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.Photo of domestic cleaning floor with a mop

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:

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:

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

This diagram 3  shows the cleaning services and is taken from the HFS Care Home Cleaning Specification

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:

Table 1: Example cleaning schedule residents room

This is an image of cleaning record A: residents room and ensuite.  The original can be found in the HFS Care Homes cleaning specification.

This is an image of the weekly tasks for cleaning and taken from the HFS Care Homes Cleaning specification

Table 2: Example cleaning SOP: Floors

This example cleaning SOP for floors is taken from the HFS Care Homes Cleaning Specification

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, funguses, 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.