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Food Hygiene Policy

Responsible Directorate:

Finance, Estates and Facilities

Responsible Director:

Director of Finance

Date Approved:

Committee:

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Version Control

Current versions of all policies can be found on NHS Kirklees internet and intranet. If printing a document, please check internet/intranet for most up-to-date version.

Document Title: Food Hygiene Policy

Document number:

Author: Sue Heeley, Hotel Services Manager

Contributors: Keith Geldard, Acting Director HPM; Gwen Ruddlesdin, Locala; Sue Ross, Lead IPC KPCT

Version: Update v5

Date of Production: January 2012

Review date:

Post holder responsible for revision:

Hotel Services Manager

Primary Circulation List:

Infection Prevention and Control Team Head of Governance, Locala Head of Therapies, Locala Ward Manager HVMH Kier Facilities Services

CQC Regulations

Safeguarding and safety Outcome 8 (Regulation 12): Cleanliness and Infection Control. Outcome 10 (Regulation 15): Safety & suitability of premises

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Contents

Section Page

1 Introduction 4

2 Associated Policies and Procedures 5

3 Aims and Objectives 5

4 Scope of the Food Hygiene Policy 5

5 Accountabilities and Responsibilities 6

6 Selection of Suppliers/ Providers of food and beverage services 7

7 Legal Requirements 7

7.1 Hazard Analysis 7

7.2 Food delivered under contract 8

8 Personal Hygiene 9

8.1 Facilities 9

8.2 Hand washing 9

8.3 Protective clothing 9

8.4 Additional information 9

9 Health of Food Handlers 10

10 Cleaning and Maintenance 11

10.1 Cleaning 11

10.2 Maintenance 11

11 Food service 11

11.1 Hot food 11

11.2 Cold food 12

12 Food brought in by Carers and Friends 12

13 Disposal of Waste 13

14 Supply of Catering Equipment, Breakdown and Repair 13

15 Storage of Food Products 13

15.1 Dry goods 14

15.2 Dairy foods 14

15.3 Canned foods 14

15.4 Refrigeration 14

15.5 Frozen foods 15

16 Use of Microwave Ovens 15

17 Use of Water Coolers 15

17.1 Bottled water coolers 16

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17.2 Plumbed-in water coolers 16

18 Control of Food Hygiene within Rehabilitation Training Kitchens 16

18.1 Training 16

18.2 Access to kitchen areas 16

18.3 Rehabilitation cooking 17

18.4 Food storage 17

19 Staff Rest Rooms and Facilities/Responsibilities 17

20 Pest Control 17

21 Vending Machines 17

22 Equality Impact Assessment 18

23 Training Needs Analysis 18

23.1 Training requirements 18

24 Monitoring Compliance with this Policy 19

25 References 19

Appendix A Example of HACCP form 20

Appendix B HACCP flow chart 21

Appendix C Format for Environmental audits 22

Appendix D Stakeholders involved in this policy 23

Appendix E Equality Impact Assessment tool 23

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Policy Statement

NHS Kirklees will ensure that food handlers and NHS Kirklees premises, in which food is stored, prepared or handled, comply with current food hygiene legislation. Due to the vulnerability of patients, good practice advice found in the Catering Industry Guide, approved by HSG (96) 20 Management of Food Hygiene and Food Services in the National Health Service, will be a contractual requirement of the Facilities Management Contract where patients are being catered for.

1. Introduction The Food Safety (General Food Hygiene) Regulations 1995 Regulation 4(3) requires: ‘A proprietor of a food business shall identify any step in the activities of the food business which is critical to ensuring food safety and ensure that adequate safety procedures are identified, implemented, maintained and reviewed…’ Regulation 4(3) is designed to make businesses focus on the activities critical to food safety in their business, and to find ways of controlling them.

NHS Kirklees: - Has a Facilities Management Contract for the provision of meals and

beverages to patients at Holme Valley Memorial Hospital, - Has a Facilities Management Contract for the provision of meals and

beverages to staff and visitors in Broad Lea House cafeteria including ad hoc requests for provision in meetings.

- Has an informal agreement with the League of Friends for the sale of food and beverages to patients, staff and visitors at Holme Valley Memorial Hospital;

- Provides rehabilitation training kitchens, where patients are involved with food handling, at Eddercliffe and Holme Valley Memorial Hospital;

- Acknowledges that food and beverages are brought into hospital by relatives/ visitors and staff.

