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Inspection report

Date of Inspection: 3 October 2013
Date of Publication: 5 November 2013
Inspection Report published 05 November 2013 PDF

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 3 October 2013, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with staff.

We looked at the cleanliness of the environment and the infection control procedures in place.

Our judgement

People were cared for in a clean, hygienic environment.

Reasons for our judgement

During our inspection of Riverbanks Clinic on 3 October 2013, we saw that the environment, including all the treatment rooms and theatre appeared clean. We saw there were enough of the appropriate cleaning products and equipment provided for staff to be able to maintain a clean environment. We saw that liquid soap, paper towels and dedicated hand wash sinks were available throughout the service and personal protective equipment (PPE) such as gloves and aprons were readily available. This meant that people were cared for in a clean, hygienic environment. We saw that correctly labelled sharps bins and clinical waste bins were available and used appropriately meaning the service had a suitable system to segregate and dispose of waste.

The provider may find it useful to note we saw fans in some of the clinical rooms. Dusty or dirty fans present an infection control risk, as when used, the dust and dirt can be blown around a clinical area contaminating other surfaces or equipment. The fans we saw were clean. However, we noted they did not form part of the service's cleaning schedule. We also noted that in one storage cupboard, items such as compression gowns were stored at floor level meaning the floor could not be cleaned properly and the items were more likely to become dirty. However, all the items were packaged and clean when we checked.

The people we spoke with during our inspection said they felt the service was very clean. They told us they had seen staff wearing PPE such as gloves and face masks and had watched the nurse cleaning while they were in clinical areas. One person could recall seeing staff: "Continually washing their hands."

We spoke with the nurse who had responsibility for cleanliness and infection control in the theatre and recovery room areas and was the overall lead on infection control issues at the service. During our conversation she displayed a good knowledge and understanding of what to clean, how to clean and how often. She demonstrated how used instruments were rinsed and prepared for transport to a local hospital for sterilisation. We looked at the service level agreement with the local hospital signed in May 2013, for all re-usable medical/surgical equipment from Riverbanks Clinic to be cleaned, sterilised, packaged and returned for use. We saw a sufficient amount of suitably packaged instruments delivered and ready for use by the service. This meant the service had appropriate arrangements in place to ensure the instruments and equipment used were fit for purpose.

During our conversations with the doctor and nurse they told us they were up-to-date with the required immunisations such as Hepatitis B. Our review of documentation in their staff files confirmed this. Both the doctor and nurse were unsure of how their uniforms were washed as this was done off site. However, their uniforms appeared clean and we noted they were provided with a sufficient amount of uniforms to be able to access a clean one as and when required.

Although both the doctor and nurse had been trained in infection control as recently as March 2013, in the nurse's case, this had not been at Riverbanks Clinic. We spoke with the practice manager who said that most staff had not received infection control training at the service. Before the end of our inspection, the practice manager had arranged infection control training for the appropriate staff and we saw the completed booking that confirmed this.

We saw the service had an infection control policy in place covering such things as waste management and hand hygiene. The staff we spoke with said they had reviewed the policy. We saw a completed infection control audit and noted this had been done for the first time on the day of our visit. The provider may find it useful to note that a rolling program of infection control audit was not being completed at the time of our inspection. Also, during our review of the completed audit, we found that some questions were being answ