Religion and Belief Policy

RELIGION AND BELIEF POLICY

POLICY NUMBER POLICY VERSION RATIFYING COMMITTEE DATE RATIFIED DATE OF EQUALITY & HUMAN RIGHTS IMPACT ASSESSMENT (EHRIA) NEXT REVIEW DATE POLICY SPONSOR POLICY AUTHOR

EXECUTIVE SUMMARY: Sussex Partnership aims to provide an environment that is fully inclusive of religion or belief for both staff and service users. The culture of the organisation will be personal, fair and diverse.

SUMMARY OR KEY ISSUES, SERVICES/STAFF GROUP POLICIES APPLY TO

If you require this document in another format such as large print, audio or other community language please contact the Governance Support Team on 01903 845735.

Current status for policies not yet ratified (This to be removed when policy ratified)

Status Version Date Author Consultation number Draft Version 01 September 2012 R Harlow Chaplains and stakeholders

1 draft Version 02 Feb 2013 R Harlow Stakeholders

2 CONTENTS

0 Introduction 3-6 1.1 Purpose of policy 1.2 Definitions 1.3 Scope of policy 1.4 Principles

2.0 Policy Statement 6

3.0 Duties 6-7

4.0 Procedure 7-11

5.0 Development, consultation and ratification 11

6.0 Equality and Human Rights Impact Assessment (EHRIA) 12

7.0 Monitoring Compliance 12

8.0 Dissemination and Implementation of policy 12

9.0 Document Control including Archive Arrangements 12

10.0 Reference documents 12

11.0 Bibliography 13

12.0 Glossary 14

13.0 Cross reference 14

14.0 Appendices 15-21

BODY OF THE DOCUMENT

1.0 Introduction The United Kingdom has a diverse population of people who adhere to different religions and beliefs. Freedom of Religion and belief is a human right, protected by legislation. Sussex Partnership NHS Foundation Trust seeks to provide an environment for staff and service users which is fully compatible with the range of religions and beliefs that make up our society.

In the 2011 Census people in the South East of England declared their religion or belief to be: Christian (60%), No religion (28%), Muslim (2.3%), Hindu (1%), Jewish (0.2%), Sikh (0.6%), Other (0.5%). Within this large scale data there is considerable local variation. (e.g. In Brighton and Hove 1% of people are Jewish, and within Crawley 7.2% are Muslim).

1.1 Purpose of policy  This policy and procedure details how the Trust will deliver its services and treat its staff in a personal, fair and diverse manner in relation to religion and belief.  It sets out a safe, reliable and cost effective approach to the provision of Chaplaincy and Spiritual Care to the community and in-patient services that the Trust provides.

1.2 Definitions

Religion is a system of beliefs, including belief in the existence of at least one of the following: a human soul or spirit, a deity or higher being or self after the death of one’s body; e.g. Islam, Christianity etc. People who affiliate to a religion are called e.g. Christian, Muslim. Some religions are also cultural identities, e.g Jewish. Thus religion may affect language, culture, diet, clothing, and end of life care. People may affiliate to more than one religion, or prefer to self-designate as “spiritual but not religious”.

Belief includes non-religious belief (e.g. atheism, humanism). It is possible for a person to be both religious (in identity) and yet atheist (in belief): e.g both Jewish and atheist, or Hindu and atheist.

Chaplain: a man or woman who is ordained within a faith community recognised by the Department of Health (DH) and appointed by an NHS Trust to work within and alongside its multi-disciplinary teams. A Chaplain, or the Chaplaincy team may also be called the Multi-Faith Team.

Chaplaincy Volunteer: volunteers from diverse faith communities, which may or may not be formal or recognised by DH, working under the supervision of chaplains or other faith leaders.

4 Spirituality Advocates: members of staff who have agreed to take on extra responsibilities within their team to model high standards of spiritual assessment and care.

1.3 Scope of policy  The Trust has a legal responsibility to ensure that the services it provides and the way it manages its staff do not unfairly discriminate against anybody on account of their religion or belief. Furthermore the Trust is obliged to promote good relationships between people of different religions or beliefs.

 This policy relates to all staff, service users, carers and volunteers and impacts on the Trust relationships with the communities it serves.

1.4 Principles  Pluralism creates a safe place for all: the Trust is committed to a pluralist, multi-faith, provision of spiritual care that values and respects both religious and non-religious perspectives, and delivers personal, fair and diverse care.

 Promoting inclusion: diverse, tolerant and inclusive services do not just happen by chance; they must be created by purposeful, sustained action. No change is a vote for the status quo, which has sometimes excluded people who are different from the majority.

 Fairness: Religion and Belief is a protected characteristic under the Equality Act 2010. This act protects the individual against direct or indirect discrimination on grounds of religion or belief. It requires public bodies to have due regard to the need to:

 eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Equality Act 2010;

 advance equality of opportunity between people from different groups; and

 foster good relations between people from different groups.

