food hygene nhs

Food Hygiene Policy Version 3

Ratified by: Business Integrated Standards Executive Date of ratification: February 2010

Date of review: February 2012

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FOOD HYGIENE POLICY AND PROCEDURES ID # 2009 123

Author Jacky Jones

Author’s Job Title Hotel Services Site Manager

Division Strategy and Infrastructure

Department Hotel Services

Version number 3

Ratifying Committee Integrated Standards Executive

Ratified Date February 2010

Review Date February 2012

Manager responsible for review Jacky Jones

Manager Job Title Hotel Services Site Manager

E-mail address of Manager [email protected]

Source of Evidence (If applicable) N/A

Level of Evidence indicated N/A

Referenced (Yes / No) Yes

Key Words (to aid searching) Food, catering

The Trust is committed to promoting an environment that values diversity. All staff are responsible for ensuring that all patients and their carers are treated equally and fairly and not discriminated against on the grounds of race, sex, disability, religion, age, sexual orientation or any other unjustifiable reason in the application of this policy, and recognising the need to work in partnership with and seek guidance from other agencies and services to ensure that special needs are met.




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CHANGE HISTORY

Version Date Author Reason Ratification

Required

Version 3 February 2010 Jacky Jones Old policy past review date

YES

INDEX INDEX ..............................................................................................................................2 1. INTRODUCTION ....................................................................................................4 2. PURPOSE ..............................................................................................................4 3. DEFINITIONS.........................................................................................................4 4. ROLES AND RESPONSIBILITIES..........................................................................4 Chief Executive.......................................................................................................4 Associate Director - Hotel Services.........................................................................4 Ward Manager… ....................................................................................................5 Nursing Staff ...........................................................................................................5 Domestic Service Staff............................................................................................5 Dieticians................................................................................................................................ 6

All Employees .........................................................................................................6 5. TRAINING ..............................................................................................................6 6. FOOD HANDLING AND PERSONAL HYGIENE PROCEDURES .....................................................................................................6 Food Premises and ward kitchens ..........................................................................7 Washing up and dishwashers .................................................................................7 Food preparation surfaces ......................................................................................8 Food storage...........................................................................................................8 Food Deliveries.......................................................................................................8 Drinks Trolley..........................................................................................................8 Equipment .............................................................................................................9 Safety Code............................................................................................................9 8. FOOD PROVISION TO PATIENTS ......................................................................10 Ward provision......................................................................................................10 Alternative Menus ................................................................................................10

Red Tray system...................................................................................................11 Protected meal times ............................................................................................11 Provision for the Therapeutic Diets .......................................................................11 Monitoring of Patient Meal Service........................................................................11 9. FOOD BROUGHT IN BY PATIENT/VISITORS.....................................................11 Relatives use of the ward kitchen..........................................................................11 10. WASTEFOOD.......................................................................................................12 11. REFRIGERATORS AND FREEZERS...................................................................12




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12. MICROWAVES.....................................................................................................13 Domestic Microwaves ...........................................................................................13

Industrial Microwaves ...........................................................................................13 13. RESTAURANT SERVICES...................................................................................13 Special event and functions ..................................................................................14 14. RISK MANAGEMENT...........................................................................................14 Food purchasing ...................................................................................................14 Food Temperature control.....................................................................................14 Sustainability.........................................................................................................14 Food hazard, formal complaints and infectious diseases ......................................14 Hazard warnings...................................................................................................14 Complaints............................................................................................................14 Infectious diseases ...............................................................................................15 Infectious disease procedure ................................................................................15 15. TRANSPORTATION OF FOOD............................................................................15 Delivery and collection of food trolleys ..................................................................15 16. INSPECTION, AUDIT AND MONITORING OF CATERING SERVICES...............16 17. EQUALITY IMPACT ASSESSMENT ....................................................................16 18. REFERENCES .....................................................................................................17 19. APPENDICES.......................................................................................................17 Food Safety Management System........................................................................18 Code of Practice for Ward kitchen refrigerators.....................................................19 Hygiene Code of Practice for Ward kitchen...........................................................20 Refrigerator / Freezer temperature record.............................................................21 HACCP Flowchart.................................................................................................22 National Colour Coding Scheme for hospital cleaning materials and equipment ...23




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1. INTRODUCTION Good hygiene, food safety practices and informed staff are vital in the preparation, storage, distribution and service of food. West Herts Hospital Trust places the utmost importance on food hygiene within all its premises and by any contractor providing a service to our patients. All staff involved with the production, service and delivery of patient’s food must follow the guidance contained within this policy. 2. PURPOSE The purpose of the policy is to ensure safe practice among food handlers in accordance with Trust policies and current legislation. The fundamental objective of the Food Hygiene Policy is to protect human life and health. The Policy also aims to identify procedures for safe practice for all food handlers, to prevent cross contamination and potential food related illness for service users, staff and visitors. The food hygiene controls are of a practical nature and the policy is intended to be used as a working document for the ward and departments. Adherence to the policy will ensure that the Trust compiles with all current food safety legislation.

