Dr David Stonehouse

Bringing together authors from a range of academic disciplines and research backgrounds – united as standard-bearers for the child’s right to play – and set against a backdrop evoking play’s critical essence, this book documents the ...

Within this article the author sets out the basic principles that will assist the aspiring writer to become published author. Areas discussed include: why you should write and be published; where to send your article; content; and finally, the importance of following submission guidelines for authors, set by the individual editor and journal.

Support workers are experts in what they do, bringing a wealth of knowledge, experience and skill to their role. This expertise needs to be recognised and disseminated both within the support worker community and the wider health and social care team of professionals. Support workers have a voice which needs to be heard and writing for publication is one important way this voice can be heard and quality care shared both locally, nationally and internationally.

This article discusses the important concept of autonomy and what this means for patients and their families. This concept is the first of the four ethical principles identified by Beauchamp and Childress (2019) and is an important legal issue. First, the ethical position of autonomy will be explored, before moving on to discuss the legal aspects. Next, definitions will be presented, and the relevant and pertinent parts of the Nursing and Midwifery Council (NMC) (2018) code introduced. Finally, closely linked to autonomy is capacity. This link will be discussed, highlighting the processes and considerations that need to be considered if a person’s capacity is reduced.

This article discusses the important concept of justice, one of the four ethical principles developed by Beauchamp and Childress (2019) . Gillon (1994) divided justice into three categories: distributive justice, rights-based justice and legal justice. Justice also forms an important part of British values regarding democracy, the rule of law, individual liberty, mutual respect and tolerance of those of different faiths and beliefs. Following an introduction defining what is meant by the term ‘justice’, the relevant parts of the Nursing Midwifery Council code ( NMC, 2018a ) will be identified and presented. There will then follow a discussion on the three categories of justice as laid out by Gillon (1994) and how justice fits in with British values. Finally, this discussion will point towards how justice can be achieved for the patients in your care and the colleagues you work alongside.

This article is the third in a series of three, discussing and applying four ethical principles as identified by Beauchamp and Childress (2019) . This final article examines the two interrelated principles of beneficence and non-maleficence.

First, we will present definitions identifying the differences between the two. Then we will identify relevant and pertinent parts of the Nursing and Midwifery Council (NMC) (2018) code will be identified.

This will be followed by a discussion on how beneficence and non-maleficence can be demonstrated and practised within the clinical environment to patients, their families, your colleagues, and yourself.

Ofsted is the UK body that inspects services providing education and skills for learners of all ages. Within this article there will be a discussion of what may occur if your apprenticeship and educational institution are inspected by Ofsted. Areas that an inspection would cover, and that are addressed here are: the quality of education; behaviour and attitudes; personal development (Including fundamental British values); and leadership and management. There will also be a discussion of the importance of placement experience and learning, and safeguarding. Importantly, your potential role in any inspection as apprentice and learner will be discussed.

This article discusses the importance of knowledge, skills and behaviours for the student on an apprenticeship route. The author discusses how these fit in with the occupational duties of the apprenticeship, the Nursing and Midwifery Council's code of conduct and standards of proficiencies for registered nursing associates.

In this article, the author discusses the concept of person-centred care and introduces two new concepts: peer-centred care and employee-centred care. Given the increasing pressures that all healthcare staff currently face, it is important to adopt a compassionate and empathetic attitude towards peers and employees, ensuring better workplace morale and care for patients.

This article examines the communication framework known as SBAR—which stands for ‘situation, background, assessment, recommendation’. High-quality communication between members of the multidisciplinary team is vital within health and social care. Support workers have a clear role and responsibility in facilitating effective communication. Therefore, relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted.

The article will then discuss exactly what the SBAR framework is and examine the four key parts which assist in the concise and focused transfer of information in an assertive and effective way, while empowering the support worker and developing their critical thinking skills.

The author has more than 14 years' experience in higher education, supporting students in delivering presentations for assessment and in marking across all levels up to masters, and as an external examiner. This article examines and highlights the general principles that will assist the student in writing, preparing and delivering a successful presentation. Standing up in front of your peers, tutors, or interviewers can be one of the most stressful things students and job applicants face.

The aim of this article is to give advice and encouragement to the student, thereby hopefully reducing some of the stress that presentations cause.

