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1 Organisational Induction Policy Version 3 August 2017
SH NCP 32
Organisational Induction Policy
Version: 3
Summary:
SHFT considers that Induction arrangements are essential for all new members of staff as part of its commitment to provide clinically effective and high quality health services to Hampshire. The Organisational Induction Policy sets out the definitions, responsibilities, protocols and monitoring processes to support this.
Keywords (minimum of 5): (To assist policy search engine)
Induction, New Starter, Checklist, Programme
Target Audience:
All people managers, supervisors and new starters
Next Review Date: April 2020
Approved & Ratified by:
Statutory & Mandatory Training Steering Group
Date of meeting: 4th April 2017
Date issued:
April 2017
Author:
Simon Johnson – Head of Essential Training Delivery
Sponsor:
Jane Hazelgrove – Director of Education
2 Organisational Induction Policy Version 3 August 2017
Version Control
Change Record
Date Author Version Page Reason for Change
May 2015
Review date extended to July 2015
July 2015
Review date extended to October 2015
8/10/15 Review date extended to November 2015
2/12/15 1 16 Appendix B replaced with updated version, review date extended to January 2016
22/1/16 1 Review date extended to Feb 2016
April 2016
Simon Johnson Sharon Gomez
2 Policy Review
April 2017
Simon Johnson Vicki Tinkler Moya Wareham Theresa Lewis
3 Policy Review Appendix I,J, K added
July 2017
Simon Johnson Moya Wareham Lorna Mills
3 14 HR content updated
August 2017
Simon Johnson 3 3,14,15 Minor changes to appendices
Reviewers/contributors
Name Position Version Reviewed & Date
Sharon Gomez Essential Training Lead 18 March 2016
Theresa Lewis Lead Nurse Infection Prevention and Control
18th April 2016
Debbie McGregor Named Nurse Safeguarding Adults 25th April 2016
3 Organisational Induction Policy Version 3 August 2017
CONTENTS
Section Page
1. Introduction 4 2. Scope 4 3. Definitions 4 4. Duties/ responsibilities 5 5. Organisational Induction Programme 7 5.4 Induction Process 7
5.11 Temporary Staff Induction 8 6. Training requirements 9 7. Monitoring compliance 9 8. Associated documents 12 9. Supporting References 12
Appendices
A Training Needs Analysis (TNA) 13 B Local Induction Checklist for Permanent Staff 14 C Record of Local Induction Non Permanent Staff 15 D Flow Chart Local Induction Non Permanent Staff 16 E Flow Chart Organisational Induction Permanent Staff 17 F Confirmation Letter for 5 day Organisational Induction 18 G Organisational Induction Programme 20 H Equality Impact Assessment 21
I Infection Prevention and Control Induction Checklist Inpatients and community
29
J Infection Prevention and Control Induction Checklist Children’s Services
33
K Infection Prevention and Control Induction Checklist Volunteers 36
4 Organisational Induction Policy Version 3 August 2017
Organisational Induction Policy
1. Introduction 1.1 Southern Health NHS Foundation Trust (the Trust) considers that Induction
arrangements are essential for all new members of staff. The principles of the Trust’s induction policy are to make newly appointed staff feel welcomed, valued and to provide them with a foundation of knowledge and skills to begin fulfilling their role.
1.2 A high quality Induction will also ensure that these new employees are practicing in a
way that ensures their own safety and that of the patients they care for by completing statutory training and selected elements of mandatory training.
1.3 Induction supports and is reviewed as part of the following processes:
Care Quality Commission
NHS Litigation Authority - Standard 3 Competent & Capable Workforce (3.1 – 3.5) 2. Scope 2.1 The purpose of induction is to:
Welcome and introduce the new employee to the Trust.
Give them the practical information that will enable them to perform well
Make them aware of the Trust’s culture, values and strategic objectives
Help them to understand how their service area or department fits into the organisation
Ensure that the requirements of risk management are understood and complied with under the terms and conditions of their contract
Contribute to continuous staff development and Individual Performance Review. 2.2 To meet these aims it is essential that new employees are:
Introduced to Southern Health Foundation Trust, its purpose, aims, values and principles
Introduced to the policies, procedures and practices and organisational context of the service area in which they will be working
Made aware of relevant Health and Safety Regulations, Employment Policies and other components of the Essential Training Programme
3. Definitions 3.1 Induction primarily refers to the introductory period of employment (but can also refer to
the return to work period for those staff who have been away from their work environment for a significant, unplanned period).
3.2 The process of induction begins on recruitment when the job applicant forms first
impressions about the Trust, continues through the Organisational Induction Programme (OIP) and then through to the workplace/local orientation.
3.3 Permanent staff refers to those employees who are employed on a full time or part time
basis and includes fixed term contracts that are greater than 3 months. 3.4 Temporary Staff refers to those non permanent employees working in an agency, bank,
locum, student, secondee, volunteer, sub contractor or honorary contract capacity.
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3.5 Induction contributors refer to those staff who have some responsibility for facilitating induction.
4. Duties / Responsibilities - Organisational Induction 4.1 All members of staff, regardless of staff group, will be supported and facilitated into their
new role with an individually planned induction programme. 4.2 Newly appointed permanent staff should attend the OIP closest to their start date. In any
event they must attend OIP within the first three months of joining. 4.3 Managers’ duties and responsibilities are:
To notify the Recruitment team in a timely manner of the commencement of employment.
To prioritise the release of new staff to complete all elements of the OIP.
