Infection Prevention and Communicable Disease Control Guidance

HEALTH PROTECTION AGENCY NORTH WEST
Infection Prevention
and
Communicable Disease Control
Guidance
for
Early Years and
School Settings
(Version 2)
June 2011
(Review Date: June 2013)
There are other national guidelines available.
This is recommended for use in the North West.
Membership of the Group includes:
Dr Alec Bonnington, Peter Broad, Diane Fiefield, Ed Kaczmarski,
Hugh Lamont, Lorraine Lighton, Gill Marsh, Ken Mutton, Matthew Olley, Ruth
Philp, Claire Rogers and Jeff Scott on behalf of the North West Policy Group.
HPA North West would like to thank NHS Salford, Salford Health Improvement Service, Salford
City Council and Monton Village School for their help in developing this policy.
Contents
1 Introduction ................................................................................................ 5 4. Food Handlers ............................................................................................ 6 5.
Spread of Disease ..................................................................................... 8 6. Hand Hygiene ............................................................................................ 8 7. Toilet and Nappy Facilities ....................................................................... 11 8. 7.1 Children in nappies/ nappy changing............................................. 11 7.2 Children on Potties ........................................................................ 12 7.3 Children on the Toilet .................................................................... 12 7.4 Face Cloths ................................................................................... 13 Cleaning ................................................................................................... 13 8.1 Cleaning programmes ................................................................... 13 8.2 What agents should be used for cleaning?.................................... 14 9. Care of Play Equipment ........................................................................... 18 11. Body Fluid Spillages ................................................................................. 20 12 Cuts, Bites and Needlestick Injuries ......................................................... 20 13. Action to take in an outbreak .................................................................... 23 14. Infectious diseases in nursery, pre-school or school settings................... 25 15. Vaccination and Immunisation ................................................................. 26 16. Good hygiene practice and first aid. ......................................................... 28 17. Contact with Animals ................................................................................ 28 17.1 Pets ............................................................................................... 28 17.2 Outings to Farms and Zoos (see Appendix 3) ............................... 28 18. References ............................................................................................... 29 19. Further reading......................................................................................... 30 Page 3 | Version 2
Appendix 2 .......................................................................................................... 32 Immediate management of a diarrhoea and vomiting outbreak within the
nursery, pre-school or school setting .................................................................. 32 Appendix 3 .......................................................................................................... 33 Information leaflet for Farm Visits ....................................................................... 33 Appendix 4 .......................................................................................................... 34 Appendix 5 .......................................................................................................... 35 Appendix 6 .......................................................................................................... 51 Page 4 | Version 2
1
Introduction
Nurseries and schools are an ideal environment for the spread of infection and infectious
diseases. Young children, in particular those who attend nurseries and pre-school facilities, may
be more susceptible to infection and infectious diseases because:

they have an immature immune system and will not have had previous encounters with
some micro-organisms which cause infection;

they will not have completed their full course of childhood immunisation (see section 14)

their degree of close contact with other young susceptible children;

their lack of understanding due to their age of the importance of good hygiene practices

the tactile nature of children’s play and their natural intimacy with others;
Nurseries, pre-school facilities and schools aim to provide children with a safe environment for
growth, development and learning. Good infection control measures are therefore essential to
protect both children and staff. This can only be achieved through education and awareness.
This guidance document provides you with information on the prevention and control of infection
within a nursery, pre-school or school setting. It contains a list of useful people to contact for
advice and the measures to be taken in situations such as an outbreak. Unfortunately, this
document is unable to provide a single authoritative text on all communicable diseases due to
the vast array of infections that could be encountered. However, in all situations, the primary
aim is to encourage good communication between childcare staff and the multi-agencies that
are involved. It is through this communication that outbreaks can be detected early and
managed effectively.
Specific guidance is given as to when the local Health Protection Unit should be notified and the
advisability of excluding children and staff from nursery, pre-school care or school when they
have a communicable disease.
The assistance of everyone involved in the care of children is invaluable in highlighting possible
problems so the spread of infection can be prevented or controlled and normal nursery or
school activities maintained. This includes parents, care staff and primary care trust staff
involved in child health services.
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2.
Role of the officer-in-charge / head teacher or deputy.
a.
Will inform the appropriate line management and necessary authorities (e.g. Ofsted) of
serious problems relating to infectious disease that is related to their organisation /
business.
b.
Will notify the School Nurse or Health Visitor / Community Infection Control Nurse / local
Health Protection Unit of notifiable / reportable diseases or problems relating to
communicable diseases (see appendix 1).
c.
Will monitor the level and reasons for absenteeism within the nursery, pre-school or
school environment and report to the appropriate authorities.
d.
Will ensure that time and adequate resources are made available to follow good hygiene
practices.
e.
Will in the event of an outbreak increase awareness about, and ensure the supervision
of good hygiene practices within the nursery, pre-school or school where appropriate.
f.
Will inform the appropriate line management and necessary authorities (e.g. Ofsted)
when facilities within their establishment are not adequate for infection control.
g.
Will discuss and agree with the community infection control nurse (CICN) &/or the local
Health Protection Unit (HPU) any measures deemed necessary to control the spread of
infection.
3.
Staff health
It is good practice for all new staff to complete a pre-employment questionnaire prior to
commencing work. This should include the individual’s immunisation history, ensuring, where
possible, that all vaccines are up to date.
Anyone working in the nursery or school that is found to be suffering from an infectious disease
should refer to appendix 3 of this document.
Female workers of child bearing age should ensure that they are immune to rubella (German
measles) and chickenpox as they may be at risk of exposure to these infections. A blood test
can confirm immunity if unsure of previous vaccination status or exposure to the disease. Such
women are advised to seek the advice of their occupational health department or family doctor
(GP) regarding this and consider any necessary immunisation e.g. MMR prior to pregnancy.
4.
Food Handlers
Food handlers are reminded of their statutory obligations under the Food Hygiene (England)
Regulations 2006 to notify the food business operator immediately if they are suffering with a
disease likely to be transmitted through food or afflicted, for example, with infected wounds, skin
infections, sores or diarrhoea. Examples of diseases include:
• Typhoid Fever
• Paratyphoid Fever
• Other Salmonella infections
• Staphylococcal infections likely to cause food poisoning e.g. impetigo,
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septic skin lesions, exposed infected wounds, boils etc.
• Dysentery
• Diarrhoea - the cause of which has not been established
• Hepatitis A (infective jaundice)
• E.coli O157
The catering manager/food business operator must not permit a person known or suspected to
be suffering from any of the above diseases, to work in any food handling area in any capacity
in which there is any likelihood of directly or indirectly contaminating food with pathogenic microorganisms.
The catering manager/ food business operator should also notify the Environmental Health
Team.
Any food handler who develops symptoms of vomiting &/or diarrhoea or other symptoms
associated with the above diseases should not return to work in any capacity in a food handling
area (as above mentioned) until he/she has been symptom free for at least 48 hours. Ideally,
all food handlers should submit a faecal specimen to their General Practitioner to ensure
appropriate exclusion and management. This advice also applies to children who may be
involved in the handling and preparation of food to be consumed at school, nursery or at home.
The manager of the food handler who is ill should contact the Officer in Charge/Head Teacher
to discuss exclusion of the member of staff and arrange cover for the duration of absence.
Food handlers and individuals delivering direct care to children, who are identified with more
severe infections such as typhoid, paratyphoid and E.coli 0157 will be required to remain
excluded for longer than 48 hours and such infections will be reported to the Consultant in
Health Protection (HPA) as the Proper Officer of the Local Authority. In such cases, the local
Environmental Health Team will carry out the investigation and management of individuals and
will arrange for further faecal specimens to be completed prior to returning to work. It is
important that individuals with these infections do not return to work until they have been
advised to do so by the Health Protection Agency and/or the Local Environmental Health Team.
4.1 Preparation of bottled milk
A designated area with hand washing facilities for the making up of bottles should be available
on site. All staff should be trained in bottle making and sterilisation and a written record of the
training maintained. Current guidance and best practice is to make up formula milk as required.
If bottles of milk are brought into the nursery readymade they must be refrigerated at less than
50C. If made up formula is kept in a fridge it must be used within 24 hours. Fridges should be
monitored daily and a record of the monitoring maintained. All sterilised bottles should be
removed once sterilised and not left in the steriliser.
A policy on bottle making and sterilisation should be available to all staff.
See below link.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/d/digitalasset/dh_124526.pdf
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5.
Spread of Disease
Communicable diseases can be spread in a variety of different ways.
a.
Aerosol (Small Droplet) Spread
Some organisms, which cause disease, can be spread from an infected person via small
droplets in the air caused by coughing or sneezing and then inhaled or ingested (swallowed) by
another person. Examples of such diseases are norovirus, colds, measles and mumps.
b.
Droplet Spread
Some organisms, which cause disease, can be spread from an infected person via droplets in
the air caused by coughing or sneezing and then inhaled or ingested (swallowed) by another
person. These droplets are larger in structure and cannot be carried long distances. Therefore,
close contact with the infected person is required. An example of such a disease is influenza.
c.
Direct Contact Spread
Skin contact e.g. holding hands can aid in the transmission of some contagious skin diseases
such as ringworm and scabies. Head to head contact can also facilitate the transmission of
head lice.
d.
Faecal/Oral Route of Spread
For some diseases e.g. gastroenteritis and Hepatitis A, the infecting organism is excreted in the
faeces (motions). The hands of an infected person may become contaminated after they wipe
themselves and, after inadequate hand washing when going to the toilet, the infecting
organisms may be transferred to others' hands and subsequently to their mouths.
e.
Blood/Body Fluid Transmissions
Viral communicable diseases such as hepatitis B, Hepatitis C and HIV (the cause of AIDS),
cannot be transmitted to other people without direct transfer of a person’s infected bodily fluid
(s) to another person. Potential transmission routes can include unsafe sexual intercourse and
unsafe injection practices, for example needle stick injury. Therefore, these diseases cannot be
transmitted through normal nursery or school activities or social contact.
6.
Hand Hygiene
6.1
Why is hand washing so important for both staff and children?
Hands are used for all sorts of activities during the course of a day. Hands become easily
contaminated e.g. after having been to the toilet or having changed a nappy. Germs on a
child’s hand can easily pass to other children’s hands and staff members by direct touch (e.g.
holding hands) or by contamination of objects (e.g. via contaminated toys). Once on the hands
it is easy for germs to then get into the mouth. Many infections are spread in this way. If hands
are thoroughly washed for example after using the toilet, the number of germs they carry will be
greatly reduced. Washing hands before eating helps to further reduce the risk of ingesting
(swallowing) germs that may have contaminated hands.
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6.2
When should you wash your hands?

