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GWASANAETHAU IECHYD A DIOGELWCH HEALTH AND SAFETY SERVICES
Gwasanaethau Iechyd a Diogelwch – Health and Safety Services, Penbre, Lon y Coleg. LL57 2DG Tel:
01248 38-3847
Ebost: [email protected] Email: [email protected] Fax: 38-3259
www.bangor.ac.uk/hss
TIR NA N-OG
Internal Audit of Infection Control Procedures
Report of the Health and Safety Audit of Infection Control Procedures at the University Nursery, Tir Na n-Og. The Audit followed a set audit criteria and included a site visit to inspect activities and facilities pertaining to infection control.
Internal Audits of Infection Control Procedures are undertaken to confirm the facility continues to operate at a very high standard, ensuring as far as is possible the safety and health of children and staff.
JANUARY 2013
Internal Audit of Infection Control Procedures Report – January 2013
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INDEX OF CONTENT
Ref
1.
2
3.
4.
5.
6.
7.
8.
9.
Executive Summary
Scope of Review
Exclusions
Background
Methodology
Acknowledgement
Follow-up Action and Review
Audit Checklist
Appendices
Page
2
2
3
3
3
3
3
4
14
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1. EXECUTIVE SUMMARY
The Internal Audit found that staff have a good understanding of infection control procedures and
standards were found to be either good or very good in most areas. There are good management
systems and procedures in place to control risks and regular inspections are undertaken to confirm
standards.
Following last year‟s E.coli incident a number of structural and procedural improvements have occurred; for
example, the installation of additional hand wash sinks and a sluice area which greatly improved the
Nursery‟s ability to manage infection risks. Also, following the incident a number of tasks are no longer the
responsibility of the Nursery, for example, washing soiled nappies and clothes enhancing infection control
procedures.
A number of general and specific concerns or recommendations were noted during the Audit and Nursery
staff also raised a few issues; including, questioning the practicalities of implementing some of the recently
revised procedures and seeking clarification as to how some procedures should operate. However these
should be viewed positively as it highlights, infection control and the lessons learned by the outbreak remain
very much in the forefront of the mind.
Some minor structural improvements are still outstanding and a small number of procedures need
developing and tightening-up, for example interim arrangements for the disposal of “bagged” used nappies
pending transfer to the Sluice Room or Nappy Room nappy waste bins.
Members of staff visually demonstrated that they are implementing good infection control practices and all
areas inspected were found to be clean.
Management systems operated within the Nursery revolve around the Nursery Manager and local
Supervisors. Central documentation, policies and procedures are good, with a tailored Staff Handbook
produced covering key aspects inspection control; it is said that this Handbook is used for all staff and Work-
Placement Inductions.
The kitchen area and kitchen practices with regards to food handling and preparation were not inspected as
part of this Audit. Gwynedd Council‟s Public Protection Department (Environmental Health) is due to
inspect the kitchen soon and will report accordingly.
The Audit pack used during this inspection was developed originally by Health Protection Agency
(Southwest London Unit), and reflects the Audit Pack to be introduced across north Wales in 2013.
2. SCOPE OF REVIEW
The Internal Audit focused on Nursery infection control arrangements and related management
documentation. It included:
i. Structural Arrangements: Infection control provisions, eg. hand wash, toileting, nappy changing,
laundry, kitchen, dining/eating facilities.
ii. Written Procedures: Revised and / or new procedures as per Public Health Wales recommendations.
iii. Local Working Practices: Use of disposable gloves and aprons, cleaning and disinfectant regimes,
understanding of written procedures.
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3. EXCLUSIONS
The After School Centre and food preparation within the Nursery‟s kitchen are not included within this
Internal Audit. Kitchens and food safety are inspected by Gwynedd Council‟s Public Protection Department
(Environmental Health).
General Health and Safety practices and controls, outside of infection control, were not considered as a part
of the Audit unless items arose during the inspections.
4. BACKGROUND
Robust infection control measures are essential in any environment and particularly in a Nursery/Child-care
setting as these contain a large number of young, vulnerable children sharing the space and “swapping
germs.”
Young children often become ill with stomach upsets, colds etc. and this is part of growing up and a process
the human body goes through to develop a healthy immune system. As the Nursery environment is used by
large numbers of children who are sharing toys etc and who will by nature put fingers and toys in their
mouths, more stringent infection control procedures than experienced in the home must be implemented.