Areas such as the length of the presentation, structure and content, maintaining confidentiality, referencing, presentation marking criteria, spelling and grammar, font size and clutter, animation and colour, individual or group presentations, poster presentations, preparing for questions, audience participation, notes and handouts, confidence and body language, and feedback will be discussed.

As a follow-up to ‘understanding the nursing process’ ( Stonehouse, 2017 ), this article examines the importance of goal-setting within the planning stage of the nursing process. The acronym ‘SMART’ will be explored, to help guide the support worker in making sure their patients have the correct goals in place.

Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted.

Once appropriate and attainable goals are set, the support worker can then deliver quality care to meet these goals in partnership with their patients.

This article examines the importance of identifying the anxious patient and how to support them. Recognition of physical signs will be explained. The important areas of giving enough time, developing a therapeutic relationship, always acting in the patient's best interest, involvement of the patient in their care, communication, and information-sharing will be discussed. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted. If a patient's anxiety is not reduced and hopefully removed, one must seriously ask: are they truly being given respect and dignity and the quality of care they deserve?

There are many different professionals who all contribute to the health and support of patients. Understanding each one's different specialty is important, so that support workers know who the patient needs to be involved in their care—and when.

The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) identifies that working in collaboration with colleagues is an important part of the support worker's role. Within section three and four it highlights three key areas: support workers must ‘recognise and respect the roles and expertise of your colleagues both in the team and from other agencies and disciplines, and work in partnership with them’; ‘work openly and cooperatively with colleagues, including those from other disciplines and agencies, and treat them with respect’; and ‘communicate effectively and consult with your colleagues as appropriate’. These three keys areas of partnership working, respect and communication will be explored and discussed in this article.

As a follow-up to the author's recent thoughts on ‘understanding the nursing process’ ( Stonehouse, 2017 ), this article examines the two complementary models of Roper, Logan and Tierney (1980) : their model of living and model of nursing. The different components which make up the two models will be explored and related to clinical practice.

It is important for support workers to understand both models and how they are being used within their clinical environment. Through support workers examining different models will assist in achieving section 6 of The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ), which urges employees to ‘strive to improve the quality of healthcare, care and support through continuing professional development’.

The use of touch within health and social care is the focus of this article. The different types of touch will first be defined, before moving on to examine the many benefits that expressive touch can bring to the health and social care role and to developing a supportive therapeutic relationship between the support worker and their patient. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted throughout. The important aspects of communication, compassion and empathy will be explored. Touch is not always appropriate or welcomed by the patient, and the support worker must take into account preferences, cultural needs and beliefs while also gaining consent.

In this article, the authors discuss the important issue of moral distress among support workers. Moral distress will first be defined before moving on to examine two forms this can take: initial distress and reactive distress.

The implications of moral distress for both the support worker and their colleagues, as well as patients and their carers, will be discussed. Relevant sections of the 2013 Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England will be identified.

Two common scenarios will be presented, highlighting how moral distress can manifest itself in everyday practice. The importance of self-awareness and reflective practice will be looked at, before identifying recommendations for future practice.

This article examines the Strengths, Weaknesses, Opportunities and Threats analysis tool commonly known as SWOT and how support workers can use this in decision-making, problem-solving and in identifying where changes in clinical practice are needed. The importance of this will be highlighted in the relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) and for nursing associates in the recently amended Nursing and Midwifery Council (NMC) (2018) code. The article will start with an overview of the SWOT analysis tool before examining the four separate parts. The importance of the analysis stage will be highlighted.

This article examines the important role that support workers and nursing associates play in being a coach for other less experienced team members. There is a difference between being a coach and being a mentor and this will be explored. The requirement to be a coach is laid down in both the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) and for nursing associates in the recently amended Nursing and Midwifery Council (NMC) (2018) code. Relevant sections of these two codes will be highlighted. The article will then move on to discuss the importance of planning in advance, so that the best support and development can be attained. Reflection at the end by both the coach and learner is key.

This article discusses the concept of ‘fundamental British values’ and how these can be demonstrated within clinical practice by support workers and nursing associates. Given recent events in both the US and around the world, highlighting deep-seated racism within society, it is important that the key areas of British values are examined. Following an introduction, links to the Nursing Midwifery Council ( NMC, 2018 ) code will be made. Then the five key areas that make up British values—democracy, the rule of law, individual liberty, mutual respect, and tolerance of those of different faiths and beliefs—will be discussed. The article will finish off with outlining how the controversial ‘Prevent’ training aims to protect and safeguard vulnerable patients from becoming radicalised and to challenge extremism within our society.