• The Food Hygiene (England) Regulations 2006

• Food Safety (General Food Hygiene) Regulations (EC) No 852/2004 3. DEFINITIONS

• Food ~ Any substance or product, intended to be ingested. This includes drinks and water or any substance incorporated into the food during its preparation or treatment.

• Food Provider ~ The person responsible for ensuring that the requirements of food law are met.

• Food handler ~ Any person including staff, patient, visitor, contractors, outside vendors and suppliers who handle, transport or serve food on hospital premises.

4. ROLES AND RESPONSIBILITIES OF STAFF

4.1 Chief Executive

The Chief Executive has overall responsibility for ensuring that the Trust has appropriate procedural documents and that the Trust works to best practice and complies with all relevant legislation. However all managers with responsibility for services that handle food must ensure that all staff are aware of, and adhere to, this Policy

4.2 Associate Director – Hotel Services

• Is responsible for the Management of the Contracted Food Provider

• Takes the overall operational lead for the catering services throughout the Trust




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• Ensures compliance within The Food Hygiene (England) Regulations 2006 and Food Safety (General Food Hygiene) Regulations (EC) No 852/2004

• Ensures the Food Hygiene Policy is in place and kept updated for significant changes.

• Ensures effective monitoring arrangements are in place to assess catering performance.

• Ensures Joint Partnership Board Meetings between the contractor are held monthly with representation from all stake holders

• Take the lead for contract review and negotiations

• Make sure that the contractors deliver high standards and value for money

• Establish a spirit of partnership and teamwork with service providers. 4.3 Ward Managers

• Ensure kitchen and beverage bays are clean and well maintained

• Ensure that all staff maintain good standards of personal and food hygiene

• Ensure that staff who require training are made available to attend training on food hygiene related subjects

• Ensure that staff are aware and follow the code of practice for Food Safety Management (appendix 1)

• Ensure staff adhere to the code of practice for ward kitchen refrigerators (see Appendix 2)

• All training – induction, refresher and updates should be recorded by the Ward Manager

4.4 Nursing Staff

• The maintenance of hygiene standards in ward kitchens, in conjunction with Domestic Service staff

• The hygienic service of food to patient

• The hygienic storage and correct dating and labeling of food

• Reporting any matters that may affect the ability to maintain food hygiene standards

• Adhere to the code of practice for Food Safety Management (appendix 1)

• Adherence to the codes of practice for ward kitchen refrigerators (appendix 2)

• Adhere to Hygiene Code of Practice for Ward Kitchens (appendix 3)

• Adhere to good food hygiene practices

• Report any damaged or faulty equipment used in the transportation, storage or service of food to the Estates Department

4.5 Domestic Service Staff

• The maintenance of hygiene standards in ward kitchens, in conjunction with Nursing Staff

• Reporting any matters that may affect the ability to maintain food hygiene standards to the ward sister




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• Reporting any signs or evidence of pest infestation to the Domestic Contract Services, Site Manager

• Adhere to the code of practice for Food Safety Management (appendix 1)

• Adherence to the codes of practice for ward kitchen refrigerators (appendix 2)

• Adhere to Hygiene Code of practice for ward kitchens (appendix 3)

• Adhere to good food hygiene practices

• Report any damaged or faulty equipment used in the transportation, storage or service of food to the Ward Manager

4.6 Dieticians

• Will work in conjunction with Hotel Services Site Manager to ensure that the Food Safety Act 1990 – amendment Regulations 2004 and Food Safety (General Food Hygiene) Regulations 1995 are adhered to.

• Monitor the catering practices of the contractor to ensure that the standards comply to the required nutritional needs of the individual patient.

• To attend the Joint Partnership Board Meeting to discuss current issues regarding catering in hospital for patients, visitors and staff

• Reporting to Hotel Services any matters that may affect the ability to maintain food hygiene standards

4.7 Responsibility of all Employees

• Every member of staff that has any responsibility for food handling should make themselves aware of the current version of the Food Hygiene Policy

5 TRAINING

All food handlers must receive food handling training of an appropriate content, length and frequency to reflect their role and food handling responsibilities.

