MONTHLY IPC CHECK

• Site conducted

  Select

• Month Summary is for

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  • December

• Conducted on

  Date

• Prepared by

• Location
  Address

• Have TL/Seniors completed the check everyday, according to the record

  Yes

  No

  N/A

• During the month, have you observed the TL/Seniors completing the IPC daily checks

  Yes

  No

  N/A

Have you seen staff

• Not Wearing uniform

  Yes

  No

  N/A

• Not Wearing staff ID Card clearly

  Yes

  No

  N/A

• Dressed inappropriately i.e. stains on clothing etc

  Yes

  No

  N/A

• Groomed inappropriately for shift

  Yes

  No

  N/A

• Not Wearing appropriate footware

  Yes

  No

  N/A

• Haave you observed staff

Have you observed staff?

• not wearing appropriate PPE

  Yes

  No

  N/A

• not washing hands correctly

  Yes

  No

  N/A

• Have you observed staff not washing/sterlalising hands when …

• coming onto shift

  Yes

  No

  N/A

• or after direct contact with Service Users

  Yes

  No

  N/A

• undetaking any activity or contact that contaminates the hands i.e. cleaning or cooking

  Yes

  No

  N/A

Cleaning

• Are you satisified that the bathroom and corridors is clean, tidy and free from clutter at the time of this check

  Yes

  No

  N/A

• Are you satisified that the kitchen is clean and tidy at the time of this check

  Yes

  No

  N/A

Cleaning

• Are you satisified that the medication area is clean and tidy at the time of this check

  Yes

  No

  N/A

• Are you satisified that the Staff room is clean and tidy at the time of this check

  Yes

  No

  N/A

• Are you satisified that the all rooms in the property are clean, tidy and free from clutter, at the time of this check

  Yes

  No

  N/A

• Are you satisified that the property is clean and dust free at the time of this check

  Yes

  No

  N/A

Acesability

• Are you satisified that the gloves are provided in an appropriate place at the time of this check

  Yes

  No

  N/A

• Are you satisified that antibacterial gel is provided in an appropriate place at the time of this check

  Yes

  No

  N/A

General Observations

• Are you satisified that all open foods are labelled correctly at the time of this check

  Yes

  No

  N/A

• Are you satisified that fridge temperature recording records are up to date and accurate at the time of this check

  Yes

  No

  N/A

• Are you satisified that the Sharps check records are up to date and accurate at the time of this check

  Yes

  No

  N/A

END OF MONTH SUMMARY

• 1. What trends or concerns are noted over the month?

• 2. What actions need to be taken and by who and by when?

• 3. What actions are carried over from last week to this week and what is the update?