These include observing good personal hygiene as well as regular cleaning and disinfection of surfaces
which people regularly come into contact with.
5. METHODOLOGY
Applicable management procedures were considered prior to the site visit and a number were tested, to some
extent, during the inspection of the Nursery facilities. Documentation considered included:
New / Revised Procedures, eg Nappy Changing, Toy Cleaning, Laundry Procedure.
Internal Inspections / Cleaning Record Sheets
The “Nursery Infection Control Audit Checklist” was used during the inspection element of the Internal
Audit. This document was predominantly completed during the inspection by a member of the HSS
Inspection Team.
Discussions were held with a range of Nursery staff in a „semi-formal‟ meeting setting and informally during
the „walk round‟ of the Nursery facilities to gauge their understanding of infection control procedures and to
discuss any concerns they might have regarding the practicalities of implementing the procedures on a day to
day basis.
The „walk round‟ inspection was undertaken to assess general Nursery cleanliness and housekeeping,
especially in those areas integral to infection control; hand wash, nappy changing, toileting and laundry
facilities.
6. ACKNOWLEDGEMENT
Gratitude is expressed to the Nursery staff for their assistance and time during the internal audit. Particular
gratitude is extended to the Nursery Manager, Head Chef and the Senior Nursery Nurse for their time and
support.
7. FOLLOW-UP ACTION AND REVIEW
The follow-up actions can be found on the next page which contains the completed Nursery Infection
Control Audit Checklist which was used during the inspection. Health and Safety Services will firstly
review progress against the actions within 6 months of publication and then annually thereafter.
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8. HEALTH AND SAFETY SERVICES
NURSERY INFECTION CONTROL AUDIT CHECKLIST
Date of Audit: 20th November 2012
Auditor’s: Gareth W Jones (Head of Health and Safety Services) / Suzanne Barnes (Health and Safety Support Officer)
Auditee’s: Susan Kennedy (Nursery Manager), Karen Williams (Senior Nursery Nurse)
1. HAND WASHING (to reduce risk of cross infection)
Hand / Hygiene Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Liquid soap, paper towels by
hand wash sinks (labelled)
Y All hand wash sinks in Children‟s toilet, Staff toilet, Nappy Changing Areas,
Kitchen, Play Room and Dining Room had suitable liquid soap & paper towels.
Hand wash sinks located in the baby room and the play room are used for
instructing / teaching children about hand washing techniques. These are also
used when a child‟s hands are soiled after painting or having played outside.
There was no soap dispenser by the baby hand wash sink in the Baby Room.
Place suitable, baby friendly, soap
by the children‟s hand wash sink in
the baby room.
Nursery
2 Sinks free from nail brushes
and bar soap
Y
3 Hot & cold water available
(preferably mixer taps)
Y Mixer / automatic temperature controlled taps installed in child accessible areas.
4 Hand washing poster on
display
Y The “poster” is included in the Staff Handbook. A small number of posters are
fixed, eg Sluice Room.
Posters are not suitable for children so requirement is only applicable for staff.
5 Sinks accessible, eg. no
equipment soaking
Y No equipment found in hand wash sinks during inspection
6 Sinks clean and tidy Y All sinks clean & tidy. The sinks in the Play Room were found to have paint
next to the taps, indicating paint brushes are cleaned in the sinks.
As sinks in Play Room are dedicated children‟s sinks and are used to not only
teach children about hand cleaning but also how to clean brushes and pots etc.
It is recommended one sink is used
for sundry items and the other is
kept for hand cleaning only. The
appropriateness of this
recommendation needs to be
considered by Nursery staff.
Nursery
7 Dedicated hand wash sinks for
use in toilet / nappy areas
Y All nappy changing areas have a dedicated hand wash sink (x4).
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8 Dedicated hand wash sinks for
use in play areas
Y See comment 1.6. Above. See comment 1.6. Above.
9 Dedicated hand wash sink in
kitchen / dining room
Y The sink is clean and tidy.
10 Children taught hand washing
& drying techniques
Y Integral part of what the Nursery the does.
2. NURSERY PRACTICES (reduce risk of cross infection to children etc, whilst protecting staff)
PPE Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Disposal gloves (non latex) /
aprons available
Y Disposable gloves and aprons located by nappy changing areas.
2 Different sizes of gloves
available
Y Only medium sized gloves were seen.
When training was undertaken on glove techniques 12 months ago a number of
staff required “small” gloves.
