Frequently Asked Questions (FAQs)
AIMS STANDARDS
Terminology - Supervision
The following is derived from RCN guidance on the differences
between the different types of supervision identified in the AIMS
Standards.
Clinical Supervision
Clinical supervision is a professional
relationship between a staff member and their supervisor. A
clinical supervisor’s key duties are:
- monitoring employees’ work with
patients;
- maintaining ethical and professional
standards in clinical practice.
Managerial Supervision
Managerial supervision involves issues
relating to the job description or the workplace. A
managerial supervisor’s key duties are:
- prioritising workloads;
- monitoring work and work
performance;
- sharing information relevant to
work;
- clarifying task boundaries;
- identifying training and development
needs.
Personal (or Pastoral)
Supervision
Personal/pastoral supervision relates to
personal issues raised through work. A personal/pastoral
supervisor’s key duties are:
- discussing how outside factors are
affecting work;
- enabling people to deal with
stress.
SELF-REVIEW
Determining your Self-Review targets: Staff
Questionnaires
Once you've completed your registration
with AIMS, and in advance of your self-review period,
we'll send you a 'Starter Form' (formerly a "Contextual Data
Questionnaire'). We ask you to provide a full breakdown
of staff who “have regular input to the ward”. We then
set a target equal to the total number you provide
and encourage you to approach each and every “regular” staff
member – even if they are not directly managed by the ward/Ward
Manager – to complete a Staff Questionnaire. It is in your
interests to do this: more responses means better and more accurate
data, which can only help you in your efforts to achieve (or
re-achieve) accreditation.
It is important to remember that
the number we give you is a target. We know that
circumstances change: staff move on, have annual leave, are taken
ill, and so on. If we ask you for 35 and you are only able to
give us 32, we won’t be too worried! It’s worth remembering
that we are always able to give you updates on how many responses
we have received, and can even give a breakdown by profession/job
title (though we are unable to identify individuals). Also,
if it helps, it is worth remembering that this is a golden
opportunity for staff to give open, honest and – most importantly –
completely anonymous feedback about their ward.
Determining your Self-Review targets: Health Record Audits
We calculate how many Health Records we
want from you on the basis of your "patient turnover" during the
three month self-review period. This is based on the number
of beds you have, your occupancy rates, and the average length of
stay. It's a rough average based on how many patients are
likely to pass through your doors, and we do appreciate that this
might not pan out in reality. We aren't too concerned if you
fall a little short of your target (but not too much) - if you have
any doubts, get in touch.
Completing the Health Record Audit
Health Record Audits are to be
completed using our online data submission tools. When you receive
your Self-Review pack, you'll receive a username and password for
this, as well as sending one paper copy of the Health Record
Audit for your reference. If you wish to photocopy the
reference copy and complete your audits on paper before entering
the data online, you are welcome to.
If we ask for 20 Health Records, you have to repeat the audit
questionnaire 20 times for 20 separate patients'
notes. Collating results onto one questionnaire and
submitting that will result in the submission being deleted, and
you being asked to submit separate audits for separate
patients.
Logging in to enter questionnaires
If you are having difficulty logging in to enter questionnaires,
you should first check the following:
- Are you entering the username and/or password in the
correct case?
Both are case-sensitive.
- Has someone else been entering
questionnaires on your computer?
You may need to click the 'Logout' button on
the right-hand side, and then try to log in yourself.
- Do you have the right logins for the
right data collection tool?
The logins for the Checklist, Environment and
Facilities Audit, Health Record Audit and Ward Manager
Questionnaire will not work for the Staff Questionnaire, and vice
versa.
If you are still having difficulties, please
get in touch with us.
PEER-REVIEW
Attending a Peer-Review: selection of reviewers
Our process for selecting reviewers to attend review visits is
more complicated than it might appear. Here are some of the
factors that affect our decisions.
- We try to send out requests for reviewers as soon as we have
confirmed dates with wards. Obviously the earlier we can do
this the better, which is why we now ask for wards to set their
dates as soon as we start working with them
- Often we have a lot of different priorities which we have to
balance. We usually start with ‘first come first served’, but
if we get multiple offers, other factors come into play, such as
geography and travel links.