 Freedom of thought, religion and conscience: Article 9 of the Human Rights Act 1998 (HRA) protects the right of individuals to freedom of thought, religion and conscience, and the right to manifest that belief. This Right applies to staff, service users and carers. Individuals are free to express, or change their religion or beliefs. The act and subsequent case law has established that:

1. Staff, carers and service users may express their chosen religion or belief without obstacle or stigma.

2. The expression of a person’s religion or belief may not contravene any other Human Rights (e.g. freedom of expression does not allow anybody to express hatred against people on the basis of race, religion, sexual orientation or any other protected characteristic).

3. HRA 1998 may be tempered by the Mental Health Act 2003 and/or the Mental Capacity Act. Freedom of religious expression may be curtailed by the need to protect the safety of the individual or others.

4. Employees may not appeal to their religion or belief to escape their contractual duties.

 Recovery: Research into spirituality and religion has established it as important in recovery and well-being and essential to some people’s self understanding. However, it is a diverse field, and there is a need for more research. Whilst it can be stated that in general spirituality is protective of mental well-being and useful in recovery, some religious beliefs or spiritual practices may not be helpful.

 Respectful of the integrity of religions: The Trust recognises that some people choose to describe themselves as spiritual but not religious, or as belonging to more than one religion. However, DH guidance (2003) is that Chaplains will only be appointed to represent a particular World Religion. No inter-faith appointments will be made.

 Personal care requires individual assessment: The DH recognises 10 main World Religions. It also recognises that people may affiliate to 146 different sects or denominations within those World Religions, and other religions or belief systems (DH 2009). A workable but useful data system requires a compromise solution between the 10 World Religions and 146 possible entries. For the purpose of data collection to ensure equality of provision and safe clinical practice, the Trust has approved the following data set for collection of religion and belief affiliation: 1 Agnostic 2 Baha’i 3 Buddhist 4 Chinese (Taoist/Confucian) 5 Christian 6 Hindu 7 Jain 8 Jewish 9 Muslim 10 Pagan 11 Rastafarian 12 Sikh 13 Spiritualist 14 Any other 15 No religion 16 Not disclosed

However, because collection of religion and belief affiliation data is not a sure guide to service user needs and preferences, The Trust recommends the use of a more detailed Spiritual Assessment Tool (HOPES). This enables service users to specify their strengths, past experiences and needs in relation to the 5 D’s: diet,

6 dignity, devotion (prayer, spiritual practice), religious festivals (diary) and end of life (death). (HOPES can be found at Appendix A)

 Diversity is recognised: This policy recognises that the diversity within world faiths is almost as great as the diversity between world faiths. Whilst The Trust respects the differences between denominations, for practical reasons it may not be able to provide chaplains that exactly correspond to denominations with less than 1% of the population, but will expect any chaplain to have a working knowledge of the core beliefs and practices of any service user that s/he is supporting.

 Complexity requires expertise: During periods of mental distress service users may express religious ideas or wish to engage in spiritual practices, which are symptomatic of illness and not part of their religious identity. The complex practice of treating mental distress, whilst respecting religious belief, is a fundamental reason to employ chaplains and for multidisciplinary teams to harness their expertise and support.

 15 Step Challenge: First impressions matter: buildings, signage, materials in different languages, food, symbols, appointment letters, decency, awareness of festivals, multi-faith rooms (Sacred Spaces) – all communicate a welcome or otherwise.

2.0 Policy Statement The Trust actively supports freedom and respect of religion and belief in order to facilitate a fully engaged workforce and a welcoming and supportive environment for service users and carers. The culture of the organisation will be personal, fair and diverse.

3.0 Duties Executive Director of Nursing and Quality: has overall responsibility for the implementation of this policy, chairing the Spirituality Reference Group, and delivering the Religion strand of the Equality Outcome Scheme.

Chaplaincy/Multi-Faith team leader: leads and manages the Multi-Faith team; ensures that Chaplaincy Standards are agreed and maintained; recruits and manages suitable chaplains for faith groups represented in Sussex; liaises with local faith communities

Managers and team leaders: are responsible for ensuring that the services they manage or commission adhere to this policy, and that their team members are made aware of religious festivals and their associated requirements; they should encourage team members to take on the role of Spirituality Advocate and release them to attend training. They are responsible for maintaining adequate procedures to ensure that service users are enabled to give information about their religion or belief at any point in their care pathway, and that such information is correctly recorded and used throughout their care.

Chaplains: provide leadership in the provision of spiritual and religious care to service users, carers and staff. Chaplains will not assume responsibility for the

7 spiritual care of individual service users; this remains the responsibility of Care Co- ordinators or the Responsible Clinician. However, Chaplains are a specialist resource for the use of Care Co-ordinators and Responsible Clinicians.