6. FOOD HANDLING AND PERSONAL HYGIENE PROCEDURE Almost all the food we eat may become infected with germs through poor personal hygiene and poor practices that are harmful to human beings and can cause food poisoning. In a normal healthy person, such illness may not be very serious, but in hospital patients who are already ill or those who are handicapped by age or infirmity, it can be serious and may even be fatal.

• Food should be kept in the trolley for the shortest time possible. The trolley should be plugged in at the time of arrival and food served as soon as possible.

The following catering codes of practice are designed to promote good food hygiene practices;




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1. Wash your hands frequently and particularly before and after handling food and after using the toilet

2. Report any skin, nose, throat or bowel trouble to the Ward Sister or to your Supervisor

3. Hair should be clean, tied back when handling food. Never scratch your head when there is food around

4. Cover any cuts with a waterproof blue dressing 5. Wear clean clothing and maintain high standards of personal hygiene 6. All food handlers must wear a clean single use plastic disposable apron, which is

exclusively used for food handling 7. No jewellery other than a single wedding band and sleeper style earrings without

studs should be worn 8. Nails should be kept short and nail polish must not be worn and cosmetic false

nails should not be worn. 9. Smoking in a ward kitchen is strictly prohibited and disciplinary action will be

taken against anyone found smoking. 10. “CLEAN AS YOU GO” in kitchens and never cough or sneeze over food 11. Keep food covered, dated and stored at the correct temperature i.e. in the

refrigerator between +1ºC and +4ºC. Do not leave food of any kind exposed and uncovered anywhere in the kitchen

12. Food that has been heated up should be served immediately. Hot food should not be retained on the ward for periods longer than 2 hours. Cold food should be stored in the refrigerator.

13. The ward refrigerator procedure must be followed at all time and the temperature should be recorded twice daily (appendix 4)

14. Every food handler has a legal responsibility to safeguard food so that it does not cause illness or harm and in the eyes of the law anyone who either prepares, cooks or serves food is deemed as a “FOOD HANDLER”

7. Food Premises and Ward Kitchens Food premises should be kept clean, maintained in good repair and well ventilated. The lay out and design, site and size must allow adequate working space to allow for the hygienic performance of all food handlers and to avoid airborne contamination.

• Drainage should be designed to prevent waste from a contaminated area draining towards a clean area. Toilets should not open directly into any room where food is handled.

• Hand basins should be located conveniently and used for hand washing only. Separate sinks for washing food should be available.

• All cleaning and sanitising should be carried out in accordance with the ward based cleaning specification

• Separate colour coded equipment and cloths should be used for cleaning the ward kitchen (appendix 6)

7.1 Washing Up and Dishwashers

• Pre-scrape any plates

• Detergent wash should be at 60ºC and the rinsing process should be for




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a period of 2 minutes at 82ºC. With higher temperatures the rinse time can be reduced.

• Dishwashers should only be purchased after getting advice and recommendations from the Estates Department.

• The Estates department monitor the hot and cold water supply to the dishwasher

• After drying, ensure that all crockery and cutlery are stored appropriately

• Advice should be sort from Estates before purchasing a replacement.

7.2 Food Preparation Surfaces

• These should always be clean and dry

• Before and after any food preparation takes place, the whole surface must be cleaned thoroughly and then sanitized with a solution supplied by the contract cleaners

7.3 Food Storage

• The minimum amount of food should be stored at ward level

• Good stock rotation should be applied i.e. “first in first out” and attention must be paid to “use by dates” and “best before date”. Food that has gone beyond the use by date should be discarded.

• All food storage areas should be clean, dry and regularly checked for any sign of pests.

• Any spillages must be cleaned up immediately

• All food in storage must be covered and dated. Perishable foods must be stored in the refrigerator

• Food storage containers must be washed and dried regularly. The contents should be used up completely before re-filling ~ no “topping up”

• Raw foods should be stored or refrigerated in a clean container.

• Raw eggs are not permitted at ward level.

• Raw meat and fish must be stored at the bottom of the refrigerator

• Food preparation must be carried out in a separate area from cooked food

• Ice cream should always be served frozen and never refrozen once it begins to thaw

• Butter ~ should be supplied to the ward in boxes which has the date stamp on.

• Any left over food must be disposed of in to green bags

• If a patient is not available at mealtime, the Steamplicity meal must be refrigerated and cooked at a more convenient time. Bulk food can only be held in the hot trolley until the Porter removes the trolley from the ward, this meal should then be discarded.