Before preparing, serving or eating food

After using the toilet

After changing a nappy

After handling pets

After any cleaning procedure, including spillages

After handling soiled clothing or bedding

After dealing with waste

When hands look or feel dirty
Children must be encouraged to wash their hands after every visit to the toilet and always
prior to eating. Children should be supervised when washing their hands to ensure hands are
thoroughly cleaned. Nursery, pre-school or school staff also need to be aware that
contaminated hands are a potential source of spread of infection and in the importance of good
hand hygiene procedures. It is important that regular education regarding hand hygiene is given
to and available for children to follow, this may be in the form of posters on walls and especially
above sinks.
6.3
How should you wash your hands?
Staff and children should develop a good hand washing technique so that they get their hands
thoroughly clean. It does not need to take a long time to get hands really clean: Lathering your
hands with soap for ten to fifteen seconds will be sufficient to remove most dirt. It is important to
wet the hands before applying soap, and to make sure that all parts of the hands and fingers are
cleaned, especially the fingertips, nails, thumbs and between fingers (the webs), which often get
missed. It is recommended that liquid soap should always be used, as bars of soap can
become contaminated with bacteria. Hands should be rinsed well and then dried thoroughly with
disposable paper towels as damp hands encourage bacterial growth. This will minimise
bacterial growth on the hand whilst preventing dry, chapped skin.
To ensure effective hand washing technique, please refer to page 35, Appendix 4 This poster
can be downloaded, laminated and used as a poster at each hand washing sink to encourage
effective technique.
6.4
Key points for hand hygiene
Warm water should always be available for hand washing.

Wet hands under running water

Apply liquid soap

Wash hands without adding more water for 10 - 15 seconds ensuring all areas of hands
are covered - paying particular attention to fingertips, thumbs and between the fingers.

Rinse hands under running water.
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
Dry hands thoroughly on disposable paper towels.
Cotton (terry) towels are not recommended for general hand hygiene. Children will share
towels (even if they are instructed not to do so) and this can be an excellent way of spreading
infection. Even if each child has their own towel with their name on it, the risk of sharing is high,
increasing the risk of cross-infection.
Hot air hand dryers are not suitable for nurseries and schools. In a nursery, pre-school or
school or school setting the only satisfactory method of drying hands is with good quality
disposable paper towels.
6.5
Additional points on hand hygiene for staff

Keep nails short and clean

Remove nail varnish at work

Artificial nails should not be worn at work

Remove jewellery i.e. rings with stones or ridges, wristwatches or bracelets before
washing hands.
NB:
The use of nailbrushes in the nursery, pre-school or school setting is not recommended,
as they are a potential source of infection.
6.6
How else can hands be protected?
Any fresh abrasions, cuts, etc. on the hands should be covered with an impermeable waterproof
dressing i.e. one without holes.
6.7
Who else can help?
Nurseries, pre-school and schools are only one of the influences on children. Perhaps more
important, but less easy to control, is the home environment. Parents should be encouraged to
promote good hand hygiene in their children.
The Community Infection Control Nurse (CICN), Health Visitor, School Nurse or Environmental
Health Practitioner can assist nurseries, pre-school and schools in education on personal
hygiene and hand washing. Education aids such as posters and teaching packs are useful in
encouraging hand and personal hygiene.
A hand hygiene poster for staff can be found on page 35, appendix 4 of this document and this
can be photocopied and laminated for staff and visitor use.
6.8
Alcohol gels
It is important to note that alcohol hand gels are not cleansing agents and should not replace
the need for hand washing. Hands that are visibly soiled should be washed using soap and
water, following the effective hand washing technique. Alcohol hand gels do not have any
lasting action and have limited effectiveness against bacterial spores, such as C.Dif. However,
alcohol hand gels can be used to disinfect hands after hand washing, especially in outbreaks
of diarrhoea and vomiting. The CICN and/or the local HPU can advise you accordingly.
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Alcohol hand rubs or gels offer a practical and acceptable alternative to hand washing in most
situations, as long as hands are not visibly dirty or have undertaken a dirty procedure e.g.
nappy changing.
Alcohol is useful for rapid hand decontamination between contact with children, particularly
where access to adequate hand washing facilities may be lacking e.g. in the play rooms. The
build up of emollients (used in the alcohol to moisturise and protect hands), however, means
that hands need to be washed with soap and water after 2-3 applications of alcohol hand rub.
7.
Toilet and Nappy Facilities
Staff and children will only develop good hygiene practices if they are provided with adequate
facilities. These should be available at all times, not just when there is an outbreak as it is often
too late by then.
7.1
Children in nappies/ nappy changing
Any nursery, pre-school or school, which accepts children who are still in nappies, must have
appropriate changing facilities. NB. Ensure that nappy changing areas are designated for that
use only and that they are not near a play or kitchen area.

Staff undertaking nappy changes should not be involved in the preparation of food.
However if these staff do handle food strict hand washing must be adhered to.

Staff should wear a disposable plastic apron to protect their clothing or uniform from
contamination when involved in nappy changing.

Disposable CE marked gloves should be available for staff that undertake nappy
changing. Please remember the use of disposable gloves is not a substitute for good
hand hygiene.

Nappies must be changed in a designated area away from play facilities, and away
from any area where food or drink may be prepared or consumed.

Soiled nappies should be wrapped in a plastic bag and disposed of using local
arrangements with the local authority (DH, 2006).

The nappy disposal bin should have a foot-operated lid.

Nurseries, pre-school and schools, which produce a substantial number of used nappies
(*or sanitary products) should make arrangements for appropriate disposal (e.g. a
contract with a registered waste disposal company).

Children’s skin should be cleaned with a disposable wipe. Flannels should not be used.
Nappy creams, lotions, etc. should be labelled with the child’s name and must not be
shared between children. It is important to use clean, disposable gloves when removing
creams for containers, this will help to avoid cross infection and contamination of the
container.

Nappy changing mats/mattresses should be waterproof, impervious and washable.
Nappy changing mats should be wiped with soapy water and dried after each use.
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
If disposable paper is used on the changing mat this must be removed immediately after
use.

Changing mats should be checked daily for tears. If the plastic cover is torn, the mat
should be replaced.

Hand washing facilities for staff (which includes hand wash basin, liquid soap, paper
towels and foot operated bin) must be available within the nappy changing area/room.

Staff must wash and dry their hands after every nappy change, after glove removal,
before handling another child or before leaving the nappy changing area.
7.2
Children on Potties
Children who are being ‘toilet trained’ should only use a potty until they are able to sit on the
toilet.

Potties should only be used in a designated area away from play facilities, and away
from any area where food or drink may be prepared or consumed (e.g. in toilet or nappy
changing areas).

Hand washbasins, liquid soap and paper hand towels suitable for use by children and
adults should be available in areas where potties are used.

A designated sink for cleaning potties (i.e. not a hand wash basin) should be sited in the
area where potties are used.

After use by the child the contents of the potty should be flushed down the toilet. The
potty should be washed in soapy water, dried and stored upside down - never stack
damp potties.

Staff should wear disposable gloves and disposable aprons while emptying and cleaning
potties. Both gloves and aprons should be disposed of immediately after emptying
and/or cleaning the potties as per disposal procedure and hands washing as per
effective hand washing technique.