Complete a local induction with the new member of staff (Appendix B)
In exceptional circumstances, where a new permanent member of staff fails to attend OIP within the three month period, the manager needs to ensure that all Statutory and Mandatory training, as outlined on the MLE, has been completed within a maximum of three months If informed by LEAD that an employee failed to complete OIP (in full or in part), investigate the cause and take appropriate action (including performance management) as required
4.4 Inductees’ duties and responsibilities are:
To participate within the OIP To complete all identified elements of identified training in the OIP as a matter of
priority and within 3 months of start date. To complete all required Statutory and Mandatory training identified for their role on
the Managed Learning Environment LEaD training account. To sign attendance register To evaluate the OIP process as a whole at its completion and with the line manager
as part of the first Personal Development Review interview 4.5 HR duties and responsibilities are:
To ensure the recruitment process is consistently applied and reflects the welcoming and open culture within the Trust
To ensure that the pre-employment welcome packs are sent to new employees in good time.
Liaise with LEaD on Forecast for future flow of new starters into the organisation. Provide details of all new starters with the Trust to LEaD.
4.6 LEaD responsibilities are:
Organise, coordinate and schedule sufficient OIP capacity to meet anticipated demand
Liaise with HR on Forecast for future flow of new starters into the organisation. Monitor all feedback from the Organisational Induction evaluation forms and use
this information to improve future induction programmes Provide reports on the Organisation Induction process (attendance, updates and
evaluations) to be included in governance and compliance meetings.
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The Managed Learning Environment (MLE) will automatically generate a notification of those staff who do not attend and will be sent to both the Manager and new member of staff.
4.7 Induction Contributors duties and responsibilities
Ensure the content of the session maps to agreed national and local standards.
Review and amend content and course evaluation in line with LEaD Induction reports
Inform LEaD of any changes to the session or presenter in advance of the Induction programme and source a suitable replacement as appropriate.
Ensure that all participants have signed in for the session to record their attendance.
Duties and Responsibilities – Workplace/Local Induction for All Permanent
Members of Staff 4.8 All permanent members of staff, regardless of staff group, will be supported and
facilitated into their new role by an individually planned induction programme; part of this is achieved through the workplace/local induction (appendix B) which should be completed within the first two weeks of their start date.
4.9 Managers need:
Background knowledge of the newly appointed staff member/competencies (as appropriate) - available through the Recruitment process or discussion with staff member
Knowledge of the staff member’s perception of their induction needs (gained from 1:1)
Knowledge of the working environment and local facilities (available from service manager)
Knowledge of the organisations aims, objectives, culture and policies Knowledge of this policy for induction of new staff
4.10 Managers duties and responsibilities are:
Planning with others as appropriate an outline workplace induction programme for all new starters in their local area. This is to be outlined and discussed with the new starter on their first day or, if not possible, within their first week.
Providing the member of staff with their induction check list for completion and managers must ensure it is completed and retain a signed copy of the induction completion sheet locally. Staff who do not fully complete local induction within the timescales set out in this policy should be followed up at monthly 1:1’s with an objective being agreed to complete local induction as soon as possible.
The completion of appropriate subject specific local induction checklist e.g. Infection Prevention
A local induction must include: (Appendix B) o Introduction to team members o Orientation to service areas (including emergency arrangements) o Expectations of post
What the job is Who the supervisor is What knowledge and skills are required What the duties and responsibilities are
o Limitations of role
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o Familiarisation with equipment, procedures and appropriate training required o Communication/bleep system and resuscitation procedures o Local policies and procedures o Medication common to the area/patient group and any directives (where
applicable) o Pharmacy and local protocols including prescription, administration and
incident reporting o Sources of help and advice o Access to relevant policies
Finalising the overall induction plan with the permanent member of staff within one week of their start date
Ensuring that new staff have protected time to attend the OIP, enabling the programme to be completed and for a graduated introduction to their work role
Evaluating the programme at its completion with the staff member as part of their first Personal Development Review interview
4.11 Inductees’ duties and responsibilities are:
To participate within the induction process To complete the local induction check list, including appropriate subject specific
checklists. Ensure adherence with LEaD’s reporting processes by recording completion of local
induction as directed by LEaD 4.12 HR’s duties and responsibilities are:
Ensuring the recruitment process is consistently applied and reflects the welcoming and open culture within the Trust
Monitor and maintain with LEAD the local induction checklist for use locally across the Trust.
4.13 LEaD duties and responsibilities are:
Record attendance at organisational induction 5. Organisational Induction Programme (Appendix G) 5.1 The Organisational Induction Programme (OIP) has been constructed to ensure that the
right information is provided for the right people in an appropriate time frame. 5.2 To facilitate this all new staff will be invited to a half day face to face organisational
induction session
5.3 An example of the content of the face to face element of the OIP is attached (Appendix G), please note, this is subject to change depending upon feedback, Trust strategy and external regulatory guidance. Induction Process
5.4 The Trust believes that sound induction practices are an essential part of helping
employees settle and become effective in their new posts, and is prepared to support the programme with appropriate resources. Attendance at the OIP is mandatory for those newly appointed to the Trust.
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5.5 All full time and part time employees (including NHSP and Agency staff – clinical and non-clinical) newly appointed to the organisation or to a service area are subject to the induction process. The Organisational Induction Process Chart (Appendix D & E) outlines the OIP process.
5.6 For employees transferring to a new service area/profession within the Trust, it is not a
requirement for them to attend the OIP either in full or in part if they have already attended an induction programme or been with the Trust for a period longer than three months. However, they are still subject to the workplace aspects of the induction process i.e. the local induction.
5.7 Line managers are required to ensure that new employees are released from normal
duty for participation in the OIP. 5.8 The Trust will make reasonable adjustments to the content and process of the OIP, in
accordance with the Trust Disability Employment Policy, for personnel who are disabled, experience sensory impairment or have special needs.
