The NHS Scotland National Cleaning Services Specification: Healthcare Associated Infection Task Force

1.1 Remove Debris
Pick up litter which cannot/should not be removed by suction cleaning. This could include paper towels, tissues, empty drinks cans, apple cores and similar items.

1.2 Mop Sweep
Remove dust and litter from all hard floor surfaces including floor edges and corners using dust control mops which are either of the impregnated yarn type, anti-static type or are part of a disposable system.

1.3 Suction Clean
Remove dry dust and soil using dry suction equipment complying with three stage filtration In-patient areas. This process includes floor edges and corners. Check filters and replace per manufacturers instructions.

1.4 Damp Mop
Remove soil and dirt from hard floors using a cotton or mixed fibre mop and appropriate cleaning agent in solution with hand hot water. Mop water should be changed at least once per 15 minutes and at the commencement of a different location type.
When damp mopping corridors or circulation areas, leave a dry margin for "Traffic" to pass, for safety purposes, using at all times warning signs, when floors are wet.

1.5 Spot Mop (Referred to as 'Check Clean' on Definition Sheet) :
As part of the check cleaning process, remove spots, spillage or ingrained dirt from hard floors using the same method as for damp mopping. Clinical Staff / Health Care Professionals are responsible for the disinfection process of spillages of urine, faeces, vomit or blood in clinical areas.
NB. All spots and spillages of a hazardous nature must be removed immediately. Hazardous can mean spillage likely to cause accidents to staff, patients, visitors, through falling or spillage which is hazardous from a Control of Infection view point.

1.6 Spray Clean (Non clinical areas only)
Carry out after first mop sweeping or suction cleaning. Then, using a prepared liquid solution in a hand-spray, spray an appropriate amount onto the hard floor. Using a high-speed polisher with an appropriate pad, pass the machine over the hard floor until the surface is clean, dry, dust free and an acceptable finish is achieved, taking care to avoid wandering cables. Spray cleaning should not be carried out on terrazzo, concrete, non-slip flooring or anti-static flooring. Solution should be discarded on completion of task.

1.7 Buff/Burnish
Carry out after routine damp mopping or scrub/re-dress. Pass machine over floor from side to side and at the same time, ensuring minimum overlap of pad or brush attachment on each pass.

1.8 Scrub
Remove floor soil, ingrained dirt and scuff marks using a mechanical scrubbing machine, an appropriate pad/brush and appropriate cleaning agent in solution with hand hot water. Using a wet pick-up where suitable, or mop dry the floor surface, rinse and dry hard floors.

1.9 Strip/re-dress
Remove furniture and dry mop sweep or suction clean area to be treated. Apply floor dressing remover, mixed in accordance with manufacturer's instructions, scrub floor a section at a time until the whole area has been re-treated. Use hand pad to treat perimeter. Suction dry entire area to remove slurry. Damp mop rinse floor with clean water to neutralise.
Allow floor to dry thoroughly. Apply coats of polish/dressing according to manufacturer's instructions, using polish applicator, allow each coat to dry. Buff all areas when last coat has completely dried.
Throughout process leave dry margin for "traffic" to pass, for safety purposes, Caution/ wet floor cleaning in progress signs to be positioned and visible on floor being treated.

1.10 Manual Scrub
The removal of ingrained dirt and soil from hard floor surfaces, using the appropriate Manual Scrubber. Rigorous hand action to be used on scrubber pad.
Colour coded protective gloves must be worn.
Leave dry margin for "traffic" to pass, for safety purposes, caution/wet floor cleaning in progress sign to be positioned and visible on floor being treated.

1.11 Suction Dry
Indicates the use of mechanical wet-pick-up equipment complying with three stage filtration In-patient areas to remove water/slurry from floor after scrubbing.

1.12 Anti-Static Flooring
Testing of anti-static properties will take place periodically in accordance with local policy. Test failing may require remedial action by the Domestic Service Department and namely increased frequency of tasks 1.8 and 1.11; followed by re-testing of anti-static properties and as required repeating of tasks 1.8 and 1.11 until satisfactory readings are achieved.

1.13 Hand Sweeping
The removal of dust, dirt, litter from floor/ground surfaces using appropriate brush.
This process is only for specific areas e.g. outside entrances/garden patios.

REQUIRED OUTCOME MEASURES

• The floor is free of dust, grit, litter, chewing gum, marks and spots, water or other liquids.

• The floor is free of polish or other build-up at the edges and corners or in traffic lanes.

• The floor is free of spots, scuffs or scratches on traffic lanes, around furniture and at pivot points.

• Inaccessible areas (edges, corners and around furniture) are free of dust, grit, lint and spots.

• Polished or buffed floors are of a uniform lustre.

• Appropriate signage and precautions are taken regarding pedestrian safety on newly cleaned or wet floors.

2.1 Remove debris
Pick up litter which cannot/should not be removed by suction cleaning. This could include paper towels, tissues, empty drinks cans, apple cores and similar items.

