Making hospital hospitable
The ward environment and services are major influences on the quality of inpatients’ stay. In appreciation of this, the Government has supported the introduction of ward housekeepers in mental health hospitals. Housekeepers, cleaners, domestic and catering staff are the unsung heroes of inpatient wards. They’re principally focused on the needs of the patients, helping them feel welcome, nourished and comfortable; after all, a good ward environment is essential for patients to feel at home and supports their recovery.
These staff members’ key roles are keeping the ward clean and tidy, preparing meals and maintaining the environment. Duties may include things like monitoring and maintaining special dietary needs, keeping bed linen and towels stocked up and meeting and greeting new patients. Housekeeping staff also often go beyond the call of duty, happily chatting with patients who don’t have any visitors, volunteering on the ward outside of their substantive role and organising special dinners. On wards where the focus is very much on developing independence skills, cleaners play a vital role in providing motivation and practical help to patients so that they can as far as possible be responsible for keeping their room clean and tidy.
Introducing the role of the housekeeper has allowed wards to not only provide the fundamentals of care, but also the extras, which are incredibly vital to patients’ overall well-being. A housekeeper in one Trust has even been known to nip home to pick up some milk when an order wasn’t fulfilled one morning! You’ll see from the many examples below that the housekeeping team are very involved and appreciated in the Star Wards’ community.
The following quotes are taken from publications listed in the resources section.
“The patients needed milk with their cereals — it just seemed an obvious thing to do. I couldn’t have them sitting waiting for their breakfast when I had plenty of milk in my fridge just round the corner,” she says. “The thing is to sort the problem out immediately, and then put systems in place to make sure it doesn’t happen again.”
“It’s important to keep the patients’ spirits up and make them feel special. I have time to chat with the patients who don’t have any visitors, or who can’t decide what meal to order for lunch. I read out a letter to an elderly patient the other day and it made her so happy. She didn’t have any visitors, but her letter kept her going.”
- One Ward Manager said, “Patients regularly say they didn’t want to disturb the nurses because they are too busy. We feel the housekeeper has bridged a gap and allowed nurses to spend more time on patient care, which has improved the team’s morale. It also means the patient has someone on hand to nip problems in the bud and prevent complaints.”
- A housekeeper commented “We are here to make sure that everything’s there for the patients and to allow the nurses to spend more time caring for patients. I fell in love with the job as soon as I started, it’s fantastic. I’m always thinking of new things to do to improve the service we offer.”
- From the Chief Nurse in one Trust: “I am convinced. Housekeepers are the very essence of teamwork — nursing and facilities management working together to benefit the patient.”
- One Ward Manager said, “…all of those jobs have now been taken off us and given us a lot more time to do this, so its integral, it kind of ties together all the bits that we used to do, puts them in a package and gives them to somebody who is appropriate and recruited to do that. It allows the nurses to be freed up to do what they are paid to do”.
- Another said, ‘[The]…conversations between the ward housekeeper and residents are:… “part of the therapy, it comes under part of the therapeutic care, there is benefits to come from that, but the role itself isn’t a therapeutic one”.
- One Nurse said,”…there are some positive aspects to the fact that she’s not seen as a nurse and she is sort of seen more of this housekeeper mother figure, and so…[residents] do perhaps respond differently to [the ward housekeeper] to how they do to us and maybe it is a good thing that she isn’t seen as one of us”.
- As the domestic staff are ward-based and are present on a daily basis, they have become completely incorporated into the ward team.
- Housekeepers play an active part in ward meetings, briefings, nights out and fund-raising events.
- Housekeeping staff attend and contribute to handovers.
- Photographs of domestic staff are displayed along with other ward staff on the ward photo board.
- Housekeepers are recognised as an important part of the ward team.
- Members of the housekeeping team attend ward community meetings to gain feedback about food etc.
- Cleaners, domestic and housekeeping staff attend the food focus group.
- A very basic mental health session takes place in the induction. This gives staff some understanding of what to expect on the ward and some reassurance.