Support staff work closely with their patients and members of the multidisciplinary team to deliver high-quality care. Often this care will have been planned by a nurse using ‘the nursing process’. It is therefore important for the support worker to understand how the patient has been assessed and that the care they are providing has been planned.

Within this article, the author will be discussing the nursing process, explaining the different stages and how these are used to deliver quality care. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted.

Support workers have a clear and important role in making sure the nursing process is successful and patients receive the best quality care.

This article explores the important activity of reflection and reflective practice. Support workers and nursing associates, as well as all healthcare professionals, have a responsibility to reflect upon their own practice, identifying not only areas of good practice but also where improvements can be made. The article starts by defining what reflection and reflective practice are.

The requirement to reflect is clearly laid down within the recently amended Nursing and Midwifery Council (NMC) code for nursing associates ( NMC, 2018 ) and is implied within the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ). Relevant sections of these two codes will be highlighted.

The article will then move on to highlight two reflective models, the Gibbs (1988) Reflective Cycle, and Driscoll's (2007) Model of Structured Reflection, both of which are commonly used today. Clinical supervision will be discussed and the importance of recording reflections will be emphasised.

This article discusses the end point assessment (EPA) for the nursing associate apprenticeship. The format of the EPA will depend on when the nursing associate commenced their training.

Both formats will be presented, together with the two different occupational standards that apply to each. The article will finish by introducing the nursing associate to the role of end point assessor.

This article discusses the important role that playrooms provide for children when they are in hospital, either as inpatients, outpatients or even as visitors. Following an introduction highlighting the importance of play, the background to hospital playrooms will be identified. Links to the Nursing and Midwifery Council code will then be made, before discussing and highlighting the clear benefits of having designated and bespoke children's playrooms.

However, there is a cautionary note: not all playrooms are being used for the purpose they were designed for. This other inappropriate use can prevent children from accessing playrooms when they need them, or even worse, are being subjected to clinical procedures within them. This will be highlighted and discussed.

Finally, the role of the support worker and nursing associate will be made clear in how they can support children in accessing play opportunities within their clinical areas.

This article discusses the important concept of person-centred care and how this can be achieved. Following an introduction defining what is meant by this term and contrasting it with the term patient-centred care, the relevant and pertinent parts of the Nursing and Midwifery Council code will then be identified and discussed.

The four principles of person-centred care will then be presented. The role of the support worker and nursing associate will be made clear in how the wishes and needs of patients can be gained. Self-awareness, emotional intelligence and communication will be discussed in relation to this.

Finally, two potential barriers to the successful achievement of person-centred care will be identified.

The importance of the hospital playroom has been recognised for the last 70 years. As part of a wider piece of research, participants studying pre-registration children's nursing were asked questions regarding the use of playrooms on children's wards where they had been on placement. This chapter will first give the background and importance of play for children in hospital and the role that the playroom provides in this. Research methodology will be stated before presentation and discussion of the results. Conclusions and recommendations will be made, before highlighting the implications for children's wards and children's nurses worldwide.

Under direction from the Nursing Midwifery Council, nurse education is becoming more generic. With an increasing adult focus there is a risk and concern that issues relevant to children’s nursing may become diluted or removed altogether. When a child is hospitalised, play becomes an important link to home. It is a way they can take control of what is potentially a very painful and distressing time for them. There is concern that children’s nurses may not be taught to assess and plan for the children’s play needs - a key part of being able to provide holistic nursing care.  The aim was to investigate the education which pre-registration children’s nurses receive in play in both academic and clinical arenas. To achieve this three research questions were identified. First what experiences of play do pre-registration children’s nurses have whilst out on clinical placement? Secondly what are pre-registration children’s nurses taught in university concerning play? Third, what education in play would pre-registration children’s nurses like to receive to prepare them for their clinical role?  A mixed methods design was utilised. Programme specifications and focus groups have been examined using inductive content analysis and thematic analysis. This was the first time that both programme specifications have been examined, and the opinions and experiences of student children’s nurses around play researched.  Concerning programme specifications, only 17% cite play. Those that do, make clear links between play and communication and distraction. They do not contain any reference to therapeutic play or the benefits which play in hospital can bring. Focus group discussion centred around two main categories, ‘play within hospital’ and ‘education needs.’  Recommendations are made around a number of areas: the content of teaching of play within the curriculum, placement documentation, increased nurse’s awareness of the importance of play, parents being supported to play with their children in hospital, and the importance and use of the hospital playroom.