All staff: have a duty to promote understanding between followers of different religions and beliefs, to work in ways that include people of different religions and beliefs, to report bullying or harassment, and to enable service users to advocate for their cultural and religious needs. All frontline clinical staff should acquire a basic awareness of major religions and beliefs, how to perform a spiritual assessment and how to secure the practical requirements of diverse religious groups.

Spirituality Advocates: have the additional role of assisting their team to improve assessment, referrals and the spirituality resources available to service users. They are required to attend initial training and the annual conference.

Equality and Human Rights Team To monitor the Trust provision for people of different religions and beliefs To monitor the Trust adoption and implementation of fair employment processes

4.0 Procedure

Service users :

4.0.1 The Trust needs to know a service user’s religion or belief, in order to protect and promote their rights. Service users will be given opportunities to express their strengths and needs via HOPES assessment in relation to the 5 Ds: diet, dignity, diary, devotion and end of life. (HOPES Spiritual Assessment and a brief guide to religious needs is in the appendix A and B)

4.0.2 First Contact: All service users will be asked to declare their religion or belief during their initial assessment. The Trust data set (in 1.4) will always be used. If the service user is unable to respond at the initial assessment, they will be given a chance to respond as soon as they become well enough. This information needs to be entered into PIMS at whatever point it is shared.

4.0.3 If a service user is acutely unwell and unable to disclose his or her religious belief or affiliation, staff should make every effort to provide food that is religiously appropriate (e.g. a vegetarian diet will satisfy most religious requirements) and not remove any religious items, unless safety considerations overrule. Decisions should be verified by reference to any next of kin as soon as possible.

4.0.4 Out-patient/Community: Religion and belief is important in many service users’ self-definition, thus it is an important area for assessment by clinical staff. The HOPES spiritual assessment tool should be used (see Appendix), a version of which is included in initial assessment documentation for adult services. Alternative assessment tools may be developed in consultation with the multi-faith team. Despite difficulties assessing the significance of religion or belief in some specialist services, this task should not be avoided.

8 4.0.5 Service users for whom religion or belief is a significant source of support, or a factor complicating their recovery, should be offered the support of a chaplain.

4.0.5.1 If members of staff fear that a service user is being radicalised or abused by a religious group, advice should be sought from chaplains, the Responsible Clinician or the Strategic Director of Partnerships.

4.0.6 In-patients: Not every patient will be well enough to undertake a full HOPES assessment. As a minimum, staff need to ascertain: religion or belief, dietary requirements, devotional patterns, and end of life needs. As recovery begins, further enquiry is required to establish: religious/cultural diary, and notions of dignity.(the 5 Ds)

4.0.7 It is the responsibility of the member of staff who undertakes the initial in- patient assessment to ensure that requirements for a religious diet are communicated immediately to hotel services, to orientate the service user to the ward and the availability of a Sacred Space. Supporting information about religious provision should be in a Welcome Book/leaflet, available in a range of formats and languages.

4.0.8 Hotel services and catering staff will have responsibility for the correct preparation, storage and provision of religious diets. Religious diets will be supplied as requested by service users in pre-packaged single meals at main meal times. Snacks will be supplied appropriate to the culture or religion of the service user (fresh fruit is acceptable).

4.0.9 Service users in in-patient units should be supported in expressing and practising their religion or belief. They may be prevented from practising an element of their religion only under certain circumstances, for example:  When the practice may cause harm to the person or other persons  When the person is detained under MHA or Home Office conditions and the practice requires attendance off site, and insufficient notice has been given to enable adequate staff cover  When the service user is sufficiently unwell that his/her Responsible Clinician believes that practise would jeopardise recovery  When the practice is unlawful. Service users who are denied the right to practice may appeal to the Unit manager or Equality and Human Rights Team. Chaplains may act as advocates in such appeals.

4.0.10 More specific guidance about how to ensure that people who affiliate to major world religions are included and welcomed within ward environments is available from chaplains or on the Nursing and Quality pages on the intranet. General information about diverse religious groups can be found at www.bbc.co.uk/religion and in the appendix.

4.0.11 Chaplains will be available on all in-patient units at least once a week.

4.0.12 Prominent displays of sexualised images on TV or in magazines are offensive in many cultures. Staff will remove articles or change channels when nudity or indecency are displayed.

4.0.13 Behaviour or acts of racial or religious hatred will be reported to the police.

Members of staff:

4.1: Members of Staff are encouraged to communicate their religion or belief sensitively to their colleagues. Respect and tolerance must be given, in order to be received. Bullying or harassment should be reported immediately, according to the Trust’s Dignity at work policy. With service users, staff should focus on creating a welcoming and supportive environment, not on self disclosure. Staff will provide spiritual care according to their role and expertise. They should seek help from chaplains, if they feel unsure about appropriate responses to religious need or distress, or if the service user requests additional support.

4.1.1 Staff training will be provided within induction, Equality and Human Rights Training, and through electronic learning. More detailed training will be cascaded to multi disciplinary teams by Spirituality Advocates and Chaplains. It is the responsibility of team leaders to ensure that their teams are trained to perform spiritual assessment.