This policy identifies the activities which are critical to food safety in NHS Kirklees for the above, and identifies ways of controlling them through the application of Hazard Analysis Critical Control Points (example Appendix A).

This process will provide a foundation for the Trust to exercise/demonstrate ‘Due Diligence’ provided the measures for managing the critical control points which have been identified in this policy are implemented, managed, documentation maintained, monitored and reviewed as required by the Facilities Management Company (Kier).

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The Catering Industry Guide, approved by HSG (96) 20 Management of Food Hygiene and Food Services in the National Health Service, details the specific requirements of The Food Safety (General Food Hygiene) Regulations 1995 and the Food Safety (Temperature Control) Regulations 1995, and advises on their implementation. Current Statutory Legislation:

- Food Safety Act 1990 - Regulation (EC) No 852/2004 – (Article 5 which covers Hazard analysis

and critical control points) - Food Hygiene (England) Regulations 2006 - Food Safety (Temperature Control) Regulations 1995 - Food Labelling Regulations 1996

2. Associated policies & procedures This policy should be read in accordance with the following policies, procedures and guidance:

Acute Occupational Therapy Service Guidelines for good practice (Locala)

Cleaning Policy (PCT)

Dress Code Policy (Locala)

Hand Decontamination Policy (Locala & PCT)

Infection Control Policy (PCT)

Policy for the management of water systems and prevention of Legionella (PCT)

Policy for the Maintenance of PCT Premises

Waste Management Guidelines (Locala & PCT)

3. Aims and objectives

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 Policy aims to:

Ensure that staff are fully aware of all potential food hazards

Ensure that high standards of personal and environmental hygiene are adhered to at all stages to ensure that food safety is not compromised

Satisfy current legal requirements

Minimise the risk of customer complaints or other action against the Trust

4. Scope of the Food Hygiene Policy In addition to being a contractual requirement of the Facilities Management Contract this policy must be followed by all staff who work for NHS Kirklees and Locala employees who are involved with preparing, serving, ordering or storing food and/or beverages. It must be followed by all staff working for NHS Kirklees or Locala including those on temporary or honorary contracts, bank staff and students. Breaches of this policy may lead to disciplinary action being taken against the individual.

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Independent Contractors are responsible for the development and management of their own procedural documents and for ensuring compliance with relevant legislation and best practice guidelines. Independent Contractors are encouraged to seek advice and support as required. 5. Accountabilities and Responsibilities 5.1 All managers with responsibility for services that handle food must ensure that all relevant staff are aware of and adhere to this Policy. A food handler is anyone who is involved in the handling or preparation of food goods and beverages and as such can include catering, domestic, nursing and allied health professions staff. 5.2 Kier Facilities Management will be responsible for ensuring that agreed standards of hygiene are maintained at all times within kitchen areas in Holme Valley Memorial Hospital, other than staff rest rooms. Provider staff (Locala) are so responsible at Eddercliffe ICC. This policy applies to all staff engaged in the service of food who will be required to certify in writing that they have read and understood the policy by completing the proformas on the back page. These proformas are to be kept with respective staff records. 5.3 All staff have a responsibility for ensuring that the standards are maintained by their own actions in accordance with this policy. 5.4 Staff must liaise with Kier and/or dieticians to ensure patients are provided with a choice and that individual nutritional, personal and clinical dietary requirements are met. This must include any necessary feeding and access to food 24 hours a day in a ward situation. Suitably trained staff must be available to provide this service. 5.5 As purchasers of food, Kier and Locala must ensure suppliers provide copies of food hygiene policies and procedures to meet the requirements set out in this document. 5.6 The Hotel Services Manager will undertake ad hoc environmental and HACCP (Hazard Analysis Critical Control Point) audits to ensure Kier are supplying food in accordance with the Food Safety Act 1990 and Catering Industry Guides. 5.7 In buildings/staff facilities which are used by many different staff groups/organisations, responsibility for ensuring staff observe this Policy rests with the individual’s line managers. Should staff encounter problems with the kitchen facilities which they use, they must report this to their line managers for them to take appropriate action. 5.8 Health Property Management are responsible for the provision of appropriate premises for food prepared/ provided within the Trust.

