear a name badge at all times and
should only be removed for safety reasons. Staff working in the community must
carry their Trust Photo ID Badges with them at all times.

Students must wear their educational establishment’s badge at all times.

5.3.    Clothing

All clothing should be neat, clean and without holes or slogans. All clothing should
be safe, having regard to the activity being carried out at the time. Staff should
comply with the Health and Safety regulations to ensure personal safety and that of
the service users and carers. Clothing that is too tight, revealing or see-through
should be avoided as it may be interpreted as being provocative.

       5.3.1. Sports Clothing

       It is recognised that some activities require the wearing of tracksuits/shorts.
       However, it is expected that staff revert to normal clothing once the activity is
       completed. It is acknowledged that there are some areas of work where, due
       to the continuous nature of the activity, appropriate tracksuit attire is
       acceptable. It is the responsibility of managers to agree what clothing is
       suitable for a particular activity and to ensure they comply with health and
       safety regulation.

       5.3.2. Summer Clothing

       During periods of warm weather, staff clothing must remain appropriate and
       suitable. Staff should be aware that certain items of clothing could be seen as
       provocative, e.g. short revealing/tight garments, and therefore not acceptable
       for work.

5.4.    Jewellery & Piercing

It is good practice to avoid wearing jewellery, such as necklaces and earrings that
can be hazardous, especially where they can get caught or pulled. The wearing of
small studs are more appropriate when working in areas where service users are, or
can be, challenging in their behaviour. Injury arising from wearing inappropriate
jewellery/piercing (such as face and multiple ear piercing) will invalidate any related
claim against the Trust.

5.5.    Hair & Beards
                                                                          Policy No: HR041
                                                                                Page 6 of 10

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     While tolerance of the differences we all display is always necessary, consideration
     should be given to the impact we might have on others. Hair and beards should be
     neat and clean. Long hair should be tied back when handling food or when
     undertaking physical interventions with service users.

     5.6.    Tattoos

     Visible tattoos are to be discouraged and where present should not be offensive or
     provocative to others. Where they are deemed to be offensive they should be
     appropriately covered.

     5.7.    Nails

     Particular attention should be paid to nails in particular for staff working in clinical
     areas and staff preparing or handling food. Artificial nails or nail polish must not be
     worn as they discourage vigorous hand washing (Lawson; 2001). They are also a
     source of contamination. Nail polish tends to flake and can become a source of
     contamination (Gould & Verso; 2000).

     Nails should be neatly manicured to prevent service users and staff being scratched
     when involved in direct handling procedures.

     Nails should be kept short and particular attention paid to them when washing hands,
     as most microbes on the hands come from beneath the finger nails.

     Hand or wrist jewellery should not be worn in clinical areas when undertaking clinical
     procedures as they can harbour microrganisms and reduce compliance with hand
     hygiene, (Hand Hygiene Policy).

     5.8.    Neckties

     The wearing of necktie is optional. If worn, they should be removed if a potentially
     dangerous situation occurs, or is likely.

     5.9.    Religious Dress Requirements

     Although the Trust welcomes the variety of appearances brought by individual styles
     and choices, religious requirements regarding dress will be treated sensitively and
     will be agreed on an individual basis with the Manager and the Trust, but must
     conform to Health and Safety and Security Regulations, infection control and moving
     and handling guidelines. The wearing of, e.g., saris, turbans, skullcaps, hijabs,
     kippahs and clerical collars, arising from particular cultural/religious norms are seen
     as part of welcoming diversity.

     5.10.   Head Dress

     Headwear worn as part of one’s religious belief may be worn but must conform to
     Health and Safety, Infection Control and Security Regulations. Wearing of baseball
     caps or other non-religious head wear is not acceptable.

6. Process for Implementation of the Policy (Trust wide and Local)

     Meeting the requirements of this policy will be discussed as part of every clinical
     staff’s supervision process. The policy is designed to guide managers and
     employees on the standards of dress and appearance. All employees’ appearance

                                                                               Policy No: HR041
                                                                                     Page 7 of 10

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      must be professional at all times, both within the workplace and when representing
      the Trust.

      The policy is not exhaustive in defining acceptable and unacceptable standards of
      dress and appearance and staff must use common sense in adhering to the
      principles underpinning the policy.

      The Trust recognises the diversity of culture, religions and disabilities of its
      employees and will take a sensitive approach when this affects the way you dress.
      However, priority will be given to health and safety, security and infection control
      considerations. Risk assessments will take place as appropriate.

      If any staff member has cultural or religious beliefs that make it difficult for them to
      comply with this policy, they must discuss the issue with their line manager or their
      Human Resources Manager or the Head of Equalities to resolve the issue.

      All clinical staff will be made aware of the policy by their line managers.

7. Monitoring Arrangements

      All directors will ensure that the dress code is monitored and reviewed in their areas,
      through appraisals. In addition a 6 monthly audit of observation of a particular clinic,
      or ward should take place to measure compliance with the policy (Appendix 1).

