Achieving best practice in healthcare

ACHIEVING BEST practice working with a client to improve their standards is a key part of what BICSc offers – generally this is by offering a tailored training programme for their cleaning team, but we also offer a review of custom and practice to identify not only the issues that the site or client is facing but, more importantly, the underlying causes of these issues.

With facilities management it is often the view that running the cleaning team can be an add-on to the catering or hard service manager’s role, after all, anyone can clean. For anyone who knows me well, you will appreciate my irony as I typed that statement. Cleaning truly is a science and for the huge number of cleaning professionals out there it is difficult to express the frustration when a cleaning team is merged, generally for cost saving, with other soft service delivery. Best practice in cleaning delivery can achieve outstanding results but generally it requires a cleaning professional to drive those results.

Achieving best practice

Best practice should be something we all strive to deliver but just how do we achieve this aim? It is always a challenge to achieve a true change in the delivery of a service and yet in reality the promise of this is generally how we have won the contract.

Back in the days before TUPE was deemed to apply – yes, I am that old – we were often told upon meeting the new client to sack the current staff as they weren’t delivering. My answer was always a request for six weeks’ grace, let me work with them I would request – it’s new equipment, different chemicals and we’ll train them. I’m pleased to say that six weeks was generally repaid by a lengthy and positive contract. Best practice, in reality, is what we are trying to achieve whenever we train. Effective training should not only change how cleaning operatives work, but it should also impact positively on the results that they produce.

Over the years of working with BICSc I have been regularly challenged by senior management of a multitude of companies as to how they can achieve training over a large and multi-shifted workforce and regularly asked: ‘What if we train them and they leave?’ BICSc challenge back would be: ‘But what happens if you don’t train the operatives and they stay?’ Wherever we really want to install a robust training programme we will find a way to do it, remember though one model really doesn’t fit all, we need to look at just what we want to achieve and the train frame for change before agreeing our route.

It may surprise some people, but cleaning operatives do not spring perfectly formed from the cleaning cupboard or from the agency where they have just been waiting to be called upon. The cleaning operative who knows the right products and machinery for one site to deliver a quality service may be ineffective on an alternate site as products, machinery and surfaces may differ. I have to confess I have long been an advocate of human cloning, after all I believe every cleaning manager will have expressed the desire to have 100 more operatives like their very best one and perhaps a dozen of a particular area or site manager… As this is probably some way in the future, as well as being more than a little unethical, we need to look at ways in which we can achieve a workforce of cleaning operatives who are both capable and competent.

Now although it may shock some people to read this, BICSc is not a magic wand. We cannot magically transform sites overnight into high performing self-motivated units. What we can offer though is a solid foundation on which to build. 

Our training model is a cascade model, we train people to rollout our training, we verify their standards and check their delivery but, ultimately, we aim to provide the structure rather than the physical trainer for every operative that a company employs. We have enhanced our original model over the years ensuring that the companies who choose to offer BICSc training can do so cost effectively – the addition last year of the BICSc Accredited Trainer means that more staff can be used to train operatives in a cost-effective manner. 

When looking at a client’s operation before considering the training that their workforce requires, we first look at how we are going to achieve this and what we are going to achieve it with. It may sound simplistic but the following challenges prior to a training programme being designed could hugely simplify the process for everyone and I’m a big fan of simple.

To commence the process, I would suggest looking at the following areas:

Communication

How effective is the communication from both the senior management to the frontline operative and also from the operative to the senior level? As a sales rep I learnt early on that not only did I have to sell to the management team but also to the operatives using my intended solution – if the operatives couldn’t see the benefits for themselves, they could soon jeopardise the rollout. 

Communication needs to be effective and easy, there’s no point in an electronic roll out if site staff don’t have access to computers. Operatives need to feel involved and be consulted on a regular basis so that they provide the best service that they can and interact confidently and correctly with the clients.

Core product range

Keeping it simple helps not only with the training process, as it minimises the choice of product, it should also simplify the dilution of product for a trigger spray or a mop bucket. It will help with the production of the relevant COSHH assessments and site manuals as there will be a condensed range rather than an encyclopaedic one. Operatives will be able to cover on other sites with just a short orientation to the layout as they are already trained on the products in use.

Machine range

This can mirror the benefits from the core chemical range, limiting training and aiding cover but, additionally, the maintenance costs can also be more easily managed than with a rainbow fleet across your portfolio. I would suggest examining the true-life costs of your machine fleet: How long does the machine work effectively for? What is its warranty period? What are the true costs of repairs? Sometimes the cost of repair would be uneconomically viable. Decide what this point is prior to the rollout of the machine range. Examine the support that comes with the machines – posters, videos, face-to-face training – the value of all of these should be part of your consideration.

Cleaning equipment

Does every site have the same mops, trolleys and buckets? If so, you are only training one range, something I have always found the manufacturer’s being willing to help with, as when the range is standard, they receive a worthwhile number of orders. But also, if one site is short you can move stock around and it is suitable for all sites. This limits the emergency stocks the area managers and support staff tend to carry in their vehicles as well.

Consumables, such as paper and soap

While some clients will insist on a particular range this is actually quite rare. As long as we can avoid leaving different screw holes all over the washroom walls the majority of customers are happy to look at a standardised offering, especially as this can usually offer some savings for them. The benefits of one core range again means stock shortages can be more easily covered and, potentially, used to volume a better price agreed with the supplier.

Only when all these points have been addressed would I want to look at the training of the operatives as potentially new equipment and product training could be central to the training programme designed.

The importance of training in healthcare

BICSc training is a standardised methodology, repeating set up and close down procedures to instil these processes as habit within a workforce. Only when it is truly followed as the way to work do you start to see the difference in the standards achieved. It is not about passing the skill assessment it is about following the process every time you commence work and establishing the BICSc methodology as the standard operating procedure. 

Working with two hospital trusts who had received poor CQC reviews, following the plan provided previously – reviewing product, equipment and kit – as well as implementing BICSc training with on-site trainers and assessors I am very happy to report that their subsequent follow up visits were a far more positive experience. BICSc may not have a magic wand but we do offer a successful plan to engage, train and motivate the cleaning operatives. 

With the experience gained from these contracts in distress, the BICSc healthcare skills, compliant with the NHS Manual 2020 (awaiting formal publication) and PAS 1616, were born. Adapting the BICSc Cleaning Professional’s Skill Suite to fully reflect the additional requirements so vital in a professional healthcare setting. 

Working closely with East Kent Hospitals service provider, 2gether, these healthcare skills have been practically delivered over the last 6 months providing accreditation for over 350 of their workforce with a robust training programme to ensure all staff achieve not only the Licence to Practice but also an additional 5 key skills. A successful programme of toolbox talks with practical demonstrations to deliver the theory of the skill followed by on-the-job assessment has meant the training can be delivered in an effective and efficient manner. Seeing the pride with which the successful candidates wear their BICSc badges has been truly satisfying especially when this has been achieved whilst battling the COVID-19 pandemic. 

Achieving best practice

So, to truly achieve best practice:

• Look at what you are doing – which bits work, which need adaption and which areas are failing
• Communicate with all your staff your plans for change and invite their views
• Set the timeline for change and allow for unforeseen issues
• Celebrate the successes along the way and recognise those staff members who have gone the extra mile for you.

In short, have a plan A, a plan B and a plan C!

Denise Hanson FBICSc is head of technical services at BICSc. 

For more information visit www.bics.org.uk