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IC3 - Environmental Audit - Communal Areas and Support Plans
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CA1-1<br>Are communal areas free from unpleasant smells?
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CA1-2<br>Are visitors actively informed to decontaminate their hands on arrival and prior to departure? (clear notice on all entrances)
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CA1-3<br>Are high and low surfaces clean and dust free?
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CA1-4<br>Are dining tables cleared and cleaned after each meal?
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CA1-5<br>Are curtains and blinds clean / cleaned 6-monthly? (documented)
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<br>CA1-6<br>Are walls, wallpaper, ceilings and tiled areas clean?
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CA1-7<br>Is the furniture clean and in a good state of repair, free from rips and tears?
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CA1-8<br>Are soft furnishing clean and in a good state of repair?
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CA1-9<br>Are soft furnishings made of impermeable and washable materials?
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CA1-10<br>Are windows and window sills clean and in a good state of repair?
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<br>CA1-11<br>Are radiator covers removed regularly to facilitate cleaning and included on a documented cleaning schedule?
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<br>CA1-12<br>Is there a robust cleaning programme in place for the steam/cleaning of carpets/curtains and blinds in communal areas? (evidence of the frequency and how documented)
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CA1-13<br>Are carpets and floors clean and free from stains and in a good state of repair?
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CA1-14<br>Does the home have access to a suitable carpet cleaner or shows evidence that carpets are deep cleaned regular (at least 6 monthlies for communal areas and monthly for bedrooms)?
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CA1-15<br>Is the home clear of pests? (e.g. no evidence of pests)
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<br>CA1-16<br>Are hand washing posters available at each sink used by staff?
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CA2-1<br>For any residents with short- or long-term infections, is this is detailed in their support plans and reviewed as a minimum weekly for short term infections and monthly for long term infections? (check residents with any infections)
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<br>CA2-2<br>Is there is evidence that the care plan is being followed in relation to the resident’s infection?
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CA3-1<br>Are single use plastic aprons available?
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CA3-2<br>Are single use plastic aprons stored appropriately away from the risk of contamination?
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CA3-3<br>Are single use apron and gloves worn when in contact or anticipated contact with body fluids or contaminated items or significant physical contact?
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CA3-4<br>Are Residents clothes protectors cleaned after use?
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<br>CA3-5<br>Is there a range of sizes of sterile and non-sterile powder free gloves available?
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<br>CA3-6<br>Are polythene gloves only used for non-care activities? (e.g. serving food)
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CA3-7<br>Are gloves worn when any invasive procedure is performed?
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CA3-8<br>Is eye and face protection available and worn by staff when anticipating contact with blood and body fluids with a high risk of splashing into the face and eyes?
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CA3-9<br>Are gloves removed after care activity and hand hygiene performed? (Check gloves are not worn when handling records, answering phone etc. Moment 3 - after body fluid exposure.)
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CA4-1<br>Do all care staff observed all have long hair tied back?
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CA4-2<br>Are staff observed are free from nail polish or false nails?
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CA4-3<br>All staff observed have short and clean nails?
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CA4-4<br>All staff observed are wearing minimal jewellery? (One wedding ring permitted)
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CA4-5<br>Are all staff observed bare below the elbow?
IC4 - Management of Resident Equipment
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RE1-1<br>Are pressure relieving cushions clean and intact?
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<br>RE1-2<br>If applicable, is there evidence of monthly visual oxygen cylinder checks? (Check IPC folder)
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RE1-3<br>Is there evidence of a cleaning schedule for all residents Moving and Handling equipment?
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RE1-4<br>Is there evidence of a weekly cleaning schedule for all wheelchairs in the home?
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RE1-5<br>Are items sent for service, inspection or repair, appropriately cleaned and / or disinfected, and a label of contamination status attached? (Ask to see labels used.)
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RE1-6<br>Is all reusable equipment routinely cleaned between every resident with general purpose detergent or as per local policy/manufacturer`s instructions where this differs?
