Buyers' guide to infection control - helping you to stay infection free and compliant

This guide includes

• gain control, keep compliant
• chain of infection
• good hygiene procedures
• choosing the right product
• reducing risk in the environment
• stopping contamination
• good catering practice
• hand hygiene
• body hygiene

Everyone will get stick at some point in their life - fact!

With this guide you can review your own policies and training on infection control to keep everyone healthy.

Areas of control

Every Care Home and Nursery should have policies, facilities, products and training in place to include the following as a minimum:

• Personal Protective Equipment (PPE) for staff (e.g. gloves and aprons)
• Suitable hand-washing facilities for both staff and those they care for
• Safe waste disposal of all cleaning products and equipment
• Policies for managing outbreaks of infectious diseases, e.g. vomiting and diarrhoea, MRSA and other easily transferred superbugs

Preventing and controlling infections can be problematic!

• Recommending that everyone receives their routine immunisations e.g. flu vaccinations
• Implementing effective hygiene procedures both environmental and personal
• Prompt and appropriate treatment of any illness

For additional information regarding latest legislations click on these links:

Health & Social Care Code of Practice

For Nurseries

For Care Homes

Where do germs come from?

The main sources of germs are from people, animals, food and water. Viruses can only multiply inside the body, but bacteria and fungi can multiply anywhere there is warmth and moisture, and will build up rapidly where water and waste residues accumulate, such as sinks, u-bends, toilets and wet cleaning cloths, or towels and bedding.

The 5 touch-points

Germs not only accumulate on surfaces but on skin too, this is why hygiene is so important. The diagram below clearly shows how easy it is for germs and infection to spread.

Be an infection preventionist!

No matter the germ, the chain can be broken at any of these six points: the infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host (person at risk). Keep germs at bay by ensuring everyone cleans their hands before and after every task, cleans the cleaning equipment as well as the environment, and wears the correct PPE clothing.

Stopping the spread

It is often said that the best form of protection is prevention. This can be applied in the following ways with regards to Care Homes and Nurseries:

• Reducing and eliminating sources of infection; for example cooking food properly, keeping contagious children and adults isolated from others and disposing of waste properly
• Ensuring all members of staff are fully trained in the correct hygiene procedures
• Educating children and adults about the importance of good hygiene practices e.g. not visiting vulnerable residents if you have suffered vomiting or diarrhoea within 48 hours

What is hygiene procedure?

In order to stay compliant with the latest legislation and guidelines, Care Homes and Nurseries are required to keep their premises and equipment clean to prevent the build up of germs and harmful bacteria. There are several ways to do this

Heat

• By making sure all food is cooked, or reheated properly. Food can be checked with a temperature probe.
• Washing clothes, bedding, towelling and reusable cleaning cloths at high temperatures
• Heat can also be used to sterilise equipment, refer to government guidelines at gov.uk

Cleaning

• Choosing the most appropriate cleaning agents and equipment for the task and using them correctly
• Certain super-viruses (such as Norovirus) requires a bleach based product
• Preventative cleaning is better than reactive - disinfect daily, don't wait for the outbreak!

Disinfecting

• Disinfecting destroys pathogenic micro-organisms that are living on objects, the chemicals used work by destroying their cell walls.
• Target high risk areas such as surfaces that cannot be rinsed properly or can be contaminated by body fluids

Sterilising

• This process eliminates all forms of life, including transmissible agents such as viruses, spores and fungi
• Apply sterilising chemicals to equipment, as well as using heat or steam for the most effective results

We recommend

To prevent cross-contamination we recommend using colour coded items for reusable cleaning cloths, cleaning utensils and protective clothing. The usual system is:

• RED - High risk sanitary appliances and washroom floors
• YELLOW - Wash basins and other washrooms
• GREEN - General food and food preparation areas
• BLUE - General low risk areas (except food areas)

Choosing the best product

Antibacterial cleaners are the most effective products at killing germs and super-bugs, containing a mixture of biocides that prevent bacterial formation. Killing flu viruses, Salmonella, MRSA, E.Coli, Staphylococcus Aureus, Enterococcus Hirae, Pseudomonas Aeruginosa and Candida Albicans in just 30 seconds.