In this article, the author will be discussing the importance of equality, diversity and inclusion, and how support workers can promote these values within their care delivery.

The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) clearly states the importance of equality, diversity and inclusion, and the relevant clauses of the Code will be identified and discussed. The two key pieces of legislation, the Equality Act 2010 ( Ministry of Justice, 2010 ) and the Human Rights Act 1998 ( Ministry of Justice, 1998 ) will be discussed, identifying how these apply to the support worker's role.

Where discrimination is occurring, the support worker will need to have the courage to speak out and challenge this bad and unlawful practice.

Through promoting equality, diversity and inclusion, the support worker will be delivering care of the highest quality, as well as demonstrating respect and dignity to service users, their families and to colleagues.

This article discusses the important part that the nursing handover plays in providing quality care to patients and the smooth running of the shift and clinical area. Following an introduction stating exactly what is meant by a handover, the relevant and pertinent parts of the Nursing and Midwifery Council code will then be identified and discussed. The importance of good communication as well as delegation will be discussed, before moving on to identify potential issues to achieving a quality nursing handover and ways to overcome these. Finally, the role of the support worker and nursing associate will be made clear.

This paper discusses the importance of ethics for play and playwork practitioners as the sector and work force move towards becoming a recognised profession within the United Kingdom. Exactly what is meant by the term ethics is defined, before moving on to a discussion of two key areas. First, the ethical framework known as F.A.I.R. (this mnemonic stands for Fairness, respect for Autonomy, Integrity, and to seek the most beneficial and least harmful consequences or Results) devised by Rowson [2006. Working ethics: How to be fair in a culturally complex world. London: Jessica Kingsley) and second, the four ethical principles of Beauchamp and Childress (2013. Principles of biomedical ethics (7th ed.). Oxford: Oxford University Press]. Throughout links are made to the eight Playwork Principles developed by the Playwork Principles Scrutiny Group, Cardiff in 2005 and endorsed by SkillsActive (2013a. Playwork principles [Internet]. Retrieved August 26, 2015, from http://www.skillsactive.com/PDF/sectors/Playwork_Principles.pdf).

Clinical supervision involves a supportive relationship between supervisor and supervisee that facilitates reflective learning and is part of professional socialisation. Clinical supervision can take many different forms and may be adapted to suit local circumstances. A working agreement is required between the parties to the supervision and issues surrounding confidentiality must be understood. High-quality clinical supervision leads to greater job satisfaction and less stress. When it is absent or inadequate, however, the results can be serious and it is particularly important that student nurses are well supported in this way. Further research in this area is necessary.

Nurses have a duty to promote the values of equality and diversity during their interactions with patients and their families and carers, as well as peers and colleagues. This article defines the terms equality, diversity and inclusion, and explains the importance of the Equality Act 2010 and the Human Rights Act 1998 in protecting people from various types of discrimination. It also outlines nurses' responsibilities in promoting equality and diversity by treating all patients and colleagues with respect and dignity, providing compassionate leadership, and practising in accordance with the ethical principle of justice. The article encourages and empowers nurses to recognise and challenge discrimination wherever they see it, thereby delivering high-quality care to all patients.

This article seeks to comment on the important part that reflective practice can play in enhancing the manager's day-to-day role and performance. Staff holding professional qualifications such as doctors and nurses are trained and experienced in using reflection as part of their everyday clinical practice. However, as managers, this is something which is rarely prioritised or seen as important. It is the author's view that the value of reflection within management therefore needs to be recognised. Managers need to develop skills and use models of reflection, becoming aware of the benefits that reflective practice can bring. Reflective practice is about ensuring quality care is delivered and quality decisions are made.

This article focuses on delegation and what this means for the support worker in their everyday practice. Support workers are now performing roles and tasks which even just a few years ago would have been unheard of. They are working in a wide range of clinical environments and liaising and working alongside professionals from different fields of expertise. Having work and tasks delegated to you, as well as delegating to others, is a major part of the support worker's role; understanding how and when this should be done is key to successful delivery of quality care.

This article examines the importance of teamwork within professional settings and what is meant by being in a team or group. It focuses in particular on how support workers may understand good teamwork within the context of local or national codes of conduct. It also discusses how teams develop and what roles individuals play within them. The leadership of teams is also addressed.