• Staff are not permitted to consume any food or drink that is intended for patients

7.4 Food Deliveries

• All food items brought to the ward for patient consumption should be checked for temperature:




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• Hot food should be above 75ºC

• Cold food for heating (Steamplicity) should be at or preferably below 8°C 7.5 Drinks Trolley

• Cup holders must be washed up after each use

• The water tank must be emptied, cleaned and dried daily and the trolley itself should be cleaned thoroughly once weekly

• Sleeves of drinks should be stored in a clean dry area, and any damaged sleeves should not be used.

7.6 Equipment

• Avoid touching the food by hand, use utensils such as forks, tongs or slices.

• All equipment should be kept off the floor.

• Defects or faults in mechanical or electrical equipment must be reported to the Estates Department and the item taken out of use immediately. No attempts should be made to repair of dismantle any electrical or mechanical equipment.

• Empty cans and food containers must be promptly disposed of as domestic waste

• Food Probes should be calibrated for accuracy monthly as follows:

Cold

• Fill a 500ml measuring jug with ice and top up with cold water.

• Place the probe into the iced water. Agitate / stir the probe until a steady reading is achieved.

• Check the display reading. This should be –1ºC to +1ºC. If outside this range, the thermometer must be replaced or repaired.

• Record the result of the calibration check on the Thermometer Calibration & Accuracy Record.

Hot

• Bring a pan of unsalted water to the boil

• Place the probe carefully into the boiling water. Agitate / stir the probe until a steady reading is achieved. Ensure that the

probe does not touch the base or sides of the pan.

• Check the display reading. This should be +99 ºC to +101ºC. If outside this range, the thermometer must be replaced or repaired.

• Record the result of the calibration check on the Thermometer Calibration & Accuracy Record. N.B. ‘Built-in’ thermometers on refrigerated equipment are usually not calibrated and not reliable for accuracy. Always use your digital probe thermometer.




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7.6.1 Safety Code When using Electrically Operated Equipment the following must be adhered to:

• Ensure you hands are dry before inserting or removing electric plugs, do not pull the plug out by its flex and switch on and off at the socket and at the machine.

• Ensure all switches are in the “Off” position before connecting and disconnecting to an electrical supply

• Before cleaning or adjusting any equipment, it must be switched off at the mains and the plug removed from the socket.

NB: All movable electrical appliances must be appliance tested yearly. This can be checked by looking at the test tag on the appliance or plug. Items that have not been tested must be taken out of use and reported to the Estates department. 8. Food Provision to Patients The catering department provides catering services throughout the Trust to inpatients. Food is available 24 hours a day, seven days a week. Nutrition is a vital part of a patient’s treatment and it is essential to ensure that the food provided meets the patient’s individual requirements. Food provision must also take into account personal, cultural and religious needs. Patient food provision ~ Steamplicity at Watford General Hospital and Hemel Hempstead Hospital and traditional bulk service at St Albans City Hospital is supplied to the Trust under a service level agreement with Medirest

• Steamplicity offers a comprehensive menu, which offers a choice of hot or cold meals, these have all been approved by the Dieticians who can confirm that the menus deliver nutritional requirements sufficient to meet the needs of all patients, within the guidelines of the Adult Nutrition Policy.

• The standard menu card contains codes, indicating items suitable for variations to standard food; H = Healthy Option. These meals are also suitable for people with

diabetes and those requiring less fat. E = Higher Energy. These dishes are particularly high in calories. S = Softer. These meals are easier to chew or which can be easily

mashed with a fork. V = Vegetarian. Suitable for vegetarians. GF = Gluten Free. Meals suitable for those with Coeliac Disease.

LS = Moderate/Lower Sodium. These meals are suitable for people following a lower sodium or no added salt diet.

At St Albans City Hospital the food is cooked on site using traditional methods and served in bulk to the wards using heated trolleys, they also offer a comprehensive menu cycle and the dietary indicators are;

☺ = Healthy eating.




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D = Diabetic S = Soft H = High energy P = Pureed

8.1 Ward Provisions ~ 24 hour service � Ward snacks are available twenty-four hours a day and are available to

all in-patients between meals. � Outside of normal catering hours a snack box can be provided at any

time of the day or night by contacting the Porter. �

8.2 Alternative Menus � Ethnic Menu ~ these can be provided for patients with ethnic and cultural

preferences who require Halal, Kosher or Caribbean food in a variety of different languages. Braille menus are also available.

8.3 Red Tray System

The Trust operates this initiative to identify patients who have particular needs with feeding or in-take of food. This can range from patients with a broken arm, complex medical cases e.g. stroke or high risk of malnutrition. Patient’s needs may be temporary or permanent and can apply to normal or special diets. Issuing a red tray to a patient indicates to ward staff that additional support is required during mealtime and that the patient’s food intake should be monitored.

