We have tried to help you by simplifying the process of cleaning in hospitals. The cleaning stages are broken down here for you in seven different steps; follow the guidelines and you won't go far wrong!

1. Empty Wastebins: Remove liner from the bin. Tie it securely with the correct tag and dispose of it at the disposal point. Replace it with a clean liner ensuring the front of the liner is at the front of the bin. Damp wipe the bin with cleaning solution inside and out. Always use gloves. Never empty contents of yellow bags into another. Sharps (blades, needles etc.) should always be placed in their designated containers.

2. High Dust: High dust all ledges, curtain rails, doors etc. which cannot be reached by normal damp wiping, working from left to right. Replace the mop head as necessary. Remove the mop head at the end of shift for laundering, damp wipe the mop frame and store it away. Always be careful not to shake the mop, as you will redistribute dust into the atmosphere.

3. Sanitise & Spot Clean: Starting from the left side of the area, sanitise all furniture and fittings. Use a solution of cleaner to spot clean the walls. Remove any smears from mirrors using glass cleaner. Clean the soap dispenser and the paper towel holder. Clean the sinks with cleaning solution. Pay special attention to pipes and soap build-up, working towards the top of the sink cleaning the bowl last then rinse and wipe dry with a paper towel. Refill the paper towel holders. Remember to change the water and rinse your cloths frequently. At the end of your shift, damp wipe any spray bottles, empty your bucket, rinse and wipe dry and store it upside down on your cart. Always use the correct chemicals designated for the purpose. Always use gloves.

4. Floor Dusting: Starting from left hand side (or furthest side if you're cleaning a patient room) use an "S" movement to collect all dust/debris from the floor area. Use a floor scraper to remove any gum. Move away any small objects and rolling furniture for ease of cleaning. Pick up dust/debris with dustpan and brush away from the patient area. Remove the dust mop at the end of the shift for laundering. Damp wipe the frame and store it away. Again, always be careful not to bang or shake mop head as you will redistribute dust into the atmosphere.

5. Floor Sanitising: Place your "wet floor" signs your work area!! Wring out your mop tightly. Start at the left-hand side of the ward (furthest side if a patient room) using the "S" stroke movement clean the floor area and ledges. The water and cleaning solution should be changed as necessary (and often). At the end of the shift empty and rinse the bucket, dry thoroughly and store it upside down. Remove the soiled mop for laundering, damp wipe the handle and frame and store it on the cart. Always use the wet floor signs and always use the correct dilution of cleaning solution.

6. Bathroom/ Toilet Cleaning: Spot clean the walls, clean pipes/fittings, flush handle, light switch, and door handle with the cleaning solution. Clean and sanitise the sink as in step two (above). Clean the outside of the toilet bowl. Pump the water from toilet bowl and clean using a special cleaning solution for stubborn marks, clean inside of toilet bowl. Clean toilet brush and holder. Replace any disposable items. Sanitise baths/shower trays working from outside, rinse and dry them. Then, clean the floor paying special attention to the edges. Never use descaling products unless your Supervisor is with you. Never mix chemicals. Always use gloves. Always flush toilets after cleaning with chemicals.

7. Inspect: Ensure the area you have cleaned is complete and that furniture is replaced.

Because of the nature of the work carried out in hospital laboratories, you should always take extra care when cleaning these areas. Firstly, never forget that we would NEVER put you at any risk. You cannot catch any diseases or become contaminated by any chemicals or otherwise come to any harm if you remember these simple points:-

Always use the correct colour-coded rubbish bag when disposing of waste;

YELLOW bags are for clinical waste

BLACK bags are for household type waste

PAPER bags are for tins and bottles etc.

Remember to securely tie all bags. Some hospitals require that you clearly mark all bags with the name of the laboratory or department that the waste came from - check with your supervisor to see if this is the case.

Any accidental spillages from clinical waste bags must be cleaned up immediately; however, you MUST wear protective gloves when you clean up this type of spillage.

NEVER touch any of the equipment set out on laboratory benches, NEVER attempt to clean or tidy a bench (no matter how bad it looks). DO NOT be tempted to touch anything; only laboratory staff are permitted to move or clear anything from benches, and they are responsible for cleaning them. Strangely, if you ever notice that a tap has been left running in a laboratory, LEAVE IT RUNNING!. Never turn taps off. If you think that there might be a risk of flooding, contact your supervisor and let him or her deal with it.