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6. Selection of Suppliers/ Providers of Food and Beverage Services HSG (96) 20 Management of Food Hygiene and Food Services in the National Health Service Executive Summary ‘Good hygiene and food safety practices and informed staff are vital in the preparation, storage, distribution and service of food. These matters are of particular importance in hospital catering because patients may have less resistance to infection from contaminated food.’ NHS Kirklees will work with current and future suppliers of food and food/beverage services to patients to ensure the implementation of HSG (96) 20. All providers of food catering services to the Trust must supply copies of their Food Hygiene Policies prior to being authorized to provide food; these must illustrate that they have undertaken comprehensive hazard analysis, identified potential hazards involved in handling foods, implemented and adhered to effective controls. In addition to meals for in-patients which will be provided in accordance with HSG (96) 20, NHS Kirklees purchases snacks and beverages for meetings, staff and patients prepare and consume food and beverages in Rehabilitation Training Kitchens and the League of Friends supply beverages and snacks. The requirements outlined below must be applied to each of these situations/ contracts as appropriate. 7 Legal requirements All kitchens within Trust premises, and the activities undertaken within them, will comply with standards as defined by current legislation. All premises handling food will be registered with the local Environmental Health Department in accordance with the Food Safety Act 1990. 7.1 Hazard Analysis The principal aim of the hazard analysis framework included in this policy is to ensure that all those involved in procuring food services and handling food are working to a degree of uniformity in assessing compliance with and implementing the requirements of Regulation 4 of the Food Safety (General Food Hygiene) Regulations 1995. In legal terms the assessment is known as Hazard Analysis and Critical Control Point (HACCP). HACCP is a comprehensive assessment, which is carried out to ensure food safety (Appendix B). It identifies the potential hazards involved in handling foods and must be implemented, maintained and reviewed on the basis of the following principles/stages;

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- Analysis of the potential food hazards - Identification of where the food hazards occur - Decision on which points identified are critical to ensure food safety - Identification and implementation of effective controls and monitoring

procedures on those critical points - Periodic review of the analysis of food hazards, the critical control points and the control and monitoring procedures and whenever the services being provided change.

All suppliers of food services must demonstrate that they have compiled HACCP documents for their staff and (where appropriate) for customers to follow. All purchasers of food or food services must keep a file with copies of the suppliers’ food hygiene policy and HACCP documents to demonstrate how they have considered the suitability of the supplier. It is the responsibility of the Ward/Department manager to update current practices and carry out further assessments to ensure their actions/activities are commensurate with the requirements and Food Hygiene controls outlined in this policy. 7.2 Food delivered under contract Under the Assured Safe Catering System all companies who supply food to the Trust, usually via the Facilities Management Company (Kier), must comply with the following legal requirements:

High risk foods * will be delivered chilled between 0-4o C

Fresh meat, poultry and fish will be delivered chilled between 0-4o C

Fresh fish preferably should be iced

Frozen foods will be delivered at or below -18o C. There must be no evidence of defrosting or freezer burn

Cook-chill products will be delivered at 3o C *High risk foods are usually those which contain protein and are intended for consumption without treatment which would destroy such organisms, e.g.:

i. All cooked meat and poultry ii. Cooked meat products including gravy and stock iii. Milk, cream, artificial cream, custards and dairy produce iv. Cooked eggs and products made with eggs, for example mayonnaise, but

excluding pastry, bread and similar baked goods v. Shellfish and other seafood vi. Cooked rice

Food that does not reach these standards will be rejected at the point of delivery and returned to the supplier.

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8. Personal Hygiene 8.1 Facilities Sufficient suitable facilities for ensuring the personal cleanliness of food handlers shall be provided within each kitchen area. Facilities will include hand wash basins, with suitable and sufficient supply of hot and cold running water, liquid soap and clean disposable paper towels. These items are to be used solely for securing the personal cleanliness of food handlers and nothing else. 8.2 Hand washing Hands are the main route for transferring food poisoning bacteria and must therefore be kept scrupulously clean at all times. All staff and patients handling food must wash their hands regularly throughout the working day, especially:

- On entering the food room - After using the toilet - Before handling any food or equipment - In between handling raw and cooked food - After combing or touching hair - After eating, smoking, coughing or blowing their nose - After handling cleaning chemicals - After their break

The correct hand washing procedure is essential. The hands must be wet and a liquid soap should be applied. A good lather is required, and the wrists and forearms and in between the fingers must all receive attention. The hands must be thoroughly rinsed and dried using disposable paper towels. 8.3 Protective Clothing Clean disposable aprons shall be provided for use by personnel handling food to reduce the risk of contamination of food. 8.4 Additional Information - As a legal requirement, smoking will not be allowed in food areas. - Eating is only permitted in designated dining facilities - Nails must be short and clean, nail varnish and false nails must not be worn. - Food handlers must not wear jewellery; the only exception is a single plain band. Rings that contain stones are not permitted. - Wrist watches must not be worn.