Provide disposable gloves in
different sizes. Nursery
3 Staff seen using / not using
PPE appropriately
Y Staff were observed changing nappies. Gloves, aprons changed as detailed in the
procedure.
4 Staff know how to use PPE eg
safe removal of gloves
Y Member of staff observed changing nappies with gloves removed and disposed of
correctly.
5 Staff know when to use PPE Y The staff spoken to clearly understood when they should wear and change PPE.
There was some confusion as to when an apron was needed in the kitchen.
Seek advice from Gwynedd
Council regarding when aprons are
required in this area.
Nursery
Staff Awareness Y / N EVIDENCE / COMMENT ACTION BY WHO
6 Nappy changing protocol –
procedure displayed
Y Procedure displayed by all nappy changing areas.
7 Handling blood spills (only
First Aiders treat) incl. cleaning
up
Y Staff are aware who the First Aiders are and where the First Aid Box is located.
A First Aid box was placed on the window sill in the children‟s toilets.
Move the First Aid Box to a more
suitable location. Nursery
8 Hand washing protocol (incl.
kitchen) - procedure displayed
Y The Hand Washing procedure is included in the Staff Handbook and was
displayed in some areas of the nursery.
9 How often to clean toys, store
until cleaned
Y Staff understood that toys should be cleaned regularly, especially if visibly
soiled. However, concern was expressed that the HPA‟s requirement to
machine soft toys daily at 60oC and larger / older children toys washed weekly
and /or after each child‟s use with water and detergent was unachievable (see
SOFT TOYS: After-use by children,
toys should be washed daily, with
toys that can‟t be washed stored in
laundry area until it can be washed.
Nursery
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Appendix 3).
LARGER / OLDER CHILDREN’S TOYS: Establish a rolling weekly
cleaning schedule for such items.
VISIBLY SOILED TOYS / TOYS
AWAITING CLEANING: Place in a
bin which is clearly marked as
„Toys Awaiting Cleaning‟.
Ensure documented procedure
reflects the above with procedure
communicated to staff.
10 Notifiable illnesses, type, what
to do - (chickenpox, d&v etc)
Y A procedure is in place with a summary included in the Staff Handbook.
11 Handling of different waste
streams – colour coding of bins
Y Staff were aware of which waste went in which internal and external bin. A
summary is included in the Staff Handbook.
When new bins are purchased
ensure written procedures are
amended and staff are informed if
bin colour coding changes.
Nursery
12 Cleaning requirement eg
kitchen, toilets
Y Staff were aware of cleaning requirements, with records kept of when cleaning
is undertaken. Summary included in Staff Handbook.
13 Toy cleaning (daily – soft,
weekly – hard)
N See 2.9 Above. See 2.9 Above.
14 Disinfectant use – which type
to use, how to use
Y Staff understood which disinfectant to use.
Staff queried the protocol for clearing large spills eg vomit on floor.
Remind staff of attached
disinfectant protocol. Nursery
15 Laundry protocol, ie. bag
children items, min temp 60oC
Not assessed at the time of the visit. Children‟s own soiled clothes / nappies are
now bagged and stored in the Sluice Area for collection by the parent.
16 First Aid (all blood injuries
handled by First Aider)
Y Staff are aware that only First Aiders may treat children. First Aid boxes are
available in the Baby Room, Back Baby Room and Play Room.
See 2.7 Above. Establish First Aid
Box checks to ensure contents
remain suitable and in date.
Nursery
17 Of „dirty‟ and „clean‟ areas Y Staff understood which Nursery areas are „clean‟ and „dirty‟.
18 That kitchen is cleaned
separately
Y Staff understood the kitchen has its own cleaning materials and regime. Chef
confirmed mops and other cleaning materials do not leave the kitchen and
therefore are not used elsewhere.
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3. NURSERY ENVIRONMENT (maintained)
General Environment Y / N EVIDENCE / COMMENT ACTION BY WHO
1 General areas clean and tidy Y All areas were very clean and tidy.
2 Equipment etc in good order
(repair system in place)
Y Nursery staff monitor the condition of equipment, disposing of unsafe items or
removing them from use until their repair.
3 Surfaces (eg chairs / tables)
impervious with wipeable
surfaces
Y Chairs / tables were impervious with wipeable surfaces.
BABY ROOM: There appears to be no daily disinfection regime for the gate
which is handled regularly by staff and children.