5.9 Associate Specialists, Staff Grades and Doctors in Training (who are recruited out of
rotation), student nurses, locums and staff on honorary contracts are required to complete the locally recorded induction (for details see Appendix B & C) and relevant aspects of training identified
5.10 Outcomes will be:
A completed, individually planned induction programme held by each staff member, a copy of which is held in their personal file and with the completion recorded on the central electronic database
A plan for meeting further needs will have been agreed. The staff member’s first Personal Development Review interview will have taken
place
Duties and Responsibilities – Workplace / Local Induction - Temporary Staff Induction (Appendix B & C)
5.11 Non-permanent staff will be supported and facilitated into their new role by an individually planned induction programme; part of this is achieved through the local induction checklist (Appendix B) within 30 minutes of commencing a shift or period of duty (which may be several continuous days) in areas that they have not worked in before or if they have not completed an Induction Form previously for that area.
5.12 Managers need:
Background knowledge of the newly appointed staff member/competencies (as appropriate) - available through the Recruitment process or discussion with staff member
Knowledge of the staff member’s perception of their induction needs (gained from 1:1)
Knowledge of the post being filled (available from service manager/KSF outline) Knowledge of the working environment and local facilities (available from service
manager) Knowledge of the organisations aims, objectives, culture and policies Knowledge of this policy for induction of new staff
5.13 A copy of Appendix C will be retained by the manager/supervisor on duty to demonstrate
that all agency staff are inducted to the local workplace and provide evidence that the following points were covered:
9 Organisational Induction Policy Version 3 August 2017
o Introduction to team members o Orientation to service areas (including emergency arrangements) o Expectations of post
What the job is Who the supervisor is What knowledge and skills are required What the duties and responsibilities are
o Limitations of role o Familiarisation with equipment, procedures and appropriate training required o Communication/bleep system and resuscitation procedures o Local policies and procedures o Medication common to the area/patient group and any directives (where
applicable) o Pharmacy and local protocols including prescription, administration and
incident reporting o Sources of help and advice
5.14 The retained copy of the completed temporary staff induction form should be kept on file
for 6 years and compliance monitored by Directorate Service Team on a regular basis. Where staff are identified as having not fully completed local induction within the timescales set out in this policy, an immediate objective should be agreed locally to complete the local induction as soon as possible. This should then be followed up at an agreed time to ensure local induction has occurred.
5.15 Inductees’ duties and responsibilities are:
To participate within the induction process To complete the induction check list Ensure adherence with LEaD’s reporting processes by recording completion of local
induction as directed by LEaD
5.16 HR’s duties and responsibilities are:
Ensuring the recruitment process is consistently applied and reflects the welcoming and open culture within the Trust
Monitor and maintain with LEAD the local induction checklist for use locally across the Trust.
5.17 LEaD duties and responsibilities are:
Monitor and maintain with HR the local induction checklist for use locally across the Trust.
Monitor completion of local inductions on the Managed Learning Environment (MLE) system
Provide information about training in an accessible format 6. Training Requirements 6.1 Refer to Induction Training Needs analysis (Appendix A) 7. Monitoring Compliance 7.1 Managers will be required to monitor that the above is occurring and that systematic
follow up is in place to ensure local workplace induction is completed for all staff groups
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7.2 The following table outlines the Trust’s arrangements for monitoring compliance with this
policy –
Monitoring Compliance
Element to be monitored
Lead
Tool
Frequency
Reporting arrangements
Minimum content of corporate induction
Head of Essential Training
Content mapping to NHSLA MDS CQC requirements
Annual review or with any changes in governance or legislation
Strategic Workforce Committee
Documented process for booking all new permanent staff onto corporate induction
Head of Essential Training
Process for Induction for Permanent Staff (Appendix E) documents the process. Annual audit of this process will determine compliance
Annually Strategic Workforce Committee
Timescales for completion of corporate induction
Head of Essential Training
Section 4.2. Audit of the 3 month compliance will evidence compliance with this element.
Annually Strategic Workforce Committee
Documented process for how the organisation records that all new permanent staff complete corporate induction
Head of Essential Training
Compliance report from MLE will compare all new starters with attendance at OI.
Annual Strategic Workforce Committee
Documented process for how the organisation follows up those who do not complete corporate induction
Head of Essential Training
Process for Induction for Permanent Staff (Appendix G) documents the process.
Annual Strategic Workforce Committee
Minimum content of local induction (permanent staff)
Head of Essential Training
Content mapping to NHSLA MDS
Annual review or with any changes in governance or legislation
Strategic Workforce Committee
Minimum content of local induction
Head of Essential Training
Content mapping to NHSLA MDS
Annual review or with any changes in
Strategic Workforce Committee
11 Organisational Induction Policy Version 3 August 2017
(temporary staff)
and CQC requirements
governance or legislation
Timescales for completion of local induction (temporary staff)
Head of Essential Training
Managers retain copy of local induction form
Annual Strategic Workforce Committee
How the organisation records that all temporary staff complete local induction (temporary staff)
Head of Essential Training
Managers retain copy of local induction form
Annual Strategic Workforce Committee
7.3 The effectiveness of the induction process and OIP will be monitored via the evaluation
feedback on a monthly basis by the Essential Training Lead to ensure it is meeting the needs of the inductees and the trust. An annual review by LEaD and HR at the Strategic Workforce Committee to ensure it is meeting the needs of the Trust.
7.4 All OIP delegates will be asked to complete an evaluation to provide immediate feedback
on the content of the OIP, its perceived usefulness, the standard of various presentations and any suggestions for improvement.
