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Inspection report

Date of Inspection: 14 January 2014
Date of Publication: 21 February 2014
Inspection Report published 21 February 2014 PDF

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

Not met 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 14 January 2014, observed how people were being cared for and sent a questionnaire to people who use the service. We talked with staff.

Our judgement

People were not protected from risk of infection because appropriate guidance had not been followed. People were not cared for in a clean, hygienic environment.

The providers did not meet:

Regulation 12(2)(c)

Reasons for our judgement

People were not protected from the risk of infection because appropriate guidance had not been followed.

We saw that the provider had not made all of the improvements that were required to be compliant with the regulations following our inspection in January 2013.

We asked people who used the service if the clinic was always clean when they attended. All of the people agreed with this statement. We asked if they ever had any concerns about the cleanliness of the clinic, three out of four stated they did not.

During our visit in January 2013, we identified that the cleaning schedule was not sufficient to cover all of the areas of the building. During this inspection, we saw that a schedule for cleaning was kept for one treatment room only. This was where the minor operations took place. Staff had a daily list of cleaning tasks. The list provided details of the items that needed to be cleaned and the different cleaning products used for each task. We saw that staff had signed when the tasks had been completed. However, the scheduled did not cover the remainder of the clinic. We saw that there were some cleanliness issues such as dirty air vents, limescale in the sinks and dirty trolleys in the treatment rooms. This meant that whilst there were some arrangements in place to manage hygiene and infection control, people were not fully protected against the risks as there was no systematic approach which ensured that all areas of the clinic were appropriately or routinely cleaned.

During our visit in January 2013, we identified that there was only one mop available to clean the entire clinic. During this visit we noted that there were three mops, one used for the floors, one for the toilets and the other for the treatment room where the minor operations took place. This meant that there were arrangements in place that reduced the risk of cross contamination.

During this visit, we raised concerns about the condition of some of the sinks in the clinic which had limescale. This would make it difficult to clean effectively as limescale is a rough surface that can harbour bacteria. The manager told us they would arrange for the limescale to be removed.

During our visit, we raised concerns about the condition of the trolleys in the treatment rooms which were dirty. This meant that there were not adequate arrangements in place to manage hygiene and infection control

We saw that the provider had policies and procedures that related to hygiene and infection control. The policies included managing spillages, managing waste and needle stick injury. During our visit in January 2013, we identified that the manager could not provide evidence of vaccination or immunity to protect staff, who used needles, from Hepatitis B which is a blood borne virus. During this visit the manager informed us that the doctors and nurse had provided Hepatitis B certificates; however the manager could not produce this information at the time of our visit. This meant that the provider could not assure us that staff were protected against the risk of infection from a blood borne virus.

We saw that the clinic used single use equipment items which were disposed of after use in appropriate clinical waste bags or containers. This meant there were arrangements in place that minimised the risk of contamination.

We saw that clinical waste and sharps containers were available throughout the clinic. Waste was separated and stored securely for collection at the rear of the building. This meant that there were systems in place that related to waste management. The provider might wish to note that during our visit however, we noted that not all of the sharps bins had the necessary information recorded on the front of the bin.

We asked the people who used the service if they noticed staff wash their hands and use protective clothing when appropriate; three out of four people stated that they did. We saw antimicrobial gel, surgical scrub and antibacterial gels