This article examines what it means for the support worker to be responsible for the care they deliver and to be accountable for their actions and omissions. Both terms will be defined and discussed, before moving on to identify the five different arenas that the support worker may find themselves accountable to.

The support worker's role is ever-expanding, with fresh tasks and roles being undertaken that even only five years ago would have been the sole domain of other health and social care professionals.

Assistant practitioners (APs) are now becoming firmly embedded within organisations. These new roles and jobs mean increased responsibility and ultimately increased issues of accountability for the support worker.

This article examines the important role that good communication plays in enabling the support worker to deliver quality care. Communication will be defined, as well as examining the different forms and components that make up communication. Potential barriers will be highlighted, together with advice on how these may be overcome.

Support workers are closest to patient care, spending more face-to-face time with patients and their families/carers. It is vital therefore that support workers communicate in a patient-centred way, taking into account the patient's preferences and needs, while maintaining respect and dignity.

Within this article, the author will be discussing professionalism and what this means for the support worker in their everyday practice. The difference between being a member of a profession and acting with professionalism will be discussed.

The importance of following the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be stressed, as it is through meeting these standards and behaviours that professionalism will be supported.

Topics that will be highlighted include: having a professional attitude; the importance of appearing professional and of communicating in the correct way; confidentiality; together with the maintenance of professional boundaries with service users.

This is an article written following a presentation given at a national conference on the ‘Progression and Development in the Role of Support Workers’ in November 2012. Within this article, the author will highlight the important leadership role that support workers can and need to embrace.

The article is aimed at three groups: first and most important, support workers themselves; second, managers; and third, educationalists in charge of developing and delivering both in-house and external training courses.

Two key areas will be discussed where leadership by support workers is vital: quality and the management of change. The article will finish by looking at how support workers can be supported and developed within this often new role by managers and educationalists.

Within this article the author will be examining what ethics and ethical practice actually means for the support worker. What an ethical dilemma actually is. The four main ethical principles as identified by Beauchamp and Childress (2009) will be discussed and how these relate to our everyday practice. Veracity and fidelity will also be examined as important ethical principles.

Within this article, the author will examine a number of the main ideas and theories of change management, together with a change tool, ‘The Model for Improvement,’ which support workers can use to deliver successful change. Change is often a state that is forced upon us, often with little or no warning or forward planning. Having an awareness of the theory behind change and which tools are available will enable the change to be planned and executed in a controlled and positive way. When change is required, it should be to improve the quality of the care delivered or the clinical environment for both patients and staff. It is therefore important that the change goes ahead as smoothly as possible and support workers play a major part in helping to achieve this. It is vitally important that staff are involved in all stages of the change process. Support workers are the staff best placed, being closest to their patients and clients, to recognise where service delivery needs to be improved. They can identify what changes can be made and how these can be put in place. It is therefore vitally important that managers support staff in developing change-management skills and experience.

The author will examine how change within an organisation can be faced with resistance from the organisation itself. By ‘the organisation’ we do not mean the physical building, hospital or even trust, but more the culture, policies and procedures—and the senior staff who facilitate the running of the business. When change is identified as necessary or desirable by those on the ground, it is hard to accept why it is not embraced further up the organisation. Understanding how and why resistance can build up will help support staff to understand the issues and solve the problems, thereby not giving up on delivering successful change.

Within this article, the author will be examining the support worker's role in advocacy, looking at exactly what advocacy is and what being an advocate means. Who should be an advocate, and when you should not be an advocate? The importance of communication to the process and the ultimate aim of the client becoming a self advocate and the formation of self-advocacy groups will be discussed.

Support workers have a privileged position within the team of professionals looking after clients. They are the one group of staff that spends the most quality time with them. They are the ones delivering the basic fundamental care needs and through this develop a close professional working relationship with patients and clients. When things within the delivery of care are not going quite as they should, it is the support worker who is often the first member of the team to become aware of this—either by identifying the problem themselves or being informed of it by clients. How support workers deal with issues and complaints will play a major part in how the service is viewed by the client from then on. Complaints should not be viewed negatively or shied away from, but seen positively as a way that support workers. All staff can develop and improve the quality of care delivered.

Within this article the author will examine what clinical governance is. It will discuss some of the many different, but interlinked, components, which, when all working together, help to ensure the quality of care that individual support workers deliver, as well as the organisation as a whole.