7.5 LEAD will compile reports including the summary of evaluations, attendances and
outcomes of feedback which is sent to the head of LEAD, all OIP contributors and education leads.
Risks – assessment of impact if:
7.6 Permanent member of staff fails to attend OIP
RISK - Member of staff is working a mental health/learning disability environment and representing the Trust with limited understanding of their workplace, associated factors and systems in place to minimise/moderate these as appropriate.
Risk managed by
Member of staff is working within an experienced team
A range of information is available in hard copies and e-versions in all areas
Information given during the recruitment/interview process
Full DBS checks (aimed at minimising risks to services users)
Professional standards (as appropriate) and codes of conduct 7.7 Temporary member of staff fails to complete local induction record
RISK - Member of staff is working a mental health/learning disability environment or Integrated Community Services environment and representing the Trust with limited understanding of their workplace, associated factors and systems in place to minimise/moderate these as appropriate Risk managed by
Member of staff is working within an experienced team
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A range of information is available in hard copies and e-versions in all areas
Full DBS checks (aimed at minimising risks to services users)
Professional standards (as appropriate) and codes of conduct 7.8 Permanent member of staff fails to book and complete elements of training through non
attendance of OIP
Member of staff is working within an experienced team
Many Essential Training Topics can be accessed online
Few Essential Training topics require face to face attendance within three months of starting with the organisation (and this is reflected in relevant policies)
All staff and line managers can access training records so bookings and attendance can be monitored locally and centrally as appropriate
8. Associated Documents
Recruitment & Selection Policy
Appraisal Policy
Education and Development Policy
9. Supporting References
Care Quality Commission
NHSLA Minimum Data Set NHSLA Risk Management Standards for NHS Trusts providing Acute, Community,
or Mental Health & Learning Disability Services and Independent Sector Providers of NHS Care 2011/12
Agenda for Change/NHS Knowledge & Skills Framework
13 Organisational Induction Policy Version 3 August 2017
APPENDIX A – LEaD (Leadership Education & Development) Training Needs Analysis If there are any training implications in your policy, please complete the form below and make an appointment with the LEaD department (Louise Hartland, Quality, Governance and Compliance Manager or Sharon Gomez, Essential Training Lead on 02380 874091) before the policy goes through the Trust policy approval process.
Training Programme
Frequency Course Length Delivery Method Facilitators Recording Attendance Strategic & Operational
Responsibility
Organisational
Induction
Once
Half day Face to Face session and online or face to face Statutory & Mandatory training
required for role
Face to Face and online
Representative Trainers from
LEaD, HR & People
Development
LEaD
Bobby Moth Associate Director LEaD
Simon Johnson Head of Essential Training
Directorate Service Target Audience
MH/LD/TQ21
Adult Mental Health
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
Specialised Services
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
Learning Disabilities
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
TQtwentyone
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
ISD’s
Older Persons Mental Health
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
ISD’s
Adults
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
ISD’s
Childrens Services
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
Corporate
All
All staff to attend the half day face to face element of Organisational Induction within the first three months of employment, and complete all required statutory and mandatory training identified for their role within 3 months of employment.
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APPENDIX B
□ E-rostering, employee on-line, vehicle
registration form, expenses claims & requesting annual leave
□ Health & Wellbeing + workplace options □ Absence/sickness reporting policy &
procedure □ ID badges, Working time directive rules □ Other:
□ Welcome & Intro to Dept. /Team, including tour. □ Who’s who in our Organisation, service structure
charts, explain each Division - including the HQ base □ One to ones/supervision □ Setting objectives in first 3 months, then annual
appraisal – including annual time cycle & recording □ Communications in the trust, internal newsletters,
staff briefings, press office & intranet pages □ Confidentiality □ Out of Hours procedures, bleep & emergencies □ Equality & Diversity expectations (and e-learning) □ Dress code & Uniforms □ Fraud Awareness □ Personal Transport or site car parking □ Facilities: canteen, coffee room & changing rooms □ Contact numbers: work area & managers. □ Other:
□ Smartcard/RiO access □ Email/Internet Use □ Mobile phone calls/personal/work □ Laptops □ IT support access (phone/intranet) □ Data protection & IT protocols/policy □ How to find Trust Policies Online □ Other:
□ Registering with LEaD training department on the electronic booking system (MLE) using you’re your National Insurance Number & any email address.
□ http://www.southernhealth.nhs.uk/career/lead/ □ Statutory & Mandatory training needs (red/green
buttons on your training ‘Home’ page) □ Organisational Induction – how to book □ How to start mandatory electronic training online □ Booking a face to face training course (like BLS)
□ People Development opportunities (via website)
□ Health & Safety overview in the
workplace (fire procedure, exits, incident reporting, First Aiders etc.)
□ Personal safety at work (including lone working)
□ Security of property, premises, procedures
□ Display Screen Equipment regulations □ Risk Assessments □ Ligature risks, process & equipment □ Incident Reporting (Ulysses) □ Moving & Handling (plus training
required) □ Infection Control/Local Induction checklist □ Pregnancy, other health needs □ Emergency procedures, i.e. medical
emergencies or psychiatric emergencies □ Important Policies (please identify) □ Other:
List any specific local requirements that your new member of staff needs to be aware of:
□ E.g. Observations (physical or MH/LD): State type □ Local Policies relevant to your workplace □ Other (list here - continue overleaf if needed)
□
□
□
Local Induction Checklist for your first day at work - please complete this with your line manager:
Name (new staff member): Signature:
Name of Line Manager: Signature:
Date:
LEaD Helpdesk: 02380 874091 Email: [email protected]
HR Contact Centre: 02380 475160, Email: [email protected]
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APPENDIX C Record of Local Induction for Non-Permanent Staff
(For use of staff identified in the local Organisational Induction Policy NCP 38 and PP 32)
It is essential that all staff that are not required to attend Organisational Induction (i.e. locums, doctors in training, honorary contract, student nurses, bank/agency staff) complete this form with the appropriate supervisor before commencing work in a ward/unit/office for the first time.
