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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

AIMS
 

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 the Finance Department.  Claims sent to the Finance Department 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, Accommodation and Subsistence

Please refer to the College's guidance for expense claims before filling out a claim form - this guidance can be found here.

When completing your claim, please check the following:

  • the correct claim form has been used;
  • supporting paperwork (e.g. receipts) have been included;
  • amounts claimed fall within College policy;
  • mileage is accurate;
  • the claim is signed.

In addition, please note the following:

  • A receipt must be included for every item claimed.  Items without receipts will not be reimbursed.
  • Where a reviewer has purchased, for example, a train ticket themselves, which has then been retained by an automated barrier, we can make an exception to the College guidance and allow the claim upon production of a receipt, which we will then check against advertised fares.  Please try to retain your ticket wherever possible – and remember that it is always preferable that we book your travel for you in advance.
  • We will reimburse subsistence only as self-contained meals – it is not permissible to purchase several snacks and claim them all as dinner.  Snacks and beverages purchased outside of these meals will not be reimbursed.
  • One alcoholic drink is permissible with a meal – not separate to the meal, and not, for example, a whole bottle of wine.
  • Subsistence receipts must show the date upon which the meal was purchased, and detail what was purchased.
  • The 12-hour absence begins when the journey we book for you starts, and ends when the return journey does.  Snacks and beverages outside this time will not be reimbursed.  We would normally expect reviewers to have eaten breakfast before leaving home, if they are travelling on the day of the review.  It is also not permissible to arrive at the departure station early and purchase and claim for a lunch or dinner before travelling, or purchase a meal after completing the return journey. If you chose to extend your travel by departing earlier or returning on a later date when not required by train schedules (i.e. for personal reasons/holiday), we cannot reimburse any meals or accommodation outside what would be required of a standard journey.
  • If you are staying in a hotel and the booking includes breakfast, and/or the ward you are visiting provides you with lunch, we cannot reimburse additional breakfasts or lunches, and the relevant amounts will be deducted from the 12-hour absence allowance.
  • Mileage is calculated on a postcode-to-postcode basis using the AA’s ‘Route Planner’ facility on its website.  We are unable to verify any changes to this because of, for example, detours.

If you are in any doubt about any aspect of your claim, please get in touch with us before submitting it.  If we have any queries, outside of the points listed above or in the attached document, we will get in touch before we submit the claim to our Finance Department.

 

Please remember when submitting a claim that the College is a registered charity, and that AIMS has no other source of income other than subscription fees from member wards/units.

 

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

At Cycle 2 or at interim review stage, we sometimes find that slippage has occurred since initial accreditation – 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.

Where next...


AIMS
21 Prescot Street, London E1 8BB
Email: aims@rcpsych.ac.uk

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