8.4 Protected meal times

All in-patient areas are expected, where practicable, to observe a protected mealtime protocol. This allows patients the maximum opportunity to enjoy meals in a relaxed environment conducive to eating. During the protected mealtime, clinical interventions and medication of patients should be kept to an absolute minimum and where necessary for essential patient care.

8.5 Provision for therapeutic diets

Provision for special diets (pureed, fortified, etc) is made and can be provided to patients following consultations with dieticians. Provisions for special diets include food that has been modified and textured meals suitable for patients with dysphasia.

8.6 Monitoring of Patient meal service

Regular audit of patient satisfaction is under taken by the catering contractor and the results reported through the Joint Partnership Board. Patient Environment Assessment Team (PEAT) inspections also monitor the patient

9. Food Brought In by patient/visitors

• Patients and visitors should be discouraged from bringing food into the ward, with the exception of fruit, cordial and confectionary

• Patients and visitors must be strongly discouraged from bringing high risk




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foods into the ward kitchen e.g. cooked meats, rice, fresh cream products, shell eggs etc.

• Staff, patient and visitors must not bring raw foodstuffs into the ward kitchen.

• Nursing staff must advise patient and visitors that if food is brought in from outside it should be:

1. Wrapped and labeled with the patients name and date received. 2. It should be exclusively for that patient and not shared with anyone else. 3. If the food is perishable, it should be stored in the ward refrigerator. 4. Any food brought in from outside should be discarded within 24 hours of

receipt. 5. Uncooked food should not be brought into the ward kitchen.

9.1 Relatives’ use of Ward Kitchens Under certain circumstances such as when a patient is particularly poorly and needs encouragement and involvement of relatives to eat the relatives will be permitted to use the ward kitchen. If relatives are permitted to do so by the ward manager then it is the responsibility of nursing staff to ensure that:

• Relatives are given a tour of the ward kitchen indicating the correct use of all equipment, this should include food hygiene awareness information.

• Only nursing staff are permitted to authorise relatives to use the ward kitchen.

• Permission for relatives to use the ward kitchen should only be based on patient’s needs and not an open access to every patient relative.

• Children must not be allowed to use ward kitchen or be present whilst others use the area.

• No more than two relatives should be allowed to use the ward kitchen at a given time.

• The ward kitchen is NOT to be used for food preparation. It can only be used for sealed pre-cooked food, which is either to be eaten cold or microwaved.

10. Waste Food

• All waste food from meal times should be scraped into green food waste bags and then disposed of by the contractor.

11. Refrigerators and Freezers and Display Units

• All food stored in the refrigerator must be covered and dated.

• The temperature of the refrigerator should be between 1 and 4 ºC and should be checked and recorded on appropriate sheet (appendix 4) twice daily by the Domestic assigned to the ward.

• Storage of staff or patients’ private home-cooked food should be restricted as necessary. It should be properly labeled with the patient’s name and the date prior to being placed in the refrigerator.

• Patients, relatives and visitors should not have access to the refrigerator.

• Take food out of cans and transfer to containers before storing




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• Keep uncooked and cooked food separately

• Never put hot food in the refrigerator, it raises the temperature of the fridge and may create condensation, which can cause contamination by dripping onto other foods.

• Drugs, blood and specimens should never be stored in the food refrigerator.

• The outside of the refrigerator should be damp wiped daily, and any spillages inside should be cleaned up immediately. Once monthly the refrigerator should be cleaned thoroughly and defrosted (if not self-defrosting), by the Domestic Services staff

• Freezers must not be used to store ice cream.

• Freezer temperatures should be working at –18 ºC

• Always ensure that food is wrapped before putting it in the freezer

• Once thawed DO NOT refreeze.

• Faults should be reported to Estates as soon as possible

• Advice should be sort from Estates before purchasing a replacement.

12. Microwaves

There are currently two types of microwaves being used within the Trust;

12.1 Domestic Microwaves

• Domestic microwave ovens must not be used for re-heating patients meals

• All food items must be covered or in containers to prevent splashing /spillage.

• Food brought in by visitors for patients should not be re-heated using the microwave ovens.

• Metal containers must not be used in microwave ovens.

• The microwave oven should be PAT tested once a year and must also be omission tested annually.

• Advice should be sort from Estates before purchasing a replacement

12.2 Industrial Microwaves ~ for Steamplicity

• These microwave ovens are pre-set for the cooking of Steamplicity meals and should only be used by the Catering staff.

• Once the meals are cooked they must be probed to reach a temperature of 75 degrees C and this must be recorded.