Name: ___________________________________________________________
Employment Date (of 1* occasion of employment): ________________________________
Ward/Dept: ________________________________________________________
Job Specifics
Job role: ________________________ Main duties: ______________________ ________________________________________________________________________________________________________________________ Reporting to: _____________________
Location telephone no: _______________
In an emergency, contact:
Medical: ______________________ On call arrangements: ______________ Other: ________________________ First Aid/resus arrangements: ___________ ______________________________ Please tick the boxes (or note ‘Not applicable’) to record that
you have discussed the following with the member of staff
Tour of ward/department Contact numbers
Security procedures IM&T arrangements/security Observation arrangements/policy Safeguarding procedures
Fire evacuation/exits/extinguishers Infection Prevention & Control (Clinical):
Psychiatric emergencies Bare below elbows Medical emergencies Hand hygiene Incident/accident reporting Personal Protective Equipment
Facilities (toilets, canteens, etc.) Decontamination
Pharmacy arrangements Sharps
Local guidelines/policies Waste
Confidentiality
Please raise any further questions with your supervisor/line manager:
______________________________________________________________________________________________________________________________
Staff signature: _________________________ Print name: ____________________
Supervisor/manager signature: ________________ Print name:
____________________
Important information about the working
environment
16 Organisational Induction Policy Version 3 August 2017
APPENDIX D - Process for Local Induction for Non Permanent Staff
Temporary/locum staff arrives in work environment (for the first
time)
Welcomed by manager/appropriate responsible
person
Records subject to random audit
Notified of local processes/emergency
arrangements and working environment – recorded and signed for using Trust form
Copy retained by temporary/locum staff for
information and future reference (as appropriate)
Copy retained in ward/office/ unit for future reference and
audit
Temporary/locum staff arrives in work environment (on a subsequent occasion)
Information record checked (up date if appropriate) – no further
action/record
Non-compliance performance
managed locally
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APPENDIX E - Process for Induction for Permanent Staff
All potential new staff are entered on Electronic Staff Record (ESR) during the recruitment process by the Recruitment Team at the point of application
Applicants who are successful at interview and verbally accept their job
offer are notified to the Recruitment Team
Confirmation of start is sent to the Recruitment Team once the new staff member commences in post
OIP joining instructions are sent to the permanent employees Line Manager via MLE (see Appendix F), this includes a copy of the Organisational
Induction Programme (see Appendix G).
Local induction completed – permanent staff ‘inducted’ within 3 months of joining, leading into ongoing development
Permanent ‘employee’ attends face to face OIP (signing the
Register of Attendance)
Permanent ‘employee’ does not
attend OIP (in part or in full)
LEaD update employee’s training record
LEaD notify line manager of non attendance (by follow up with email for audit trail) – if
DNA, reason recorded on MLE
‘Employee’/line manager notifies
‘exceptional circumstances’ to LEaD - unable to
attend allocated date. Rescheduled and confirmation sent
Line manager schedules attendance (if within 3 month
period) or advised to undertake ‘enhanced’ local induction –
booking staff member on appropriate training courses
Permanent employee completes all required Statutory
& Mandatory training as identified on MLE
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APPENDIX F - Joining Instructions
Leadership, Education and Development (LEaD)
Development and Training Centre Tatchbury Mount
Calmore Hampshire SO40 2RZ
Tel 023 8087 4091 Email: [email protected]
www.southernhealth.nhs.uk/LEaD
Dear <Delegate Name> Joining instructions for your forthcoming course We are pleased to inform you that your booking for attendance on the above course has been approved and a place has been reserved for you.
If you use employee online, please click here to log in and add in your study leave. If you are not sure of how to do this, please click here to access the e-Rostering User Guide. For e-Rostering support please contact the e-Rostering team via ([email protected]) or telephone: 02380 475220 Please see attached document for venue, directions & refreshment information Course Information Some courses require pre course reading or pre course work. There will be an attachment to this email if required for this course. Please bring a pen and paper to the event. You can find the aims and objectives of all courses, useful links and further training information on the Training Website www.southernhealth.nhs.uk/LEaD. You will also find the contact details of the Course Lead here if you have any question prior to the event.
Always remember to sign in at the event. Failure to do so will mean we cannot update your training record.
Course <Course Title>
Date <Course Title>
Time <Course Title>
Venue <Training Venue>
Acceptance of late arrival to training is at the discretion of the facilitator. However, you will not be allowed entry if you arrive more than 20 minutes after the expected start time
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Please respect your course colleagues and the trainer by arriving in plenty of time for the start of the course. Trainers may request latecomers to reschedule onto a future course if they arrive after the start time. Course Cancellations We understand that occasionally staff need to reschedule training events at short notice. If you need to make any changes to your booking or cancel a reserved space please do so quickly by logging onto the training website and amending or cancelling your order. Others may be waiting to attend the course in your place.