4.1.2 Staff Spirituality: The Trust encourages staff members to maintain those spiritual practices that sustain their well-being. Members of staff are encouraged to discuss these needs with line managers. Any time needed during contracted hours to pray, fast, or meditate, or undertake any other spiritual practices should be agreed with line managers in personal development reviews or supervision. The Trust will make reasonable adjustments to ensure that no staff members are discriminated against due to their need to observe spiritual requirements.

4.1.3 Staff may wear any religiously mandated clothing, so long as it does not affect the health or safety of other staff or service users. Outlets that serve food to staff should be able to meet the religious requirements of diverse diets. Some notice may need to be given where requests are infrequent. The Trust cannot ensure that staff are not required to work on a religious holiday or Sabbath; safety of patients and services will take priority. However, staff are encouraged to discuss their religious holiday requirements with managers.

4.2: Spirituality Advocates. Every clinical team within Sussex Partnership will be expected to identify one Spirituality Advocate. Spirituality Advocates will exemplify best practice in clinical teams in spiritual care: performing spiritual assessment, making appropriate referrals and using local resources related to religion and belief. Spirituality Advocates will receive initial training, and will be expected to attend an annual conference/training event thereafter.

10 4.2.1 Spirituality Advocates will need to ensure that their role does not interfere with their professional standards, behaviours and any code of practice to which their regulatory body expects them to comply. They may not use the role to proselytise or give favourable treatment to one religious or belief group.

4.2.2 Teams will give Spirituality Advocates adequate time to attend training and perform agreed aspects of the role. This includes making time at team meetings for Spirituality Advocates to cascade training to team members related to diversity and spiritual assessment.

4.3: Chaplains

4.3.1 The Chaplaincy team will be led by a board registered Chaplain from whichever religion has the majority of members (according to OPNS Census Data) in the area served by the Trust. All Chaplains will be expected to have achieved board registration within one year of employment.

4.3.2 Chaplains will normally visit all acute and secure in-patient units on a weekly basis, and take referrals from community teams. Chaplaincy contact details and referral forms are on the intranet: http://staff.sussexpartnership.nhs.uk/staff/nursing/chaplaincy/ Maximum response times will be agreed with service directors (usually 4 days for in- patients and 14 days for community service users). Chaplains will adhere to the confidentiality regulations that govern all healthcare workers.

4.3.3 The Chaplaincy Team will include permanent and bank chaplains. It will include representatives of all religions that make up over 1% of the population of Sussex. The Chaplaincy team will not employ non-religious chaplains. Non- religious spiritual care is provided by all staff who are not chaplains.

4.3.4 Chaplaincy protocols will be approved by the Spirituality Reference Group, Chaired by a Director. Currently Chaplaincy protocols exist for:  Working with service users in the community  Record keeping  Safely using Bank Chaplains.

4.3.5 Chaplains will receive all mandatory and essential training appropriate to clinical roles. They may receive additional training provided by the Trust to improve clinical skills. Chaplains would not normally occupy the role of Care Co-ordinator.

4.3.6 Chaplains will have clinical supervision. This may be provided by the Team Leader if he/she is suitably trained. The Team Leader will have supervision from another clinical discipline.

4.3.7 Chaplains may support carers at times of tragedy or crisis. Chaplains are not considered to be a key part of staff support, which is provided through other services; however, staff may use chaplains for support around religion and spirituality, especially if they perceive that their religion or belief is leading to stigma or discrimination, or if their work is felt to challenge their religion or belief.

4.4 Chaplaincy Volunteers Chaplaincy Volunteers will enhance the Trusts’ ability to respond to the needs of diverse faith groups. They will work under the supervision of chaplains and ward staff in in-patient units. It is not anticipated that Chaplaincy Volunteers will work with service users in the community.

4.4.1 Chaplaincy Volunteers may have access to service users who are highly vulnerable. As well as CRB and other volunteering checks, they will be expected to have an additional reference from their faith group, which will be reappraised annually, as a further safeguarding measure.

4.4.2 Chaplaincy Volunteers will be supervised on a monthly basis by Chaplains. They will be expected to declare any contact with service users which occurs outside Trust premises to ensure full accountability.

4.4.3 Chaplaincy Volunteers will be given additional training by Chaplains, and may be recommended to attend elements of staff internal training.

4.5 Buildings The first impression that the Trust’s buildings create is hugely important.. Best practice would suggest that entrance areas should have signage in different languages (including directions to the Sacred Space). Trust buildings that provide care to Acute or Secure/Forensic in-patients will be equipped with a multi faith prayer room (“Sacred Space”). Buildings for community, recovery or administrative purposes will not usually have designated Sacred Spaces, but staff members who wish to pray may request temporary use of a private room for that purpose.

4.5.1 Sacred Spaces will be equipped with a standard set of religious books and items that reflect the main local cultures and religions. They will have wash facilities nearby.

