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Cleaning Management Audit Report Date audited:

12/10/2014

Location:

Sample General Dental Practice Sample surgery Your town Your Post Code

Client name:

Your practice

Auditor:

Yourself

Accompanied by:

Staff member

Additional info:

Rooms: 5 treatment rooms, decon room, waiting area, public toilets, staff kitchen, staff toilet

Section

% Compliance

Governance and Documentary Evidence of effective cleaning practices

61 %

Healthcare cleaning training

33%

Hand hygiene

71%

Use of Personal Protective Equipment for Cleaning

55%

Waste Management

82%

Spillage Management

90%

Treatment room 1

48%

Treatment room 2

72%

Treatment room 3

50%

Treatment room 4

48%

Treatment room 5

50%

Decontamination Room

77 %

Clean Instrument Store

92 %

Public WC

52%

Staff toilet & shower

36%

Staff kitchen

32%

General office

60%

Reception area

92 %

Domestic/Housekeeping Room

60%

Standard assessment of cleanliness of the environment

40 %

Total

61 %

Copyright IPC Management (Holdings) Ltd Š 2005–2014 Template: Primary Care with Minor Surgery (AT017)

Date Approved: 13/05/2014

ICAT Audit Tool Vrs 2.0 Page 1 of 3


Your Surgery Governance and Documentary Evidence of effective cleaning practices Governance documents should be accessible to staff and available for inspection Question

Compliance

Environmental cleaning schedules/check lists are available.

Non-Compliant

There is a daily cleaning schedule/check list for toys.

Not applicable

Comments

Rationale

Expert Guidance Code of Practice for the prevention and Environmental cleaning control of infections 2010 Criterion 2; check lists are available but are not completed or National specifications for cleanliness in the NHS: primary care medical and up to date. dental premises NPSA 2010 Being implemented

Expert Guidance

Full compliance

Non compliance

Non applicable

Total (%)

11

7

2

61 %

Your Surgery General Office The environment will be maintained appropriately in order to reduce the risk of cross infection Question

Compliance

Comments

Rationale

All general areas are clean and dust free.

Compliant

Expert Guidance

Computer keyboards in general office areas should be clean, covered or wipeable.

Compliant

Expert Guidance

Full compliance

Non compliance

Non applicable

Total (%)

22

2

3

92 %

Your Surgery Waste Management Waste is disposed of safely without risk of contamination or injury and in accordance with national legislation and regulations Question

Compliance

Comments

Copyright IPC Management (Holdings) Ltd Š 2005–2014 Template: Primary Care with Minor Surgery (AT017)

Date Approved: 13/05/2014

Rationale ICAT Audit Tool Vrs 2.0 Page 2 of 3


All clinical waste bins are visibly clean.

Compliant

Expert Guidance

Clinical/domestic waste bags are segregated whilst awaiting collection.

Compliant

Expert Guidance

The waste storage area is clean.

Compliant

Expert Guidance

Full compliance

Non compliance

Non applicable

Total (%)

11

1

0

92 %

Your Surgery Domestic/Housekeeping Room Ensure that the environment is decontaminated using appropriate chemicals and appropriate equipment Question

Compliance

Comments

Detergent based cleaning agents are available for the cleaning of the environment.

Compliant

Expert Guidance

Cleaning equipment/products (mops, buckets, cloths, gloves etc.) are colour coded or designated for specific areas and all staff are familiar with/aware of the system in use.

Compliant

Expert Guidance

Cleaning equipment is stored clean, dry, and mops are stored inverted.

Compliant

Expert Guidance

Mop heads are replaced regularly and either laundered or discarded.

Non-Compliant Re-usable mop heads are not replaced at least weekly.

Copyright IPC Management (Holdings) Ltd Š 2005–2014 Template: Primary Care with Minor Surgery (AT017)

Date Approved: 13/05/2014

Rationale

Expert Guidance Revised Healthcare Cleaning Manual AHCP 2013

ICAT Audit Tool Vrs 2.0 Page 3 of 3


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