Children should be supervised when using a potty and when washing and drying their
hands after using the potty.
7.3
Children on the Toilet
Children should be supervised to ensure they wash their hands after using the toilet. The
following facilities should be available:

Child-sized toilets, with lids to the seats.

Adequate supplies of soft toilet tissue in each toilet cubicle.

Hand washing facilities in toilet area – children should not have to leave the toilet
area to access wash basins. If hand washing facilities are some distance from the
toilets, children will either not wash their hands (because it is inconvenient or they forget)
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or they may contaminate other children and objects before washing their hands. Taps
should be easily accessible to children.

Running water – This should be warm, since children are more likely to wash their
hands if the water is comfortably warm. Soap will produce a better lather in warm water
and so clean hands more effectively. It is important that hands are washed under
running water. Running water also helps to wash germs away down the drain. Bowls
should not be used as they can easily become contaminated and there is a risk that
children will share the bowl and contaminate each other’s hands. The temperature of the
hot tap water should be regulated to avoid scalding.

Soap – Soap helps the physical removal of germs. Liquid soap should always be used
be used as a bar soap can easily become contaminated with bacteria.

Disposable Paper Towels – This is the only satisfactory way of drying hands in
nurseries, pre-schools and schools. There should be adequate provision of paper
towels and foot operated bins to put them in. If children and staff are washing their
hands as often as they should, they will use a surprisingly large number of towels.
Washable cotton (terry) towels should only be used after baths, showers or swimming.
They should not be available near toilets. Children will share towels (even if they are
not supposed to do so) and this can be an effective way of spreading infection.
7.4
Face Cloths
The use of face cloths must not be encouraged within nurseries, pre-schools and schools. Even
if each child has their own face cloth there is a risk they may be shared and transmit infection.
Children’s faces should be wiped with a disposable wipe and dried with a soft paper towel.
8.
Cleaning
8.1
Cleaning programmes
A clean environment is essential to prevent the spread of infection. Germs cannot grow on
clean dry surfaces.
A written cleaning schedule clearly stating what to clean, when to clean and how to clean it, is
essential and should include specifics such as toilets, sinks, toys, equipment and general
environment (e.g. following contamination due to accidents).
-
The cleaning programme should be agreed and followed.
-
A daily record should be kept identifying the date/time and name of the person
who completed the cleaning.
-
Regular ad-hoc cleaning checks are encouraged
person/manager to ensure compliance and standards.
by
the
designated
It is important to note, equipment that is shared between two or more children can be a potential
source of infection. Objects such as high chairs and toys, for example, can become
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contaminated when handled by children and/or when they put them into their mouths.
Therefore, communal toys should be washable and must be cleansed in hot water and
detergent, at least weekly and then dried. A daily wipe down of toys in hot water and detergent
should also be carried out on communal toys, and visible contamination removed. Toys should
be checked regularly and broken toys should be replaced. Soft toys are not generally
recommended for nurseries, pre-schools and schools as they can become quickly contaminated
and are not easily cleaned. If soft toys are used, then these should be washed in a washing
machine then allowed to dry either in a tumble dryer or air dried.
Toilet seats, flush handles and toilet bowls must be cleaned every day or sooner if visibly
contaminated. Other surfaces that may have been touched by contaminated hands e.g. door
handles and taps should also be cleaned daily. In addition, the designated person/manager
should make arrangements for regular checks on toilet areas so that any accidental spillage or
contamination can be dealt with promptly.
An example cleaning schedule and cleaning rota can be found on page 34, appendix 5.
8.2
What agents should be used for cleaning?
Detergent and hot water is adequate for cleaning most surfaces and furniture. This includes
toilet areas. A cream cleanser should be used for dirt that is difficult to remove. Disinfectants
should not be used routinely for environmental cleaning. Disinfectants should never be poured
down the toilet bowl or drains as they can interfere with the natural decay of sewage.
In summary, nurseries and schools will need the following routine cleaning agents: 
Neutral detergent liquid

