Inspection

Name of Auditor

Date and Time of audit

Nurse in charge at time of audit

Number of beds in care home

Number of residents

Number of residents CoVID 19 positive

Date of first positive case
Date of last positive case
Standard 1: Leadership in the prevention and control of infection

Standard Statement: the organisation demonstrates leadership and commitment to infection prevention and control to ensure a culture of continuous quality improvement throughout the organisation.

Rationale: Robust leadership in infection prevention and control is essential for effective decision-making, effciient use of resources and ensuring the provision of high quality, safe, effective, person-centred care.

Manager completes regular infection control audits for care home

Manager shares any issues identified from audit with teams during safety brief and this is recorded

All staff know how to contact Health Protection Team for advice

Home has an identified Infection Control lead / champion

COVID-19 Specific

Manager will co-ordinate and manage the care staff, to ensure quality care for residents

Manager will ensure that all activities are carried out safely

Standard 2: Education to support the prevention and control of infection

Standard statement: Education on infection prevention and control is provided and accessible to all healthcare teams to enable them to minimise infection risks that exist in care settings.

Rationale: To minimise the infection risks associated with healthcare, all staff are provided with the necessary knowledge and skills in infection prevention & control to confidently and competently demonstrate behaviours integral to safe, effective & person-centred care

All staff have access to & have completed mandatory Infection Prevention & Control (IPC) training

Manager ensures that the IPC education needs of their staff and themselves are identified, supported and evaluated through personal development reviews and personal development plans

Staff have had training around how to contact GP, Health Protection, Partnership, Care Commission and relatives – check evidence

Do staff have access to up to date educational resources (e.g. web based system)

Unit has a named Responsible Person for Hand Hygiene and Skin Surveillance as per https//www.hse.gov.uk/skin/professional/health-surveillance.htm

COVID-19 Specific

Is there evidence to show that staff have received training about COVID-19, infection prevention and care?

Standard 3: Communication between organisations and with the patient or their representative

Standard statement: The organisation has effective communication systems and processes in place to enable continuity of care and infection prevention and control throughout the patient’s journey

Rationale: Residents are vulnerable to infections and some present an infection risk to other residents, visitors and staff. As a single resident journey can involve staff in multiple care settings, effective care provider communications are vital in infection prevention and control, and safe, effective and person-centred care. Wherever possible, residents and their representatives must be assured of, and involved in, communications regarding their care

All residents, where appropriate, have been informed of how they and their family can reduce the risk of infection

All residents in isolation have the reason for isolation documented in notes

When infection risks to or from the resident are identified, all communication with the resident or their representatives is recorded in the notes

Staff aware how to identify residents with Infection Risks

Infection Prevention & Control posters are displayed (suggest the following):

Hand hygiene

Standard Infection Control Precautions (SICPs)

Management of Occupational Exposure Sharps assembly/closure

Management of Blood Body Fluid Spills

4 moments for Hand Hygiene

Linen Segregation

Domestic Colour Coding Guidelines

COVID-19 Specific

All entrances are clearly sign posted stating the service is closed to visitors due to Covid-19 restrictions?

Signage is visible on doors of residents who have tested positive for Covid-19

Residents with capacity understand why the precautions are in place – ask one resident

Are there any floor markings/signage to indicate the 2 metre social distancing guidance?

Is their signage/guidance to remind staff about reporting illness, Covid-19 testing and return to work?

Standard 4: Infection surveillance

Standard statement: The organisation has a surveillance system to ensure a rapid response to HAI

Rationale: Infection surveillance is the ongoing and systematic collection, analysis and interpretation of data, relating to infection , which is used to reduce the risk of infection and improve resident outcomes

All staff are aware of the process of reporting suspected infection

All staff are aware that the findings from the visits by assurance teams and the improvement plans

COVID-19 Specific

Staff have accurate records of residents affected

When in outbreak, staff complete HPS COVID – 19 Outbreak tool daily

Standard 5: Antimicrobial stewardship

Standard statement: The organisation demonstrates effective antimicrobial stewardship

Rationale: Antimicrobial stewardship, in the form of a co-ordinated programme, has been shown to reduce inappropriate antimicrobial use, improve patient outcomes and reduce adverse consequences of antimicrobial use including, antimicrobial resistance, toxicity and unnecessary costs

At present there are no question sets available to measure / monitor antimicrobial stewardship

All nursing staff involved in the prescribing and administration of medicines must comply with 2007

Standard 6: Infection prevention and control policies, procedures and guidance

Standard statement: The organisation demonstrates implementation of evidence-based infection prevention and control measures

Rationale: The minimum standard of infection prevention and control to be practiced by all staff, in all care settings, for all care procedures is the application of standard infection control precautions, as detailed in chapter one, of the National Infection Prevention and Control Manual. Standard infection control precautions are the most effective means to prevent cross transmission and cross-infection with micro-organisms in care settings

All staff can access the local Infection Prevention & Control of Infection Policy

All policies are within date and align to HPS National Infection Prevention and Control Manual

Patient Placement / Assessment for Infection Risk

Are the residents assessed regularly for infection risks (to themselves and from themselves) and placed appropriately to negate cross-transmission risks?