The microwave ovens will be cleaned before and after each service by the Catering staff.

13. Restaurant Services




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Restaurant services are available at WGH and SACH to staff, visitors and patients. Services include;

• Breakfast, lunch and supper meals (only available at WGH)

• Salad Bar

• Sandwich Selection

• Hot and cold beverages

• Light meals and snacks

• Vending machine provision

Café style catering is available at HHGH including,

• Pastries

• Pasties

• Jacket Potatoes with hot and cold fillings

• Sandwich selection

• Hot and cold beverages

• Snacks

• Vending machine provision

It is the policy of the Trust that healthy food choices are promoted in all dining areas, including working lunches and in vending machines, with the objective of increasing the availability of foods which are healthy but enjoyable choices. The restaurant food pricing is subject to annual price increases. Staff are not entitled to free meals.

13.1 Special Event and functions Meals and/or refreshments may be provided for all attendees at special events managed by the Trust. Budget holders are responsible for ensuring the appropriate authority is sought prior to booking a function or event.

14. Risk Management 14.1 Food Purchasing, delivery, storage, preparation and service

The Trust provides a hazard analysis and critical control point (HACCP) (appendix 5) protocol to all its catering functions to patients, staff and visitors which is available through the Catering Services Manager, this details all food processes and is monitored by the Environmental Health Department for adequacy to ensure compliance to food safety.

14.2 Food Temperature Control All hot food must reach a temperature of 75ºC within 15 seconds; food can not be served if below 63ºC. Cold food can be kept on display above 8°C for up to four hours. It can then be refrigerated but must not be displayed again.

14.3 Sustainability




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The Trust is committed to providing sustainable food procurement by sourcing local produce and goods where possible, through the NHS supply chain procurement process.

14.4 Food Hazards, Formal Complaints and Infectious Diseases All information received relating to food safety hazards and formal complaints must be forwarded to the Associate Director – Hotel Services. In cases where food poisoning is indicated the Environmental Health Department and the CCDC – Consultant in Communicable Disease will be informed and take the lead on

fully investigating the case. CCDC - Consultant in Communicable Disease Control

14.4.1 Hazard Warnings and Food Alerts The Catering team will be responsible for distributing copies of any hazard warning information to the Associate Director – Hotel Services for dissemination to appropriate locations issuing guidance and assistance as necessary.

14.4.2 Complaints If a food complaint is received the Catering Services Manager and the Hotel Services Site Manager and Head of Dieticians will be informed. The Catering Services Manager will investigate the incident and decide if food is substandard, draw up an action plan and ensure corrective action has taken place. The Hotel Services Site Manager will ensure that incidents/complaints relating to all food are reviewed and recorded. They will also be responsible for bringing it to the Joint Partnership Board Meeting.

14.4.3 Infectious Diseases Further information should be sort through the Occupational Health Department. Anyone suffering from or carrying a disease such as diarrhoea, vomiting, skin infection, infected wounds or gastrointestinal infections must not be allowed to work in an area where they may be directly or indirectly contaminate food. All staff must be instructed of their obligation and managers be aware of this policy. Occupational Health are responsible for ensuring that any person known or suspected to be suffering from, or to be a carrier of a food borne disease or infection, including vomiting, diarrhoea, skin infections, sore and open wounds is excluded from working with food in a way that might present a risk to food. The Catering Department will also inform and take advice from the Trusts Infection Control Team regarding infectious diseases.

14.3.4 Infection Disease Procedure;

• All staff are advised at induction of the reporting procedure for illness,

• Anyone suffering from an infectious disease, especially food poisoning, will be excluded from work,

• Staff are monitored for signs of infectious illness,

• It in not permitted for any person who has been ill with symptoms of food




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poisoning or other illness likely to put food safety at risk to return to work until 48 hours after symptoms have stopped naturally,

• Good personal hygiene practices can be carried out effectively by ensuring the wash hand basins are kept clear for use and that hand cleaning and drying equipment are always available.

Further information may be obtained from the Department of Health guidance “Food Handlers: Fitness to Work (H16/07 718 2P 107k August 96 (03)

15. Transportation of Food

Porters involved in the delivery and collection of food trolleys are deemed to be “Food Handlers”. All Porters must be made aware of these guidelines and they should be incorporated into the induction of all new employees.

15.1 Delivery and collection of Food Trolleys Great care should be taken in the delivery and collection of food trolleys, in order to minimize risks whilst in transit to patients, visitors, staff and infrastructure. It is essential that the food be delivered to its destination without spillage or breakage etc. The following rules must be followed:

• Only two food trolleys should be transported at any one time.