Remember - you cannot reschedule onto a different course date on the day of your original booking. Course evaluation You may receive a post course evaluation questionnaire via email following attendance at this course. We value your feedback in developing and improving the quality of education and development events in Southern Health. Please take 5 minutes to complete if you do receive one. Similarly if you have any feedback for us (LEaD) on how we can improve our service or to tell us what we are doing right please email us at [email protected]. Above all else, we look forward to welcoming you to this training event and thanks for booking your event through LEaD. Yours sincerely Leadership, Education and Development (LEaD)
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APPENDIX G – Organisational Induction Example Programme
09:00 - 09.30
Registration and
Networking
9:30 - 9:45
Welcome to the NHS and Southern Health
NHS Foundation Trust
9:45 - 10:25
Shop Window
Value of Values
Exercise
10:40 - 11:00
Coffee Break
11:00 - 12:30
Videos &
Discussion
12:30 - 13:00
HR and LEaD
Evaluations
Statutory and Mandatory Compliance
What happens after your Organisational Induction?
Organisational Induction forms one part of your Induction Programme. When you return to work you are required to complete a Local Induction Checklist and to complete both online training for your role (make your red buttons turn green) and book on any face to face training topics required for your role. Please see: www.southernhealth.nhs.uk/LEAD for further information.
10:25 - 10:40
Trust Values
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APPENDIX H - Southern Health NHS Foundation Trust: Equality Impact Analysis Screening Tool
Equality Impact Assessment (or ‘Equality Analysis’) is a process of systematically analysing a new or existing policy/practice or service to identify what impact or likely impact it will have on protected groups.
It involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the potential effect of your functions, policies or decisions. The form is a written record that demonstrates that you have shown due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations with respect to the characteristics protected by equality law.
For guidance and support in completing this form please contact a member of the Equality and Diversity team.
Name of policy/service/project/plan: Organisational Induction Policy
Policy Number: SH NCP 10
Department: Learning and Education Development
Lead officer for assessment:
Ricky Somal Equality and Diversity Lead
Date Assessment Carried Out: 27 October 2015
1. Identify the aims of the policy and how it is implemented.
Key questions Answers / Notes
Briefly describe purpose of the policy including
How the policy is delivered and by whom
Intended outcomes
SHFT considers that Induction arrangements are essential for all new members of staff as part of its commitment to provide clinically effective and high quality health services to Hampshire. The Organisational Induction Policy sets out the definitions, responsibilities, protocols and monitoring processes to support this.
2. Consideration of available data, research and information
Monitoring data and other information involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the potential effect of your functions, policies or decisions. It can help you to identify practical steps to tackle any negative effects or discrimination, to advance equality and to foster good relations. Please consider the availability of the following as potential sources:
Demographic data and other statistics, including census findings
Recent research findings (local and national)
Results from consultation or engagement you have undertaken
Service user monitoring data
Information from relevant groups or agencies, for example trade unions and voluntary/community organisations
Analysis of records of enquiries about your service, or complaints or compliments about them
Recommendations of external inspections or audit reports
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Key questions
Data, research and information that you can refer to
2.1 What is the equalities profile of the team delivering the service/policy?
The Equality and Diversity team will report on Workforce data on an annual basis.
2.2 What equalities training have staff received?
All Trust staff have a requirement to undertake Equality and Diversity training as part of Organisational Induction (Respect and Values) and E-Assessment
2.3 What is the equalities profile of service users?
The Trust Equality and Diversity team report on Trust patient equality data profiling on an annual basis
2.4 What other data do you have in terms of service users or staff? (e.g results of customer satisfaction surveys, consultation findings). Are there any gaps?
All new staff are required to undertake induction; therefore there is no current evidence to suggest any one staff group will be better served than another by this policy.
Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
The Trust is preparing to implement the Equality Delivery System which will allow a robust examination of Trust performance on Equality, Diversity and Human Rights. This will be based on 4 key objectives that include:
1. Better health outcomes for all 2. Improved patient access and experience 3. Empowered, engaged and included staff 4. Inclusive leadership
2.5 What internal engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? Service users/carers/Staff
2.6 What external engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? General Public/Commissioners/Local Authority/Voluntary Organisations
In the table below, please describe how the proposals will have a positive impact on service users or staff. Please also record any potential negative impact on equality of opportunity for the target: In the case of negative impact, please indicate any measures planned to mitigate against this.
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Positive impact (including examples of what the policy/service has done to promote equality)
Negative Impact
Action Plan to address negative impact
Actions to overcome problem/barrier
Resources required
Responsibility Target date
Age
Applied to all protected characteristics: Induction contains a Human Resources session that can be used to signpost Trust policies that support staff Applied to all protected characteristics: Equality is promoted as part of the induction by including awareness raising of the organisation’s
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
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values, signposting to relevant policies and raising awareness of equality and diversity legislation and training provided by the organisation.
Disability
Delegates are asked about access requirements and The Trust will respond positively to requests of reasonable adjustment. Hearing Induction Loop available Large print and Easy Read materials can be provided Venues wheelchair accessible
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
No negative
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Gender Reassignment
impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
Marriage and Civil Partnership
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and
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the appropriate changes would be made.
Pregnancy and Maternity
LEaD will ensure safe and appropriate facilities for delegates who wish to express milk
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
Race
The Trust will respond to requests for information in alternative formats to facilitate the learning experience
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the
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course evaluation forms are actioned by the training section and the appropriate changes would be made.
Religion or Belief
Access to safe and appropriate prayer room will be made available for delegates who wish to pray
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
Sex
There may be an impact on staff with carer responsibilities
LEaD will work with individuals who have carer responsibilities
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who are not contracted to work on the day on which Organisational Induction is being run.
Sexual Orientation
No negative impacts have been identified at this stage of screening: Any issued raised following analysis of the course evaluation forms are actioned by the training section and the appropriate changes would be made.