We would recommend an effective multi-purpose antibacterial spray or wipe. These act as a disinfectant and detergent, replacing the need for different types of surface cleaners. Choose one that can be proven to kill 99.999% of germs and harmful bacteria in around 30 seconds (most claim 99.99%, trust us, that extra '9' on the end makes a huge difference!).

Look for products that are compliant with BS EN1276 at 30 seconds contact time, as well as BS EN13624, BS EN13727 and BS EN14348.

What formats do antibacterial cleaners come in?

Sprays

Good for cleaning tricky areas such as door handles and toilet flushes, as well as hard surfaces

Wipes

Perfect for on the go cleaning and most hard surfaces. For best results use a sweeping zig-zag motion

Liquids

Great for cleaning larger areas such as floors. You can also get antibac laundry detergent

Concentrates

Just like the liquids but concentrated saving you money, storage space and much better for the environment

Other types of cleaners

Bleach and ammonia when used correctly these are effective at removing spore building mould and mildew (but should never be used together). Some specialist products that contain bleach are also useful for sterilising toys, baby bottles, cups and kitchen utensils.

Multi-purpose cleaners as the name implies, can be used on many different surfaces. There is no 'standard' set of ingredients in these but they can typically act as a disinfectant, detergent, degreaser, descaler and solvent, all helping to reduce risk of cross contamination.

Odour Neutralisers contain enzymes that, when used regularly, will absorb the odour caused by bacteria build up, especially effective on urine, food deposits and stains.

Heavy duty cleaners such as oven cleaners will remove stubborn residues which could contain bugs and germs, and should be used regularly, always with the correct PPE due to the higher strength of chemicals.

NOTE: Whichever product you choose, make sure you read the label and check its suitability for the task, especially if you require it to be food safe.

Cleaning the cleaning equipment

Germs build up quickly on janitorial cloths, equipment and utensils. Without properly cleaning them before reusing, germs will quickly spread onto any surface they touch. Decontaminate these items regularly.

Reusable cleaning cloths

Decontaminate cloths after each use and at least once a day, by rinsing them in detergent and hot water, and then either:

• Immersing them in boiling water for minimum 2 minutes
• Putting them through the dishwasher or washing machine on a hot wash (at least 60°C)
• Soaking them in a suitable disinfectant, then rinsing them with clean water

Mops

These should have a detachable head that you can machine wash after use. Alternatively, you can clean mop heads with hot water and detergent in a designated sink, rinse them with disinfectant, then wring them as dry as possible. Mops should be stored head up or hanging, so it does not come into contact with the floor whilst drying.

Vacuum cleaners

need to be cleaned regularly by:

• Cleaning any removable parts, following the manufacturer's guidelines for wet or dry cleaning.
• Replacing the bag (or if bag-less - emptying and washing the canister) when it is 2/3 full.
• Washing and cleaning any reusable filters and allowing them to dry. Replace non-reusable filters every 3 months.
• Cleaning brush rollers to remove any items that have wrapped around or are trapped within the head.

Do

• Dry cloths and cleaning utensils rapidly after decontaminating them
• Store mops head up or hanging
• Adhere to COSHH regulations when using cleaning products and disinfectants
• Follow the instructions for using cleaning products and disinfectants
• Wear appropriate protective clothing (e.g. gloves and aprons)
• Wash and dry your hands thoroughly after each cleaning task

Don't

• Use mops to clean blood or body fluid spills
• Use cloths and cleaning utensils from the kitchen to clean toilets and washrooms
• Clean mops and cleaning utensils in a sink used for food preparation
• Leave cloths and cleaning utensils soaking in dirty water

Other areas to think about

Kitchen drawers, chopping boards, storage cupboards and containers, fridges and freezers, washing machines and dishwashers, toys, rugs and mats, door handles, dispensers including water dispensers, computer keyboards and the office environment, baby changing units, etc.

4Cs of food hygiene

Most germs are picked up as a direct result of poor kitchen hygiene, with germs from raw foods being transferred to kitchen surfaces or other foods whilst preparing meals, or food not being cooked properly. By following the 4Cs of food safety (Cross-Contamination, Cleaning, Cooking and Chilling) you can reduce the risks.