• Trolleys should be delivered to the ward as quickly and safely as possible, ensuring that the trolley doors remain shut at all times.

• Porters must inform a member of the Nursing staff as soon as the trolley is delivered to the ward.

• All Steamplicity meals delivered to HHGH must be decanted to the fridge upon arrival.

• The temperature of incoming foods must be checked and recorded.

• If applicable, the trolley must be plugged into the appropriate wall socket as soon as it arrives on the ward.

• If trolleys are damaged during transit, this should be reported immediately in all instances to the on site Catering Manager and the Estates Department.

• All food containers must be lidded and transported inside the trolley.

• If any spillages occur during transit, this should be reported immediately to the Catering Manager. The spillage should be made safe and a warning sign or cone put in place until the spillage can be cleaned up thoroughly.

• In circumstances where the collection of a trolley is not possible due to late meal service, the Porter must liaise with the Nursing staff and agree a later time for collection.

16. Inspections, Audit and Monitoring of Catering Services

Environmental Health food hygiene inspections are carried out unannounced. Visits are made in accordance with the outcome of a food hygiene scoring system contained within the Food Law Code of Practice produced by the Food




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Standards Agency and used by all local authorities. Where serious food hygiene or food safety deficiencies are found the Environmental Health Officer can serve a Hygiene Improvement Notice or Probation Notice.

Document Audit and Monitoring Table

Patient Satisfaction Audit Audit conducted by the service provider twice annually

Dietician Audit Monthly audit of catering service, to ensure patients are receiving a nutritionally balanced meal and that standards are being met.

Hotel Service Catering Audit A monthly catering audit of all aspects of catering to include, HACCP control, Food safety standards, cleaning and infection control issues

Environmental Health Officer Inspection Six monthly or adhoc when required 17. Equality Impact Assessment

The Trust is committed to promoting an environment that values diversity. All staff are responsible for ensuring that all patients and their careers are treated equally and fairly and not discriminated against on the grounds of race, sex, disability, religion, age, sexual orientation or any other unjustifiable reason in the application of this policy, and recognising the need to work in partnership with and seek guidance from other agencies and services to ensure that special needs are met.

18. References

� The Food Hygiene (England) Regulations 2006

� Food Safety (General Food Hygiene) Regulations (EC) No 852/2004

19. Appendices;

� Food Safety Management System � Code of Practice for Ward Kitchens refrigerators � Hygiene Code of practice for ward kitchens � Refrigerator/Freezer Temperature Record Sheet � Cleaning colour coding for equipment




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Appendix 1

Ward Procedures ~FOOD SAFETY MANAGEMENT SYSTEM POINT OF DELIVERY: Ensure that all food in trolleys is in good condition (no spillages, damage etc). Report any spillage/damage/discrepancies to the Main kitchen or Site Services Manager If appropriate plug trolley in and check it is operating correctly. Remove milk and other cold ward items to refrigerator before serving hot food. Remove food (Steamplicity – cook according to the times indicated) take core temperatures.

HOT FOOD: 75ºc COLD FOOD: 1-3ºc RECORD TEMPERATURES ON THE FOOD TEMPERATURE RECORD

SHEET BEFORE SERVING (This MUST have the ward name at the top of the sheet)

SERVE HOT AND COLD FOOD Ensure that meals are allocated correctly to patients within 10 minutes of arrival or preparation to ensure optimum temperature is maintained. If food is NOT reaching the correct temperature, place back into the microwave and continue cooking or return to the heated trolley for bulk and operate the “REGEN” switch until it probes 75ºC, then record this temperature. Report faulty trolleys to the catering department. MICROWAVES; Other than industrial microwaves for Steamplicity, these should not be used to reheat kitchen prepared foods. RECOVERY / WASTE At WGH and SACH, all food should be scraped into the green plastic bag supplied by the contractor. ESSENTIAL DOCUMENT RECORDING Refrigerator / Freezer Temperature Record ~ to be completed am and pm. Hot / Cold Food Temperature Record Sheet ~ to be completed at EVERY meal service for all items of food




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Temperature Probe Calibration records – (monthly, or if device is suspected of not performing) ALL RECORDS MUST BE KEPT IN AN ARCHIVE FILE FOR EHO / AUDIT PURPOSES FOR ONE YEAR, MINIMUM. Appendix 2

West Hertfordshire Hospitals NHS Trust Procedure for Ward Fridge Temperatures

Introduction It is a requirement of the Environmental Health Officer that we maintain regular records of the ward fridge temperatures. It is the responsibility of the Ward Manager/Sister to ensure that these records are maintained and displayed in the ward kitchens and to ensure procedures are followed should a fridge not be keeping the correct temperature, eg. Job ticket logged with Estates, replacement fridge ordered if needed. It is the responsibility of Medirest to check and record the temperatures and report to the ward should a fridge be failing to keep temperature. It is the responsibility of the Estates Department to check a fridge, once the ward has logged a job, and complete the necessary condemned notice should the fridge be un-repairable.