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9. Health of Food Handlers Food handlers suffering from possible infectious conditions likely to give rise to food poisoning, must report symptoms to their manager immediately and leave the food handling area. If experiencing any of the following they must not handle food;

- Boils, skin lesions/cuts - Discharges from the eyes, ears or nose - Diarrhoea and/or vomiting - Heavy colds and coughs

Staff with any of the above symptoms MUST report them to their manager immediately whether on duty or off. For the clinical management of individual cases and for public health protection, appropriate investigations, such as stool sampling, may be necessary. This will be co-ordinated by the Occupational Health Department or the individual’s GP. If a member of staff’s family has symptoms of food poisoning, they must inform their manager who may consult the Occupational Health Department for advice regarding food handling duties. Staff suffering from symptoms of food poisoning MUST be excluded from food handling whilst symptomatic and until they are 48 hours symptom free before returning to work. On occasions, medical clearance may be required from their GP or Occupational Health Department. There are some causes of diarrhoea, which require special consideration, for example, typhoid fever, paratyphoid fever, verocytotoxin producing Escherichia Coli and Hepatitis A. The investigation and management of these individuals is usually carried out by the local authority and the Consultant in Communicable Diseases (Proper Officer). It may require that food handlers remain off work for longer than previously suggested. The Consultant Microbiologist will notify the Proper Officer immediately by telephone if the member of staff involved in food handling has a positive stool specimen as listed above. For cases of food poisoning or suspected food poisoning, Local Authority Environmental Health Officers will contact the member of staff to obtain a food history in an attempt to ascertain the source of the food poisoning. For additional information please contact: Occupational Health Department Tel: 01924 816049 Infection Prevention and Control Tel: 01484 464419

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10 Cleaning and Maintenance 10.1 Cleaning Cleaning shall be in accordance with the cleaning schedules as specified in the Domestic/Housekeeping services element of the Total Facilities Management Contract and in line with the Trust Cleaning Policy. All cleaning materials in use in the kitchen will be colour coded in accordance with Trust policy: Green is the designated colour for catering departments, ward kitchen areas and patient food service at ward level: this includes mops, buckets, cloths and household gloves. Cleaning substances available shall be strictly controlled in accordance with COSHH legislation and the Trust COSHH Policy. Cleaning substances must be stored separately from food items, preferably in a separate room or cupboard. Careful storage will eliminate the risk of chemical contamination of food. All items of equipment used in food service must be washed by an approved method. Dishwashers must reach thermal disinfection temperatures.

Where food services are provided by independent contractors their reporting channels must be utilized and action taken to remedy any reported problems. Repeated failures by a contractor to observe the requirements of this policy and their documented HACCP procedures may result in the contract being reviewed/ terminated. 10.2 Maintenance of Facilities and Equipment Defects arising within the HVMH kitchen shall be reported immediately to Kier, within the Eddercliffe rehab kitchen reported to MITIE, for rectification. Responsibility for ensuring that defects are reported and completed satisfactorily lies with the Ward/Department Manager of the area. Written records of reported defects must be available. Kier and MITIE will make annual Portable Appliance Testing on all electrical equipment within the kitchens as part of a planned program. Contacting the on call engineer, through the usual procedure provides services out of normal hours for urgent repairs. See Policy for Maintenance of PCT Premises.

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11. Food service 11.1 Hot Food

- It is important that time and temperature factors are controlled to ensure that food remains safe

- Hot food MUST NOT be served below 63°C - Food service must commence as soon as possible after it arrives on the ward to

maintain quality of the food - If commencement of food service delivery has exceeded 15 minutes from its

delivery time, a temperature check of food items must be made: if the temperature of the food is found to be below 63°C, at this point, the affected food must be discarded and the incident reported.

- If an incident occurs on the ward which delays/interrupts food service, whilst the food is in the hostess trolley, where available it can be left in the hot/switched on hostess trolley until the incident is over. Food must then be re-probed to ensure that it has kept above 63°C before serving to patients.