The care home has facilities to isolate those residents presenting an infection risk

Doors to isolation/cohort rooms/areas are closed and signage is clear (undertake a resident safety risk assessment for door closure). If the door cannot be kept closed the bed/chair are at the furthest safest point of the room to keep 2m distance from the open door

COVID-19 Specific

Visiting is restricted and Visitors log utilised appropriately

Staff are checking and recording resident’s temperature at least twice a day, and reporting if raised and checking for other symptoms

Staff are logging their own temperature on arrival to the service and if raised, being asked to go home (documented evidence)

Residents dining rooms, sitting rooms and other shared space are clean and tidy, and there is evidence of social distancing measures

Electric fans should not be in use

Facilities are available for virtual visiting for residents

Is there a contingency plan for ‘cohorting’ or zoning to keep suspected or confirmed infected residents apart from non-infected residents

Records are kept if staff are supervising residents with outdoor exercise to note social distancing

Hand Hygiene

Alcohol based hand rub (ABHR) is available at ward entrance / exit and close to point of care

All staff in clinical areas are wearing Alcohol Gel

Hand washing facilities are designated for staff in their changing area and each floor or unit of the service

Staff are bare below the elbows and not wearing wrist watches, bracelets or stoned rings

All staff comply with for hand hygiene WHO 4 moments for hand hygiene

Hand wash sinks used only for hand washing - not for discarding wash water from basins or other fluids

Do all wash hand basins have liquid soap, paper towels and a pedal bin or open bin for waste towels (no flip bins)?

Wall mounted or pump dispenser hand cream available in at least one location

Staff are observed carrying out effective hand washing technique at the correct times

Are there documented checks by the manager on hand hygiene compliance?

COVID-19 Specific

Staff should support residents with frequent hand hygiene

Staff should include forearms when undertaking hand hygiene when there are incident of COVID-19 in the unit

Respiratory & Cough Hygiene

Residents are provided with a supply of tissues if they have respiratory symptoms and supported with

Staff can describe respiratory / cough etiquette in care areas

Used tissues are promptly disposed of in a bin or disposal bag

Staff are aware of what Personal Protective Equipment (PPE) to use for patients with respiratory infections and where to access them

Personal Protective Equipment (PPE)

PPE is available close to the point of use and stored appropriately to avoid contamination

Staff can don and remove PPE appropriately as per Appendix 6 of the National Infection Prevention & Control Manual

Aprons are worn to protect uniform when in close contact with the resident or their environment

Appropriate colour coded aprons are worn by domestic staff

Correct gloves type is used for task refer to Appendix 5 – Best Practice - Glove Use and Selection

Gloves are worn when exposure to blood/body fluids may occur

Facial protection is worn where there is a risk of blood/body fluid contamination

PPE is changed between resident (or end of task) and appropriately disposed

COVID-19 Specific

Ensure staff using the PPE safely and appropriately? (e.g. staff do not wear PPE in break rooms while eating/drinking)

Staff aware of need to risk assess for eye protection

Staff are aware of and can describe the difference between the following:

Staff Management of Care Equipment

Staff are aware of and can describe the difference between the following

Single-use

Single person use

Re-usable invasive equipment

Re-usable non-invasive equipment

Sterile stock is in date

No communal prodcuts are used i.e. soap, shower gel, shaving foam

Commodes are visibly clean

Raise toilet seats are visibly clean

System in place for mattress checks and audit

Mattresses are clean (inside and outside mattress cover)

Bed rails/frames clean

Equipment is cleaned following resident use (Check a selection of equipment)

Appropriate claining materials available and staff aware of correct process for cleaning and decontamination, Appendix 7 NIPCM

COVID-19 Specific

Equipemnt used for residents is either personal or cleaned correctly to prevent cross infection.