Cream cleanser

Lime scale remover for toilets

A deodoriser may be used if desired in toilet areas. Care should be taken to use them
according to the manufacturer’s instructions and to spray them away from the face.
In specific circumstances e.g. during an outbreak of diarrhoea and vomiting within the nursery,
pre-school or school, additional cleaning materials may be required. For example, if the cause
of the outbreak was due to a viral infection then the use of a good quality hypochlorite bleach
may be required, but the Community Infection Prevention and Control Nurse/Environmental
Health Practitioner/ local HPU can advise you about this.
Nurseries, pre-schools and schools must adhere to COSHH Regulations (HSE, 2009) and
manufactures guidance when using chemicals such as hypochlorite bleach.
8.3
What other resources are needed?
Separate cleaning equipment should be used for toilets, hand wash areas and non-toilet areas.
A standard colour coding system is a useful way of achieving this. This means that mops,
cloths, buckets and non latex gloves must indicate the appropriate colour for the area that it is to
be used in and adhered to. An example of colour coding recommended by National Patient
Safety Agency (2007) is as follows:
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Red
- bathrooms, washrooms, showers, toilets & basins
Green
-
Blue
- general areas including offices and public areas.
8.3.1
kitchen & food preparation areas
Cloths used for cleaning should always be disposable and should be thrown away at the
end of each day.
8.3.2 Non latex disposable gloves should be worn when in contact with body fluids is likely
(e.g. when cleaning potties or toilet areas. Always remember to wash your hands after
removing the gloves.
8.3.3
Mop heads should be either be disposable and used once only or detachable and
washable. They should be washed in hot soapy water after use, rinsed and wrung out
as much as possible. The mop should then be inverted (mop head facing upwards) to
dry thoroughly. Never leave a mop in a bucket of water. Nurseries with deep sinks
should only use this for cleaning equipment, i.e. washing mop heads and not for hand
washing.
8.3.4
Buckets should be rinsed out with hot water after use, dried and stored inverted. Do not
leave water in a bucket as this can quickly become contaminated and if used
later,
can be a potential source of the spread of infection within the environment.
8.3.5
Where advice states to use hot water and detergent, it is expected that the water is not
too hot to the gloved hand and that a neutral detergent is used. A risk assessment
should always be undertaken and use of appropriate personal protective equipment
such as gloves and plastic apron may be advisable. Please note that there are specific
regulations regarding hygiene in the kitchen, for advice about this please contact the
local Environmental Health Department.
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8.4
Specific cleaning advice for a variety of items:
Item
How Often
Method
Basins and taps
After use
(minimum daily)
Clean with hot water and detergent.
Disinfectant is not routinely needed.
Bins
Daily
Clean with hot water and detergent.
Buckets
After use
Wash with hot water and detergent
and store so that they can dry.
Carpets
Minimum daily
Vacuum daily. There should be a
schedule for steam cleaning carpets
at least six monthly.
Cloths/Dusters
Daily
Use appropriately colour coded
disposable cloths and throw away at
end of each day.
Drains
Daily
Clean with hot water and detergent.
Never clean drains with disinfectants.
Floors
Minimum daily
Clean with hot water and detergent,
rinse and dry.
Do not use
disinfectants for general everyday
cleaning.
Furniture
Daily
Surfaces should be damp dusted with
disposable cloths.
Mops
After use
Use detachable mop heads. Wash in
hot soapy water, wring out and store
mop upside down to dry
Toys
As schedule
Toys should be washable. A schedule
for regular cleaning should be
devised depending on the kind of toy
and the likelihood of soiling.
Toilets
As schedule
Lime scale remover or toilet cleaner
should be available for use.
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Item
How Often
Method
Vacuum Cleaners
(with a HEPA
filter)
As maker’s instructions
Change the HEPA air filter regularly
according
to
manufacturer’s
instructions. Wipe detachable tools
with hot water and detergent.
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9.
Care of Play Equipment
9.1
Soft Toys
Soft toys are not recommended for multi play use. All toys should be on a regular cleaning
schedule, and should be cleaned with detergent and hot water at least weekly or sooner if
visibly dirty. This schedule will also assist in disposing of damaged toys or those that cannot be
easily cleaned. (See section 8.0 Cleaning)
9.2
Play dough / Plasticine
It is important that children wash their hands before and after use and ideally, play
dough/plasticine should be replaced daily after each session. Skin lesions must be covered. In
an outbreak, play with play dough should be suspended until the outbreak is over and play
dough disposed off.
9.3
Plastic / Wooden Toys
Toys should be cleaned after use using hot soapy water and dried thoroughly. (This includes
play homes and play tables). Toys should be inspected regularly for breakages and discarded if
not intact. Broken toys may harm children and could harbour bacteria.
9.4
Electrical/Mechanical Toys
Non-electrical toys should be surface wiped after use with a damp cloth that has been rinsed in
hot water and detergent and then dried, and electrical toys surface wiped with an alcohol wipe
after being unplugged from the mains.
9.5
Storage of Toys
Toys must be stored in a designated container that is rigid and washable. Toy containers
should be washed and dried weekly.
9.6
Second-hand Toys
It is advised not to accept second-hand toys. However, in instances where second hand toys
have and/or are being received, then the nursery must ensure the equipment is clean and
providers should be aware of the requirements of health and safety legislation (including
hygiene requirements). This should include informing and keeping staff updated (DfE, 2008)
9.7
Water play equipment
Water play pools and paddling pools should be emptied immediately after use and dried. They
should be stored deflated or inverted. Water play equipment should be cleaned using detergent
and water and dried.
9.8
Sandpits
Sandpits should be covered for protection and sand kept clean by regular sieving. The sand
should be changed regularly (e.g. two –four weekly for indoor sandpits) and the tank washed
with detergent and water before the sand is replaced. Outside sandpits (e.g. sports jump pits)
should be raked regularly (daily) when in use) but not less than weekly and changed as soon as
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it becomes discoloured and/or malodorous (HPA, 2010b). It is important that outside sandpits
are also covered for protection when not in use.
9.9
What to do in an outbreak of gastroenteritis
When an outbreak of gastroenteritis occurs in a class, play with sand, water and plasticine/play
dough should be suspended until the outbreak has finished. The CICN will advise on the
suitability of play activities.
10.
Linen
Linen and clothing can potentially be sources of cross-infection. Laundering reduces
contamination and the risk of infection. A laundry facility needs to have an appropriate
washing machine for use including a drying component, and cold pre-wash cycle if not
sluice cycle. It is advisable to purchase an industrial type of machine and to consider the
cost of ongoing maintenance in general. A laundry area should be designated for that
purpose only, with separate ventilation and hand washing facilities. It should also be
situated as far as possible from areas that food is prepared and should be inaccessible
to children. There must be enough space in the room to ensure that both clean and dirty
linen is kept separately from each other.
The laundry operator should use protective clothing (gloves and apron) when dealing
with dirty linen and hands should always be washed after handling linen/detergent.
Correct high temperature wash programmes plus detergent products that remove
organic residues (e.g. faeces, urine and blood stains) from fabric should always be used
as the fabric could otherwise continue to harbour germs.
10.1
Handling linen
Linen used for sleep mats should either be used once and then washed or dedicated for
an individual child’s use for a few days and then washed. In this case, the linen should
be stored in a bag/box for that named child’s sole use.
Children’s personal cloths/towels should not be left to dry in toilets and should be dried
in a designated area only.
Used linen should be removed from the sleep mat with care, avoiding the creation of
dust and placed either in a labelled bag/box for that child’s reuse or sent for laundering.
Red soluble alginate bags should be used when linen is soiled with bodily fluids. The red
water soluble alginate bag prevents unnecessary manual handling of soiled linen by
staff. The soiled linen should be placed directly into the water soluble alginate bag and
then into a red linen bag and brought directly to the laundry area.
The water soluble alginate bag is then placed directly into the machine. The washing
machine would need to be compatible with such a bag so that is dissolves in the hot
water. Used soiled linen should be laundered by a process in which the temperature in
the load is maintained at 650C for not less than ten minutes or preferably at 710C for not
less than three minutes.
Do NOT manually rinse/soak soiled items. Flush any solid material (e.g. vomit, faeces)
into the toilet, carefully avoiding splashing, and then put items in the washing
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machine, using the pre-wash/sluice cycle followed by a hot wash cycle, as tolerated by
the material. If this service is not provided at your facility then the soiled clothing should
have the solid waste flushed away as before and then be placed into a sealed,
waterproof bag for the parent to collect and wash at home.
10.2
Soiled clothing
Ensure that all soiled linen is washed as promptly as possible.
Other washing e.g. clothes, should be washed on the hottest possible wash that will not
damage them. Clean and dirty linen should be kept separate to avoid cross
contamination.
The laundry area should be located away from the kitchen area. This will reduce the risk
of cross-contamination, as soiled linen could introduce faecal pathogens into the food
preparation and handling environment.
Further advice can be obtained from the community infection control nurse at the
Primary Care Trust.
11.
Body Fluid Spillages
It is essential to keep designated equipment for the cleaning of body fluids.
11.1
Urine, vomit, faeces and blood
All spillages of body fluids (e.g. urine, vomit, faeces or blood) should be dealt with
immediately. (Please refer to appendix 8, page 36) Wearing disposable non latex
gloves and a disposable apron, absorb as much of the spillage as possible with
absorbent paper towelling. This can be disposed of into a plastic waste sack (or flushed
down the toilet if small amounts). If indoors, clean the area with a neutral detergent, e.g.
washing up liquid and hot water, rinse and dry and ventilate the area. For spillages
outside (e.g. in the playground), sluice the area with hot water. Do not forget to
thoroughly wash your hands after you have taken the gloves off.
11.2
Carpets or soft furnishings
Carpets and upholstery should be thoroughly cleaned with warm soapy water or a
proprietary liquid carpet shampoo, rinsed and where possible, dried.
After an outbreak of gastroenteritis or norovirus, it is best practice to have carpets steam
cleaned by a contractor with specialised equipment.
12
Cuts, Bites and Needlestick Injuries
12.1
Dealing with cuts and nose bleeds
When dealing with cuts and nosebleeds, staff should follow the nursery, pre-school or
school’s first aid procedure, and record the incident in the accident book. It is best
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practice for staff to wear disposable CE marked gloves when dealing with all
bleeding wounds.
Children who are known to be HIV or hepatitis B or C positive do not need to be treated
any differently from those whose status is not known. Intact skin provides a good barrier
to infection, and staff should always wear waterproof dressings on any fresh cuts or
abrasions on their hands. Staff should always wash their hands after dealing with other
people’s blood, even if they have been wearing gloves or they cannot see any blood on
their hands. Disposable gloves should be disposed of immediately after use, even if
they look clean.
12.2
Human bites
Human mouths are inhabited by a wide variety of organisms, some of which can be
transmitted by bites. Human bites, which break the skin, are more likely to become
infected than dog or cat bites, so it is important that they are treated promptly. There is
a theoretical risk of transmission of hepatitis B from human bites and though HIV can be
detected in the saliva of some people who are HIV positive, there is no documented