It will use as a base for its discussion 7 of the components that make up ‘The Temple Model of Clinical Governance’ devised by the Clinical Governance Support Team.

Clinical governance is a mechanism that enables quality to be placed at the heart of everything that we do as support workers. Every patient has the right to know that the care they are receiving is of the highest possible standard and quality. It is therefore every member of staff's responsibility to work towards ensuring that quality care is being delivered.

In this article, the author will examine how change can affect individuals, both staff and patients, and how resistance to change can be managed to enable organisations to be successful. Support workers are at the forefront of change. Where there are any changes within an organisation, or of service delivery, support workers will be directly affected by it. They are the ones who will be closely involved in the implementation of the change and also the frontline staff who are left to manage the new situation or working practice. More importantly, patients and clients will be directly affected by any changes that occur. It is therefore important for support workers to have an understanding of how change is implemented and to recognise why people are resistant to it.

The importance for support workers of managing both the resources within the workplace and importantly their own time will be considered in this article. Identifying resources as and planning how these can be managed successfully will be discussed. If resources are not managed correctly this can and will have a negative impact on the quality of patient care and service delivery and so is an important part of the support workers role.

Within our working lives, and in our relationships with colleagues, patients, and stakeholders, our interactions will not always be harmonious. However, support workers should not shy away from conflict, but recognize it as an opportunity to develop practice and improve quality. This article will start by examining what conflict is. It will then move on to dispel some of the myths surrounding conflict, before looking at how individuals respond to conflict situations. Causes of negative conflict will be discussed, before highlighting how it can be used constructively and why support workers should embrace it in a positive way.

Within this article, the author will examine what an appraisal is and how, if done correctly, it supports and develops quality care. Appraisals receive a negative press with both employees and managers. Reasons for this will be explored before moving on to identify the purpose and benefits that following an appraisal process brings. The many different forms that appraisals can take will be highlighted. What factors make up an appraisal will be discussed, from reviewing past performance to the setting of realistic and yet challenging goals. The importance of preparation for the support worker prior to the appraisal process will be highlighted as a key factor to success.

Some support workers mistakely believe that reflective practice is difficult to undertake or is only performed by staff members who are engaged in written assignments. This article aims to encourage all support workers to adopt reflective practice as an activity to be undertaken within their everyday working lives. Reflective models are discussed as well as mentoring and the use of reflective diaries and journals.

In this article the author will examine the important role that the appraisal system, or performance review, plays in ensuring and improving quality care. As a manager it is your responsibility to support and develop your staff. Through appraisal you can identify good practice and support the achievement of organisational goals. It is also your opportunity to sit down with your staff on a one to one and discuss short falls and problems in performance. This article will start by highlighting the benefits and importance of appraisals, before examining why they have also generated such bad press in the past with both managers and staff? It will then identify the role and purpose that appraisal brings when performed correctly. Why difficulties may arise in performing appraisals will be highlighted. The importance of training for both managers and staff, in the appraisal process will be discussed as a key element to success.

In this article the author will examine the two important and distinct roles of both manager and leader. Often, out of necessity, these two roles are performed by the same individual, but this however, is not always ideal or practical. Therefore, as a manager, it is vital to recognise the focus of your role and to support and develop those staff within your department who can and are already fulfilling their leadership potential. This article will start by demonstrating the differences between a leader and a manager. Change management will be discussed before finishing with how the manager can support and develop their own staff to become successful leaders, thereby allowing the manager to concentrate upon the vital job of managing.

Within this article the author will examine the manager's role in the change process. Change within the NHS is an ever-present reality, whether proposed from within your own department and identified by your own staff, or forced upon you from outside. However, participating within the change process can distract managers away from the vital job of managing their service or department. Therefore, as a manager it is vital to recognise the focus of your role and to then support a strong leader and expert who will act as ‘change agent’ to see the change through to a successful conclusion.

In this article, the author will examine and discuss how the manager can practice in an ethical way, thereby enhancing their performance and day-to-day role. Codes of conduct are both legal and ethical frameworks which assist managers in knowing what is expected of them by their employers, service users, government and the wider public. What is meant by ‘ethics’ will be discussed before examining the ethical framework of Rowson (2006) applying this to the manager's role. By following codes of conduct and thinking in an ethical way will enable the manager to ensure quality care is delivered and the best decisions are made for service users, staff and the wider community.