Procedure Action Owner

Daily check and record the temperature of the fridge and ensure that the temperatures records are displayed in the Ward Kitchen

Medirest

Regular check to ensure that the records of the fridge temperatures are visible and that action has been taken should the temperature be failing

Ward Manager/Sister

Should temperature be +5o or over, this must be reported to the Ward Manager/Sister immediately and also written into the Medirest Communication Diary on the ward

Medirest

If the temperature is over +5o a job ticket must be logged with Estates (please note that if the temperature is +8 o , then all contents in the fridge must be removed immediately

Ward Manager/Sister

Estates to check out the fridge and repair if possible, if condemnable, give written report to the ward

Estates

Should the fridge need to be replaced, this is the responsibility of the ward but in consultation with Estates

Ward Manager/Sister




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CODE OF PRACTICE FOR WARD REFIGERATORS

1. This refrigerator is for the storage of cooked and prepared foods only

2. The contents must be checked daily and stock rotation followed.

3. The refrigerator should be defrosted and cleaned weekly and

checked for correct operation (between +1 and +4ºC)

4. Patient’s / staff food if stored in the refrigerator should be labeled and stored separately




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APPENDIX 3

Hygiene Code of practice for ward kitchens

1 Wash your hands frequently and particularly before and after handling food and after using the toilet.

2. Report any skin, nose, throat or bowel trouble to the Ward Sister or to your

Supervisor. 3. Hair should be clean, tied back when handling food. Never scratch your

head when there is food around.

4. Cover any cuts with a waterproof blue dressing.

5. Wear clean clothing and maintain high standards of personal hygiene.

6. All food handlers must wear a clean single use plastic disposable apron, which is exclusively used for food handling.

7. No jewellery other than a single wedding band and sleeper style earrings

without studs should be worn.

8. Nails should be kept short and nail polish must not be worn and cosmetic false nails should also not be worn.

9. Smoking in a ward kitchen is strictly prohibited and disciplinary action will

be taken against anyone found smoking.

10. “CLEAN AS YOU GO” in kitchens and never cough or sneeze over food.

11. Keep food covered, dated and correctly stored. Do not leave food of any kind exposed and uncovered anywhere in the kitchen.

12. Food that has been heated up should be served immediately. Hot food

should not be retained on the ward for long periods. Cold food should be stored in the refrigerator.

13. The ward refrigerator procedure must be followed at all time and the

temperature should be recorded twice daily.

14. Every food handler has a legal responsibility to safeguard food so that it does not cause illness or harm and in the eyes of the law anyone who either prepares, cooks or serves food is deemed as a “FOOD HANDLER”




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Appendix 4

MONTH / YEAR: REFRIGERATOR / FREEZER:

TEMPERATURE oC

DATE a.m.

Init.

p.m. Init Night Init

COMMENTS Action taken if temperature above accepted

limits

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Temperature Range: Refrigerators: +1oC to +5

o C. Twice per day (3 if night shift operation)

Freezers: -18oC to –23

oC Once per day

COMPASS GROUP UK & IRELAND

REFRIGERATOR / FREEZER TEMPERATURE RECORD




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Insert temperature and initial clearly.

CHECKED BY: DATE:

Manager to check the record form and sign. Retain for 6 months

Appendix 5

Compass Group UK & Ireland

Food Safety Hazard Analysis & Critical

Control Points (HACCP) Flowchart

12. Cold Food Display

10. Reheating Food

11. Hot Holding and Service

14. Transport of Food

9. Cooling Food

8. Cooking

7. Defrosting Food

1. Planning Food Service

2. Purchase and Food Delivery

4. Frozen Food Storage 3. Chilled Food Storage 5. Dry Food Storage

6. Food Preparation

13. Vending




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Appendix 6

NATIONAL COLOUR CODING SCHEME FOR HOSPITAL CLEANING MATERIALS AND EQUIPMENT

RED

Bathrooms, washrooms, showers, toilets and basins

BLUE

General areas including, Wards and departments

GREEN

Ward kitchens and

Catering departments

YELLOW

Isolation areas

food hygene nhs

Health & Medicine

date of review

food hygiene policy

manager responsible

ward manager

food handling

chief executive

personal hygiene procedures

index index