evidence that the virus has been transmitted by bites.
If a bite does not break the skin: 1.
Clean with soap and water
2.
Record incident in Accident Book; no further action needed.
If a bite breaks the skin: 1.
Clean immediately with soap and water and cover with a dressing.
2.
Record incident in Accident Book
3.
Seek Medical Advice by going to the local A&E department:
a.
to treat potential infection
b.
for reassurance and information about HIV and Hepatitis B infection
Further detailed information can be found in the document
‘Human bite injuries’ at the Health Protection Agency website at:
www.hpa.org.uk / North West region/Forms and Policies
12.3
Animal bites
Most animal bites are less likely to become infected than human bites, but they should
still be taken seriously. There is currently no rabies in the UK, so vaccination against
rabies is not required for bites that occur in this country. Children (and adults) who have
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received an animal bite abroad, in countries where rabies is known to occur, should
always seek immediate medical attention.
However if a person is bitten by a bat in the UK, an immediate medical assessment
will be required via the GP or the local A&E department.
In the UK, animal bites, which do not break the skin, should be washed with soap and
water. If a bite breaks the skin, wash with soap and water then seek medical advice
about the possible need for treatment to prevent infection. If someone becomes
generally unwell or the bite looks infected they should seek medical attention.
12.4
Needlestick injuries
On rare occasions children or staff may injure themselves on discarded used
hypodermic needles, which they have found. As well as ensuring that the victim gets
any necessary care, it is important that the needle is disposed of safely to avoid the
same thing happening to others.
If a discarded needle &/or syringe is found, it should be carefully placed into an
approved UN/BS Sharps container (the school nurse will have one of these).
In circumstances where an approved Sharps Container is not available then a staff
member should very carefully place the needle &/or syringe into a rigid container such
as a empty coffee jar until it can be disposed of appropriately either by the school nurse
or by handing it into a local health clinic or GP surgery for proper disposal.
If discarded needles are found frequently, then arrangements should be made for the
nursery, pre-school or school to have an approved UN/BS sharps box for proper
disposal, and the safety issues should be discussed / reported to the local police.
If someone pricks or stabs him or herself with a used hypodermic needle:
1.
Gently bleed (milk) the wound
2.
Wash the wound thoroughly with soap and running water
3.
Cover it with a waterproof dressing
4.
Record it in the Accident Book
5.
Seek immediate medical advice from the Accident & Emergency Department
about the possible need for immunisations (e.g. hepatitis B) or for treatment if the
wound becomes infected.
There have been no documented cases of people acquiring HIV or hepatitis B from
discarded needles. Nevertheless, hepatitis B immunisation and monitoring is
recommended for these incidents so it is important to seek immediate medical advice.
Further detailed advice can be found in the document
‘Inoculation injury in the community setting’ on the Health Protection Agency website at:
www.hpa.org.uk /North West region/forms and policies
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13.
Action to take in an outbreak
13.1
Why are outbreaks important?
An outbreak can be defined as “two or more linked cases of the same illness or when
the number of cases of the same illness unaccountably exceeds the expected number.”
Outbreaks of infectious disease may occur from time to time in nurseries, pre-schools
and schools. Their importance depends on several factors: -
13.2
a.
the severity of the disease
b.
the number of children affected
c.
the mode of transmission
d.
the amount of anxiety they generate in parents and staff
e.
whether any specific action is necessary to stop further cases (e.g. immunisation,
improving food-handling practices).
How do we know there may be an outbreak?
There are several ways in which nurseries, pre-schools and schools may become aware
that they have an outbreak of an infectious disease.
13.3
a.
Several children may be ill in nursery, pre-school or school with the same illness
b.
There may be a sudden increase in the number of absentees
c.
Parents may advise the nursery, pre-school or school that their children are
suffering from an infectious disease.
d.
The local Health Protection Unit staff or community infection control nurse may
contact the officer-in-charge / head teacher / deputy.
What should the officer-in-charge/ head teacher / deputy do?
If the officer-in-charge / head teacher / deputy thinks there may be an outbreak he or she
should discuss the matter with, and report the situation to, the community infection
control nurse at the local PCT or the local Health Protection Unit.
It is helpful for the initial assessment of the situation if the officer-in-charge / head
teacher / deputy can find out:
a.
How many children and staff are ill?
b.
What are the symptoms?
c.
When did each child and staff fall ill i.e. when did symptoms first start?
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13.4
Role of the Community Infection Control Nurse (CICN)
The CICN will assess the situation and decide what, if any, further action is necessary
either to investigate the source of the outbreak or to stop further spread. The nursery,
pre-school or school should make every attempt to provide the information requested by
the CICN, EHP, Local HPU. The officer-in-charge / head teacher / deputy should
encourage staff, parents and children to comply with requests for specimens, and to
follow guidance for control of spread of diseases. The local authority registration &
inspection unit should be notified. It may be that during such a situation certain play
activities e.g. water and sand play, may need to be suspended as they may be a
potential for the transmission of infection.
If the CICN is unavailable the local Health Protection Unit should be contacted, who will
advise on the appropriate action needed.
13.5
Role of Environmental Health
If an outbreak of food poisoning is suspected, the Environmental Health Department will
be asked to investigate. In certain circumstances, the Environmental Health Practitioner
(EHP) may also assist in the assessment and control of outbreaks of diarrhoea and/or
vomiting not thought to be due to food poisoning (e.g. dysentery).
13.6
Role of Ofsted (Office for Standards in Education)
Where necessary the Ofsted help desk on 0300 123 1231 should be contacted, who will
advise of any actions to be taken and of how to contact the local Child Care Regulator
13.7
Nursery or school registration & inspection unit
The local authority nursery or school registration & inspection unit / early years team
should also be contacted.
13.8
Other action.
Where necessary the CICN will visit the nursery or school and will offer further advice on
information for parents and steps that may need to be taken by both the organisation
and parents to prevent further cases. Where appropriate the CICN will speak to groups
of staff or parents to answer their questions and concerns.
For certain infectious diseases (e.g. some cases of meningitis) the CICN or local Health
Protection Unit may deem it necessary for letters to be sent home to all parents.
Arrangements for this will be made through the officer-in-charge / head teacher / deputy
as appropriate.
13.9
Cleaning in outbreaks
Additional environmental cleaning may be required in outbreaks. If the CICN considers
there is a need for extra cleaning this will be discussed with the officer-in-charge / head
teacher / deputy at the time and special advice will be given.
After an outbreak of viral gastroenteritis or norovirus, it is best practice to have carpets
steam cleaned by a contractor with specialised equipment.
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14.
Infectious diseases in nursery, pre-school or school settings
Infectious diseases are common amongst nursery, pre-school or school children and
these settings often present as an ideal situation for diseases to spread. Parents should
be encouraged to ensure that their child receives all appropriate routine vaccinations
when they are due, unless there are true medical and/or personal reasons why they
should not. It is important to note that failure to have a child immunised may put other
vulnerable children at risk. These include children that are too young to have been
immunised or who have other medical conditions that prevent them from being
immunised. Nurseries, pre-schools and schools should be encouraged to keep an up to
date record of their children’s immunisation status.
A child who has acquired an infectious disease may show general signs of illness. This can
include shivering attacks or feeling cold, headache, vomiting, sore throat or just vaguely
feeling unwell. Such symptoms, when a particular infectious disease is prevalent,
should make the teacher (and parent) suspicious.
In these circumstances, parents should be contacted so that they can collect the child with a
view to consulting their General Practitioner, if necessary. In the meantime, the child should
be kept separate from other children, warm and comfortable. If symptoms appear very
serious or distressing, staff should call an ambulance to ensure immediate assessment &/or
treatment for the child. A member of staff should accompany any child taken to hospital by
ambulance.
Exclusion of Children
Some infections are minor and excluding a child from nursery or school cannot always
be justified. However, in cases of Diarrhoea and vomiting, excluding a child from the
setting could significantly reduce the spread of infection to other children and/or staff.
For some other infections, the organisms, which cause disease, are commonly found
among apparently healthy people and this will influence the advice on whether it is
appropriate to exclude children.
There are some general rules about exclusion:
1.
Children who are not well should not be at nursery, pre-school or school, even if they
are not infectious, but in specific circumstances staff may use their discretion about
attendance with confirmed non-infectious illness.
2.
Children with diarrhoea &/or vomiting should not be in nursery or school (unless the
diarrhoea is known to be due to a non-infectious cause e.g. coeliac disease). This rule
also applies to staff, including catering staff. Children and staff should stay away from
nursery, pre-school or school until they have been symptom free for 48 hours.
3.
Children may have illnesses that affect their immunity (e.g. leukaemia, HIV disease). The
parents of these children should be informed if there are cases of infectious diseases in
the nursery or school, particularly chicken pox, shingles or measles.
4.
Children who have been prescribed antibiotics can usually return to nursery or school
before they have completed the course providing they feel well enough, for example
Scarlet Fever.
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A poster entitled ‘Guidance on Infection Control in Schools and other Child Care
Settings’ can be found and downloaded by visiting the website:
http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1203496946639
Publications
Guidance on Infection Control in Schools and other Child Care Settings
(Health Protection Agency, 2010a)
15.
Vaccination and Immunisation
Preventing an illness is much better than trying to treat it once it has developed. There are
now many safe and effective vaccines against potentially fatal illnesses. Some are given
routinely to all the population, others only to individuals thought to be at high risk of certain
infections. The recommended immunisation schedule for children in the UK is outlined
below.
Immunisation information is available on:
www.dh.gov.uk/en/Publichealth/Information/index.htm
Page 26 | Version 2
Department of Health (2010) Routine childhood immunisations from November 2010
N.B.
A second MMR should be offered to school leavers if previously not received for
optimum cover.
Page 27 | Version 2
16.
Good hygiene practice and first aid.
Guidance on First Aid for Schools. Available at:
www.education.gov.uk/schools/pupilsupport/pastoralcare/health/firstaid
There is no risk to other children or staff from an HIV infected child attending nursery, preschool or school provided sensible hygiene practices are in place.
Useful website addresses which produce excellent information and advice for teachers
regarding HIV in schools can be downloaded from the web at:
www.dfes.gov.uk/
www.avert.org
www.tht.org.uk
17.
Contact with Animals
17.1
Pets
Many schools keep small pets, especially rodents, fish and birds. Children can derive much
pleasure and educational benefit from school pets. Transmission of infection from pets to
humans can occasionally occur, and it is important for the welfare of the children and the pets
that appropriate hygiene practices are in place.

