INFECTION CONTROL MANUAL Chapter 8
Ward kitchen hygiene
Recommending Committee:
Hospital Control of Infection Committee
Approving Committee:
Clinical Performance Council
Signature: Designation:
Chairman Clinical Performance Council
Date:
1 August 2008
Version Number:
06
Review Date:
1 July 2011
Responsible Officer:
Outcome Level Equality Impact Assessment
(high, medium, low)
Low Review date July 2011
Director of Infection Prevention & Control
St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
Document history Version 1
1990
Version 2
July 1994
Version 3
1st September 2000
Version 4
1st September 2003
Version 5
1st September 2006
Version 6
1st August 2008
Review date
1st July 2011
Location of document: All wards and departments (for information purposes)
Issue Date: 1st August 2008
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
INDEX Page Introduction
4
Responsibilities
4
Training requirements
4
Personal hygiene practices
5
Ward staff practices
5
Correct storage/refrigerator Refrigerator Ice machines Cupboards
6
Food service Additional meal request Complaints
7
Beverages from drinks trolleys
7
Crockery/cutlery
8
Disposal of waste
8
Maintenance
8
Pest control
8
Use of microwaves
9
Monitoring of standards
9
Glossary of terms
9
Appendices A Training requirements for food handlers at ward level B 10 point code for food handlers C Hygiene awareness instruction
10 11 12
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
Ward kitchen hygiene policy 1.
Introduction Good hygiene and food safety practices and informed staff are vital in the preparation, storage, distribution and service of food. These matters are of particular importance in hospital catering because patients may have less resistance to infection from contaminated food. The NHS and all food handlers have a legal obligation to comply with the provisions and requirements of the food legislation. The Hygiene Policy for Ward Kitchens has been designed to ensure Food Hygiene legislation is met. Therefore, it is important that the Policy is adhered to.
2.
Responsibilities 2.1
It is the responsibility of the Ward Manager to ensure that food handling and the day-to-day standards conform to the Food Safety (General Food Hygiene) Regulations 1995 and the Food Safety Act 1990. This legislation is part of the ward operational policies and procedures. Copies of the legislation are available from the catering department.
2.2
The Ward Manager is accountable for ensuring hygiene standards are strictly adhered to and any corrective action is taken.
2.3
Ward kitchens are used for food service, the preparation of snacks, beverages and washing up. To ensure the highest standards of hygiene are maintained, all staff using the kitchen must comply with the legal requirements outlined above.
2.4
All staff involved with the service of food/beverages to patients need to be constantly aware of the importance of: i. ii. iii.
3.
good food hygiene practice preventing the spread of infection via food high standards of personal hygiene
Training Requirements 3.1.
All food handlers, as part of their induction, will have received the appropriate training (see Appendix A).
3.2
It is the responsibility of Ward Managers to ensure that only appropriately trained ward staff handle food/beverages.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
4.
5.
Personal hygiene practices 4.1
All food handlers should observe the personal hygiene rules and wear clean, protective clothing. A clean disposable apron must be worn during the serving of meals and beverages.
4.2
Each ward kitchen must be provided with a wash hand basin, liquid soap, paper towels and a foot operated pedal bin. The bin must be lined with a black, not yellow, plastic bag. Wash hand basins must not be used for any other purpose than hand washing.
4.3
Food handlers must always wash and dry their hands thoroughly before and after handling food, preparing drinks, after handling waste, after cleaning duties and after visiting the toilet. Fingernails must be kept short and clean. Nail varnish, acrylic nails or nail art must not be worn.
4.4
All food handlers involved in regenerating food must wear a hair net and hat. Food handlers involved only in the service of food of patients, must wear their hair tied back.
4.5
Cuts, burns and sores must be covered with a blue waterproof dressing. Persons with boils or septic cuts must not handle food, and must report to the Ward Manager and be referred to the Occupational Health Department.
Ward staff practices 5.1
Access to ward kitchens must be controlled by the person in charge of the ward. A notice should be placed at the entrance to the ward kitchen stating AUTHORISED PERSONNEL ONLY. The door must be kept closed.
5.2
Ward staff must not consume any type of food or drink intended for patients (including meals and ward provisions).
5.3
Smoking in the ward kitchens is not allowed.
5.4
Ward staff must never sit on worktops in ward kitchens.
5.5
Food handlers must never wear cardigans when handling or serving food.
