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Inspection report

Date of Inspection: 19 December 2013
Date of Publication: 17 January 2014
Inspection Report published 17 January 2014 PDF | 89.35 KB

People should be cared for in a clean environment and protected from the risk of infection (outcome 8)

Meeting this standard

We checked that people who use this service

  • Providers of services comply with the requirements of regulation 12, with regard to the Code of Practice for health and adult social care on the prevention and control of infections and related guidance.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 19 December 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

Our judgement

People were protected from the risk of infection because appropriate guidance had been followed.

Reasons for our judgement

We found that people visited a clean and tidy environment. There were systems in place to monitor the control of infection and the cleanliness of the hospice together with procedures regarding the control of substances hazardous to health (COSHH).

There were effective systems in place to reduce the risk and spread of infection. We walked around the building with the head of care and found the hospice to be clean and tidy. The provider had policies and procedures for the control of infection with guidelines in place for hand washing techniques. The policy identified and provided staff with clear guidelines on how to manage an outbreak of infection and the handling and disposal of clinical waste. The hospice at home staff we spoke with were informative regarding the use of personal protective equipment (PPE) such as disposable gloves and aprons.

We visited the kitchen and this was clean, tidy and well ordered. We saw that the provider had recently received a "premises intervention report" from Stroud District Council. We noted the areas inspected were the kitchens within the hospice. The report identified the provider's "compliance with food hygiene and safety procedures" and "confidence in management/control procedures." We noted the report looked at infectious disease control and cross-contamination/temperature control. We saw the action required and noted that the issues identified had been dealt with. We were informed the provider had maintained the highest food hygiene rating of five which we saw on display in the kitchen.

There were daily and weekly cleaning tasks in place which included for example, the mopping of floors and the polishing of hard surfaces. We noted these had been completed by staff and reviewed by management. Food probe and fridge and freezer temperatures were recorded daily. The kitchen had on display colour coded guidelines for the use of chopping boards. Overall this meant the provider had in place suitable arrangements to ensure that people employed were supported in relation to their knowledge to enable them to maintain a hygienic environment.

We observed the bathrooms and toilets were clean and well-presented. We observed the fridges were clean and tidy. People's risk assessments and care plans, if applicable, identified the risk of infection and provided guidelines for staff to follow. We were informed it was the responsibility of staff to clean the hoists/wheelchairs/baths after use to ensure their cleanliness. We observed staff cleaning wheelchairs after use to ensure their cleanliness. The contamination and the disposal of waste contract were up to date. This meant there were effective operating systems in place to assess the risk and to prevent, detect and control the spread of infection within the hospice.

The provider had a water and legionella policy and we saw water temperature checks had been regularly completed. The hospice used the facility of external launderers and only carried out the laundry of small items for example, pillow cases used in the therapy rooms. Staff we spoke with informed us they were aware of the different coloured clinical bags and the use of personal protective equipment (PPE). Overall, this meant that the provider had

systems and procedures in place to assess the risk of and to prevent, detect and control the spread of infection within the hospice.

We saw the provider had a control of substances hazardous to health (COSHH) policy. We found that there were appropriate storage of chemicals and cleaning materials with all behind locked doors. Staff had completed COSHH training and the COSHH folder had guidelines for staff to follow. The records we read had data sheets on each product currently in use which had been regularly reviewed. We observed there were no risk assessments in place for the products currently in use. The health and safety officer informed us they were aware of the shortfall and were in the process of constructing risk assessments which woul