4.5.2 Each Sacred Space will be governed by a locally agreed protocol.

4.5.3 Responsibility for Sacred Spaces rests with the unit manager and chaplain.

4.6 Protection from unwanted religious or anti-religious material/action: Due to the vulnerability of service users, no attempt to change the religion or belief of service users is acceptable, even if the beliefs are seen as unreasonable or harmful by clinical staff. Discussion of potentially harmful religious beliefs should normally be conducted by Chaplains. Clinical staff may draw attention to the harmful effects of certain beliefs, but should seek to refer the service user to a chaplain for fuller discussion.

4.6.1 Staff and volunteers may not bring religious or anti-religious literature onto Trust premises for the purposes of distribution without permission from both Chaplains and unit manager.

12 4.6.2 Staff, other than Chaplains, will not offer to pray with service users. If a service user requests a staff member to pray with them, the staff member will explore with them how to meet their spiritual needs (e.g. support them silently), or redirect them to the chaplaincy team. 4.6.3 Staff members may have strongly held religious or moral beliefs, however, these should not be imposed upon service users, where a behaviour is legal in English law. 4.6.4 Religious materials will be available in hospitals if requested by service users and supplied by religious groups free of charge. It is not the responsibility of the Trust to provide personal religious items to service users (e.g. Bible, Quran, Rosary, Prayer books).

5.0 Development, consultation and ratification This policy was developed by Chaplains in consultation with the Trust Spirituality Reference group, which includes service users, staff and representatives of local faith communities. It was circulated to a representative group of Trust staff and the Trust Spirituality Network, which includes staff, service users and members of the local community. It was ratified by the Trust Spirituality Reference Group and the Policy and Practice Forum.

6.0 Equality and Human Rights Impact Assessment (EHRIA)

Equality and Human Rights Impact Assessment has been undertaken and it has shaped the policy and practice.

7.0 Monitoring Compliance

Annually the Equality and Human Rights team will audit teams to evaluate how fully they are recording the religion and belief of service users. The Trust will aim for a 5% improvement year on year.

The Multi Faith Team Leader will audit chaplaincy activity monthly against OPNS Census data to ensure that the chaplaincy team is working fairly across all religion and belief groups.

8.0 Dissemination and Implementation of policy The policy will be circulated to staff members via team leaders and the Matrons’ Network. Training for staff around this policy is delivered via induction, Equality and Human Rights Training, Race Equality Training and Spirituality Advocates training and conferences.

9.0 Document Control including Archive Arrangements Service user data related to Religion and Belief will be held in ECPA or paper records. Staff data related to Religion and Belief will be held in ESR.

1 3 The Lead Chaplain will be responsible for collecting and storing data related to Chaplaincy activity.

10.0 Reference documents NHS Chaplaincy – meeting the spiritual and religions needs of patients, carers and staff (DH 2003) http://www.nhs-chaplaincy-spiritualcare.org.uk/dh_MeetingtheReligiousNeeds2003.pdf Guidance on reporting religious affiliation (DH 2009) http://www.nhs-chaplaincy- spiritualcare.org.uk/NationalHealthService/nhs_connecting_for_health_religious_list_132 009v1_1.pdf Religion and Belief (DH 2009) http://www.nhs-chaplaincy- spiritualcare.org.uk/NationalHealthService/dh_ReligionOrBelief.pdf Multi Faith Rooms (MFGHC 2013) (awaiting publication) Chaplaincy Standards (UKBHC 2011) http://www.ukbhc.org.uk/sites/default/files/standards_for_healthcare_chapalincy_service s_2009.pdf Multi Faith Guide for Healthcare Staff (NHS Scotland) http://www.nhs-chaplaincy- spiritualcare.org.uk/MultiFaith/multifaithresourceforhealthcarechaplains.pdf Religion or belief in the workplace: a guide for employers following recent European Court of Human Rights judgments (Equality and Human Rights Commission 2013) http://www.equalityhumanrights.com/uploaded_files/RoB/religion_or_belief_in_the_work place_a_guide_for_employers.doc

11.0 Bibliography Recommendations for psychiatrists on handling spirituality and religion (Royal College of Psychiatrists 2011) http://rcpsych.ac.uk/pdf/PS03_2011.pdf Spirituality and Mental Health (RCPsych) http://www.rcpsych.ac.uk/expertadvice/treatments/spirituality.aspx Nursing and Spiritual care (RCN 2012) http://www.rcn.org.uk/development/practice/spirituality Spiritual care matters (NHS Scotland 2009) Guidelines on spirituality for staff in Acute care services (CSIP 2008) http://www.nmhdu.org.uk/silo/files/guidelines-on-spirituality-for-staff-in-acute-care- services-.pdf Making Space for Spirituality (MHF 2007) http://www.mentalhealth.org.uk/publications/making-space-spirituality/ Impact of Spirituality on Mental Health (MHF 2006) http://www.mentalhealth.org.uk/publications/impact-spirituality/ Keeping the Faith (MHF 2007) http://www.mentalhealth.org.uk/publications/keeping-the- faith/ Religion guidelines at www.bbc.co.uk/religion

12.0 Glossary Agnostic: somebody who is undecided or unsure which religion or belief they affiliate to. MFGHC: Multi Faith Group for Helathcare. DH advisory group. MHF: mental health foundation. Research group.