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RE1-7<br>Is manual handling equipment stored appropriately? (Check equipment is not stored in bathrooms / sluice rooms etc.)
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RE1-8<br>Are manual handling slings / sheets single use or laundered after use? (Inspect and talk to staff.)
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RE1-9<br>Do hoists look visibly clean?
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RE1-10<br>Are aids such as walking sticks, zimmer frames, helping hands visibly clean and stored in a suitable area? (Check 2 pieces of equipment)
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<br>RE1-11<br>Is stored patient equipment (e.g. IV stands, pumps, mattresses, bariatric equipment) visibly clean ready for use and identified as such? (Inspect stored equipment and cleaning schedule)
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<br>RE1-12<br>Are clean mattresses in storage labelled and stored appropriately?
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RE1-13<br>Are soiled mattresses awaiting disposal safely managed? (Check area for disposal)
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RE1-14<br>Are decontamination forms available and is there evidence of their use?
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RE1-15<br>Are staff able to explain when decontamination forms are used? (Speak to two staff members)
IC5 - Environment - Bedroom 1
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EB1-1<br>Have you entered the room number and resident name in the comments box?
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<br>EB1-2<br>Are bedrooms clean and dust free? (Check all high / low areas)
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EB1-3<br>Are bedrooms free from unpleasant smells?
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<br>EB1-4<br>Is carpet / flooring in good condition & free from dirt / stains?
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EB1-5<br>Is all furniture wipeable and in good condition?
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EB1-6<br>Are curtains and blinds clean / cleaned 6-monthly (documented)?
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<br>EB1-7<br>Are there hand washing facilities in the room? (liquid soap, paper towels, foot operated bin and Personal Protective Equipment; gloves aprons etc.)
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<br>EB1-8<br>Are pressure relieving mattress covers clean and intact? (Unzip & inspect)
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EB1-9<br>Is there documented evidence of regular mattress audits?
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EB1-10<br>Are pillows clean and in good state of repair? (Check visually for staining and damage)
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<br>EB1-11<br>Are bed frames clean and dust free?
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EB1-12<br>Are headboards clean and free from stains?
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<br>EB1-13<br>Are bed bumpers clean and free from stains?
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EB1-14<br>Are call bells clean?
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<br>EB1-15<br>Are en-suite bathrooms / toilets clean, clutter free and in a good state of repair?
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<br>EB1-16<br>If in use, is commode is in a good state of repair and visibly clean?
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EB1-17<br>If there is any manual handing equipment in use, is it visibly clean? (Check for body substances, dust, dirt, debris or adhesive tape)
- IC6 - Environment - Bath / Shower Room
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<br>EBR1-1<br>Have you entered which bath / shower room was checked in the comments box?
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EBR1-2<br>Are wall tiles, walls, ceilings and wall fixtures (including soap and towel dispensers) clean, intact and free from mould and limescale?
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EBR1-3<br>Is pipework clean and rust free?
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<br>EBR1-4<br>Is the flooring, including edges and coving, intact and impervious?
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<br>EBR1-5<br>Are shower curtains clean and free from mould and subject to a documented cleaning programme?
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EBR1-6<br>Are all toiletries and equipment (e.g. nail brushes) stored appropriately? (e.g. securely stored, not left lying around)
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EBR1-7<br>Are bath / shower mats clean and hung to dry?
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<br>EBR1-8<br>Are lifting aids waterproof, easy to clean and appropriately maintained? (check under bath seats)
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<br>EBR1-9<br>Are communal bath / showers cleaned in between use? (Check staff can say where they can access these products and how to use)
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<br>EBR1-10<br>is the bath / shower room free from inappropriate items? (Check the room is not used for storing unnecessary equipment etc)
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EBR1-11<br>Are any hoists clean and in a good state of repair?
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<br>EBR1-12<br>Are foot operated bins available for clinical waste?
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EBR1-13<br>Are there hand washing facilities and PPE available in the bathroom / shower room? (liquid soap, paper towels, foot operated bin and Personal Protective Equipment; gloves aprons etc.)
