You are here

All reports

Inspection report

Date of Inspection: 15 March and 13 April 2011
Date of Publication: 6 June 2011
Inspection Report published 6 June 2011 PDF

Contents menu

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

Our judgement

People who use services are protected from identifiable risks of acquiring an infection by effective infection prevention and control measures.

User experience

We visited a medical ward, surgical ward, day case theatre and the minor injuries unit. All areas were clean, with good access to storage and hand washing facilities. Bathroom and toilet facilities were clean and in a good state of repair. There were disposable curtains at all bed areas including the minor injuries unit, and these were in good condition and appropriately labelled and dated. There was an appropriate supply of soaps and hand gels at the entrances to all areas and all patient contact areas had appropriate hand gel.

We spoke with visitors in the main hospital corridor who told us they were very happy with the cleanliness in the hospital. They thought there was plenty of information on infection control and they were aware of the need to gel their hands and they found this reassuring. They said they had never had any concerns about cleanliness when visiting the hospital. On the NHS Choices website between April 2010 and March 2011there were 11 positive comments from the public about cleanliness and only one negative comment. CQC’s Survey of Adult Inpatients in the NHS (April 2011) found patients across the trust were very positive about the cleanliness and hygiene of the hospitals.

We saw that infection prevention and control (IPC) policies and procedures were being put into practice and audited. We saw staff wearing appropriate uniforms, including being bare below the elbow. We saw staff hand washing before and after each patient contact, and using hand gels in addition as they moved about the wards.

Other evidence

The trust’s director of infection prevention and control (DIPC) prepares the annual statement, which contains information on the involvement and commitment of the board, the assurance framework in place and the monthly surveillance reports to the board on infection rates. The DIPC, supported by the Infection Prevention and Control team (IPCT), chairs the Infection Prevention and Control Committee (IPCC), responsible for providing advice and assurance to the board, which reports directly to the Clinical Governance Committee. At ward level there are link representatives, who are trained and attend study days. The hospital has local infection control meetings which report on training, implementation of policy, programme of audits and infection rates.

We spoke with seven members of staff who told us they sought advice from the IPCT and that link nurses attended meetings and carried out ward and department audits. On the minor injuries unit staff showed us examples of IPC risk assessments. A range of medical, nursing, support and administrative staff all confirmed they received IPC training as part of induction and through mandatory updates, and there is an e-learning course. Staff access policies and advice through the trust intranet. We were told that all contractors have induction training before they start work on the premises and this contained an element of IPC.

The inpatient wards have notice boards which display the results of IPC audits, such as for hand hygiene. The audits were up to date and area-specific. We saw the Tissue Viability Mattress Audit Record for one of the medical wards (24 November 2010). The audit was carried out appropriately and one mattress identified as an infection control risk had been replaced, and this was confirmed by the housekeeper.

The hospital matron is responsible for ensuring cleanliness in the hospital and regularly tours all areas including checking individual items of equipment. The ward leaders manage the ward housekeepers who told us how they kept each area clean, referring to the national cleaning standards, how cleanliness is audited and showed us cleaning schedules and check lists. We saw that the cleaning equipment was colour coded and used appropriately, including the use of micro fibre products. Staff knew which products to use to clean or decontaminate a given area or piece of equipment. The hospital matron told us there is a deep cleaning squad available 24 hours a day.

We saw appropriate segregation of domestic and clinical waste, and soiled linen collected in appropriate bags. There were lockable bins strategically located throughout the hospital, for example one outside a medical ward was hidden behind a screening curtain and locked. We saw that items such as needles and syringes (called “sharps”) were disposed of in properly designated bins that were correctly labelled and dated. An external contractor ensures that the hospital premises are maintained and fit for use. All senior staff we spoke with confirmed the service for requesting maintenance and repairs is excellent. Staff confirmed there were procedures in place for the cleaning and decontamination of equipment. All equipment observed in all three areas was visually clean, with no areas of concern regarding fitness for use.

We saw that some of the hand washing basins in patient areas had traditional style (hand-operated) taps. These did not conform to the requirement for lever or sensor operated taps which reduce the risk of hand contamination. We also saw some sinks with plugs attached, which also increases the risk of infection through washing hands in contaminated water. The trust showed us a work request dated 19 August 2010 to replace all conventional taps in the clinical areas at Newark Hospital to wrist or elbow operated taps, which was approved at the end of March 2011.

There is a traceability system in place for commode cleaning, which means that once the commode is clean, a tape is put on to show that is