A designated adult should be responsible for looking after school pets.

There should be a written cleaning schedule for birdcages, aquaria and rabbit hutches
etc. and these should be adhered to. Always wash hands well after cleaning out pets.

Encourage everyone to wash hands before eating or drinking, especially when there
has been contact with pets.

Keep all cuts and wounds covered. After animal scratches or bites, clean the area
thoroughly by washing with soap under a running tap. Record the injury in the accident
book. Seek medical advice for bites, which break the skin, and for any bites or
scratches which do not heal quickly or which appear infected.

If pets appear unwell, seek veterinary advice. Ensure pets receive regular veterinary
care, vaccinations, worming etc. where appropriate.

Keep pets out of the kitchen and away from all surfaces where food is prepared or
consumed.
17.2
Outings to Farms and Zoos (see Appendix 3)
The staff in charge of the group should be aware of the possibility of transmission of disease by
either direct or indirect contact with infected animals. He/she should ensure that the farm or zoo
being visited has adequate toilet and hand washing facilities including soap, running water
(preferably warm), disposable paper towels or hot air dryers, and has established procedures to
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prevent the spread of infection to visitors. It would also be useful for staff to carry disposable ‘wet
wipes’ to assist in hand hygiene practices when not near adequate facilities. It is important to note
that using wet wipes does not replace the need for hand washing using soap and water, following
the effective hand washing technique.
Infection is mainly acquired by eating contaminated material, sucking fingers that have been
contaminated through contact with animals, animals fencing/gates and/or or by eating without
washing hands. Potential hazards include animal foodstuffs, raw milk, animal faeces, untreated
water and putting fingers into animals' mouths. It is therefore imperative that children are
advised about hygiene matters before the visit and are constantly supervised.
Children must wash their hands after contact with any animals and always before eating. They
should not eat or drink in any buildings used to house animals or to store animal bedding or
foodstuffs. If there are no suitable facilities for hand washing at the site, then it is recommended
that a visit does not take place.
In wet and muddy pastures or any land contaminated by animal faeces, visitors should wear
impervious outer clothing such as wellingtons boots and plastic Macs. All outer footwear and
clothing must be adequately cleaned after the visit to the farm. This will include washing mud etc
from Wellingtons and changing soiled clothes. Soiled clothing should be washed separately from
other clothes once at home. All children should wash their hands with soap and water when leaving
the farm.
Sick animals must be isolated well away from visitors.
See Appendix 3 for an information leaflet on farm visits. Information can also be downloaded from
the Health and Safety Executive website at www.hse.gov.uk
18.
References
Department for Education (2008). Statutory framework for the early years foundation stage:
Setting standards for learning.
Page 29 | Version 2
Department of Health (2006). HTM 07/01: Safe Management of Healthcare Waste. [Internet]
www.dh.gov.uk accessed 08/06/11.
Department of Health (2010). Routine childhood immunisations from November 2010.[Internet]
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_1
22404 [accessed 08/06/2011]
Food
Hygiene
Regulations
(England)
http://www.legislation.gov.uk/uksi/2006/14/contents/made.
Crown
13/04/2011]
(2006).
Copyright.
[Internet]
[accessed
Health and Safety Executive (2009). COSHH: Working with substances hazardous to health.
HSE.
[internet]
http://www.coshh-essentials.org.uk/assets/live/indg136.pdf.
[accessed
13/11/2011
Health Protection Agency (2010a) Guidance on Infection Control in Schools and other child care
settings.
[Internet]
http://www.hpa.org.uk/ProductsServices/LocalServices/NorthWest/PoliciesAndGuidelines/
[accessed on 04/11/2011
Health Protection Agency (2010b) Guidelines for the control if infection and communicable
disease in school and early years settings. South West London Health Protection Unit. June
2010.
National Patient Safety Agency (2007). National Colour Coding Scheme. [Internet]
http://www.nrls.npsa.nhs.uk/resources/?EntryId45=59810 [accessed on 04/11/2011
19.
Further reading
Lawrence J. & May D. (2003) “Infection Control in the Community”.
London.
Churchill Livingstone,
National institute for Clinical Excellence (2003) Infection Control. Prevention of healthcareassociated infection in Primary and Community Care
Wilson, J. (2001) Infection Control in Clinical practice. 2nd Ed. Bailliere Tindall. London.
Page 30 | Version 2
Appendix 1
Diseases Notifiable under the Health Protection (Notifications) Regulations 2010
Page 31 | Version 2
Appendix 2
Immediate management of a diarrhoea and vomiting outbreak within the nursery,
pre-school or school setting
 Inform the officer in charge / head teacher / deputy if you believe you have a problem i.e.
more than expected numbers of children displaying symptoms or off ill with these symptoms.
 Inform the Community Infection Control Nurse at the local Primary Care Trust who will give
you immediate infection control advice
 Inform the Environmental Health Department in case the cause is a food source.
 Exclude children who have symptoms until they are symptom free for 48 hours
 Advise staff members who have symptoms to stay off work until they are symptom free for
48 hours
 Make a list of symptomatic children and staff. The list should include name and address,
telephone number, date when symptoms commenced, date sent home and date returned to
work/school. The Environmental Health Practitioner may require this to follow up cases. SEE
APPENDIX 7
 Ensure the list is updated daily as parents/staff telephone with further details or as children
return
 Ensure cleaning staff are made aware of the situation so that environmental cleaning can be
increased, especially within toilets and carpeted areas. Regular checks on toilets cleanliness
must be made especially at busy times
 Ensure hot water, liquid soap and paper towels are available for hand hygiene, in both staff
and child toilets
 Nursery, pre-school or school staff should reinforce good hand hygiene with children
especially after going to the toilet and before eating and drinking - supervision of hand
washing should be undertaken by staff if appropriate
 Objects, which become contaminated when handled by children or may be placed in the
mouth, are of particular significance. It is important that toys are cleaned appropriately after
use.
If a child vomits in school