Disinfect the wooden gate and wipe
down daily. Nursery
4 High chairs / chairs / tables /
cots cleaned after use
Y It was noted that children in the Play Room currently/occasionally eat their
lunch at the same tables used for play activities.
In addition confusion was expressed regarding where water used during cleaning
could be obtained and disposed of ie cross contamination between „dirty‟ and
„clean‟ areas.
Confirm how tables are cleaned
before use for lunch. Confirm why
children eat in the Play Room & not
in the purpose built Dining Room.
Staff to be informed cleaning water
may be obtained from, and disposed
of down the „Sundry‟s Sink‟.
Nursery
Nursery
5 Sleep mattresses in good repair
and waterproof
Y Those observed were in good repair.
6 Sleep mattresses cleaned
between use and stored dry
Y Staff confirmed cleaning schedule verbally.
Toys Y / N EVIDENCE / COMMENT ACTION BY WHO
7 Toys generally in good
condition / stored tidily
Y Those seen were in good condition.
8 Water pools emptied daily &
washed (detergent) / dried
Not checked during audit. Requirement included in written procedures. Not checked during audit
9 Sandpit – every 4 weeks sand
sieved with tray disinfected
Not checked during audit. Requirement included in written procedures. Not checked during audit
10 Hard toys washed (hot water +
deter. or wipes) weekly / OD
N See 2.9 Above. See 2.9 Above.
11 Soft toys washed (60oC) daily /
OD
N See 2.9 Above. See 2.9 Above.
12 General toys – weekly (hot
water + deter. or wipes)
N See 2.9 Above. See 2.9 Above.
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13 Books wiped weekly with
disinfectant wipes / OD
N See 2.9 Above. See 2.9 Above.
14 Playdough replaced on day of
use
N Not checked during visit. Requirement included in written procedures.
15 External toys (cleaned if soiled) Y Staff clean external toys when soiled.
Toilets / nappy changing Y / N EVIDENCE / COMMENT ACTION BY WHO
16 Toilet fixtures and fittings
intact
Y The majority of the toilets (children‟s / staff) were in good working order.
One toilet had a broken toilet seat. Cistern lids are also loose and could pull off
and fall on a child.
Report faults to Estates Helpdesk
(reported by HSS on 21/11/2012).
TNN to confirm when completed.
HSS / Nursery
17 All toilet rolls are on holders /
in dispensers
Y
18 Changing mats are clean, intact
and on a flat surface
Y The mats were in good clean condition and are replaced regularly.
The mat in the children‟s toilets would not fit the base. Current mats are all
patterned, possibly hiding any discolouration/soiling.
Replace changing mats with plain
white ones which will make it
easier to spot soiling.
Nursery
19 Changing mats covered with
paper towels before each use
N Paper towel is no longer used due to problems with the towel slipping and
children trying to eat and / or grab the towel. The procedure has been amended.
For this system to work fully it is important that all nappy changing mats are
changed to a single light (white/light yellow) colour.
This procedure needs to be formally
reviewed by Nursery staff after 6
months and by April 2013 at the
latest. Advice from Public Health
Wales should be obtained if needed.
Nursery
20 Paper towels available for use
on mats
N Note: paper towels used for hand drying are available if needed. See above.
21 Bags available to bag nappies
before being placed in bin
Y
22 Baby wash sink clean and tidy Y The sink and surrounding area was clean. Terry nappies were stored in plastic
bags within a plastic bowl, to await collection by Parents/Guardians. This would
be a notable problem if the sinks were needed for cleaning a soiled child.
BACK BABY ROOM: Soiled nappy bags stored on the ledge by the nappy
changing area. This is not acceptable.
BABY ROOM: Soiled terry nappy / clothes bags stored in two bowls in the sink.
It was noted there are no hooks in the sluice area to hang bags containing terry
nappies awaiting collection by parents/guardians.
Double bag the soiled terry nappies
/ clothes with bagged items stored
for the minimum time possible in
the bowls before transferring to the
Sluice Area. Disinfect and wipe the
bowl before being placed back in
the sink.
Report need for hooks in Sluice
Area to Estates Helpdesk (reported
Nursery
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by HSS on 21/11/2012).
BACK BABY ROOM: Move
disposable glove boxes to the shelf
by the side of the nappy changing
area. Place a bowl on the ledge.