Personal items must be stored in residents room

Staff are aware of products to use during a sustained transmission of COVID

Domestic Staff are aware of products to use during a sustained transmission of COVID

Safe Management of Care Environment

The care environment is visibly clean, kept free from non-essential items and equipment to facilitate effective cleaning

No inappropriate storage i.e. staff cups or food items in clinical areas

The care environment well maintained and in a good state of repair

The care environment is routinely cleaned in accordance with the Health Facilities Scotland (HFS) National Cleaning Specification:

COVID-19 Specific

Staff changing rooms, break rooms and other shared space are clean and tidy, and there is evidence of social distancing measures

Enhanced cleaning is undertaken at least at twice daily as per HPS COVID-19: Information and Guidance for Care Homes, Appendix 4 and 5

Safe Management of Linen

Clean and used linen is stored separately

Used linen is not shaken when removed from beds / trolleys

Used linen is not placed on the floor

Staff do not carry clean or used linen against their uniforms

A laundry receptacle is available at point of use

Linen bags are not overfilled

Used non infected linen is disposed of in a white linen hamper

Soiled / infected linen placed in red water soluble bags / then a clear plastic bag then red linen hamper

Is there a safe and appropriate system for laundry? (e.g. correct machine temperature, dissolvable bags for soiled linen)

COVID-19 Specific

Confirm that uniform/work wear are not worn to work

If staff are taking their uniform/work wear home to wash, do they use disposable/washable bags to transport home?

Safe Management of Blood & Body Fluid Spillages

Staff can describe the correct procedure and correct dilution of product or wet/dry blood spillages or where they would find this information, Appendix 7 NIPCM

Staff can describe the correct procedure for dealing with urine/vomit/faeces spillage or where they would find this information, Appendix 7 NIPCM

Safe Disposal of Waste (including Sharps)

Waste is segregated correctly

Waste disposed of at point of use

Gelling agent used for suction waste

Waste bags are not more than 2/3 full

Clinical waste is swan necked, ratchet tied and source identified

Waste is stored securely prior to uplift

Sharps containers are correctly assembled & labelled with date and name of staff member who assembled container

Sharps containers are Free from protruding sharps/not overfilled

Sharps containers have temporary closure mechanisms in use

COVID-19 Specific

If the care home has a clinical waste contract, there is no need to hold (quarantine) waste for 72 hours

If no clinical waste stream all waste items that have been in contact with the individual are disposed of securely within disposable bags. When full, the plastic bag should then be placed in a second bin bag and tied. These bags should be stored in a secure location for 72 hours before being put out for collection

Occupational Safety: Prevention & Exposure Management, including Sharps

All staff can describe what to do in the event of blood body fluid exposure

Where sharps are in use safety devices should be in place and all staff trained in their use and records kept of training

Standard 7: Insertion and maintenance of invasive devices

Standard statement: Systems and processes are in place to ensure the safe and effective use of invasive devices, for example, peripheral venous catheters, central venous catheters and urinary catheters

Rationale: Invasive devices present a significant infection risk to patients. These risks can be minimised by: avoidance of device use where possible
following evidence-based procedures for insertion and maintenance, and
removing the device as soon as there is a clinical indication to do so

Maintenance/insertion bundles are used to ensure best practice for invasive devices i.e. Urinary catheters

Bundles are reviewed daily and all elements of bundle for invasive devices completed

Staff can describe the care and maintenance of invasive devices

Staff aware and competent with asepsis when managing invasive devices

Patients given verbal or written information on their invasive devices and this is recorded in patient records

Closed system in place for urinary catheters

Staff can describe how to obtain CSU using needle free port

Urinary catheter bags are above floor level & below waist

Standard 8: Decontamination

Standard statement: The environment and equipment (including reusable medical devices used) are clean, maintained and safe for use. Infection risks associated with the built environment are minimised

Rationale: Effective decontamination is critical in the provision of a safe, clean environment and equipment. The built environment must be designed, planned, constructed, refurbished and maintained to minimise the risk of infection.
This standard covers the decontamination, management and maintenance of:
• reusable communal patient care equipment
• reusable medical devices, and
• the built environment

The unit is clean, dust and grit free

The unit is free from clutter (floors & work surfaces)

Stores are kept off the floor

Fixtures and fittings are intact and in good repair

A method for recording maintenance issues is available

Maintenance team inform all other teams when issues resolved

A system is in place to inform the manager of any planned works and that appropriate environmental controls have been taken

WATER SAFETY

Evidence/records of water flushing for low useage outlets are available

COVID-19 Specific

COVID-19 affected areas should be cleaned at least twice daily paying particular attention to common touch surfaces such as door handles, tablets, mobile phones, light switches, remote controls and bed rails

Standard 9: Acquisition of equipment

Standard statement: All equipment acquired for the care environment is safe for use

Rationale: The infection risk to patients is minimised by having an acquisition process in place that ensures all equipment (including reusable medical devices) is safe for its intended use. Safety refers to minimising the risk of transmission of infection

Before any purchase / donation of equipment the cleaning & decontamination guidance from manufactures is reviewed

COVID-19 Specific

All equipment must be able to tolerate chlorine based products for decontamination

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.