Cover the vomit with paper towels
Clean area thoroughly with hot water and detergent
Staff undertaking cleaning should wear disposable non latex gloves
Ventilate the area by opening windows.
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Appendix 3
Information leaflet for Farm Visits
www.hpa.org.uk/Publications/InfectiousDiseases/Factsheets/0410farmvisits
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Appendix 4
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Appendix 5
Cleaning schedule – frequency & method
Item / area to be cleaned
Cleaning cloths
Method for cleaning
Frequency
Please ensure use of appropriate colour- Dispose of after use
coded disposable cloths for cleaning:
Person(s) responsible
Cleaners and nursery
staff
Red bathroom and changing area
Green kitchen
Blue nursery areas
Yellow for bodily fluids
Floors
Floors to be mopped using hot water and Daily
detergent and left to dry thoroughly
Cleaners / nursery staff
Mop buckets and mop
*Mop buckets to be washed with hot *After every use
water / detergent and stored upside down *Change
mop
*Mops heads to be washed in hot soapy weekly
water, thoroughly wrung out and stored
head up
*Colour-coding for mops / buckets:
Cleaners / nursery staff
head
Red: bathroom and changing areas
Yellow: kitchen
Blue: nursery areas
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Skirting
Skirts to be wiped down with hot water Daily after mopping
and detergent + disposable cloth after
mopping to ensure no build up in corners
Cleaners / nursery staff
Carpets - vacuuming
Furniture to be moved for vacuuming / Daily
replaced afterwards
Cleaners / nursery staff
Carpets – steam cleaning
All carpeted areas should be steam Carpeted areas to be Cleaners
cleaned
steam cleaned weekly
Vacuum cleaner
*Vacuum cleaner detachable tools to be *Weekly
Cleaners
wiped down with hot soapy water
*bag to be changed
*Vacuum cleaner bag to be changed
weekly or when full
Floors buffed
Floors are to be buffed using floor polish One room to be buffed Cleaners
and buffing machine
once a week
Air vents
Air vents to be hoovered and wiped down Daily
using a disposable cloth
Cleaners
Basins and taps
*Taps to be cleaned after use / daily with After each session
hot soapy water
*At end of day taps and basins to be
washed with hot soapy water followed by
disinfectant
Cleaners / nursery staff
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Toilets
*Toilets bowls to be cleaned with After each session / if Cleaners / nursery staff
detergent or disinfectant cleaner if visually visibly soiled
soiled using a clean & well maintained
toilet brush
*Toilet seats to be cleaned with hot water
and detergent then disinfectant using
disposable colour-coded cloth
*Ensure the back of the toilet is also
thoroughly cleaned
Bins
Bins to be emptied and washed out with Daily
hot water / detergent then rinsed with hot
water
Wood work - i.e. all work Wood work to be cleaned with hot water, All woodwork
surfaces and wood panelling
detergent (ensure soapy), and disposable cleaned weekly
colour-coded cloth
Cleaners
to
be Cleaners / nursery staff
Windows
Windows to be cleaned with hot water, Daily
detergent and disposable colour-coded
cloth then dried thoroughly with paper
towel
Cleaners
Window ledges
Window ledges to be cleaned with hot Daily
water, detergent and disposable colourcoded cloth
Cleaners / nursery staff
Doors
Doors to be washed down with hot water, Daily
detergent and disposable colour-coded
Cleaners / nursery staff
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Door handles
Tops of doors
cloth
Door handles to be cleaned with hot Daily
water, detergent then disinfectant using
disposable colour-coded cloth
To be cleaned using hot soapy water and Weekly
disposable colour-coded cloth
Cleaners / nursery staff
Cleaners
Light fittings
Light fittings to be removed and cleaned Once a month
in hot soapy water
Cleaners
Radiators
Radiators to be washed down using hot Once a month
soapy water and disposable cloth
Cleaners
Tables, chairs, and high chairs
*Tables, chairs and high chairs are to be Before and after use and Nursery staff
cleaned with hot water and detergent at meal times
before and after every meal time using
disposable colour-coded cloths.
*Tables also to be cleaned with
disinfectant and dried before meal and
snack times
Sofas
Sofas to be cleaned with hot water and Daily and when visibly Nursery staff
detergent using disposable colour-coded soiled
cloth
Beds
*Beds must be cleaned with hot water and Before and after use
detergent using disposable colour-coded
cloth and dried thoroughly with paper
towel
Nursery staff
Page 38 | Version 2
Cots
Bedding
*All cots and framework should be After use and
cleaned with hot water, detergent and visibly soiled
disinfectant using disposable colourcoded cloth after every use.
*If a child soils the cot or mattress, clean
waterproof mattress cover with hot water,
detergent, and then disinfectant using
disposable colour-coded cloth and left to
dry or dried thoroughly (with paper towel).
If necessary, change waterproof mattress
cover.
*All bedding should be taken straight to After use
the laundry and washed at 650 C or
above.
*If bedding is soiled it should be placed
directly in a red dissolving (alginate)
laundry bag then put straight in the
washing machine and laundered at 650 C
or above
when Nursery staff
Nursery staff
Changing mats
Changing mats must be cleaned with hot After use
water and detergent, then disinfectant,
using disposable colour-coded cloth.
Nursery staff
Changing tables
Changing tables are to be cleaned with After use
hot water and detergent, then disinfectant,
using disposable colour-coded cloth and
dried thoroughly with paper towel
Nursery staff
Page 39 | Version 2
Nappy boxes
Nappy boxes are to be washed with hot Weekly
water and detergent using disposable
colour-coded cloth and dried thoroughly
with paper towel.
Nursery staff
Nappy bins
*Nappy bins to be at least daily
Daily
*Nappy bin to be cleaned with hot water
and detergent, then disinfectant, using
disposable colour-coded cloth.
Nursery staff
Floor toys
All floor toys need to be washed with hot After each session
water and detergent, then disinfectant
using disposable colour-coded cloth then
dried thoroughly with paper towel
Nursery staff
Activity toys
All toys need to be cleaned with hot water After each session
and detergent, then disinfectant using
disposable colour-coded cloth then dried
thoroughly with paper towel
Nursery staff
Sand toys and sand trays
*Sand toys to be cleaned using hot water
and detergent, then disinfectant, using
disposable colour-coded cloth
*Toys should then be put in a separate
box for storage.
*Sand in trays to be sieved and changed
regularly
Toys to be cleaned after Nursery staff
use
*All sand (indoor and
outdoor) to be sieved
after each session and
changed fortnightly
Page 40 | Version 2
Water toys and water tray
*After use all toys to be removed and After use
cleaned with hot water and detergent,
then disinfectant, using disposable colourcoded cloth
*Dried toys should then be placed in a
plastic lidded box for storage.
*Empty water tray and clean with hot
water and detergent, then disinfectant
using disposable colour-coded cloth, then
allowed to dry or dried thoroughly with
paper towel
Nursery staff
Large floor soft furnishings
Large floor soft furnishing to be cleaned Daily or if visibly soiled
with hot water and detergent, then
disinfectant, using disposable colourcoded cloth
Nursery staff
High walls
High walls need to be wiped down with Monthly
hot water and detergent using long arm
reach brush
Cleaners
1
1
Monton Village School, Greater Manchester: adapted from Monton Village School original tool, 2011.
Page 41 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Floors (D)
Mop buckets and mop
(AU)
Skirting (D)
Carpets – vacuumed (D)
Carpets –
steam cleaned (W)
Frequency for cleaning:
AU =* After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 42 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Vacuum cleaner –
tools + bag change (W)
Floors buffed (W)
Air vents (D)
Basins and taps
(AU / D)
Toilets (AES / D)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 43 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Bins
emptied
cleaned (D)
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
and
Wood work (W)
Windows (D)
Window ledges (D)
Doors (D)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 44 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Door handles (D)
Tops of doors (W)
Light fittings (M)
Radiators (M)
Tables (BAU)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 45 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Chairs (BAU)
High chairs (BAU)
Sofas (D)
Beds (BAU)
Cots (AU)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 46 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Bedding (D)
Changing mats (AU)
Changing tables
(AU /D)
Nappies boxes (W)
Nappy bins (D)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 47 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Floor toys (AES)
Activity Toys (AU)
Sand toys/trays
(AU / D)
Sand changed
(indoor play) (F)
Sand changed
(outdoor play) (F)
Frequency for cleaning:
AU = *Rota
After Use;
= Before
& After
Use; AESfor= cleaning
After Each
Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
to beBAU
signed
by all staff
responsible
duties
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 48 | Version 2
WEEKLY CLEANING ROTA
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Water toys / Water
Tray (AU / D)
Large floor soft
Furnishings (D)
Cleaning cloths (D)
High walls (M)
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 49 | Version 2
Room:
Week commencing:
Monday
Area or Item
cleaned
Time:
(am) /
Signature
Time:
(pm) /
Signature
Tuesday
Time:
(am) /
Signature
Wednesday
Time:
(pm) /
Signature
Time:
(am) /
Signature
Time:
(pm) /
Signature
Thursday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Friday
Time:
(am) /
Signature
Time:
(pm) /
Signature
Signature of manager
or auditor
Details of corrective
actions required- sign
when actions taken
Frequency for cleaning:
AU = After Use; BAU = Before & After Use; AES = After Each Session; D = Daily; W = Weekly; F = Fortnightly; M = Monthly
*Rota to be signed by all staff responsible for cleaning duties
*Please verify cleaning frequency and method for all areas and items from agreed cleaning schedule
*All areas / items to be checked and countersigned daily by manager or designated auditor
Monton Village school
Adapted for general use from Monton Village School document
Page 50 | Version 2
Appendix 6
Infection Prevention & Control Audit Tool:
Nurseries In Salford
Name & Address of nursery:
Ofsted registration number:
Contact name (Owner / Manager):
Telephone number / email address:
Date / time of audit:
Audit completed by (please print name & sign):
Accompanied by:
Page 51 | Version 2
Overall Rating:
Audit Section
1
2
3
4
5
RAG
Audit Section
Hand Hygiene (1)
6
Care of Play Equipment (3.2)
Children in Nappies (2.1)
7
Cleaning materials / equipment (3.3)
Children on Potties / Potty Chairs
(2.2)
8
Laundry / children’s sleep facilities (4)
Children on the Toilet (2.3)
9
Preparation of bottled milk (5)
10
Management of Infections (6)
Cleaning Programmes
Environment (3.1)
&
General
RAG
Page 52 | Version 2
1. Hand Hygiene
No:
Standard
1
Liquid soap dispenser / liquid soap at all staff / children’s hand wash sinks
2
Paper towels available at all hand wash sinks
3
Fully working foot operated waste bins for paper towels kept close to hand washing
sinks
4
There are separate toilet facilities for staff with all of the above available
5
Hand towels are not in use at the nursery
6
All hand wash sinks are free of bar soap
7
All hand wash sinks are free from nail brushes
8
Hand wash sinks in non ‘rest’ areas are free from cups and drinking facilities
9
Sinks are clean and clutter free
10
Hand washing technique posters are on display at sinks
11
Children are taught / supervised in hand washing / drying technique and reminded
regularly
12
Children wash their hands before eating
Yes
No
Comment / area
Page 53 | Version 2