5.6.
Ward kitchen area must not be used as a rest room facility, and, therefore, only appropriate kitchen equipment should be provided.
5.7.
All surfaces must be kept clean, even difficult to reach areas e.g. under the microwave as remnants of food will attract pests e.g. cockroaches, ants etc. Use a disposable cloth, hot water and detergent to clean surfaces.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
6.
Correct storage/refrigerator 6.1
Refrigerator 6.1.1 A notice on the refrigerator door will state FOOD ONLY. Medical products must never be stored in the ward kitchen refrigerator. 6.1.2 Unauthorised persons must not be allowed access to the refrigerator. 6.1.3 Any food item belonging to a patient which requires refrigeration should be stored in the refrigerator in a sealed container, clearly labelled stating the patient’s name and the date the food was brought into the hospital. If the product is not consumed within 24 hours, it must be disposed of by ward staff. 6.1.4 Temperatures of ward refrigerators must be checked daily at lunchtime and suppertime, by Hotel Services Staff, to ensure they are maintaining temperatures of between 1oC and 4oC. These temperatures will be recorded on the Ward Food Service Control Sheet. Where temperatures are above 5oC, this must be brought to the attention of the Assistant Hotel Services Manager (Catering). 6.1.5 Ward refrigerators will be cleaned externally on a daily basis, and internally on a weekly basis, by the Ward Housekeeper or Hotel Services staff. Any spot spillages will be removed as necessary by the Ward Housekeeper or Hotel Services staff. The refrigerators have an automatic defrost cycle. 6.1.6 Out-of-date food items will be removed for immediate disposal by ward staff. 6.1.7 The Ward Manager should pay particular attention to the use by date of liquid feeds. They should be kept no longer than 24 hours after opening or preparation. 6.1.8 The purchase of a refrigerator for ward use should meet the agreed Trust’s specification for the purchase of a ward refrigerator (available from Purchasing and Supply Department).
6.2
Ice machines 6.2.1 Ice machines are to be cleaned weekly by the Ward Housekeeper or Hotel Services Staff.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
6.2.2 Ice should only be handled using the scoop provided. The scoop should be cleaned with hot water and detergent, rinsed and left in a clean, dry uncovered container after each use. The scoop must not be left in the ice machine. 6.2.3 Unused ice must not be returned to the ice storage chest. 6.2.3 Food or drinks must not be stored amongst ice. 6.2.5 Access doors to the ice chest, except when removing ice, must be closed at all times. 6.2.6 The purchasing of an ice machine for ward use should meet the agreed Trust’s specification for the purchasing of ice machines (available from Purchasing and Supply Department). 6.3
Cupboards 6.3.1 All dried food, e.g. cereals, powders, biscuits etc, should be stored in airtight, pest proof containers, clearly marked with the use by date, once the original packet has been opened. These containers should be washed and dried regularly by Ward staff. The contents should be completely used up before refilling. 6.3.2 Ward staff should check expiry dates on all dried food items at least weekly. Out of date items must be disposed of, and the Supplies department informed.
7.
8.
Food service 7.1
Additional meal request If a meal is required for a patient at a time other than the appointed mealtime, arrangements should be made by contacting the Catering department. Meals must not be kept in a ward kitchen.
7.2
Complaints If food is found to be unacceptable, this should be reported immediately to the Catering department, who will take the necessary action.
Beverages from drinks trolleys 8.1
Where drinks trolleys which dispense beverages into cups are used, the cup holders should be washed daily, and the water tank must be emptied and filled daily by Hotel Services staff.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
9.
10.
8.2
Beverage trolleys should be cleaned daily by the Ward Housekeeper or Hotel Services staff and any spillages wiped up as they occur, by ward staff.
8.3.
Water supply – Any water suitable for drinking must be identified as “Drinking Water”.
8.4
Patients must not be provided with water from bottled water dispensers.
Crockery/Cutlery 9.1
Chipped or cracked crockery should be marked/identified and returned to the Catering department for disposal. All staff who are involved in using crockery are responsible for this action.
9.2
After each meal service, crockery and cutlery must be returned to the Catering department for central dishwashing.
9.3
Isolated patients do not require disposable crockery or cutlery, unless on the advice on the Infection Control Team.
9.4
Any breakages must be reported to the Catering department so that stocks can be replenished.