- The word game on a whiteboard in the centre of the ward is popular with everyone – patients, nurses, domestics, visitors. Such a simple, clever, inclusive, involving idea.
- Beneficial for domestic and catering staff to be involved in attending ward forums.
- The weekly community meeting involves all staff and patients including domestic and catering personal. It’s an inspired idea to involve not just domestic staff, who often have very positive, relaxed relationships with patients, but catering staff as well, given how important the meals are to patients.
- One of the housekeeping staff contributes to the ward newsletter.
- One of the cleaners is also a ward activity volunteer. He helps out in the art group. This helps build up relationships with the patients.
- One of the housekeeping staff was nominated as ‘unsung hero’ in the yearly celebration of achievement ceremony.
- The housekeeper role has been tailored to reflect the needs of the patients and this is shown in the interaction they have with patients.
- These staff are an “information gateway” for particular matters between patients and nursing staff.
- Housekeeping staff maintain a board in the ward detailing menus, food facts, dietary specifications, as well as cleaning information and schedules.
- The domestic staff, when less busy, spend a considerable amount of time on the ward talking to patients.
- It is a common sight to see the domestic staff playing games of table tennis with patients on the wards or board games.
- Impressively and imaginatively, the housekeeper also has a nursing assistant role, which includes going to patients’ homes. This seems to increase staff retention because it’s a more enriched role.
- The housekeeper liaises with estates, catering, linen services and ensures appropriate stock levels, including avoiding excess stock which helps keep the wards within budget.
- One catering staff member is now involved in the patients fishing group, but this is not with intention of increasing the food choices in the hospital!
- The catering staff are encouraged to take an active role in the dietary intake of patients and the development of meals taking into account the suggestion put forward by patients.
Training and Development
- These staff attend basic listening skills courses, for example TalkWell.
- GNVQ and other professional development courses are offered.
- These staff attend a customer care workshop.
- A regular support group takes place for these members of staff.
Part of the Therapeutic Environment
- The ward harness the positive, informal relationships domestics often have with patients.
- While chatting with patients isn’t a formal aspect of the role, it’s flexible enough to be integrated if recommended by the nursing team.
- Patients sometimes tell housekeeping staff things they wouldn’t tell other staff. There’s perhaps less sense of pressure, expectation or authority.
- Cleaners, domestic and housekeeping staff have time to speak with patients who have little or few visitors.
- These staff are positive role models of hospitality, cleanness and tidiness.
- Housekeeping staff understand and are awareness of boundaries and explain to patients that if they want to talk about something that is distressing them to talk to the nursing staff.
- Domestic staff can form particularly good relationship because of intimacy of working environment, i.e. cleaning a patients’ room.
- The ward displays posters explaining that if patient need help in the kitchen or laundry room they can approach one of the housekeepers for assistance.
- The housekeeper welcomes new patients and gives them a tour around the ward.
- Domestic and other non-medical staff are involved in providing informal support to patients.
- Service users are involved in training non-clinical staff – eg domestic, cleaners and housekeepers.
Care Planning / Dietary requirements
- The catering staff play a key part in monitoring and maintaining special dietary requirements.
- Some patients have care plans which involve specific dietary requirements. The housekeeper reports back on what they have eaten and drunk. This is really helpful and important, especially when the nursing staff are busy and don’t have opportunity to observe patients during meals.
- The catering staff help manage portion control.
- The housekeeping staff make sure the ‘snack box’ is stocked up and that there’s always fresh fruit available on the ward outside of meal times.
- Bread, cereal, biscuits, fruit as well as milk, sugar, tea, coffee and hot chocolate in the patients’ kitchen is kept stocked up by the housekeepers.
- The Catering Department are running an initiative called ‘Just for You’ where the patients are invited to design a meal themselves and the catering department will cook it for them.
- The cleaning staff are like good friends, because they’re not as formal as other staff…
- Housekeepers give a good listening ear too.