- We are working on a system now to introduce more fairness into
the system. We are going to keep a log of who has offered to
do a review, in the hope that if we have to decline their offer, we
can prioritise them the next time they put themselves
forward. We’ll also try to do this when a review is cancelled
– i.e. offering the re-scheduled date to the same reviewers
first.
- Newly-trained reviewers are usually prioritised, as we like to
get people out on the road as soon as possible, to put their
training into practice! We do have to be careful not to have
too many newly-trained people on one review – we try to strike a
balance between new reviewers and those with experience. This
is often most difficult to do if we’ve just had a training session
– we do greatly appreciate when our newly-trained reviewers put
themselves forward, but often we have a lot of offers to choose
from!
- Occasionally we have to decline offers because of the skill mix
on the review team – we have to have at least one nurse, and we do
try to have at least one other profession represented. We
also need to select people from different Trusts/organisations – we
can’t have a whole team from one Trust/organisation reviewing
another ward.
It is also worth remembering that we have a lot of very active
service user and carer reviewers, which is great, but does mean
that we often get lots of offers which we have to choose
from! Hopefully some of the new systems we’ve put in place
will enable us to be fairer.
Please be assured that the above reasons are the only criteria
by which we choose reviewer, and no personal preferences affect our
decision. The only slightly personal factor that affects our
choice is in the selecting of Lead Reviewers, simply because you
have to have attended a couple of reviews at least before you can
lead.
If you do volunteer to go on a review, please check your emails
over the subsequent days. We try to confirm quickly, so you
should hear from us either way very soon after you’ve been in
touch. If you subsequently find you are unable to attend,
please let us know as soon as you can.
Attending a Peer-Review: what about expenses?
Please send your claims to the AIMS Project
Administrator directly, not to Belgrave
Square. Claims sent to Belgrave Square have to be
send to the AIMS Project Team to be signed off, which may delay
payment.
We pay a standard fee of £100 per day to Service User and Carer
Representatives who attend our reviews.
Travel and Accommodation
- The AIMS Team reimburses all reasonable travel
and expenses for attending Peer-Reviews, including meals and
accommodation if an overnight stay prior to the review is
necessary. You must retain all receipts/tickets to support
your expense claim, including taxi journeys.
- We will book travel (trains etc.) in advance on your behalf
wherever possible. The College is part of the 10:10 campaign to reduce
carbon emissions and as part of this we encourage you to travel by
public transport as much as possible.
- If you would like us to book travel for you, AIMS should be
notified at least three weeks in advance.
- If a ticket is bought by the reviewer on the day, we will only
be able to refund the cost up to the price of an advance
ticket.
- If you choose to drive, AIMS will refund mileage costs up
to the price of an advance train ticket. We are required to
provide our Finance Department with a mileage printout, from
postcode to postcode, for which we use the AA website. Your
claim may be adjusted to reflect the mileage given by the AA.
Reimbursement of Alcohol
Please be advised that AIMS will only reimburse you the cost of
one alcoholic beverage per day whilst on review. This is to be
consumed with your dinner (for which you are permitted to claim a
maximum of £25). Any further alcoholic beverages will be purchased
by yourself and at your own discretion.
The Peer-Review Visit: evidence to demonstrate compliance with
standards
One of the biggest difficulties the AIMS
Project Team faces is the amount of documentation we receive from
wards/units, after the Peer-Review Visit has taken place, as
evidence to show compliance with standards. This is
problematic for a number of reasons – not only is it
administratively very time-consuming (we are doing work that should
have been done on the day of the review), it is also beyond the
remit and expertise of most of the Project Team, most of whom are
not clinicians. All the evidence we receive has to be
considered by the project’s clinical advisor, which can be quite a
hefty task at times. Even then, this is a little
unsatisfactory, as the documentation is not being considered by
someone who has been to the ward/unit, which somewhat defeats the
object of conducting a Peer-Review Visit at all.
To alleviate this issue, and the implications
it has for the validity of the accreditation process, we will from
now on be more proscriptive about what we can and cannot do after a
Peer-Review Visit has taken place.
- The Peer-Review Visit is your one and only
opportunity to provide evidence that you are meeting standards,
particularly if your self-review data is indicating that you are
not meeting those standards.