Disposal of waste All left over food, whether used or unused, must be discarded in the receptacle provided in the ward kitchen. The left over food will be returned to the Catering department for disposal after each meal service. Only food products should be disposed of and returned to the Catering department. Ward staff must follow Trust’s procedures for the disposal of all other waste.
11.
Maintenance Any member of staff discovering defects or faults of ward kitchen equipment must report these to the Ward Manager who will take the appropriate action with the Maintenance Department. It is expected that the Maintenance Department will instigate the appropriate action within seven working days. Defective regeneration equipment will be reported by Catering staff to the Catering department.
12.
Pest control 12.1
Any pest sightings or other evidence of infestation should be reported to the Ward Manager for immediate action.
12.2
Staff must not feed birds or animals.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
13.
14.
Use of microwaves 13.1
Microwaves must not be used for cooking any type of patient’s own food.
13.2
If microwaves are used by ward staff, then the operator of the microwave has the responsibility to follow the instructions laid down in the Trust’s “Microwave Oven Policy”.
13.3
The microwave oven must be kept clean by ward staff. Food spillages/splashes must be wiped up after each use, including the wave guide cover on the ceiling. It is easier to wipe up spillages when they are fresh. Once dried on they are more difficult to clean. In addition, if grease is left on the wave guide cover on the ceiling, it may overheat next time the oven is used, and start to smoke or even catch fire.
Monitoring of standards 14.1
15.
The Ward Manager is responsible for checking on a daily basis that the standards within this policy are maintained.
Glossary of terms Food handler
=
Any person involved in handling or preparing food (NB: food includes drinks and ice)
Ward staff
=
Any member of the nursing team
Hotel Services Staff
=
Either a Domestic, Catering Assistant or Porter. (i.e. ex Support Services Staff)
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
APPENDIX A TRAINING REQUIREMENTS FOR FOOD HANDLERS AT WARD LEVEL CATEGORY OF STAFF
STAGE 1
STAGE 2
STAGE 3
STAGE 4
Ward Manager/Sister
Nursing staff
Catering assistants
Domestic assistants
STAGE 1 (Induction) 10 point code for Food Handlers (Ref: Hygiene Policy for Ward Kitchens Appendix B) STAGE 2 (Induction Hygiene Policy for Ward Kitchens STAGE 3 (within 8 weeks) Hygiene awareness instruction STAGE 4 (within 3 months) Formal training (preferably certificated Basic Food Hygiene Course or equivalent)
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
APPENDIX B 10 POINT CODE FOR FOOD HANDLERS 1.
Access to ward kitchens must be controlled and limited by the person in charge of the ward.
2.
Smoking in the ward kitchen is not allowed.
3.
Staff must always wash and dry their hands thoroughly before handling any food.
4.
Any left over food must be discarded in the appropriate receptacle.
5.
If a meal is required for a patient at a time other than the appointed mealtime, arrangements should be made by contacting the Catering department. Meals must not be kept in the kitchen.
6.
The refrigerator must be used for storage of food items only. Medical products must not be stored in the ward kitchen refrigerator.
7.
Keep yourself clean and wear clean clothing. Report any skin, nose, throat, stomach or bowel infections and cover cuts and sores with blue waterproof dressings.
8.
Any food stored in the refrigerator must be sealed and labelled with the patient’s name and the date the food was brought into the hospital, and disposed of after 24 hours.
9.
Temperatures of refrigerators should be checked at lunch and supper services by Hotel Services staff (Catering) and recorded.
10.
Potted plants must not be left in ward kitchen areas.
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St Helens & Knowsley Teaching Hospitals NHS Trust - Infection Control Manual - Chapter 8 - Ward kitchen hygiene – Version 6
APPENDIX C HYGIENE AWARENESS INSTRUCTION The overall aim is to develop knowledge of the basic principles of food hygiene. The topics covered should be specific to the job of the individuals, and may include: •
The ward’s policy and staff responsibilities with priority being given to food hygiene.
•
“Germs” – the potential to cause illness
•
Personal health and hygiene – the need for high standards, reporting illness, rules on smoking.
•
Cross contamination – causes and prevention
•
Food storage – protection and temperature control
•
Waste disposal, cleaning and disinfection
•
Awareness of pests
The depth, breadth and duration of the training will be dependent upon the particular job requirement and the degree of risk involved in the activity.
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