Double bag soiled nappies and
place bagged items in the bowl with
items held for the minimum time
possible (minutes not hours) before
transferring to the Baby Room
nappy bin or Sluice Area if waiting
collection by parent.
Disinfect and wipe the bowl before
being placed back on the ledge.
Nursery
23 Sluice area clean and tidy Y
24 Nappy bins clean, working Y All the bins are clean and pedal operated although they do break so staff have to
lift the bin lids with their hands.
Investigate purchase of pedal
operated „twist‟ nappy bins. Ensure
procedure and Staff Handbook
amended if bin colours change.
Nursery
25 Disinfectant available to clean
toilets / nappy areas
Y Labelled spray bottles were available in relevant areas. Nominate specific staff to monitor
bottles and prepare disinfectant
solution as required.
Nursery
26 Hand wash sinks for staff
(liquid soap / paper towels)
Y
27 Toilets / urinals / hand wash
basins clean (children / staff)
Y
28 Potties dedicated for one
child‟s use only
Y The Nursery rarely potty trains but a potty will be dedicated for one child‟s use
if needed. Potty Training procedure is in place if required.
4. CLEANING (suitable without risk of cross contamination)
Cleaning Regime Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Cleaning programme in place Y Daily and Weekly cleaning schedules are established for each Nursery area.
Staff must sign a Record Sheet to confirm the tasks have been undertaken.
Monitor record sheets to ensure
tasks are completed. Nursery
2 Carpets vacuumed daily (steam N The carpets are vacuumed daily but not steam cleaned every two months. Arrange for carpets to be steam Nursery
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cleaned every two months) through industrial steam or high
temperature clean every 2 months.
3 Vinyl floors washed daily Y See 4.1 above. See 4.1 above.
4 Dirty areas 3x a day with cloths
(disposable) / dedicated mop
Y See 4.1 above. See 4.1 above.
5 Clean areas cleaned daily with
cloths, dedicated mop
Y See 4.1 above. See 4.1 above.
6 Kitchen cleaned daily with
cloths, dedicated mop
Y See 4.1 above. See 4.1 above.
7 Kitchen / toilet / bathroom
equipment identifiable
Y The Kitchen has its own cleaning equipment. A sign is displayed on the
cleaner‟s cupboard to indicate the colour coding to be used for cleaning
equipment with equipment to be used in the toilet clearly marked.
8 Mop heads machine washed
daily & hung dry
Y The cleaner washes mop heads used in dirty areas at the end of the day.
9 Buckets cleaned, dried &
inverted after use
Y The bucket in the cleaner‟s cupboard was not inverted but appeared to be dried.
10 Kitchen cloths / mop heads
washed and stored separately
Y Kitchen staff are responsible for washing their own mop heads which are then
stored in the kitchen.
11 Cleaning water used in „dirty‟
areas disposed in sluice sink
Y
12 Bins cleaned weekly / visibly
soiled with disposable cloths
Y The bins were clean on the outside. See 4.1 above.
5. WASTE (safe disposal without risk of contamination / risk of injury)
Waste Management Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Working foot operated bins
available by hand wash sinks
Y
2 System to identify bin waste
stream eg colour / labelled
Y The following system is used; blue = general, red = clinical, yellow external =
clinical.
Ensure relevant procedures are
amended and staff informed if new
bins are purchased and colour
coding changes.
Nursery
3 Yellow clinical waste bags
available / used
Y
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4 Clinical waste and domestic
waste correctly segregated
Y
5 Waste bags less than ¾ full and
securely tied
Y
6 Clinical waste stored in correct
area prior to disposal
Y Nappies remain in nappy bins until bagged and taken to external clinical waste
bin. Comments were made that the nappy bins can smell as they wait until they
are quite full before taking to the external clinical waste bin.
Transfer bin bags to the external
clinical waste bin more frequently.
Contact PHS to arrange for charges
to be per collection and not per bag
(PHS charges sent by email 19th
July, 7th
August, and 20th Nov
2012).
Nursery
7 Clinical waste storage area
marked with biohazard sign
Y Sign is displayed on the bin on the opposite side to the path. Display clinical waste sign on the
front „path side‟ of the bin. Nursery
8 Waste collected regularly –
external bin area tidy
Y Domestic waste and clinical waste is collected regularly by licensed waste
carriers.
