External site - Surgery

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

Standard 1: Toilets, Showers, Baby changing facilities (Daily)

• Area / Room number

• Collect and dispose of refuse, change liner

  Yes

  No

  N/A

• Clean hand basins, urinals and toilets

  Yes

  No

  N/A

• Damp dust fixtures, fittings, switches, data points and skirting boards

  Yes

  No

  N/A

• Spot wipe walls, doors, tiles and paintwork

  Yes

  No

  N/A

• Replenish hand towels, toilet paper, soaps

  Yes

  No

  N/A

• Damp mop floors

  Yes

  No

  N/A

Standard 1a: Toilets, Showers and Baby changing facilities (Weekly)

• Area / Room number

• Clean toilet brushes and holders

  Yes

  No

  N/A

• Damp dust inside toilet roll holders and paper towel holders

  Yes

  No

  N/A

Standard 2: Clinical areas (Daily)

• Area / Room number

• Collect and dispose of refuse, change liner

  Yes

  No

  N/A

• Damp dust fixtures, fittings, switches, data points and skirting boards (only if accessible)

  Yes

  No

  N/A

• Spot wipe walls, doors, tiles, paintwork and mirrors

  Yes

  No

  N/A

• Replenish hand towels and soaps

  Yes

  No

  N/A

• Clean all sinks

  Yes

  No

  N/A

• Damp mop / suction clean floors

  Yes

  No

  N/A

• Clean / Damp dust top and underneath of couches

  Yes

  No

  N/A

Standard 2a: Clinical areas (weekly)

• Area / Room number

• High dust, damp dust pipes and skirting boards (only if accessible)

  Yes

  No

  N/A

• Damp dust inside paper towel holders

  Yes

  No

  N/A

• Damp dust / vac chairs

  Yes

  No

  N/A

Standard 3: Reception / waiting / corridors and speech therapy (Daily)

• Area / Room number

• Collect and dispose of refuse, change liner

  Yes

  No

  N/A

• High dust, damp dust pipes and skirting boards

  Yes

  No

  N/A

• Damp dust furniture, chairs, fixtures, fittings, data points, switches and skirting boards (only if accessible)

  Yes

  No

  N/A

• Spot wipe walls, doors, paintwork and internal glass

  Yes

  No

  N/A

• Damp mop or suction clean floors

  Yes

  No

  N/A

Standard 3a: Reception / waiting / corridors and speech therapy (Weekly)

• Area / Room number

• High dust, damp dust pipes and skirting boards (only if accessible)

  Yes

  No

  N/A

• Damp dust inside paper towel holders

  Yes

  No

  N/A

• Damp dust / vac chairs

  Yes

  No

  N/A

Standard 4: Offices (Daily)

• Area / Room number

• Collect and dispose of refuse, change liner

  Yes

  No

  N/A

• Clean wash basin (where fitted)

  Yes

  No

  N/A

• Replenish hand towels and soaps

  Yes

  No

  N/A

• Damp dust furniture, fixtures, fittings, switches, data points and skirting boards (only if accessible)

  Yes

  No

  N/A

Standard 4a: Offices and Stairs (Weekly)

• Area / Room number

• Damp dust furniture, fixtures and fittings (only if accessible)

  Yes

  No

  N/A

• Damp mop, suction clean floors

  Yes

  No

  N/A

Standard 4b: Offices (Fortnightly)

• Area / Room number

• High dust, damp dust pipes and skirting boards (only if accessible)

  Yes

  No

  N/A

• Spot wipe walls, doors, paintwork and internal glass

  Yes

  No

  N/A

Standard 5: Kitchen / Messroom (Daily)

• Area / Room number

• Collect and dispose of refuse, change liner

  Yes

  No

  N/A

• Damp dust, fixtures, fittings, switches, skirting boards and high dust (only if accessible)

  Yes

  No

  N/A

• Spot wipe walls, doors, tiles, paintwork and mirrors

  Yes

  No

  N/A

• Clean sink and draining board (if clear of cups, plates etc)

  Yes

  No

  N/A

• Damp mop floor

  Yes

  No

  N/A

• Replenish hand towels and soaps (where fitted)

  Yes

  No

  N/A

Standard 6: Cleaning cupboards (Daily)

• Area / Room number

• Mops are inverted and buckets are clean and dry

  Yes

  No

  N/A

• Clean sluice sink and hand basins (where fitted)

  Yes

  No

  N/A

• Replenish hand towels and soaps (where fitted)

  Yes

  No

  N/A

• Damp mop floor

  Yes

  No

  N/A

Standard 7: Entrance / Bin areas (Weekly)

• Area / Room number

• Sweep bin area and entrance areas (where applicable)

  Yes

  No

  N/A

Standard 8: All areas (Weekly)

• Area / Room number

• Clean radiators and external grills

  Yes

  No

  N/A

Standard 9: All hard floors (Monthly)

• Area / Room number

• All hard floors to be scrubbed, spray cleaned

  Yes

  No

  N/A

Standard 10: Carpets, chairs and blinds (Annually)

• Area / Room number

• Spot clean all carpeted areas

  Yes

  No

  N/A

• Thoroughly clean all chairs

  Yes

  No

  N/A

• Thoroughly clean all blinds

  Yes

  No

  N/A

Infection control standard statement

• Environment - The environment will be maintained appropriately to reduce the risk of cross infection.

  Safe

  At Risk

  N/A

• Hand hygiene - Hands will be decontaminated correctly and in a timely manner using a cleansing agent to reduce the risk of cross contamination.

  Safe

  At Risk

  N/A

• Personal protective equipment - Personal protective equipment is available and used appropriately to reduce the risk of cross infection.

  Safe

  At Risk

  N/A

• Prevention of blood and bodily fluid exposure incidents, including needle stick injuries - Blood and body fluid exposure risks are managed in a way the reduces the risk of injury or infection.

  Safe

  At Risk

  N/A

• Management of waste - Waste is disposed of safely without the risk of contamination or injury in accordance with legislation.

  Safe

  At Risk

  N/A

• Equipment management - All clinical equipment is fit for purpose, decontaminated appropriately and stored correctly to reduce the risk of cross infection.

  Safe

  At Risk

  N/A

• Organisational controls - Polices and procedures are in place to reduce the risk of cross infection.

  Safe

  At Risk

  N/A

Audit action plan

• Details of any actions taken or required