14 Spirituality: includes religious and non-religious beliefs and practices which are performed with the intention of developing inner peace, experiencing transcendence and/or building community. E.g. meditation, prayer, yoga. A person may describe him/herself as “spiritual but not religious”. Spiritual care (also called pastoral care): a skilled response to a person’s search for meaning and transcendence, often in the context of crisis or loss. It includes active listening, and, where appropriate, prayer, ritual or referral. Spiritual care may be offered by any staff, trained or untrained, within their appropriate professional boundaries. It is the responsibility of chaplains to provide specifically religious spiritual care and to ensure that spiritual care is available to all who request it. UKBHC: UK Board for Healthcare Chaplaincy. Voluntary professional body for chaplains in UK.

13.0 Cross reference  Dignity at work (Bullying and Harassment) policy  Channel: Protecting vulnerable people from being drawn into terrorism (HM Government 2012)

14.0 Appendices A. HOPES Spiritual Assessment tool B. Basic Cultural needs: the 5 Ds. C. Guidance for Community Teams on the use of Chaplains D. Multi Faith Guidance Document

HOPES: Spiritual Assessment Tool.

Questions to ask Brief note of responses H H = Sources of hope  What are your sources of hope, meaning, or connection?  What sustains you, keeps you going (when life is hard)? O O = Organised religion  Do you consider yourself part of an organised religion?  How important is this to you?  Have you belonged to a religious group in the past?  What do I need to know about your religion/belief? (Diet, Dignity, Diary, Devotion, end of life needs?) P P = Personal spirituality  Do you have personal spiritual practices?  Do you have spiritual or philosophical beliefs?  What do I need to know about your spirituality? E E = Effects of your beliefs on your care  Has being unwell affected your ability to do things that help you spirituality?  Are you worried about any conflicts between your beliefs and your medical care?  Are there any specific practices I should know about in relation to your care? S S = Support  Is there anyone we can contact who would offer you support.  Is there anyone you would like to talk to?

Name of patient:

Name of Date: assessor:

16 Basic Cultural Needs: the 5 Ds.

Domain Examples Questions Diet Halal (Muslim) Do you follow a http://www.faqs.org/nutritio Kosher (Jewish) religious diet? n/Pre-Sma/Religion-and- Itaf (Rastafarian) Dietary-Practices.html Vegan (Jain) Are there any Vegetarian (some foods you cannot Buddhists, Hindus, & eat? Pagans) Devotion 5 Ks (symbols of Do you have any http://en.wikipedia.org/wiki/ Sikhism) special or sacred Prayer Rosary items or books with Mala beads you? Prayer books Would you like a Scriptures (Bible, Quran) place to pray or meditate? Dignity Forms of address and What name do you greeting prefer to be called? Washing Clothing Would you prefer a Touch between genders female/male Attitudes to authority member of staff to assist you?

Diary Fasts: Ramadan (Muslim) Will you be http://www.interfaithcalend Lent (Christian) observing any Holy ar.org/ Yom Kippur (Jewish) days? Festivals and Holy Days New Year

Death/End of Life Rituals of preparation Who do you want Rituals of grieving to be with you? Handling bodies What would make Funeral rites you more comfortable?

Chaplaincy and Spiritual Care Guidance for Community Mental Health Teams.

Chaplaincy is a small, multi faith resource within Sussex Partnership. Our role is to help in-patients meet their spiritual and religious needs, and to assist service users in the community to resolve complex spiritual or religious situations, and/or to access religious groups that will support their recovery.

Roughly 12% of the population actively belong to a faith community (church, mosque, temple etc.). About 55% of the population hold religious beliefs; others would define themselves as “spiritual but not religious”. Clearly chaplaincy cannot support all of our service users who are religious/spiritual. Our aim is not to replace community faith groups, but to help resolve religious/spiritual conflicts or losses. We depend on Care Co-ordinators and Spirituality Advocates to make service users aware of our existence (you can use the YOUR BELIEFS AND CULTURE leaflet), to assess when we might be of use to a service user, and to make a referral, if the s/u would like our support. Service users may self refer, but we will always contact care co-ordinators if this happens.