9 Bins clean outside / inside? Y See 4.1 above. See 4.1 above.
6. DISINFECTION (available / used correctly to negate the risk of infection)
Disinfectants and detergents Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Disinfectants - available for
different tasks
Y Spray bottles with disinfectant solution available in dirty areas. Other cleaning
products available in cleaner‟s cupboard. BS EN 1276:1997 or BS EN
13697:2001 for kitchen / body fluids.
See 3.25 above.
2 Products stored in a locked
cupboard when not in use
Y Spray bottles not locked in cupboard but they are stored out of reach of children.
3 Risk assessments / data sheets
available
Y Data Sheet available for disinfectant.
4 Training, instruction provided
on safe use
Y Information Sheet available on the safe use of disinfectant.
5 PPE provided for use when
cleaning
Y Disposable gloves and aprons available.
6 Trigger spray bottles labelled
with substance
Y
7 Trigger spray bottles kept out Y
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of reach of children
7. LAUNDRY (handled to prevent cross contamination)
Laundry Management Y / N EVIDENCE / COMMENT ACTION BY WHO
1 Laundry area – clean, tidy Y The area is quite cluttered.
Identify equipment that is no longer
used / rarely used and either dispose
of or store elsewhere.
Nursery
2 Clean & dirty washing
segregated
Y Colour coded labelled bins in place for clean and dirty washing.
3 Toys, linen, cleaning (kitchen)
washed separately (60oC)
Y
4 Hand wash sink with liquid
soap / paper towels available
N Only the sundry sink is available in this area. Arrange for liquid soap by sink. Nursery
5 Sundry items sink – labelled,
clean and tidy
Y
6 Washing machine has working
sluice / pre wash cycle
Y
7 System in place to maintain
washing machine
Y Washing Machine repairer contacted as and when required.
8 Child owned soiled items
double bagged for collection
Y See 3.22 Above. See 3.22 Above.
9 Area where soiled items held
for collection clean / tidy
Y See 3.22 Above. See 3.22 Above.
10 System in place if soiled items
not collected on the day
Y Items will be stored in the Sluice Area until collection. There have been no
problems with parents taking soiled items so far.
11 Bed linen (nursery owned)
washed daily / on discharge
Y
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OTHER ACTIONS
PROBLEM IDENTIFIED: ACTION: BY WHOM: DATE:
BABY ROOM:
There were inconsistencies with regards to use of overshoes in the Room.
Reassess the need to wear overshoes. Once agreed
implement.
Nursery
KITCHEN:
There appears to be inconsistencies with regards to staff entering the
kitchen to make drinks for their own consumption. A separate rest area is
available (see below).
Clarity is required as to whether aprons need to be worn by every member
of staff entering the kitchen, even those not involved in food preparation
eg to collect a cup or spoon.
As per Regulatory Authority recommendations (see Appendix
2), use of the kitchen by non kitchen staff should be restricted.
In addition staff may not use the kitchen to make drinks or
prepare food for their own consumption.
Request Gwynedd Council to advise on good hygiene
practices for non-kitchen staff use of the facility.
Put into place alternative arrangements so staff only enter the
kitchen to prepare or assist with foodstuffs for children,
including storing breast milk and preparing feed bottles.
Produce revised Kitchen Use and Access Procedures –
following advice from Gwynedd.
Nursery
REST AREA:
There is no drinking water available in the rest area.
Arrange for a water bottle & cooler to be installed in the rest
area.
Establish additional tea / coffee points in the Nursery.
Extend the worktop across the washing machine / dryer to
facilitate a coffee / tea point in the Back Corridor.
Nursery
Nursery
Reported by HSS to
Estates on 21/11/2012
STAFF HANDBOOK: Keep a record indicating that every member of staff has
received the Handbook.
Ensure all new staff and work-placements receive an
Induction based on the Handbook, and a record is kept.
Nursery
HYGIENE:
Concern was expressed as to the suitability of using soap on babies and
toddlers.
Supply and use baby-specific soap for hand washing.
Nursery
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9. APPENDIX 1
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APPENDIX 2
Extract from Report prepared following visit by Sion Wynne and Sioned Johnson (Environmental Health
Officer, Gwynedd Council) and Ann Rees, Food Safety Officer for Gwynedd Council on 22/11/11
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APPENDIX 3
Extract from Report prepared following visit by Gary Porter-Jones (Health Protection Nurse, Public
Health Wales NHS Trust) and Louise Jones (Infection Prevention and Control Nurse, Betsi Cadwaladr
University Health Board) on 18th
November 2011