Undressing the Uniform Debate

In a Nursing Times survey in 2014, almost 60% of staff consulted, indicated that they thought uniforms were an important part of the job. It is, like the uniforms, a multi-layered topic that generates strong opinions.

The Evolve Care Group run 6 care and nursing homes across the South West of the UK, employing some 450 carers and offering over a million hours of specialist care, over the last 14 months.

Four years ago, they started discussing the pros and cons of not wearing uniforms. After careful consideration, they decided that this was a good idea because it was in line with their Household Model of Care and would help them minimise the institutionalisation seen in their care homes.

 

They announced to their Care Teams across the company, that they no longer needed to wear a uniform. By and large, the teams were delighted, but a few carers argued against it. One said that she thought that uniforms were important because they were respected, and it simplified identifying senior carers.

At the time, Health Care Assistant, Rose Pearce, from the group’s Gibraltar Nursing Home in Monmouth, said visitors needed to quickly identify who they could talk to about important care issues and argued to keep the wearing of uniforms.

Talking with her recently, however, she has changed her mind, completely.

She said “It’s not often that I admit that I was wrong, but I was”

She went on to say that within the first few weeks of giving up uniforms, she began to notice the people she cared for, who are referred to as family members by the care teams, started commenting on the clothes she and the other team members wore to work. Nobody had ever commented on the uniforms, before, she said, but since but the change, they were regularly hearing comments such as “I love that top” and “That colour really suits you, dear”

She also noted that the care staff and family members seemed more relaxed and began to realise how divisive uniforms had been, drawing a line between the carers and the cared for.

Being able to choose what to wear for work also meant that staff were able to choose clothes to wear that would be more likely to generate a positive reaction, such as wearing a particular football top when working with a family member who supported that team, or wearing a T-shirt with a picture of a horse, and asking if anyone had ever been horse riding.

Communication levels between carer and cared for, increased, as did the level of wellbeing.

Although uniforms made it easier to recognise care staff, this was primarily benefitting visitors to the Home. For the family members, especially if they were living with dementia, seeing a uniform was not something they were used to seeing in their own homes and could increase levels of anxiety. Also, from the Care Teams’ point of view, uniforms could be uncomfortable and poorly designed, or cheaply made. It also seemed that some people had an antipathy towards uniforms. This may have its roots in our history of associating them with war or the emergency services or even school bullies.

Nocturnally, the care teams were encouraged to wear night attire, such as dressing gowns and pyjamas, so that if a family member rose in the night and saw a carer in a nightie or pyjamas, this seemed normal, but had the carer been wearing a uniform, this could have become problematic.

Evolve’s bold policy change has won favour with the CQC which recently rated one of its homes as Outstanding. Inspectors found that no uniforms promoted an “inclusive family environment” and minimised confusion for people living with dementia.

Having received top marks and approval from CQC, the Group now plans to roll out its innovative model of care with an ambitious £75m acquisition and new development plan.”  Jerry Short

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