As part of the Health and Social Care Act 2008, Care Quality Commission (CQC) registration requires care home providers to comply with essential standards of quality and safety. This includes the need to protect those who may be at risk of exposure to infections and in so doing requires an effective cleaning regime.
National cleanliness specifications provide a framework for providers of care homes to demonstrate to the CQC how they ensure their premises are clean and safe and meet the required standards.
Good infection prevention and control are essential to ensure that people who use health and social care services receive safe and effective care. Effective prevention and control of infection must be part of everyday practice and be applied consistently by everyone.
Since 2001 for hospitals, and 2009 for ambulance trusts, a national specification for cleanliness has been available. These non-mandatory documents are designed to assist providers in ensuring their cleaning services address infection risks and provide a cleaning service which meets the required standards. They have been widely adopted – either in full or in principle – and now these national specifications for cleanliness guidance and best measuring performance outcomes is applicable to care homes.
Let’s look at the issues relating to floors and the maintenance of the equipment used in care homes to keep floors clean.
The majority of workplace injuries are as a result of slips, trips and falls so particular attention should be paid to ways of preventing them.
It is important that floor coverings are appropriate to the environment but, where possible, slip-resistant surfaces are advisable. In addition, flat floor surfaces that are free from obstructions will help to reduce the likelihood of such accidents.
A system to minimise the amount of wet floor area and warning signs should be used when washing hard floor surfaces.
Holes and defects in floor coverings should be repaired promptly, particularly those on staircases. Where immediate repair cannot be made, it may be necessary to prevent people passing through the area by cordoning it off.
Slips are the main cause of accidents in kitchens. A slip-resistant floor surface should be provided in kitchens and serveries. The floor should be in a good condition and kept clean. Spillages should be cleaned up immediately and warning signs displayed.
Key cleanliness targets and frequency of floor cleaning
The complete floor including all edges, corners and main floor spaces should be visibly clean with no blood and body substances, dust, dirt, debris, spillages or scuff marks.
Dust removal (vacuum clean or dry flat mop) one full clean daily and one check clean daily.
Wet mop one full clean daily and one check clean daily.
Machine clean hard floors weekly or more frequently if required for a thorough clean and sanitisation.
(i.e. carpets, rugs and matting)
The complete floor including all edges and corners should be visibly clean with no blood and body substances, dust, dirt, debris or spillages.
Floors should have a uniform appearance and an even colour with no stains or watermarks.
Dust removal (e.g. vacuum cleaning) one full clean daily and one check clean daily.
Complete shampoo six-monthly, and ad-hoc when required to remove spills, stains and accidental soiling.
Cleaning equipment should be visibly clean with no blood and body substances, dust, dirt, debris or moisture.
The cleaning equipment that is regularly used should be fit for purpose, easy-to-use and well-maintained. It is imperative that each healthcare provider regularly reviews its cleaning equipment to ensure that it is fit for purpose and, importantly, can demonstrate that it has clear infection control benefits.
Vacuum cleaners with HEPA filtration, carpet extraction cleaners used with appropriate carpet cleaning chemicals*, steam cleaners and floor scrubbers / scrubber driers for effective hard floor cleaning are recommended for use in all care homes.
*e.g. Prochem Neutra-Soft which is developed exclusively for the healthcare market and is an all-in-one extraction cleaner, urine neutraliser, deodoriser and rinse agent.