Cleaning Management Audit Report Date audited:
12/10/2014
Location:
Sample Sample Sample Sample
Client name:
Your practice
Auditor:
Yourself
Accompanied by:
Staff member
Additional info:
Rooms: 1 minor surgery suite (inc clean utility & dirty utility) 3 consulting, 2 treatment rooms, 1 minor surgery, clean utility, dirty utility, office areas, staff & public toilets, staff kitchen.
General Practice surgery town Post Code
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%
Minor surgery room
48%
Treatment Room 1
77 %
Treatment Room 2
92 %
Consulting Room 1
47 %
Consulting Room 2
51 %
Consulting Room 3
82 %
Dirty Utility
82%
Clean Utility
77%
Public WC & baby changing
74%
Staff WC & shower
52%
Staff kitchen
36%
General office
60%
Reception area
92 %
Domestic/Housekeeping Room
84%
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
Sample General Practice 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 %
Sample General Practice General Office The general 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 areas should be clean, covered or wipeable.
Compliant
Expert Guidance
Dirty utility/sluice rooms are clean and free from spillages.
Compliant
Expert Guidance
Full compliance
Non compliance
Non applicable
Total (%)
22
2
3
92 %
Sample General Practice Waste Management Waste is disposed of safely without risk of contamination or injury and in accordance with national legislation and regulations 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 2 of 3
Question
Compliance
Comments
Rationale
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 %
Sample General Practice 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