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Appendix I
Infection Prevention and Control Induction Checklist For New Staff
(Physical, OPMH, Adult Mental Health, Specialised Services & LD:
for in-patient and community use)
Please complete this checklist within the first four weeks of commencing employment
Name of staff member:
Ward/dept:
Contact number:
Name of Manager/Supervisor :
Contact Details:
Topic Aim Requirements Date Achieved
Hand Hygiene Understand the importance of hand hygiene.
Staff member is observed to follow the correct hand hygiene procedure using (soap and water or alcohol hand rub)
Staff member can locate and has read the trust hand hygiene appendix 6 of the over-arching IPC policy
Can identify the location of hand hygiene facilities (soap and water, alcohol hand rub, and hand care products e.g. moisturiser) in their work environment.
Staff member can verbalise situations when bacterial alcohol hand rub is ineffective
Staff member presents for duty ‘bare below the elbows’ as applicable to the work environment.
Staff member understands why it is important to look after their skin on their hands and the process to contact OH Dept (PAM) / GP if there are any skin integrity issues
Routine practices to prevent the transmission of infection
Knows how to access IPC policies/care plans and information leaflets. Knows how to contact the IPCT for further advice. Has a basic
Staff member can locate the trust isolation appendix 9 & Standard precautions appendix 5.
Staff member is able to recognise the source isolation poster (red) and protective isolation poster (blue) if applicable in their work environment.
Staff member knows how to contact the IPCT for further advice.
Staff member can locate the trust MRSA & resistant organisms appendix 14
Understands the procedure for
:
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understanding of how infections can be transmitted in health care settings.
MRSA screening in their area.
Staff member can locate the trust D&V appendix 13 and C. diff appendix 15.
Knows where to access the D&V outbreak packs from.
Staff member can verbalise when it is necessary to isolate service users in their work environment
Personal protective equipment (PPE)
Is able to recognise when PPE (gloves and aprons) are required – if this is applicable.
Staff member knows where to obtain PPE in their work environment.
Knows to speak to nurse in charge / IPCT if further advice is required.
Staff member understands when to wear additional respiratory protection e.g. FFP2/FFP3 masks in their work environment and the importance of being fit tested prior to use of this respiratory protection.
Decontamination and cleaning
Understands that any re-usable equipment used in the health care environment or in direct contact with service users must be kept clean.
Understands what product can be used to decontaminate equipment and where to locate the product.
Can identify the single use symbol
(if sterilised consumables are used)and knows what it means.
Knows to speak to their manager or IPC Team if further advice is needed.
Staff member can locate the trust Decontamination of medical devices appendix 12.
Waste Understand how to dispose of waste safely as per trust policy.
The staff member can identify which colour bag they should use for any waste that they generate during their duty (question)
The staff member can identify which colour sharps bin (if applicable) they should use for any sharps waste they generate during their duty (question)
The staff member is aware of the emergency 24 hour sharps hotline tel number.
The staff member can locate the sharps poster in their work environment.
Staff member can locate the trust Sharps and Inoculation management appendix 10 & Transportation of Specimens appendix 18
The staff member is aware that there is an E & FM help desk tel number
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to ring for advice.
If applicable the staff member knows how to arrange home collections of waste (if applicable).
Staff member can verbalise how to manage infected linen (if applicable).
Personal safety Know the correct actions to take to maintain their own safety in the clinical environment. Knows First aid treatment and subsequent management protocol following exposures to blood and bodily fluids.
The staff member has attended their IPC training as part of their induction programme
The staff member knows how to contact OH Dept (PAM) and can locate the PAM 24 hour sharps help line tel number.
Is able to describe the basic first aid if an inoculation incident occurs.
Is able to describe the protocol for fluid exposures to the eyes, nose or mouth.
Has been shown how to safely manage blood and body fluid spillages.
Has read the COSHH data sheets for any products used.
Knows how to escalate concerns if poor practice is evident and is aware of how to complete a safeguarding/incident form
If sharps are generated:
Knows that all sharps must be disposed of at the point of use.
Uses sharp safety devices where possible
Understands the importance of correct assembly and temporary lock positions of a sharps bin.
Understands importance of completing written details required on the label of sharps bin
Community staff transporting sharps bins in their own vehicle know the procedure
Fitness to work Understands the importance of remaining at home if they are unwell e.g. have diarrhoea and vomiting.
Understands the process to access advice from their GP or Occ Health regarding their fitness to work
Understands the need to contact Occ Health for skin care/allergy advice and suitability for work
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Signature of Manager/Supervisor:
Date
Signature of staff member
Date
This local induction checklist links with the SHFT Organisation and Induction Policy. A signed copy should be kept by the staff member for their portfolio & another copy retained locally by the manager.
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Appendix J
Infection Prevention and Control Induction Checklist For New Staff
(Children’s Services)
Please complete this checklist within the first four weeks of commencing employment
Name of staff member:
Ward/dept:
Contact number:
Name of Manager/Supervisor :
Contact Details:
Topic Aim Requirements Date
Achieved
Hand Hygiene Understand the importance of hand hygiene.
Staff member can locate and has read the trust hand hygiene appendix 6 of the over-arching IPC policy
Can identify the location of hand hygiene facilities (soap and water, alcohol hand rub, hand care products e.g. moisturiser) in their work environment.
In addition staff member knows how to access individual tottles of alcohol hand rub & Clinell sanitising wipes for hand hygiene purposes as required
Staff member presents for duty ‘bare below the elbows’ as applicable
Routine practices to prevent the transmission of infection
Knows how to access IPC policies/care plans and information leaflets. Knows how to contact the IPCT for further advice. Has a basic understanding of how infections can be transmitted in health care settings.