Any accidents or injuries of any kind must immediately be reported to your supervisor. This is not because you are in any danger, but because certain paperwork has to be completed in order to comply with hospital health and safety regulations.

INFORMATION

• Showing you where first aid facilities are located
• Informing you what protective clothing is provided at your workplace
• Explaining cleaning arrangements for protective clothing, and showing you where outdoor clothing (e.g. raincoats) should be kept

FOOD HYGIENE

• Always wash your hands in warm soapy water after visiting the w.c., blowing your nose, handling refuse, before handling food
• Check and adhere to 'best before' and 'use by' dates on goods, whether in storage or on display for sale
• Ensure that raw meats, fish, dairy products and cooked foods are stored and prepared separately
• Use cupboard stocks efficiently, by taking older products first.
• Never refreeze food once defrosted
• Do not wash food in the same sink as the one used for washing hands
• Never use the same knife or chopping board to prepare raw meat, cooked food and fresh vegetables without washing them in between times
• Handle food only when unavoidable; use tongs plates and trays in preference to hands

GENERAL HYGIENE

• Report to your Supervisor in the event of injury or any illness
• Ensure that cuts and sores are covered with a waterproof dressing
• Food containers should be clean, protective and free from contamination
• Notify your supervisor of temperature discrepancies in fridges and freezers
• Thaw frozen food completely in a fridge or microwave before cooking
• Do not leave cooked foods to cool for more than one hour before refrigeration or freezing
• Never reheat foods more than once, and on that occasion ensure that they are piping hot all the way through
• Ensure that meat is cooked thoroughly, use a temperature thermometer (if available) to check that the centre has reached 70 degrees
• Frozen meat and poultry must be thawed completely. The liquid from the defrosting product must not come into contact with other food (eg. by use of a cloth)
• Cook foods thoroughly and observe microwave standing times
• Cooked meats should be displayed at or below 4 degrees, they must never be displayed for sale at ambient temperatures
• If in doubt, consult your supervisor

As an agency driver, you are, for liability reasons treated as self-employed. This means that you are responsible for checking the vehicle you are given, and you are responsible for reporting any faults that develop or are present. If you consider any vehicle to be unroadworthy, be sure to call us at the office before you start working with it. Failure to do so could lead to licence endorsements (or worse); you obviously need to keep your licence as clean as possible so do take care when you're driving, NEVER rush around or take chances on the road; our clients would rather you were a bit late and safe than on schedule and injured. For your information, when you drive for any of our clients you are covered by their insurance, not ours or your own. You should also remember that you are responsible for your own parking tickets; if making a delivery means that you will get a ticket, don't make that delivery. Instead, call us at the office and we will take advice from our client; very rarely, when it can't be helped, our clients will take responsibility for any parking tickets, but only by prior arrangement - so check with the client (the "User") first!!

When you registered as a driver with us you signed the following declaration:

"I undertake to inform you of the number of hours I have driven should I at any time work as a driver on my own behalf, or on behalf of any person, firm or company at, between or during any period(s) of driving that I may do as a result of any introduction by you and between the time of completing this application form and accepting my first assignment. I acknowledge that it is my responsibility to ensure that sufficient tachograph charts are issued to me by the user and I shall ensure that these are returned to the user within 21 days of date of completion. I further confirm that all details given on this form and on the accompanying "Rehabilitation of Offenders Act" form are true to the best of my knowledge and belief."

This declaration is meant to ensure that you do not exceed the maximum driving hours in line with current legislation. In addition the following questions were asked on your form, and you were asked to answer "yes" or "no". If you answered "yes", we would have also asked you for details. The questions are repeated here in case you forgot to tell us something, as making a false declaration is a criminal offence and we really would like to keep you out of trouble!

• Have you in the last five years been convicted of any motoring offence?
• Have you during the last ten years had your licence suspended or revoked?
• At the date of signing this form, is there any prosecution pending or has anything occurred which may result on a future prosecution?
• Have you, to your knowledge, any physical or mental defect or infirmity or do you suffer from diabetes, heart complaint or other disease or condition which may impair your driving efficiency?

Finally, you agreed to inform us of anything occurring in future which may result in prosecution or of contracting any disease or complaint mentioned on our application form.

If you registered with PSR to be one of our Special Care Assistants, we probably gave you some information about the work that we do. The information is repeated here for your reference.