Some Criteria for referral to a chaplain:  For initial assessment regarding spirituality and its overlap with symptoms of mental illness.  When a service user expresses doubts or concerns about the support they are getting from their own faith community. (e.g maybe s/u behaves inappropriately around other members when unwell and faith community has responded by rejecting them, or inability to accept the life-style of the service user by their community)  When the CC is concerned that the faith community may be undermining the service user’s recovery. (e.g delusional beliefs being reinforced, or inappropriate expectations being placed on s/u)  For on-going pastoral care with regard to chronic conditions or long term suicidal ideation, where faith is a supportive/protective factor.  When a service user has religious objections to the treatment offered by SPT. (e.g non-compliance with medication, or religious duties prevent access to support)  When the service user believes that their spirituality is being mis-diagnosed as an aspect of illness. (e.g religious OCD, “delusional” beliefs)  When a service user has lost contact with their faith community, and seems to need help either in resolving the loss or finding another group. (e.g following bereavement or “loss of faith” or change of leadership in faith group)  When the service user is troubled by an aspect of spirituality and doesn’t seem to be able to resolve it within his/her own faith community. (e.g acceptance of sexual orientation, or beliefs that their voices are god/devil)  When a s/u is conflicted in their religious/spiritual beliefs or life choices. (e.g meaning of life type questions that are undermining ability to conduct life).

18 What will chaplains do?  Confirm that the referral has been received, and read the latest risk assessment and care plan on eCPA.  Pass referral to most appropriate member of chaplaincy team.  Offer to meet the service user (usually in a Trust venue, but possibly at home, subject to appropriate risk assessment) and notify you when we have agreed to meet.  Enter a contact/case note on eCPA each time one takes place with relevant details from the meeting.  Either continue to see the service user until an agreed end point, or make a referral to a more appropriate community faith leader (and advise you that we have done so).  Provide written or verbal feedback to care co-ordinator at conclusion of contacts (or earlier if required).  Sign off the contact after the agreed number of meetings.

How do care co-ordinators make a referral?  Use the paper based referral form (mail it to Richard Harlow, Multi faith team leader, Langley Green Hospital, Crawley, RH11 7EJ)  Or contact Richard Harlow on 07789 272 508 or 01293 590400 ext 501  email: [email protected] and ask me to phone you, or send me a first name and NHS number, so I can find the service user on ECPA/PIMS.  If service users self refer, chaplains will contact CC for a risk assessment, and to discuss appropriateness of contact at this time.

Not sure whether referral is appropriate? Phone me to discuss any issue related to religion or belief or spirituality, or if you need advice or resources related to spirituality.

Multi faith? The chaplaincy team employs Christian, Buddhist, Muslim, Jewish and Pagan chaplains in proportion to the population needs/percentages, and has voluntary Hindu chaplaincy support. Due to the size of the Trust some areas are a long way from the base that the Buddhist, Pagan, Jewish, Hindu and Muslim chaplains work from, and travel may be difficult for them. Service users may need to travel to meet chaplains in other parts of the Trust. The Chaplaincy team will aim to find a chaplain for any service user, but there may be occasions when there isn’t a precise match between the service user’s stated religion or denomination, and the denomination of the chaplain.

Richard Harlow Multi faith team leader Mob: 07789 272 508.

Faith or Likely Diary Diet Dress Physical contact Medical Culture languages in (key days, most (Dignity) treatment UK dates vary)

Baha’i English, Ridván (12 fast No alcohol No special Baha’is are unlikely to object No special dress code. to being requirements http://www.bah Arabic, Farsi days) touched or treated by ai.org.uk/ Ascension of Bahá’u’lláh, members of 19

Martyrdom of the the opposite sex Báb

Buddhist English, Cantonese, Buddha day, Often vegetarian No special dress A Buddhist may be touched No special Hakka, Japanese, or vegan. Salads, code for lay by a requirements http://www.the Dhamma day, Thai, rice, Buddhists. person of either sex for May prefer not to use buddhistsociet Sangha day Tibetan, vegetables and May carry comfort, medication. y.org/ Sinhalese fruit are usually mala beads. treatment and medical acceptable examinations.

Chinese Cantonese, New Year, Cow’s milk is Both men and Women usually prefer to be Injections are Mandarin, avoided. Rice is women usually treated preferred to (Buddhist, Hakka, Hokkien, the staple wear shirt by women. Pills. May wish Taoist English diet with lots of /blouse and to use Chinese freshly cooked trousers / medicine Christian, vegetables, slacks alongside Confucian) fish and very Western. little meat.

