Foyle Hospice partially compliant with hygiene standards

But staff were also praised for their work and standards in a number of areas.

Inspectors conducted a surprise survey of the Culmore Road facility on November 24, 2010, looking at the general environment, the handling of linen, waste and sharps, patient equipment, hand hygiene, kitchens and clinical practice and found that there was room for improvement in the majority of areas.

In terms of environment and facilities the Hospice was deemed partially compliant. The reception and main entrance lounge had a “welcoming atmosphere and was in good decorative order” but there was “minor wall damage at the nurses’ station, the edges of formica covered shelving throughout the unit were worn, compromising the cleaning process, and there was minor door damage.”

There were also stains and a build up of dirt in parts of the communal bathroom area and the inspectors noted that in the clinical room and clean store the outside of the drugs trolley was rusty and there were worn sticky labels on shelving, compromising the cleaning process.

Elsewhere, the ‘dirty utility room’ was in poor decorative order and had wall damage. The domestic sluice store was also in poor decorative order and the inspectors noted that domestic staff were using Hycolin - a product removed from general use since September 2006 as it contained active substances which, as part of the Biocidals Products Directive review, cannot be placed on the EU market or stored for any purpose (except export and disposal).

The Hospice was also found to be partially compliant with hygiene standards when it came to the handling of linen.

However, staff were praised by the inspectors for achieving compliance in waste handling.

“Staff are commended for their hard work and commitment to safe practice when handling and disposing of waste,” the report states.

“Two issues that were observed and, if addressed, would improve scoring were that the underside of some waste bin lids were dirty and that prescription medication bottles were disposed of into a yellow lidded burn bin, used for ‘free fluids’ rather than a black lidded burn bin designated for pharmaceutical waste.

“Staff stated that this practice was advised by the local trust infection prevention and control team, clarification on this practice is advised,” it adds.

The facility was also scored partially compliant under the patient equipment section of the audit.

This was because cleaning schedules - although available for both nursing and domestic staff - did not detail all areas within the environment or all equipment used by nursing staff that required cleaning.

Compliance was achieved under the category of hand hygiene and staff were again “commended for their hard work and commitment to good hand hygiene practices and for the posters on display to encourage visitors, patients and staff to wash their hands.”

However: “Inspectors observed that the clinical sink in the clinical room did not conform to HTM 64 as it had a plug and overflow present and that the taps were wrist operated rather than sensor operated or automated. At the feedback session management advised that these issues were currently under review.”

Partial compliance was once again the rating achieved for the kitchens due to an observation that “the flooring at the edges and corners were worn, with debris present, the dishwasher frame required cleaning and the microwave tray in the ward pantry, used to heat patients’ food, was stained.”

Furthermore, the storage of foodstuff, e.g. flour, in unlabelled sealed plastic containers meant the contents or expiry dates could not be easily determined.

“An additional observation was that kitchen staff were diluting milton into a container and using it along with reusable cloths for cleaning surfaces.

“This process promotes contamination of the milton solution. Cloths were steeped in milton after use and prior to laundering.

“It is advised that a review of the cleaning solution in use is carried out to prevent contamination and that cloths are laundered immediately after use or disposable cloths are used,” it adds.

A staff commendation was also achieved for clinical practice at the Hospice.

“Staff are commended for their hard work in the safe delivery of patient care and for liaising with the local trusts infection prevention and control team for advice if required,” the inspectors stated.

A number of additional observations were made by the inspectors. Three different styles of commodes were noted to be in use as was a dusty plant room.

And whilst staff were observed diligently steeping mops in water prior to washing the inspectors thought this practice unnecessary as the ordinary washing process removes debris present.

The inspectors also noted that kitchen staff were diluting milton into a container and using it along with reusable cloths for cleaning surfaces; this process promotes contamination of the milton solution.

It was advised that there is a review of the types of gloves in use within the unit to ensure staff are using the correct gloves, with the correct protection for all care activities.

Notwithstanding these concerns a number of good practices were also noted.

There was proactive infection prevention with a control link nurse currently updating the infection control and decontamination policies.

Infection prevention and control audits were also carried out to monitor and improve practices and there was regular staff training on infection prevention and control carried out for all disciplines of staff.

Personal protective equipment was also located throughout the facility.

Following the inspection the Foyle Hospice was expected to develop an improvement plan to ensure appropriate steps were taken to address each point of non-compliance.