IC7 - Environment - Communal Toilet
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ET1-1<br>Have you entered which toilet was audited into the comments box?
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ET1-2<br>Are there hand washing facilities and PPE available in the bathroom / shower room? (liquid soap, paper towels, foot operated bin and Personal Protective Equipment; gloves aprons etc.)
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ET1-3<br>Is there a poster demonstrating the correct hand cleansing technique (soap and gel) above all hand wash facilities?
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<br>ET1-4<br>Is there sufficient odour control?
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ET1-5<br>Is flooring impervious and sealed including edges; corners and free of dust and grit?
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ET1-6<br>Are toilet paper and paper towels dispensed from a sealed and clean dispenser?
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ET1-7<br>Are there foot operated pedal bins for paper, clinical waste and sanitary waste disposal?
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<br>ET1-8<br>Are bins in full working order, clean, of appropriate size and not overflowing with waste.
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ET1-9<br>Are toilet raisers in good condition, clean and free from stains?
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<br>ET1-10<br>Are toilets visibly clean with no body fluid contamination, lime scale stains etc? (Check under lid, seat and around rim of toilet.)
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<br>ET1-11<br>If applicable, are extractor fans working and clean?
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ET1-12<br>Are toilet brushes visibly clean and replaced when visibly soiled?
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<br>ET1-13<br>Are cord pulls clean and subject to weekly documented cleaning?
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ET1-14<br>Are hand rails clean and subject to daily documented cleaning?
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ET1-15 Is there a process to ensure toilets are cleaned as required in addition to standard? (Check with staff who cleans toilets if there is visible soiling)
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ET1-16 Is the toilet free from inappropriate items? (Check the room is not used for storing unnecessary equipment etc)
IC8 - Environment - Dirty utility / Sluice
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<br>ES1-1<br>Have you entered the location of the dirty utility / sluice audited in the comments box?
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<br>ES1-2<br>Is the dirty utility room separate from resident`s toilet and bathing facilities?
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ES1-3<br>Are there sluice facilities available and in good working order? (If not, how are bed pans decontaminated?)
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<br>ES1-4<br>Is there a washer disinfector or macerator available? Is the equipment clean and in working order to ensure correct disposal or disinfection of bed pans, urinals , commode buckets? Check macerator is working correctly by closing the lid, applying water (enough to cover seal), start machine and check for air bubbles rising from seal or small splashes. (Please check with manufacturer`s instructions first and wear eye protection) If intact, no bubbles or splashing will be seen. Check macerator is empty at the end of the cycle. OR Bed pan washer is visibly clean and meeting the appropriate temperature of 80 degrees C for 1 minute.
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<br>ES1-5<br>Is the washer heat disinfector tested and maintained in line with HTM 2030 or equivalent? (Check: Records for periodic testing. Bedpan washer is reaching the appropriate temp of 80 degrees C for one minute.)
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<br>ES1-6<br>Is there evidence of a planned maintenance contract for macerators / bedpan washers? (Speak to maintenance person for records)
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ES1-7<br>Is there evidence of a contingency plan should the macerator/bedpan washer break down? (Ask for written contingency plan)
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<br>ES1-8<br>Are bed pans, commode buckets and urinals clean and free from rust, stains and visible dirt?
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<br>ES1-9<br>Are commodes and frames are visibly clean, cleaned after each use and in a good state of repair?
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ES1-10<br>Are catheter stands visibly clean?
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<br>ES1-11<br>Are measuring jugs either disposable or processed through a washer disinfector?
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ES2-1<br>Are there separate hand washing facilities available including wall mounted liquid soap, gel and paper towels?
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<br>ES2-2<br>Are there elbow taps on the separate hand washing sink? If not, can staff state they would use a paper towel to turn taps on?
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<br>ES2-3<br>Is the separate hand washing sink plug free? (There should not be a plug in the hand washing sink)
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<br>ES2-4<br>Is there a pedal bin in the room for disposal of paper towels which is in good working order?