Christian English, and many Sundays(or Generally, all Most have no Most Christians would have Some may decline other Saturdays for 7th foods are dress code no conventional medical (incl. languages day Adventists) permissible. except for clergy objection to being treated or treatments. Jehovah’s Coptic, Christmas (25 Some follow and comforted by members of the Witnesses have Jewish customs. members of opposite sex. special Mormon Dec or 6 Jan), Some are religious orders. procedures regarding and Easter, Good vegetarian. Some Some women blood Friday, Lent are forbidden to cover their transfusions. Jehovah [Coptic and use Heads. Witness) Orthodox dates alcohol and Some wear a other cross or http://www.ctbi differ from stimulants. rosary. .org.uk/ Western]

Hindu English, Bengali, Maha Shivaratri Hindus do not eat Modesty and Some Hindus would prefer to No medicines Gujerati, Hindi, (day of fasting), beef. Some decency are be containing gelatine. http://www.nch Punjabi, Rakhee/ Hindus essential. comforted or treated by Some

20 tuk.org./ Tamil Raksha Bandhan, are strictly someone of Hindus prefer Shri Krishna vegetarian and the same sex Ayurvedic Janmashtami, Shri also avoid medicine. Ganesha Pooja , fish, eggs and Vijayadashami – animal fat. Navaratri ends Salads, rice, Diwali vegetables, yoghurt, milk products and fruit are acceptable.

Jain English, Gujerati, Paryushan (9 day No alcohol, meat, Unless they are Jains may prefer to be treated No medicines Hindi, fish, poultry or monks or by containing http://www.ncv fast) Samvatsary Punjabi Rajasthani, eggs. nuns, Jains may people of the same sex. gelatine a.co.uk/Pages/ (fast day), Lord Tamil. Salads, fruits, follow a default.aspx Mahavir's Nirvan grain, vegetables, western dress (Diwali) bread code, while New Year or biscuits made avoiding leather. without eggs or Females dairy may dress products are traditionally. acceptable. Some do not eat root vegetables or honey Jewish English, Hebrew, Sabbath (Fri Pork is forbidden; Some Jewish men For some Jewish men and No medicines Yiddish so is shell-fish. and women it containing gelatine. http://www.bod eve- Sat eve) Fish women keep their is not usually acceptable to be All laws normally .org.uk/live/ind Yom Kippur, must have fins heads touched by someone who is applying to ex.php Passover/ and scales. Red covered at all not a the Sabbath or Pesach, meat times. Some member of their close family. festivals are Shavuot, and poultry must Jewish men wear However, the need to save life overruled for the Rosh comply with black always purpose of Hashanah kosher clothes and have takes precedence within saving life or standards of side-locks Judaism safeguarding slaughter. Milk and beards. health. and meat Some Jews are usually kept have no strict separate. dress code. Vegetarian Women and girls food is usually acceptable. Dress Alcohol is modestly. usually acceptable.

Muslim English, Arabic, Fridays, Pork is forbidden. Some Muslim Treatment by medical staff of Blood transfusions Bengali, Alcohol is also women and any are http://www.mc Eid al Fitr, Dari, Farsi, Gujarati, forbidden. Meat girls wear a head religion is permissible but Acceptable. b.org.uk/ Eid al Adha, Kurdish, Punjabi, Ramadan, must be halal. covering. both men No medicines Pushto, Turkish, Kosher All are expected and women usually prefer to containing Urdu Mawlid-Al- food is usually to dress be gelatine or and many others Nabi acceptable. modestly. Both treated by members of the alcohol. (dates vary) Vegetarian males and same sex meals and females may fresh fruit are choose to wear acceptable. clothes that reflect their cultural background.

Pagan Mostly English Imbolc, Most Pagans eat Ritual jewellery No special requirements. No particular meat and drink is common requirements. http://paganfed Beltane, alcohol. and has deep Alternative treatments .org/ Summer Solstice, Lammas, Many Pagans are significance. may vegetarian and Some wear a be preferred. Samhain, Yule some special ring, may be vegan the removal of which would cause distress Rastafarian English. The Birthday of Pork, pork Many wear The cutting of the hair is Although cannabis vocabulary products and standard Western prohibited in any may be used, this is http://en.wikipedia. Haile may include shellfish are dress but some circumstances not a religious org/wiki/Rastafari_ Selassie, Jamaican banned. Most Rasta men requirement, and movement patois. Rastafarians are wear crowns or there is no legal vegetarian and Tams (hats) exemption. avoid all and some Rasta stimulants such women wear as alcohol, tea wraps and coffee. (headscarves) Sikh English, Hindi, The birthday Many Sikhs are Initiated Sikhs Treatment by medical staff of Some Sikhs prefer Punjabi, vegetarian or wear five K any Ayurvedic http://www.nso of Guru Swahili, Urdu. vegan and symbols: Kesh religion is permissible but medicine. uk.co.uk/index. Gobind Singh do not eat eggs. (uncut hair), men and In general, cutting or html and Guru Those who do eat Kangha (comb), women prefer to be treated by removing any body Nanak, meat Kara (steel members of the same sex hair Baisakhi, will generally bangle), Kirpan should be avoided. If Bandi Chor avoid beef. ( short it is (Diwali) Salads, rice, dagger) and necessary to do so, dahl, vegetables Kachhera don’t and fruit are (shorts). Other throw it away. You acceptable. The Sikhs may should use of tobacco, wear some of give the hair to alcohol these symbols. another Sikh and drugs is Most men wear to dispose of. forbidden. turbans. However, Women usually some Sikhs do cut cover their their hair heads.