13
Children wash their hands after using toilet or potty
14
Children wash their hands after handling pets / animals
15
Taps are thermostatically set to deliver warm water at children’s hand washing sinks
16
Staff wash hands before preparing food, including snacks and fruit
17
Staff observed to have short nails and do not wear acrylic or false nails
18
Staff do not wear rings with stones / wrist watches / jewellery
Total
/18
/18
Additional comments:
Actions / timescale:
Page 54 | Version 2
1. Toilet and Nappy Facilities
1.1 Children in Nappies
No:
Standard
1
Nappy changing area(s) is/are visibly clean and uncluttered
2
Nappies are changed in a designated area away from play facilities and away from food
preparation / consumption areas
3
Staff wear a disposable plastic apron to protect their clothing from contamination when
involved in nappy changing
4
Disposable CE marked single-use gloves are worn during nappy changes
5
Staff undertaking nappy changes do not handle or prepare food or make up bottles until
they have removed aprons / gloves and washed their hands thoroughly
6
Disposable wipes are used for cleaning babies skin during nappy changes
7
Face cloths are not in use at the nursery
8
Soiled nappies are wrapped in a plastic bag before disposal in a bin or nappy disposal
container system in use.
Yes
No
Comment / area
Page 55 | Version 2
9
Hand washing facilities are available in nappy changing area with liquid soap / paper
towels and working pedal-operated bin
10
Nappy changing mats & surfaces are cleaned with detergent & hot water / dried
thoroughly between every change – if visibly contaminated disinfectant is used in
conjunction with detergent
11
Nappy changing mats are intact and checked daily for tears – disposed of if damaged
Total
/11
/11
Additional comments:
Actions / timescale:
Page 56 | Version 2
2.2 Children on Potties / Potty chairs
No:
Standard
1
Potties are only used in a designated area away from play facilities and away from any
area where food or drink may be prepared or consumed
2
Hand wash basin suitable for children and adults available in areas where potties are
used with liquid soap, paper towels and pedal operated bin
3
Designated sink (i.e. not hand wash basin) for cleaning potties sited in area where
potties are used
4
Detergent / disinfectant available for use by staff near toilets / potties
5
After use, staff wear disposable gloves / aprons and tip contents of potty flushed down
toilet - potty then washed with warm soapy water and dried
6
Potties are stored upside down – un-stacked
Total
Yes
/6
No
Comment / area
/6
Additional comments:
Page 57 | Version 2
Actions / timescale:
2.3 Children on the Toilet
No:
Standard
1
Child sized toilets with lids to seats available
2
Toilet seats, flush handles and toilet bowls are cleaned every day or when visibly
contaminated
3
Toilets areas are odour free and free of clutter
Yes
No
Comment / area
Page 58 | Version 2
4
Toilets are free from children’s personal items / items of clothing
5
Adequate supplies of toilet tissue available in each toilet cubicle on holder / in
dispenser
Total
/5
/5
Additional comments:
Actions / timescale:
Page 59 | Version 2
3.0 Cleaning
3.1 Cleaning programmes & General Environment
No:
Standard
1
All general areas are clean and uncluttered
2
Surfaces (chairs / tables / floors) are impervious, in good state of repair and easily
wipeable
3
Is the environment free from smells / odours
4
An agreed cleaning programme is in place
5
A daily record is kept identifying the date and name of the person who completed the
cleaning
6
Cleaning is regularly audited; inspected and approved
7
High chairs / chairs / tables and cots are cleaned after every use
8
There is limited use of carpet (kept to baby room)
9
Carpeted areas are vacuumed daily
Yes
No
Comment / area
Page 60 | Version 2
10
Steam cleaning schedule for carpeted areas is in place
Total
/10
/10
Additional comments:
Actions / timescale:
3.2 Cleaning materials / equipment
No:
1
Standard
Yes
No
Comment / area
Neutral liquid detergent is readily available in all areas
Page 61 | Version 2
2
A disinfectant is available for use
3
Disinfectants / detergents are stored in a locked cupboard when not in use
4
If used, trigger spray bottles as clearly labelled with substance within, emptied and
washed out after use (as per COSHH regulations)
5
Cleaning cloths are single use, colour-coded (see below for
shedding
6
Mops are clean, colour coded and stored inverted / hung to dry between uses
7
Mop heads are disposable or laundered after use
8
Buckets are clean dry and inverted after use
9
Mops for kitchen and toilet / bathroom areas are stored separately to prevent cross
contamination
10
Is a deep sink available for cleaning equipment, separate to hand washing facilities
11
Disposable gloves and apron are worn for all environmental cleaning
Total
example) and non-
/11
/11
Additional comments:
Page 62 | Version 2
Actions / timescale:
Red
- bathrooms, washrooms, showers, toilets & basins
Green
- kitchen & food preparation areas
Blue
- general areas including offices and public areas
Example of Colour-coding (National Patient Safety Agency 2007)
3.3 Care of Play Equipment
No:
Standard
1
All communal toys are of washable material
2
Wipeable toys are in good state of repair and cleaned with warm soapy water and dried
thoroughly after each play session
Yes
No
Comment / area
Page 63 | Version 2
3
Soft toys (not recommended for multi play use) are washed at least once a week on hot
wash if tolerated, or when visibly soiled
4
Water play pools are emptied after play session, washed with detergent / hot water and
dried thoroughly
5
Sandpits have fitted lids when not in use and sand is sieved regularly and kept clean
and dry
6
Sand is renewed once per fortnight
7
Outside sandpits are covered at the end of the day to prevent soiling (e.g. by animals)
8
Play-dough is made prior to play (flour, water, salt, veg. oil, cream of tartar, colouring)
and disposed of after session / plastecine disposed of after play session
9
Toys are stored in a designated container that is rigid and washable – toy containers
should be washed and dried weekly
Total
/9
/9
Additional comments:
Page 64 | Version 2
Actions / timescale:
4. Laundry / children’s sleep facilities
No:
Standard
1
There is a separate designated laundry area away from food preparation sites / kitchen
2
Hand washing facilities are available in laundry area (liquid soap, paper towels, pedal
operated bin)
3
Disposable gloves and aprons are worn when handling dirty linen
4
Red water soluble (alginate) bags are available for soiled linen. Soiled linen placed in
bag and taken directly to laundry area / washing machine
5
Washing machine has a sluice / pre wash cycle and all soiled linen is laundered at a
temperature of 65o C or above
Yes
No
Comment / area
Page 65 | Version 2
6
Clean and dirty linen are kept separate to avoid cross-contamination
7
Children’s soiled clothing is stored in sealed, plastic bags for collection by parent / carer
or placed in alginate bag and laundered on-site
8
Is there a tumble dryer or separate area to dry laundry / linen
9
Cots have imperviously sealed, waterproof covers which are washed with warm soapy
water and dried between use – any linen used removed and laundered
10
Sleep mats are waterproof and checked regularly for tears / breaks – torn mats are
disposed of
11
Mats are cleaned with warm soapy water and dried thoroughly after use – stored in
closed cupboard or covered area
12
Linen used for sleep mats is laundered after use – or single child use (stored in bag or
box for that child’s sole use and washed at least weekly)
Total
/12
/12
Additional comments:
Page 66 | Version 2
Actions / timescale:
5.
No:
Preparation of Bottled Milk
Standard
1
If bottles are brought in ready made by parents / carers are they refrigerated (if bottles
not brought in – tick yes)
2
Is the temperature of the fridge monitored – below 50 C
3
Are fridge temperature records kept (ask to see)
4
Are staff trained in bottle making and sterilisation
5
If bottles are made up on site, is a clean designated area with hand hygiene facilities
available
7
Is there a written policy which covers making up of bottles and bottle sterilisation (ask to
see)
Yes
No
Comment / area
Page 67 | Version 2
8
Are bottles removed from steriliser straight away once cycle is complete (check
steriliser)
Total
/8
/8
Additional comments:
Actions / timescale:
6. Management of Infections
No:
Standard
1
Staff are aware of the signs of infection
2
Staff have undertaken Infection Control Training in the last 12 months
Yes
No
Comment / area
Page 68 | Version 2
3
Staff know where to obtain infection control advice or have access to infection control
guidelines
4
Outbreak management policy available (ask to see)
5
Staff / manager aware of the multi agencies involved in an outbreak (as per policy)
6
Staff are aware of the definition of an outbreak (randomly ask one member of staff)
7
Staff aware of how to deal with blood / body fluid spillage (gloves / apron worn, majority
of spillage absorbed by paper towel / blue roll – clean with disposable cloth, hot water &
detergent – dispose of cloth. Dry area or if outside sluice area with hot water)
8
Sharps / needlestick injury policies are available to staff
9
Records are kept regarding children’s vaccination history & sickness episodes
10
Child’s vaccination history is requested on initial application for nursery place
11
Staff vaccination records are available and staff are encouraged to receive Hep B
vaccination
12
HPA poster - Guidance on Infection Control in Schools and other Childcare Settings
(April 2010) is on display
Total
/12
/12
Additional comments:
Page 69 | Version 2
Actions / timescale:
Audit findings and feedback
1. Audit score will be RAG rated (Red, Amber, Green). ‘Yes’ and ‘No’ scores correlate to Infection Prevention and Control
compliance / non-compliance.
2. Scores are calculated from each section out of a possible total – e.g. hand hygiene, section 1 out of total of 18.
3. If ‘No’ scores equal 40% or more of the section total, this will be marked as red – or non-compliant.
4. Audit has total of 10 sections – including sub-sections for Toilet / Nappy Facilities and Cleaning.
5. Nurseries will be rated Green (Infection Control Compliance 80% or over), Amber (Compliance 50% to 70%) or Red (40% or
less compliance) on the basis of percentage of scores obtained from yes (compliant) and no (non-compliant) answers.
Page 70 | Version 2
6. Overall rating is calculated based on the number of GREEN section scores as per the following table:
10/10
100%
09/10
90%
08/10
80%
07/10
70%
06/10
60%
05/10
50%
04/10
40%
03/10
30%
02/10
20%
01/10
10%
00/10
0%
Page 71 | Version 2
7. Advice can be sought from NHS Salford Infection Prevention and Control Team, Environmental Health or Ofsted on any areas
of concern which the auditor or nursery feel require input or support.
8. Audit findings will be fed back to nurseries with timescale indicated and advice offered to rectify any areas of concern.
9. Red and amber rated nurseries will be re-audited after specified time period to monitor progress. Any remaining areas of
concern will need to be rectified prior to awarding a Green rating for Infection Control compliance.
10. Nurseries achieving Green compliance will be awarded the ‘We’re Clean’ kite mark and which will be shared with other
agencies and can be utilised by the nursery to advertise their achievement.
References
North West Health Protection Agency - Infection Control & Communicable Disease Guidance for Early Years and School Settings
(2011)
Audit tool adapted from:
1. NHS Salford Infection Prevention and Control Team Care Home Audit (2011);
2. West Midlands ICNA audit tool (1998).
Page 72 | Version 2
Appendix 7
Name of Nursery ………………………………………………………………………………………………………………..
Cases Affected
Name
Date
of
Birth
Incident No.
Address
Contact
number
diarrhoea
vomiting
Date /Time
of onset
Date of
recovery
Date returned
School/work
Page 73 of 75
Date
sampled
submitted
Result
s
Page 74 of 75
Appendix 8
Health Protection Agency (2010b)
Page 75 of 75