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Infection control and cleanliness: CQC expectations

Donna Hickey advises GP practices on the action they may have to take to meet CQC standards around infection control and cleanliness.

Hand hygiene is an extremely important part of infection control (SPL)
Hand hygiene is an extremely important part of infection control (SPL)

All healthcare professionals understand the importance of infection control. As part of CQC registration, GP practices and other primary medical service providers must demonstrate strict adherence to CQC regulations for this.

Abiding by the edicts set out in the Health and Social Care Act 2008: The Code of Practice for health and adult social care on the prevention and control of infections and related guidance is part of this.

According to UK law, the CQC must take the Code of Practice into its judgement framework. It is therefore essential that all healthcare providers are able to show they are compliant with every aspect of its requirements.

GP practices should also make sure they are fully aware of the latest NICE evidence-based guidelines. This includes the recently updated document CG139 - Infection: Prevention and control of healthcare-associated infections in primary and community care.

Furthermore practices should ensure they regularly check MHRA and other health and safety alerts, and are also familiar with NHS Employers health and safety guidance.  

Medical and non-medical areas

While treatment areas are of course the number one priority for healthcare providers when it comes to infection control, many neglect to give the same attention to communal or non-medical parts of the practice.

With CQC regulations so tough, providers really need to have policies for all areas of the premises, from toilets to waiting rooms and staff areas.

Toilets are particularly important in this regard, and should always be well stocked with hand towels and other necessities. It is also highly recommended that practices keep a log on the back of the toilet door to show regular checks and cleaning protocols are undertaken.

Not only does this reflect well on the practice’s cleaning policy, but also gives a good impression of the practice’s wider cleaning and infection control processes.

Code of Practice familiarity

Naturally, to adequately address all relevant infection control requirements, planning is very important. The approved Code of Practice stipulates ten criteria that all providers should strive to meet, and supplies a number of relevant examples to highlight these points.

Practices should therefore familiarise themselves thoroughly with the Code of Practice and make sure they address all sections applicable to their own situation.

One extremely important point is to create an annual statement in line with the approved Code of Practice. This statement should include:

  • Notification of any known infection transmissions.
  • Logs of any regular audits that have been put in place.
  • Risk assessments – including control measures that have been established and records of any improvement.
  • Evidence of staff training.
  • Review and update of current policies and procedures.

Infection prevention lead

GP practices should also ensure they assign a member of staff as infection prevention and control (IPC) lead, and a second member of staff as deputy. The IPC lead should check staff members are adhering to practice policies, and should also arrange audits, risk assessments, staff training and so forth.

This is extremely important to the practice for adhering to CQC regulations and meeting the essential standard for cleanliness and infection control.

Practices should remember that everything the CQC does is centred on outcomes in relation to providing the very best patient care.

The key to meeting the essential standard for cleanliness and infection control is to have a fully patient-centred approach, with processes and plans of action put in place to keep risk of infection at a minimum.

Common areas where providers fail to comply

Some of the most common mistakes made by providers are listed below:

  • Single-use policy: Healthcare providers should have a policy in place that covers all single-use devices.

  • Hand hygiene: This is an extremely important part of infection control. Not only does a suitable policy need to be in place, but there also need to be regular training sessions and training reviews, as well as audits of all hand hygiene products on the premises.

  • Personal protective equipment: Practices should ensure staff use personal protective equipment as per health and safety guidelines, and that safety equipment receives regular audit and review.

  • Control Of Substances Hazardous to Health regulations (COSHH): Relevant risk assessments should be completed by the practice and staff should receive training as appropriate. Practices should also ensure they have the correct forms to hand relevant to any areas of COSHH guidelines that apply.

  • Needlestick injuries: The practice should have a policy to cover needlestick injuries and should make sure occupational health procedures are in place.

  • Immunisation: Records should be retained on site and updated in line with the DH’s ‘green book’.

  • Waste management policy: This should include not only medical waste but also general business waste as well as confidential waste.

  • Training: This is an essential part of meeting all CQC regulations, and should include plans and processes covering staff induction and supervision and should also factor in staff personal development plans. 

  • Risk assessment, control measures and monitoring: Policies need updating and reviewing on a regular basis to ensure efficacy.

Donna Hickey is head of compliance at dbg, and is responsible for all aspects of compliance for dbg service provision, delivery and content. www.thedbg.co.uk 

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