6. Safe management of the care environment
There are many areas in care homes that become easily contaminated with micro-organisms (germs) for example toilets, waste bins, tables.
Furniture and floorings in a poor state of repair can have micro-organisms (germs) in hidden cracks or crevices.
To reduce the spread of infection, the environment must be kept clean and dry and where possible clear from clutter and equipment.
Non-essential items should be stored and displayed in such a way as to aid effective cleaning
Keeping a high standard of environmental cleanliness is important in the care home settings as the residents are often elderly and vulnerable to infections.
The care home environment should be:
visibly clean, free from non-essential items and equipment to help make cleaning effective
well maintained and in a good state of repair
routinely cleaned in accordance with the specified cleaning schedules:
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- A fresh solution of general purpose neutral detergent in warm water is recommended for routine cleaning. This should be changed when dirty or at 15 minutes’ intervals or when changing tasks.
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- Routine disinfection of the environment is not recommended. However, 1,000 parts per million available chlorine (ppm available chlorine (av.cl.) should be used routinely on sanitary fittings.
Staff must:
Report any issues with the environment cleanliness or maintenance to the person in charge to ensure that the care environment is safe. The person in charge must then act on problems reported to them.
Be aware of the environmental cleaning schedules and clear on their specific responsibilities.
Cleaning schedules should include:
- responsibility for;
- frequency of; and
- method of environmental cleaning.
Managing cleaning services:
Cleaning services should be managed in a systematic way, and staff responsible for cleaning should be appropriately trained to carry out the tasks they are responsible for.
The Care Home Manager is responsible for managing the cleaning service which has a number of essential elements outlined in the cleaning services diagram.
Select the diagram for full size version
Cleaning Services
An effective service will include all of the elements above.
Care Homes Cleaning Specification
The Care Homes Cleaning Specification provides a guide to planning cleaning services. It has tools to help with the planning and recording of cleaning activities and with the management activities marked with a * in the diagram above. These include:
- A structure to identify all spaces within a care home and plan appropriate cleaning tasks and frequencies.
- A set of weekly and monthly cleaning templates to be assigned to each space within a care home. These can be used to develop a schedule and to provide a method for recording all cleaning activity. An example of a cleaning schedule and record is provided.
- The tools are examples and designed to support you. Care homes can use their own tools if preferred, however if a local tool is utilised it should reflect the standards set out in the Care Homes Cleaning Specification.
Table 1: Example cleaning schedule residents room
- Standard operating procedures (SOPs) for all cleaning tasks. Each SOP outlines the correct equipment, safety considerations, method, and outcomes required for each task. The example shows the important steps that must be taken during the cleaning of floors.
Table 2: Example cleaning SOP: Floors
- A process for checking the cleanliness of the care environment, to ensure standards are being maintained and to identify areas for improvement.
The tools within the Cleaning Specification should be used by the care home manager in the planning, training of staff, delivery, and checking of standards of the cleaning services they provide.
When an organisation uses cleaning and disinfectant products that differ from those stated in this CH IPCM these products need to meet BS EN standards.
This means that the product has passed tests and is shown to reduce different viruses, bacteria, fungi, yeasts and spores. If you do not use an BS EN standard product you have no assurance that it will work effectively.
Manufacturers instruction and recommended contact times must be adhered to.
BS EN standards and what they mean
- BS EN 13727 - quantitative test used to evaluate bactericidal activity of disinfectants intended for use in the MEDICAL area (e.g. surface disinfection, surgical and hygienic handrub and handwash). Products must achieve ≥ 5 log reduction (must kill 99.999%) against P. aeruginosa, S. aureus and E. hirae.
- BS EN 14476 – quantitative test used to evaluate virucidal activity of disinfectants intended for use in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against Adenovirus, Norovirus and Poliovirus.
- BS EN 13624 – quantitative test used to evaluate fungicidal and yeasticidal activities of disinfectants intended for use in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against A. brasiliensis, C albicans.
- BS EN 17126 – quantitative test used to evaluate sporicidal activity of disinfectants in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against bacterial spores. (Used for C. diff). BS EN 13704 has also been used to test products against C. diff.
Decontamination of soft furnishings
Decontamination of soft furnishings may require to be discussed with the local HPT/ICT. If the soft furnishing is heavily contaminated with blood or body fluids, it may have to be discarded. If it is safe to clean with standard detergent and disinfectant alone then follow appropriate procedure.
If the item cannot withstand chlorine releasing agents staff are advised to consult the manufacturer’s instructions for a suitable alternative to use following or combined with detergent cleaning. Any alternative disinfectant used must meet the relevant BS EN Standards as detailed previously
Read the routine cleaning of the care environment literature review to find out more about why we do things this way for the care environment.