TIR NA N-OG Internal Audit of Infection Control Procedures · PDF fileInternal Audit of Infection Control Procedures Report – January 2013 Internal Audit Report by Health and Safety

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

Internal Audit Report by Health and Safety Services Page 1 of 16

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



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.



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.



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).



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



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.



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


11 Soft toys washed (60oC) daily /

OD


12 General toys – weekly (hot

water + deter. or wipes)




13 Books wiped weekly with

disinfectant wipes / OD


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



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



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


6 Kitchen cleaned daily with

cloths, dedicated mop


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



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



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



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



9. APPENDIX 1



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



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

Documents

TIR NA N-OG Internal Audit of Infection Control Procedures · PDF fileInternal Audit of Infection Control Procedures Report – January 2013 Internal Audit Report by Health and Safety