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<br>ES2-5<br>Is the pedal bin visibly clean?
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ES2-6<br>Is there a Hand washing poster on display? (Poster: ACM93d2 WHO How To HandWash Poster)
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ES3-1<br>Is the room clean and free from inappropriate items?
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<br>ES3-2<br>Is flooring clean, impervious, sealed including coved edges and in a good state of repair?
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<br>ES3-3<br>Can you confirm that nothing is stored at floor level?
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<br>ES3-4<br>Are walls clean and washable?
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ES3-5<br>Are bed pans, commode buckets, & urinals clean and stored inverted on racks?
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<br>ES3-6<br>Are shelves and cupboards clean inside and out and free of clutter, dust, litter and stains?
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<br>ES3-7<br>Is there evidence of colour coding of cleaning equipment (cloths, mops).?
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<br>ES3-8<br>Is there a dedicated deep sink for washing used equipment?
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<br>ES4-1<br>Is there a disposal unit available for disposal of body fluids?
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<br>ES4-2<br>Are staff aware of the procedures to be used when removing body fluid spillages? (Ask 2 members of staff to explain the process)
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<br>ES4-3<br>Are cleaning / disinfectant products available for decontamination of equipment and the environment? (Check there are cleaning and disinfectant products available as per policy and that there are instructions on use e.g. poster)
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<br>ES4-4<br>Can staff describe which products should be used for routine cleaning? (Speak to two members of staff)
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ES4-5<br>Is a disinfectant available (e.g. hypochlorite) for environmental / equipment disinfection?
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ES4-6<br>Is Personal Protective equipment available? (e.g. aprons, eye protection, gloves)
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ES4-7<br>Are items sent for service, inspection or repair, appropriately cleaned and/or disinfected, and a label of contamination status attached? repair, appropriately cleaned and/or disinfected, and a label of contamination status attached? (Ask to see labels used to mark items being sent for service, inspection or repair)
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<br>ES4-8<br>Is there a hands-free waste bin available for the disposal of offensive waste?
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<br>ES4-9<br>Is the foot pedal of the offensive waste bin in good working order?
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<br>ES4-10<br>Is the offensive waste bin visibly clean, including lid and pedal? (Check bin internally and externally)
IC9 - Domestic / Cleaning Storage Room
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<br>ED1-1<br>Have you written the location of the domestic / cleaners room audited in the comments box?
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<br>ED1-2<br>Is there a robust documented cleaning schedule available for cleaning activities throughout the home which includes equipment?
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ED1-3<br>Is equipment used by the domestic team clean, well maintained and stored in a locked area in accordance with COSHH regulations?
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<br>ED1-4<br>Is there a policy for the maintenance of the steam cleaner including Legionella risk assessment?
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<br>ED1-5<br>Is a colour coding poster displayed in the cleaning equipment storage area?
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ED1-6<br>Is personal protective equipment available and appropriately used by the domestic staff (colour coded aprons, eye protection and gloves)?
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<br>ED1-7<br>Is all cleaning equipment colour coded? (Red for toilets, bathrooms & sinks in these areas; blue for general areas; green for kitchens & yellow for clinical areas)
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<br>ED1-8<br>Speak to Domestic Staff are they able to explain the correct colour coding for cleaning equipment?
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<br>ED1-9<br>Are cleaners' trolleys clean and well maintained?
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<br>ED1-10<br>Are products used for cleaning and disinfection to the correct dilution compliant with policy and stored in clearly marked containers?
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<br>ED1-11<br>Is there a chlorine releasing cleaning agent at 1,000 ppm readily available?
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<br>ED1-12<br>Are cloths single use or laundered after each use?
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ED1-13<br>Are buckets and mops stored clean, dry and inverted?
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ED1-14<br>Are mop heads laundered / changed on a weekly basis?
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<br>ED1-15<br>Is flooring in the cleaning equipment storage area impervious, with sealed edges and in a good state of repair?