- All Cook Freeze/Cook Chill food not consumed at the end of meal service must be discarded.

- Prior to serving any meals all staff must thoroughly wash and dry their hands. Nursing staff assisting with meal service must also wear a clean plastic apron.

- The Facilities Management service will provide suitable food temperature probes.

11.2 Cold food All cold food must be served from a chilled display unit running at or below 5oC. All food intended for service on a particular day must be discarded if not served, it must not be re-served the following day.

12. Food Brought in by Carers and Friends Relatives/visitors must be discouraged from bringing in high-risk foods (as defined in 6.2.2) for patients. However, where foods are brought in and need to be stored in a refrigerator they must all be:

- Placed in a clean airtight container or wrapped in foil or a plastic bag; - Labelled with the date, time and name of the patient; - Consumed within 24 hours, or by the use by date if less than this; - Raw meats, raw fish and uncooked eggs must not be stored in the ward

fridge under any circumstances. Patients and visitors must not be allowed access to the refrigerator. If staff are aware that patients have consumed food brought in by relatives, details of the date and time of consumption must be documented in the patient’s notes. This is to allow a food history to be taken should the patient suffer from symptoms of food poisoning.

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13 Disposal of Waste Food Waste food must be disposed of immediately after each meal or snack using the waste disposal unit or other suitable method. Waste food can be disposed of with other domestic waste so long as it is not high quantity and of a texture/moisture content which will leak from bags. Waste food must not be left to accumulate within the kitchen and must be removed frequently. Foot operated waste bins with good fitting lids must be provided for temporary storage of waste materials. These must be emptied when two thirds full, or at least daily as required. Hands must always be washed after handling waste. The quantities of food waste generated by NHS Kirklees are minimal, so the documentation and systems outlined in NHS Estates Guidance for Managing Food Waste in the NHS are disproportionate. The Trust will review food waste with ad hoc audits and part of the monitoring of the implementation of the Food Hygiene Policy.

14 Supply of Catering Equipment, Breakdown and Repair NHS Kirklees is responsible for the purchase, maintenance, repair and replacement of all catering equipment, required on site for the provision of food services Food Service Contractors must maintain records to ensure equipment is functioning correctly, PAT tested, maintained, reported for repair and/or replacement as appropriate, and they must have contingency plans for use in event of equipment failure. In the case of equipment used by staff e.g. fridges for milk, snacks and patients own food, the Ward/ Department Line Managers are responsible for ensuring it is functioning correctly, maintained, repaired and replaced as appropriate. Maintenance and repair is an integral part of the Total Facilities Management Contract (Kier FS). 15. Storage of Food Products New stock must be stored to the back to ensure good stock rotation. Stock levels must be maintained and over-stocking rectified. All goods must be stored above floor level. The cleaning of storage areas will be undertaken as part of the routine work schedule. It is a legal requirement that all products bearing use by dates must be used by the end of the day on which the date code expires. The use by date on perishable food items is considered to be a guide as to the safety of food and an offence is committed if they are used after this date.

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All products bearing best before dates must be used before the date printed on the packaging. This is used on longer life products and is considered to be a guide to the quality of the food. It is important that effective stock control is used at all times. Food past the best before date must be disposed of.

15.1 Dry Goods Dry goods require the following conditions:

- Steady temperatures of 10-15o C - Ventilation - Pest proof containers/structure - Shelving and structure which can be easily cleaned - Products stored off the ground - Stock rotation

15.2 Dairy Products Milk and dairy products must be refrigerated immediately after delivery. Nutritional supplements, once opened, shall be used for immediate consumption. Part used sachets/packets must be discarded. Butter kept at room temperature for softening must be kept in a lidded dish, not in its wrapper. 15.3 Canned Products Cans must be checked for damage, e.g. dents, bulges, or rust. Such damaged stock must not be accepted as a stores delivery but returned to the supplier. Canned products must be checked prior to use to ensure they are within the date code. Food from part used cans must be decanted into lidded containers, labelled with the date, placed into a refrigerator and used within 24 hours. 15.4 Refrigeration Refrigeration is a method of storage by which spoilage is delayed but not prevented.