Staff member can locate and has read the Standard precautions appendix 5
Staff member knows how to contact the IPCT for further advice (ask question to this effect for assurance)
.
:
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Personal protective equipment (PPE)
Is able to recognise when PPE (gloves and aprons) are required – if this is applicable.
Staff member can identify the location of PPE in the work environment
Decontamination and cleaning
Understands that any re-usable equipment used in the health care environment or in direct contact with service users must be kept clean.
Understands what product can be used to decontaminate the equipment and where to locate the product.
If appropriate to your area can identify the single use symbol
and knows what it means.
Knows to speak to the manager in charge /IPCT if further advice is needed e.g. check with the manufacturer or IPCT for advice regarding the decontamination of equipment prior to purchase. Also knows how to access the Decontamination Appendix of the SHFT overarching IPC Policy which contains a table of how to decontaminate frequently used items and the ‘standard for cleaning equipment used in a baby clinic’.
Waste Understand how to dispose of waste safely as per trust policy.
The staff member can identify which colour bag they should use for any waste that they generate during their duty (question)
The staff member can identify which colour sharps bin they should use for any sharps waste they generate during their duty (question) and is aware of the sharps hotline/poster within their health care environment
The staff member is aware of the sharps hotline/sharps poster within their health care environment
Staff member can locate the trust Sharps and Inoculation management appendix 10 & Transportation of Specimens appendix 18
The staff member is aware of how to arrange home collections if required
Personal safety Know the correct actions to take to maintain their own safety in the clinical
The staff member has attended their IPC training as part of their induction programme
The staff member knows how to contact OH Dept (PAM) and can
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environment. Knows First aid treatment and subsequent management protocol following exposures to blood and bodily fluids.
locate the PAM 24 hour sharps help line telephone number.
Has been shown how to safely manage blood and body fluid spillages
Has read the COSHH data sheets for any products used
Knows that all sharps are to be disposed of at the point of use and can locate sharps bins in their areas if generated
Can demonstrate how to assemble and lock a sharps bin if used
Understands importance of completing written details required on the label of sharps containers if used
Is able to describe the basic first aid if an inoculation incident occurs
Is able to describe the protocol for fluid exposures to the eyes, nose or mouth
Fitness to work Understands the importance of remaining at home if they are unwell e.g. have diarrhoea and vomiting.
Understands the process to access advice from their GP or Occ Health regarding their fitness to work. Also understands the need to contact Occ Health for skin care/allergy advice and suitability for work
Signature of
Manager/Supervisor:
Date
Signature of staff
member
Date
This local induction checklist links with the SHFT Organisation and Induction Policy.
A signed copy should be kept by the staff member for their portfolio & another copy retained
locally by the manager.
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Appendix K
Infection Prevention and Control Induction Checklist For Volunteers
(including those on Work Experience)
Name of volunteer:
Ward/dept:
Contact number:
Name of Manager/Supervisor :
Contact Details:
Topic Aim Requirements Date Achieved
Hand Hygiene Understand the importance of hand hygiene
Staff member is observed to follow the correct hand hygiene procedure using (soap and water or alcohol hand rub)
Has read the hand hygiene policy
Can list 5 situations when hands need to be cleaned during their volunteer duty
Can list the 2 situations when alcohol hand rub use is ineffective
Presents for duty ‘bare below the elbows’ if undertaking any volunteer duty which involves patient contact or contact with the clinical environment.
Can identify the location of hand hygiene facilities (soap and water and alcohol hand rub) in their area.
Routine practices to prevent the transmission of infection
Is able to recognise the isolation posters used in community hospitals and has a basic understanding of when they are used.
Is able to recognise the Source Isolation poster (red) and Protective Isolation poster (blue).
Knows to contact the ward to discuss whether to present for duty in the event of a ward closure due to infection.
Knows to speak to nurse in charge if further advice is needed.
:
Personal protective equipment (PPE)
Is able to recognise when PPE (gloves and aprons) are required – if this is applicable.
Can verbalise when single use gloves are indicated i.e. when in contact with: Body fluid A chemical A service user who is undergoing specific precautions to prevent the spread of infection
Can demonstrate when to put on PPE
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and when to remove it when visiting an isolation room (if applicable)
Can demonstrate how to remove PPE, so as to minimise self-contamination
Can verbalise when protective clothing should be removed and hands washed during the course of their volunteer duty
Knows to speak to nurse in charge if further advice is needed.
Decontamination and cleaning
Understands that any re-usable equipment used in a clinical environment or in direct contact with patients must be kept clean.
The volunteer can state how frequently they should decontaminate any equipment that they use
Understands what product can be used to decontaminate the equipment and where to locate the product.
Knows to speak to nurse in charge if further advice is needed.
Waste The volunteer can identify which colour bag they should use for any waste that they generate during their duty
Personal safety Know the correct actions to take to maintain their own safety in the clinical environment.
Knows to inform the nurse in charge of any of the following: 1. If they see a used sharp object
such as a needle and syringe. 2. If they see a spillage of blood
or body fluids. 3. The volunteer must not
attempt to clear any spillage themselves or dispose of used sharp instruments.
Knows the basic first aid (e.g. allow to bleed, wash and report to Manager) in the event of a needle stick injury, bite, or blood splash to face
Fitness to work Understands the importance of remaining at home if they are unwell e.g. have diarrhoea and vomiting.
Signature of Manager/Supervisor:
Date
Signature of volunteer:
Date
This local induction checklist links with the Southern Health Induction Policy and Work Experience and Volunteer Policy and Procedure SH HR 33 A signed copy should be retained locally.