Within this article, the author will be discussing how the support worker can tell if research and evidence-based practice are good and robust and will benefit service users and their families.

What makes a piece of research worthy of implementation into the clinical area—or not? First, evidence-based practice and research will be defined and discussed. Next, the article looks at what aspects need to be considered when critiquing a piece of research. The two main types of research, quantitative and qualitative, will be highlighted before moving onto key questions to consider in critiquing published research.

The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) clearly states the importance of continuing professional development (CPD) to improve the quality of healthcare, care and support and this will be examined in more detail.

Support workers alone will not be implementing changes to clinical practice themselves. However, they should be involved as part of the wider team in doing so, and importantly should know and understand the research behind why care is delivered in the way it is. One key aspect to this is understanding what preferences the patients have for their own care needs.

Within this article, the author will be discussing the vital role that support workers have in managing risk and in maintaining a safe working environment for themselves, their colleagues and service users. The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) clearly states the importance of health and safety in delivering care of the highest standards; relevant clauses of the Code will be identified.

The Health and Safety at Work etc. Act 1974 will be highlighted as being a key piece of legislation. The five steps of risk assessment will be discussed, to demonstrate how support workers can use this process to successfully manage risk in their working environments, while following workplace policies and procedures.

Within this article the author will be discussing the importance of the support worker developing a therapeutic relationship with their patients, clients and families. What is meant by a therapeutic relationship will firstly be defined before moving on to examine the many benefits that this brings to the health and social care role. Relevant sections of The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted. The three key aspects of partnership, intimacy and reciprocity of Muetzel's (1991) model of therapeutic relationships will be identified. The important aspects of communication, rapport, empathy, self-awareness and emotional intelligence will be further explored. There are times and situations when developing this special relationship will be more difficult to attain and these will be examined, giving suggestions on how these barriers may be overcome.

Within this article, the author will be examining the importance of play for children and young people, especially when they are in hospital. Play will be defined; however, this is a concept which is difficult to grasp, as play means different things to different people. The article will highlight the benefits that play brings for healthy children, before discussing the important role it has for children and young people in hospital.

The fact that play is everybody's business and should not just be left to the play specialist alone, will be asserted and demonstrated. Support workers are closest to patient care and are therefore ideally placed to support children and young people to play within the healthcare settings where they are being cared for.

Within this article, the author will be discussing the important issue of self-awareness and what this means for the support worker in everyday practice. What does being self-aware mean and how can it support the delivery of quality care? The concept of having emotional intelligence will be highlighted and the Johari Window will be discussed as a way to explore and develop personal self-awareness. Self-awareness is closely linked to reflective practice and this will also be explored, before looking at self-awareness for leadership. Clear links to the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England will be made throughout.

Consent is not just an issue of concern for senior staff members within a health or social care setting. It is equally important for support workers and all other personnel involved in delivering day-to-day care. Consent therefore needs to be considered and understood if patient's rights are to be met and safe and quality care is to be provided. This article will explore the concept of consent and implications for healthcare assistants, assistant practitioners and other health practitioners.

Multidisciplinary team working is key to patients receiving the right care at the right time, delivered by appropriately qualified and experienced staff. Support workers are a vital part of this team and their contribution needs to be recognised, both by other professional groups, but also importantly by themselves. This article will examine why the multidisciplinary team is so important to delivering quality patient care. It will also highlight potential barriers and how these can be broken down.

The purpose of this research was to identify nurses’ involvement in play for children within the hospital environment in England. Longitudinal focus groups were used to gather data which was analysed using thematic analysis and a ‘pencil-and-paper’ strategy for coding. Themes emerged around play being part of the nurse’s role, time constraints, importance of senior staff support, identifying a play need and referring on; and the concept of ‘passing play.’ It was concluded that play for children in hospital is important. Nursing staff have an important role in recognising this need, making a play referral when required, and participating in ‘passing play.’ There needs to be an increased awareness in nurses and nurse leaders to the importance of play. Nurses need to recognise when a play referral should be made as well as making the most of all opportunities to participate in play with their patients.

To determine the number of programme specifications which cite play within the curriculum and in what context. Play is an essential part of childhood. Therefore we might expect nurses caring for children to be trained in how to facilitate play within their clinical areas. Programme specifications provide information on course aims, the intended learning outcomes and what the learner is expected to achieve.