The Care Quality Commission
Vehicle Infection Prevention and Control
In 2009, evidence produced by the Care Quality Commission suggested that infection prevention and control was poor within ambulance trusts, with four of the country’s 11 trusts violating agreed terms within their NHS contracts and needing urgent improvement. According to the report, the reasons for the ambulance trusts’ failures were many and varied but were caused by weaknesses in all areas of management practice and not by a lack of resources.
The Care Quality Commission is the independent regulator of health and social care in England.
They regulate care provided by the NHS, local authorities, private companies and voluntary organisations. Their aim is to make sure better care is provided for everyone - in hospitals, care homes and people's own homes. They also seek to protect the interests of people whose rights are restricted under the Mental Health Act.
From April 2011, all private ambulance providers working for NHS Trusts will have to be registered under a tough new regulatory system for monitoring quality and safety of care. Failure to meet these tough standards may result in substantial fines for operators or the closure of their operation.
NSL Care Services proactively seeks to engage with the wider health industry to understand the implications of changes or improvements, so that it continually complies with all standards of patient care and continually evolves as a care services provider. Our ultimate aim is to always exceed the conditions expected in inspections such as those conducted by the CQC.
Our challenge was to interpret the failings of the ambulance trusts and with regard to infection control, understand and mirror changes or improvements through a best practice approach.
Our methodology involved a review of the CQC inspections of ambulance trusts around the country including those that received formal warnings during the 2009 review and others that provide emergency services within areas where NSL Care Services has contracts.
In one ambulance trust where they had not reached the required standard of infection prevention and control of acquired infection set by the CQC, they determined that further training and education for all staff was needed, highlighting the importance of infection prevention and control. It was also clear that vehicle fleets were not sufficiently cleaned, and cleaning programmes missed key hygiene standards.
In another ambulance trust, there were shortfalls in infection control and audit. This meant that workers involved in patients' care did not receive appropriate information, training and supervision on how to prevent and control infections. Worse still, there was an inadequate provision of suitable hand-washing facilities and antibacterial hand rubs.
NSL Care Services has embedded Infection Control procedures in its standard operating procedures from day one of its patient transfer operation.
As an industry leader, we have developed further detailed action plans that encompass the learning from around the various ambulance trusts, thus ensuring NSL Care Services continues to exceed CQC, client and stakeholder expectations. A key element has been the issuing of a Learning Materials pack to all operational staff.
This pack now forms part of mandatory annual training on infection prevention and control for all staff using patient transport vehicles. NSL Care Services has always given this training as part of staff induction but we have now developed a structured procedure so that all receive this annual update. The update includes a full refresher on all the procedures that include things such as hand washing, personal protection and spillages. They also receive a quick reference booklet that explains everything in detail.
NSL Care Services completely reviewed existing management systems and audit procedures relating to Infection Prevention and Control, and a new programme of audited checks, gap analysis and rolling communication programmes have been introduced that feed directly into employee one to ones, training and performance reviews. Our solution involves embedding the understanding of infection control at every level in the business, with joined up thinking across permanent, bank and voluntary staff.
All NSL Care Services vehicles are cleaned daily and undergo regular programmed deep- cleans and our cleaning tools throughout the organisation are colour coded to avoid cross contamination. The new Vehicle Infection and Control pack and information supports this programme. The pack contains-
- Infection prevention and control procedure Information
- Cleaning standards framework for HDU, PTS, Multi-seat, and Car
- A copy of the quality audit form so that they have a full understanding of what is required.
- A copy of the infection prevention and control policy that includes details on personal care.
- Guidelines on the precautions to be taken with certain infections
- Standard operational instruction of vehicle cleaning and the cleaning stations
- Management of linen
All employees receive suitable formal audited training and instruction about vehicle infection and control and their role and responsibility, including any specific daily duties. A rigorous quality check procedure that scores performance, is used to benchmark across the whole business, continually raising standards, generating actions and ideas, and creating an engaged workforce.
NSL Care Services firmly believes everyone has a part of play in Infection control. Cross functional groups help us to embed any changes across the company and the review of the infection control process was led by the Clinical Director, Head of Training and Development, and Compliance and Quality Manager. A vehicle pack has been created for colleagues and new quality audits have been agreed. The changes have also been integrated into NSL Care Services Infection Prevention and Control Policy. The policy in particular gives new guidance on colour coding cleaning equipment and reference material.
Our Compliance & Quality Manager identifies relevant key people to disseminate any new procedures to every member of road staff, managers and trainers. NSL Care Services always aims to educate colleagues, but also uses the dissemination to highlight and reinforce the importance of a colleagues’ role in the CQC process. This helps us to build a strong ownership ethos running throughout the company that ultimately protects both our clients and NSL Care Services reputation.
The process for disseminating the information falls under the control of NSL Care Services highly experienced training team. All employees receive full instruction and guidance on procedures, and how to complete relevant check forms. From an audit perspective we rigidly control the process through quality checks and a written audit trail, thus meeting all requirements laid down through the CQC inspection process.
NSL Care Services proactive development of effective vehicle infection prevention and control policies and procedures, using ongoing research of latest developments in the care services industry, ensures that the very highest standards are maintained on behalf of local hospital and primary care trusts.