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<br>ED1-16<br>Is it observed that no cleaning supplies are stored on the floor?
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<br>ED1-17<br>Is it observed that there no inappropriate materials or equipment stored in the cleaning equipment storage area?
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<br>ED1-18<br>Are spillage kits available and in date?
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<br>ED1-19<br>Is there a disposal unit for the disposal of contaminated waste water?
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<br>ED1-20<br>Is there evidence of cleaning methods and schedules of all equipment in the home? (look at cleaning schedules and equipment cleaning schedules).
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ED2-1<br>Is there adequate storage for all cleaning products and is this locked and secure from residents in accordance with COSHH regulations? (Check storage and that no other items are stored with cleaning products.)
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<br>ED2-2<br>Are COSHH data sheets available for all cleaning products?
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ED2-3<br>Were all cleaning trolleys observed to be stored safely away from residents and visitors when unsupervised? (Observe cleaning trolleys during completion of audit)
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<br>ED3-1<br>Are there separate hand washing facilities available including wall mounted liquid soap, gel and paper towels?
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ED3-2<br>Are there elbow taps on the separate hand washing sink? If not, can staff state they would use a paper towel to turn taps on?
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<br>ED3-3<br>Is the separate hand washing sink plug free? (There should not be a plug in the hand washing sink)
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ED3-4<br>Is there a pedal bin in the room for disposal of paper towels which is in good working order?
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ED3-5<br>Is the pedal bin visibly clean?
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<br>ED3-6<br>Is there a Hand washing poster on display? (Poster: ACM93d2 WHO How To HandWash Poster)
IC10 - Treatment / Clinic Room
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ETR1-1<br>Is there a designated room for the storage of medicines and medical products?
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ETR1-2<br>Is there an identified area for the storage of clean and sterile equipment?
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<br>ETR1-3<br>Are all items are stored above floor level?
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<br>ETR1-4<br>Is the treatment / clinic room free from inappropriate items? (Check the room is not used for storing unnecessary equipment etc)
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<br>ETR1-5<br>Is sterile equipment in date and packaging intact? (Randomly check 5 items.)
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ETR1-6<br>Are dressing trolleys clean and in a good state of repair?
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<br>ETR1-7<br>Are staff able to recognise the single-use symbol? (Ask two members of staff)
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ETR1-8<br>Is there evidence that single-use items are not re-used or re-processed? (Check single use medication pots are disposed of after use, if used)
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<br>ETR1-9<br>Are single use disposable items in date? (Check dates to ensure none have expired)
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ETR1-10<br>Is there a covered vinyl flooring that is clean and free from dust and grit?
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<br>ETR1-11<br>Are walls clean and washable?
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ETR1-12<br>Are all high and low surfaces free from dust and cobwebs?
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ETR1-13<br>Are worktops and cupboards free from clutter and clean inside and out?
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<br>ETR1-14<br>Is there evidence of a weekly treatment / clinic room cleaning schedule?
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ETR1-15<br>Is there a sepsis poster displayed? (Different versions for residential and nursing homes)
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ETR2-1<br>Are all re-usable instruments returned to a sterile services provider for decontamination? (Check laryngoscope blades, handles, supra glottic airways)
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<br>ETR2-2<br>Is blood pressure monitoring equipment visibly clean? (Check there is no sticky tape or other attachments which prevents effective cleaning)
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<br>ETR2-3<br>If applicable, are all stethoscopes visibly clean? (Check for body substances, dust, dirt, debris or adhesive tape)
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ETR2-4<br>Is blood glucose monitoring equipment visibly clean? (Check for body substances, dust, dirt, debris or adhesive tape)
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<br>ETR2-5<br>If applicable, are tourniquets single use or decontaminated between uses?
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ETR2-6<br>Are thermometers visibly clean and in a good state of repair?
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<br>ETR2-7<br>Is there evidence of an approved container to transport specimens?
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<br>ETR2-8<br>Is the resuscitation trolley/bag visibly clean? (Check for dirt / dust)
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