- It is the responsibility of Host Teams
to review their own data in advance of the review visit and produce
the required evidence on the day of the review. We advise
that host teams read their Peer-Review Booklet as soon as it
arrives and start preparing their evidence – they will not have
another opportunity after the Peer-Review Visit to demonstrate
compliance with standards.
- It is the primary responsibility of
the Peer-Review Team to validate the self-review data, and to amend
it where it is inaccurate: as they are there on the ground on the
day of the review, and as they are true peers, they are the people
best placed to do this. The Project Team is not able to do
this in anything like the same way.
The guidance we give to host teams and
peer-reviewers has been combined into one document, entitled
Guidance
for Peer-Review Visits. This document is
available from the Project Team on request, and is also sent
out with each and every Peer-Review Booklet. It is vital that
both those receiving a review, and those conducting it, read this
document well and check periodically for updates.
No further evidence can be considered
by the AIMS Project Team after the peer-review day – the draft
report we send to wards/units is the report which will be submitted
to the AIMS Accreditation Committee (AC), and is the report upon
which the AC will make its accreditation recommendations. The
only amendments we can make to a report are to correct
typographical errors.
There are always exceptional
circumstances, and we won’t be completely inflexible on this, but
as a general rule, the above will apply in every case.
Our
Accreditation Process document (also
available from the Project Team) specifies that accreditation
decisions are based on the circumstances of the ward/unit at
peer-review. The above changes will ensure that we are
accurately following this requirement.
INTERIM REVIEWS/CYCLE 2
Type 1 Standards Not Met
Over the last year or two, many wards/units
have reached the Interim Review stage of their accreditation
process, and others have begun undertaking their second
accreditation cycle. Many of those wards/units appear to have
suffered some standards-slippage since they were originally
accredited – and the same unmet standards recur often. All
member wards/units might find it useful to look at this list, as it
might help them to know what to keep their eyes on between
reviews:
- On the day of their admission, or as
soon as they are well enough, the patient is given a “welcome pack”
or introductory booklet.
- The ward provides access to an
independent advocacy service that includes IMCAs.
For both of these standards, wards/units are
not meeting them because of what patients say to us – the
information may be available, but it’s not being communicated
thoroughly and regularly. Wards/units should ensure that
their welcome packs are re-visited after admission (as we are often
told by patients that they were too unwell at the time of admission
to recall if they had seen one), and that information on advocacy
is regularly provided, via a variety of methods.
- Inpatients have access to specialist
practitioners of psychological interventions for one half-day (four
hours) per week per ward.
This was not a Type 1 Standard when a lot of
wards/units conducted their original reviews, but it is now!
It is important that wards/units keep tabs on changes to the
standards as they occur, particularly when there are new Type
1s. ‘Specialist practitioners’ does not necessarily have to
be an actual clinical psychologist (though obviously we welcome
that) – we’re more concerned with seeing that the interventions are
available.
- All qualified nurses have been
assessed as competent in the administration of medications on a
yearly basis using a competency tool, and a record is kept of
this.
We are not sure why so many wards/units are
not meeting this standard – it has been a Type 1 from the
beginning! I have been reliably informed that here are lots
of suitable tools available on the internet to download.
- Records contain information as to the
security of the patient's home, whereabouts of children/animals
etc.
There appears to be slippage in this area –
most wards/units have now added an item to their ‘admission
checklist’ to reflect this standard, but it may need reiterating to
staff that it is important for this item to be completed.
Patients often tell us that their concerns in these areas are a
source of distress.
- Access to training is facilitated, and
there are arrangements for staff cover to allow staff to attend
training.
Many wards/units do not meet this standard
because staff have had training cancelled due to lack of staff
cover.
- On the day of their admission or as
soon as they are well enough, informal patients are given written
information on their legal status and rights.
This again was not a Type 1 Standard when many
wards/units undertook their first review, but it has been for a
couple of years now. It may be that the information given to
patients is not presented as being ‘information on rights’, but we
often have to ask wards/units to address this. Wards/units
that have added this as another item on their ‘admission checklist’
usually meet this standard.
This list is by no means exhaustive, but these
are the most commonly unmet standards, at least on working-age
wards. Please get in touch with the AIMS Project Team if you
feel we can assist you in ensuring you meet – and continue to meet
– these important standards.
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