Cross contamination

• Wash your hands with soap and clean water or an antibacterial hand wash before touching food and immediately after handling raw food (e.g. meat, eggs), handling refuse or bins, or going to the toilet
• Disinfect all surfaces immediately after preparing food - ensure you use a 'food-safe' product
• Using colour-coded chopping boards for raw, cooked and ready-to-eat foods - see our recommendations (right)
• Keep different food items in separate, sealed containers to stop germs spreading from one to another
• Always store and prepare raw food away from cooked and ready-to-eat foods

Cleaning

• Make sure all utensils and equipment are spotlessly clean and sterilised if required, before using
• Regularly clean and disinfect items that are often touched, such as taps, cupboard handles and switches
• Clean all food preparation surfaces with surface disinfectant spray or wipes immediately before and after use. For direct food contact surfaces, rinse thoroughly with water after cleaning

Cooking

Heating and cooking meat thoroughly kills bacteria. To check your meat is cooked sufficiently, insert a knife into the thickest part – there should be no sign of pink meat and any juices should run clear. When reheating food, make sure it is steaming hot all the way through, and never reheat food more than once. If re-heating from frozen, ensure you do so within 24 hours of the food being defrosted.

Chilling

Keeping foods cool (0–5°C) or frozen slows the growth of bacteria. Always check the storage instructions and 'use by' date on your food's packaging. If you have any leftovers, cover and store them in your fridge or freezer within two hours of cooking, making sure they have completely cooled first.

Top tip

We stock a variety of food safety labels to help sign-post food use by dates.

Colour coded boards & knives

• RED - Raw meat
• BLUE - Raw fish
• YELLOW - Cooked meat
• GREEN - Salad & fruit
• BROWN - Vegetables
• WHITE - Bakery & dairy
• PURPLE - Allergens

Hand hygiene part 1 hand washing

Hand hygiene is universally accepted as the single most important way to stop the spread of infections and outbreaks. However, hardly anyone does this properly, so whilst it may seem like a daily task you may not think too much about - here's how you should be training your staff to do it effectively, in order to stop the spread of germs and diseases.

Dealing with Norovirus

This deadly super-bug is most commonly spread by coming in contact with faecal matter, which means it lives in laundry, in food touched by poorly washed hands, and even in the air when a toilet is flushed. Proper hand washing is the most effective means of staying healthy, according to the Centres for Disease Control (CDC). The problem is that most people don't wash their hands well enough to kill Norovirus.

This is the NHS National Patient Safety Agency recommended way to clean hands.

Hand hygiene part 2 hand rubbing

Effective hand sanitisers only work properly on visibly clean hands, can kill up to 99.999% of common germs. It is important to remember that they have little effect on certain viruses (e.g. Norovirus).

The importance of keeping bugs at bay

Keeping clean means your immune system doesn't have to work so hard to keep you healthy. But for some it's not that easy, for example it could be that they are unable to wash due to ill health, be too immobile, or suffer with depression or low self-esteem, physical impairment or perhaps they are a child and don't know how to clean themselves.

So what should you do?

Keeping clean - the basics

To keep someone you 'care' for clean make sure they:

• Wash their hands after going to the toilet
• Wash their genital area every day
• Wash their face every day - preferably morning and evening
• Have a bath or shower at least twice a week
• Brush their teeth twice a day

Helping someone to wash and bath

If you're working in a Care Home, when helping someone to wash, be sensitive and try to maintain their dignity. Talk to them about any routine they had before you started caring for them. Ask them how they would prefer to be helped and allow them as much independence as possible. Below are some extra things to think about:

• Use a pleasant-smelling shampoo, bubble bath or soap, ask if they have a favourite
• If the person you're washing is confused, explain what's happening as you go along
• Be sensitive to their mood, they might be frightened of deep water or not like showers
• Be conscious that many people don't like getting undressed in front of others, provide dignity cover if need be
• Be prepared, have everything to hand before starting, towels, clothes, soap, shampoo, moisturiser etc
• Don't rush the washing process, allow time to do it properly, carefully and sensitively

What products can help?

There are a number of products available to help you:

Antibacterial soap -Ensure it has skin emollients to keep skin moisturised
Disposable wash gloves - Look for a single-use product
Dry wipes - Suitable for frequent washing and drying, and in a range of sizes
Wet wipes - Look for one that is dermatologically tested and alcohol free
Barrier cloths - Specially designed to offer cleansing, moisturising and soothing, protecting all in one
Bed bath wipes - These can be used hot or cold and have a quick drying formula
Rinse free shampoo caps - Requires no additional equipment or water