8. An Equality Statement

      The Trust’s vision is to have in place a sustainable people driven service system of
      care, which is best of class, and the values are respecting individuals and working in
      inspiring environments. The Trust will ensure that all staff will be treated equally. No
      individual will be judged or treated differently with regards to what they wear on the
      grounds of their race, gender, disability, age, sexual orientation, religious or other
      belief systems.

9.    Policy No: HR041

10.   References to other Policies/National policies/Documents

         •   Dignity and Respect Policy
         •   Food Hygiene Policy
         •   Gould, M M; & Varso, B; (2000); Getting Things done: Clean or
             contaminated? Hands of the care givers, Nursing Notes; Winter 2000;
         •   Hand Cleaning Campaign
         •   Health Act Code Practice (Duty 4)
         •   Health and Safety at Workplace Policy
         •   Trust Hand Hygiene Policy
         •   Lawson, L G (2001); Hand washing: A Neonatal Perspective; Journal of
             Neonatal Nursing; 7: 12: 42- 46)
         •   Slips, Trips and Falls Policy
         •   Uniforms and Work wear, An Evidence base for Developing Local Policy
             (DoH); Sept 2007
         •   Workplace (Health and Safety and Welfare) Regulations 1992, Health and
             Safety Executive Series, London: HMSO.
         •   Trust’s Infection Control Policies.

                                                                                    Policy No: HR041
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                                                                                               Appendix 1


Name of person carrying out the
observational Audit:

Date audit carried out on:


Name of Operational Directorate:

Ward/Clinic/Centre Audit carried out

                                                    Total number of       No of people     No of people
                                                   people involved in     portraying a     portraying a
                                                      the activity          positive       negative
                                                                             image         image
1    Total number of staff observed as part of
     the Audit
2    No. of staff wearing an identification
3    No. of staff wearing clothing that is
     appropriate, neat, clean (without holes
     and slogans).
4    In your opinion, how many staff were
     wearing sensible footwear, appropriate to
     their working environment? (No flip-flops
     and other footwear which impedes health
     and safety.
5    No. of staff wearing sports clothing due
     to the clinical activities they were
     involved in.
6    No. of staff wearing sports clothing not
     linked to any clinical activity
7    No. of staff wearing visible studs/ or no
     jewellery at all, according to the clinic
     work they are engaged in.
8    No. of staff with no visible body piercing
     that seems inappropriate or hazardous
 9   No. of staff with neat and clean beards.
10   No. of staff handling food, with hair tied
11   No. of staff with visible tattoos
12   No of staff with long nails
13   No of staff with polished nails
14   No. of staff with artificial nails

This audit should be carried out on a 6 monthly basis, by a nominated member of staff at the request
of Operational Directors. If the total number of staff is high for portraying a negative image, then it is
the responsibility of the Operational Directorate to ensure that staff are made aware of the dress code
policy again, before the next audit takes place.

                                                                                           Policy No: HR041
                                                                                                 Page 9 of 10

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                                                                                       Appendix 2

            Equality Impact Assessment Screening Tool
                         (Please include this as part of your policy)

Directorate/Department                              Director of Human Resources and Organisational
Policy or Procedural Guidelines Title/Service       Dress Code Policy

New or Existing Policy/Service?                     NEW

Name and role of Assessor                           Harjit K Bansal, Clinical Governance & Race
                                                    Equality Manager
Date of Assessment                                  6th June 2008

Please complete the following questions

                                                      Yes/No               Comments
1    Does the policy/guidance affect one
     group less or more favourably than
     another on the basis of:
          • Race, Ethnic origins (including,          YES
             gypsies and travellers) and
          • Gender                                    YES
          • Age                                       NO
          • Religion, Belief or Culture               YES
          • Disability – mental and physical          NO
          • Sexual orientation including lesbian,     NO
             gay and bisexual people
2    Is there any evidence that some groups           YES
     are affected differently?
3    Is there a need for external or user             YES
4    If you have identified potential                 NO
     discrimination, are any exceptions valid,
     legal and/or justifiable?
5    Is the impact of the policy/guidance likely      YES       It is not always possible to
     to be negative?                                            perceive how different people
                                                                interpret the policy.
6    If so, can be impact be justifiable?             YES
7    What alternatives are there to achieving                   Ensure that the policy addresses
     the policy/guidelines without the impact?                  the needs of all groups of people,
                                                                and hence the consultation
8    Can we reduce the impact by taking               YES       Issues of dress code are raised
     different actions?                                         with all staff during appraisals,
                                                                supervision, staff meetings and 1:1


Full Equality Impact Assessment required:                 NO       □    YES      ■
Assessor’s Name:        Harjit K Bansal                   Date: 6th June 2008
Name of Director:       Martin Munro, Director or HR & Organisational Development
Assessment authorised by: Name:              Harjit K Bansal Date: 6 June 2008
(member of the Equality and Diversity Group)

                                                                                     Policy No: HR041
                                                                                          Page 10 of 10

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