Our care work is all home-based. We look after people living with HIV and AIDS who are nearing the end of their lives and want to be at home. Sometimes the persons spouse, partner, family or friends live at home also so you will be working around all types of people. We aim for our carers to stay with the people that they are caring for on an ongoing basis; we don't like to keep changing a person's carers. This gives you a chance to develop a relationship with your client, which can be very rewarding. Obviously, it can be upsetting as well, the job is emotionally demanding at times but if you're the right person for the job, very satisfying as well. Most of our clients are in the age range of 25 to 40 years old and live in the South East, North and Central London areas. The kind of duties that you will be expected to undertake include personal hygiene, toileting, bed-changing, the administration of oral medication, shopping, accompanying your client on hospital and clinic visits and, of course, emotional support. Some clients are looked after 24 hours a day, seven days a week, so all kinds of shifts become available. We usually plan the care either in 12-hour shifts, days and nights or three eight-hour shifts. Some clients are looked after for only part of the day or night, so occasionally shorter shifts occur. As previously mentioned, we prefer for you to commit yourself to a particular shift so that you are working with the same person at the same time, all the time. You will need to be an experienced care assistant; you do not necessarily have to be experienced with HIV or AIDS although that is preferable. You MOST DEFINITELY must be what we call AIDS and HIV "sensitive". That is to say that you must be sensitive to the needs of people with HIV and AIDS. If you are interested in starting out in HIV and AIDS care primarily because of the money, then our advice is to go to another agency and apply for geriatric/elderly, child, physical/mental handicap or some other kind of care. Whilst all types of care are very important and worthwhile, the care of people living with AIDS and HIV is special. Very special. So that we can concentrate on getting a difficult job right every time, we at PSR specialise only in this type of care - we leave the other types of care to the other agencies.

You will need at least to have attended and successfully completed a care course; we will need to see your certificates and may test your knowledge. You should be familiar with the following:

• The role of the Care Assistant
• Ethics and general knowledge
• The nursing process
• Carer/Patient relationships
• Bedmaking
• Blanket/Bed bathing
• Bathroom bathing
• Use of bathing equipment
• Patient handling
• Patient lifting
• Positioning the patient
• Use of bed equipment
• Care of the mouth
• Care of pressure areas
• Care of the bowel
• Care of the bladder
• Urine testing
• Suppositories/enemas
• Care of catheters/catheter bags/convenes
• Infection control
• Obs. (TPR & BP)
• Serving meals and feeding
• Care of the terminally ill
• Last offices

In addition, it would be helpful if you have attended any of the following types of courses:

• AIDS and HIV Awareness
• AIDS Awareness Update
• Clinical and nursing care of HIV and AIDS

In an effort to improve the quality of our staff and our service, we occasionally run the above courses for our working carers, usually at our cost.

You must be confident enough to be left alone with sole responsibility for a client for long periods. PSR and the various health and social services departments provide extensive 24 hour backup should you need it. Personally, you must be "unflappable" and able to cope in any kind of emergency keeping a clear head at all times. You must also be particularly literate; AIDS and HIV care involves the taking and making of copious notes. This is done firstly for the medical staff in order to help them make ongoing assessments of your client helping them to monitor the progress of the client; the other reason we keep so many notes is for reasons of budget - spending public money on care has to be continually monitored and justified, your notes will show exactly what level of care your client needs and will help the authorities to make an informed decision when they regularly review cases.

AIDS and the care associated with it is a demanding field for a variety of reasons, one of which is that we discover new things about the disease every few weeks. This means that your training and awareness need to be updated at least every six months - no other field of care requires this.

The virus that causes AIDS is responsible for destroying a patient's immune system leaving them vulnerable to infections that would not usually bother a healthy person; one of the common side-effects of this is dementia. AIDS-related dementia can be caused by a variety of infections and sometimes makes dealing with patients very difficult indeed. Some patients with dementia are quite mobile and may make unreasonable decisions like, for example, deciding to go out "clubbing" or shopping or taking up some other activity that they really aren't fit enough to do, or something that would not be safe for them to do (like driving whilst on medication). As a carer, you must control the client without becoming his or her enemy! A person with dementia often can't make rational decisions but it can be almost impossible to convince them of this especially if their dementia comes and goes. At times the client may be 100% lucid and may not remember all the things he or she does during periods of dementia. Dementia is something that most carers will have dealt with during their working lives, but coping with dementia patients who are very mobile can prove hard for even the most experienced carers.