High risk foods to be stored between 0-4o C

Fresh meat, poultry and fish to be stored between 0-1o C (where possible this to be in a separate fridge due to the discrepancy in temperature for other produce)

Cook-chill products to be stored at 3o C or below Refrigerators must be sited in a well-ventilated area, preferably away from heat sources and direct sunlight. They must be in good repair without cracks to the lining, corroded

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shelves or cabinet. Door seals must be clean and in good condition (not split, broken or torn.) The door to the ice-making compartment (if present) must be closely fitted and in good repair. Refrigerators must operate between 0°C and 5°C and contain a thermometer. Refrigerators used for patient’s food must be checked daily and the reading recorded in records held by the food service contractor for three months. Refrigerators will be defrosted on a weekly basis to ensure their efficient operation, and cleaned as per cleaning schedules. Refrigerators will only be used for the storage of food items and cold beverages. Food stored in the refrigerator must meet with the following criteria:

- It is within its date code - It is kept in a clean, airtight container or impervious wrapping. - It is labelled with the name of the owner and the date that it was put in the

refrigerator. - It is for human consumption - It does not remain in the refrigerator for over 24 hours unless within its use

by date. The refrigerator must not be overloaded with food. It must be remembered that cold air within the refrigerator needs to circulate around the food to keep it cool. 15.5 Frozen food Freezers must be sited in a well-ventilated area, away from heat sources and direct sunlight. They must be in good repair; door seals must be clean and in a good condition. Freezers must operate at or below –18°C. The temperature must be checked daily by food service contractors and readings recorded in an appropriate form. Records are to be kept for three months. Thawed or partially thawed food must be destroyed if not used. It must never be re-frozen. All foods stored in the freezer must display an expiry date on the product. 16. Use of Microwave Ovens The use of microwave ovens should be discouraged because of hygiene and safety considerations. However, it is accepted there are microwave ovens purchased by staff in which staff may prepare food for their own consumption. The main hazards associated with using microwave ovens are burns and scalds from hot food, containers and steam. Microwaves can catch fire if not used properly or if their contents overheat. Microwave energy could burn the user if the door seals are not effective.

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- The microwave oven must only be sited in a designated food area and must be checked for emissions and electrical safety prior to its use by the Facilities Management provider (Kier FS or MITIE MS) and every 12 months thereafter.

17. Use of Water Coolers There are two types of water coolers; these are bottled coolers and plumbed-in coolers. A maintenance contract must be set with the suppliers and records kept of the maintenance carried out. All surfaces of the water coolers must be cleaned regularly and the drip tray emptied and cleaned daily. It is the responsibility of the Ward/Department or Line manager, whose staff/ patient’s use the area, to ensure that the maintenance and cleaning is carried out of all water coolers in their area. All staff must wash their hands thoroughly before accessing water from these coolers. 17.1 Bottled Water Coolers Bottled coolers are not thought to be suitable for patient use due to the risk of contamination to the system. Although the organisms likely to contaminate bottled water coolers would be unlikely to cause illness in healthy individuals they could affect compromised patients. All staff must thoroughly wash and dry their hands before changing the water bottles. They must also ensure that the seal on the top of the bottle is intact and all surfaces of the bottle are clean before they change the bottle over. Empty water bottles must never be refilled with tap water. 17.2 Plumbed-In Water Coolers These water coolers are plumbed directly into the mains drinking water supply. Pressure coolers produce up to 25 gallons per hour and the water is chilled and delivered by mains pressure and not via a reservoir or holding tank. 18. Control of Food Hygiene within Rehabilitation training kitchens (Please also see sections on ‘Health of Food Handlers’ and ‘Personal Hygiene’.) 18.1 Training All staff handling food working with the unit and providing supervision to patients must hold the Foundation Certificate in Food Hygiene (formerly Basic Food Hygiene Certificate.)

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18.2 Access to Kitchen Areas The rehabilitation function will be kept entirely separate from the main catering function. The aim of the rehabilitation kitchen is for the assessment of patients’ kitchen skills required in the discharge planning process. Patients must not have access to food stores and food storage equipment without adequate supervision. A thorough assessment of patients must be made by the nursing/therapy staff before they can participate in rehabilitation exercises involving the handling of food. These will include amongst other things their health status, standards of personal hygiene and their ability to handle food in a safe manner. Patients must not be taken to the rehabilitation kitchen if they have open wounds unless covered with a suitable dressing. Patients who are incontinent must only enter the kitchen area if they have incontinence aids suitable to prevent leakage of urine or faeces. All patients who are affected by infectious conditions transmissible via food MUST be excluded from handling food until they have been asymptomatic for 48 hours. 18.3 Rehabilitation Cooking Rehabilitation cooking may only take place in the facilities provided for this purpose. The work units and equipment provided for rehabilitation cooking/food preparation must be chosen to comply with good hygiene standards and reflect a ‘normal’ domestic environment as far as is possible. Cooking facilities must be grouped together to enhance the rehabilitation process and minimize the risk of contamination of other areas of the kitchen. 18.4 Food Storage Sufficient suitable facilities for the storage of different food types must be provided, including: *Chilled food *Frozen food *Dairy Produce *Perishable foods *Canned/Dry foods *Fresh Fruit and Vegetables 19. Staff Rest Rooms and Facilities/Responsibilities Staff facilities are for staff to prepare and/or consume their own meals. The facilities are covered by the Food Hygiene Regulations; staff are expected to observe good Food Hygiene Rules. Specifically:

- Food and drinks should not be stored, prepared or consumed in a consulting or treatment room under any circumstances

- Kettles, microwaves and similar appliances must only be used in a dedicated kitchen area

The management of these facilities and how they are used by staff lies with the line managers of the relevant staff groups who use the facilities.

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20. Pest Control Sufficient measures must be taken to prevent pests accessing food areas and to minimize the risk of pest infestation.

Fly screens on opening windows and doors must be installed where possible.

Windows must be kept closed where there are no fly screens.

Sufficient pest-proof storage facilities must be provided.

Good housekeeping practices must be maintained.

No food must be left out and uncovered. Written records of reported problems with pest infestation must be available. All staff must report any concerns to the relevant Facilities Management Company helpdesk. 21. Vending machine The design/ construction of machines rests with the machine manufacturers, but the Trust must ensure that equipment meets the legal requirements: i.e. ‘sited, designed constructed and kept clean and in good repair and condition as to avoid the risk of contaminating foodstuffs and harbouring pests, so far as is reasonably practicable’. It is good practice to have detailed cleaning schedules provided by the vending contractor, to monitor cleaning against: this must be kept with maintenance contract for the Trust and available for inspection. Each vending machine must display contact details of who has arranged the contract for the machine, so any issues can be raised with the appropriate person as they arise. Drinks vending machines must be connected to an adequate supply of hot and/or cold potable water. The Trust must ensure that the quality of water does not deteriorate during storage in the machine. Internal pipes and tanks must be kept clean: some materials may need to be sterilised periodically, carbon filters must be changed regularly. Spoiled or out of date stocks must be removed from the machine for disposal. 22. Equality Impact Assessment All public bodies have a statutory duty under the Race Relation (Amendment) Act 2000 to “set out arrangements to assess and consult on how their policies and functions impact on race equality.” This obligation has been increased to include equality and human rights with regard to disability age and gender. The Trust aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. In order to meet these requirements, a single equality impact assessment is used to assess all its policies/guidelines and practices. This Policy was found to be compliant with this philosophy (see appendix E).

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23. Training Needs Analysis In order to ensure that policies, guidelines and protocols are introduced and work effectively, there is a need to provide adequate training and instruction. As a result, the author(s) of this document has carried out a training needs analysis which has identified the staff who require training, the methodology of training delivery and the frequency that the training will be provided. 23.1 Training Requirements It is a legal requirement that all staff members who handle food must be trained in food safety. The level of training must be reflective of the amount of food handling carried out in their job and the associated risks involved. This training must be updated every five years. Food hygiene training is provided by the Training and Education team and the Facilities Management Company (Kier). There are two courses which must be provided: Essentials in Food Hygiene This is a two-hour course designed for staff members that are involved with providing beverages and snacks for patients. Foundation Certificate in Food Hygiene This is a full day course formerly known as Basic Food Hygiene leading to a certificate by the Charted Institute of Environmental Health. This course is for staff members who handle food as a significant part of their role e.g. catering staff, ward housekeepers and ward hostesses. 24. Monitoring Compliance with this policy Environmental audits will be undertaken by the Hotel Services Manager, which will follow the format outlined in Appendix D. Ward/Department/Line Managers must also monitor activities of their staff and be able to demonstrate how they are implementing the Critical Control Measures detailed in this policy. 25 References Assured Safe Catering 1993, DOH, HMSO, London Food Hygiene (England) Regulations 2006, HMSO, London Food Labeling (Amendment) (England) Regulations 2004, SI 1512, HMSO, London

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HSG (96)20 Management of food hygiene and food services in the National Health Service, 1996, DOH Managing food waste in the NHS, 2005, NHS Estates, Leeds Regulation (EC) No 852/2004 – (Article 5 which covers Hazard analysis and critical control points)

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Appendix A EXAMPLE Hazard Analysis Critical Control Point: Personal Hygiene

HAZARD

CONTROL

CCP (S)

CRITICAL

LIMITS

CORRECTIVE

ACTION

MONITORING

RESPONSIBILITY

Contamination of products by poor personal hygiene

practices.

Health Screening

Provision of clean protective aprons.

Provision of first aid

facilities.

Limit jewellery; nail varnish and other

potential contaminants.

Adequate facilities for hand washing.

Staff awareness of personal hygiene practices through

food hygiene training.

Yes

Satisfactory

health screening.

All staff to be

suitably trained in food

hygiene/safety.

Strict adherence to

personal hygiene

procedures.

Food handlers

suffering from any food poisoning

symptoms must be excluded from handling food.

They must refrain from food handling duties for 48 hours after the symptoms

have ceased.

Stool specimens must be provided

for culture.

Staff to be suitably trained.

Counseling/ re-training of staff.

Health

questionnaire.

Training and training records.

Regular

inspections.

Manager to regularly monitor.

All staff and Manager.

22

HACCP FLOW CHART

Linked to Food Hygiene Policy

Storage of food in

refrigerator

Storage of food at

room temperature

Storage of frozen

food

Food delivered by the

supplier

Prepare food Defrost food

Cook food

CCP

Hot-holding food

CCP

Cooling of food

CCP

Serve food

23

Appendix C

Format for Environmental audits and monitoring compliance with NHS Kirklees Food Hygiene Policy

HACCP Hazards identified Compliant / Comments

Staff Training Record Records not kept.

Personal Hygiene Contamination of food by poor personal hygiene practices.

Staff Health

Contamination of products by poor personal hygiene practices due to staff ill or carriers of communicable disease

Cleaning

Contamination of the products or ingredients by: Using dirty containers or equipment which came into contact with food; Dirty surfaces; Chemical contamination.

Structure and Equipment

Physical or chemical contamination of products or ingredients by the premises and/or equipment not maintained in sound condition and good state of repair

Chilled Products/Chilled Ready to Eat Products

Contamination of high risk or ready to eat foods. Growth of food poisoning bacteria.

Frozen Food Storage

Bacterial growth in thawed or partially thawed products through poor temperature control. Dehydration of products stored without covering. Product deterioration if stored too long. Cross –contamination.

Ambient Dried/Tinned Products Storage

Broken or open packaging with risk of contamination. Pest infestation with risk of contamination of product with bacteria. Contamination through damaged can.

Servery Service

Bacterial growth if temperature of hot food coupled with bacteria from dirty utensils, hands and uniforms. Physical contamination.

24

Appendix D. Key stakeholders consulted/involved in the development of the policy/procedure

Stakeholders name and designation Key

Participant Yes/No

Feedback requested

Yes/No

Feedback received Yes /No

Keith Geldard, Acting Director, HPM Yes Yes Yes

Sue Ross, Infection Prevention & Control Lead, KPCT

Yes Yes Yes

Gwen Ruddlesdin, Head of Governance, Locala Yes Yes Yes

Sheena Kelly, Infection Prevention & Control Lead, Locala

Yes Yes Yes

Peter Horner, Head of Therapies, Locala Yes Yes

Sharon Holroyd, Maple Ward Manager, HVMH Yes Yes

Jenny Scholefield, Facilities Manager, Kier Facilities Services

Yes Yes

Kirklees Infection Control Committee Yes Yes

25

Appendix E. Equality Impact Assessment Tool

Food Hygiene Policy Yes/No Comments

1. Does the policy/guidance affect one group less or more favourably than another on the basis of:

Race No

Ethnic origins (including gypsies and travellers) No

Nationality No

Gender No

Culture No

Religion or belief No

Sexual orientation including lesbian, gay and bisexual people No

Age No

Disability- learning disabilities, physical disability, sensory impairment and mental health problems

No

2. Is there any evidence that some groups are affected differently?

No

3. If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable?

No

4. Is the impact of the policy/guidance likely to be negative? No

5. If so can the impact be avoided? No

6. What alternatives are there to achieving the policy/guidance without the impact?

No

7. Can we reduce the impact by taking different action? No