2.2 Suction Clean
Remove dry dust and soil using dry suction equipment complying with three stage filtration In-patient areas. This process includes floor edges and corners. Check filters and replace per manufacturers instructions.

2.3 Remove Spots and Spillages
Inspect area and remove all visible dust and debris, chewing gum, etc. from floors. Remove spills and stains from soft floor covering using as appropriate a neutral detergent /carpet shampoo/urine neutraliser solution. Leave warning sign of wet area. Vacuum when dry. Using as appropriate for size of stain, hand kits or deep clean equipment.

2.4 Deep Clean
The restoration of appearance and the removal of soil/stains from carpeting. Suction clean carpet prior to deep cleaning. Protect the feet of furniture, which cannot be moved, with strips of cardboard or plastic. Spot clean heavy stains. Follow manufacturer's instructions for deep cleaning. A suitable cleaning product and method should be used which will not damage the fibre structure or colour of carpet. Care should be taken not to cause shrinkage or colour run. Open doors and windows where possible to assist drying. Suction clean carpet when dry, using at all times warning signs when floor is wet.

2.5 Apply Carpet Protector
In view of the odour associated with most proprietary products and the need for "drying time" afterwards this duty should only be carried out after discussion with client. Also it must be carried out as soon as possible after a deep clean.
Using the approved spray applicator and after ensuring optimum ventilation possible, apply carpet protector to the whole of the area in accordance with manufacturer's instructions.
Leave notices warning against "traffic" on the carpet and remove when dry.

REQUIRED OUTCOME MEASURES

• The floor is free of dust, grit, litter, chewing gum, marks and spots, water or other liquids.

• The floor is free of stains, spots, scuffs or scratches on traffic lanes, around furniture and at pivot points.

• Inaccessible areas (edges, corners and around furniture) are free of dust, grit, lint and spots.

• Carpets are of an even appearance without flattened pile. After deep cleaning, there is no shrinkage, colour loss or embrittlement of fibres.

• Barrier matting zones are free from ingrained dust, dirt and stains.

3.1 Clean
Wearing colour coded protective gloves, clear any debris. Damp clean using disposable paper/cloth, fresh solution of neutral detergent and hand hot water.
For toilets, bidets, urinals use sanitizer, in accordance with Organisation Policy. Rinse all surfaces.
Dry and buff the mirror, metal and ceramic surface.
This process applies to wash basins and surrounds, sinks and surrounds, baths, showers, toilets, bidets, urinals, commodes, mirrors, soap and towel dispensers, toilet brushes and holders, toileting and bathing aids non-slip bath/shower mats, partitions, pipes, fixtures and drinking fountains.
Report dripping taps, chipped or cracked sanitary ware, loose fittings and any other faults to the appropriate responsible person.

3.2 Descale
Descale toilets/urinals in accordance with Organisation Policy and following manufacture's instructions.

REQUIRED OUTCOME MEASURES

• Porcelain, cubicle rails and plastic surfaces are free from smudges, smears, body fluids, soap build-up and mineral deposits.

• Metal surfaces, shower screens and mirrors are free from streaks, soil, smudges, soap build-up and oxide deposits.

• Wall tiles and wall fixtures (including soap dispensers and towel holders) are free of dust, grit, smudges/streaks, mould, soap build-up and mineral deposits.

• Shower curtains and bath mats are free from stains, smudges, smears, odours, mould and body fluids.

• Plumbing fixtures are free of smudges, dust, soap build-up and mineral deposits.

• Bathroom fixtures are free from unpleasant or distasteful odours.

• Polished surfaces are of a uniform lustre.

• Sanitary disposal units are clean and functional.

• Consumable items are in sufficient supply.

• Waste is removed in accordance with the Service Standards of the Waste Management Service Level Specification or Local Policy

4.1 Remove Debris

4.2 Damp Clean
Wearing colour coded protective gloves, damp clean using disposable paper or disposable cloth immersed in hand hot water containing correctly measured cleaning solution and wring out as dry as possible.
Change cleaning solution when dirty and at least once per 15 minutes and prior to moving to different location/area.
This process applies to desks, lockers, beds, tables, overbed tables, examination couches, chairs, overchair tables, wheelchairs, soft play equipment, cabinets, bed lights, examination lights, light switches, control panels, patient call buttons, worktops, pictures, TV and hi-fi equipment, including remote controls, trolleys, radiators, and pipe work, ledges, fire extinguishers, decorative plants, trees and containers.

4.3 Periodic cleaning according to type, (including fabric upholstered chairs, non clinical areas)
To be performed in rotation and according to local specification/policy

4.4 Clean all Wheels, castors and lower part of bed frames
To be performed in rotation and according to local specification/policy

REQUIRED OUTCOME MEASURES

• Hard surface furniture is free of spots, soil, film, dust, fingerprints and spillage.

• Soft furnishings are free from stains, soil, film and dust.

• Furniture legs, wheels and castors are free from mop strings, soil, film, dust and cobwebs.

• Inaccessible areas (edges, corners, folds and crevices) are free of dust, grit, lint and spots.

• All high surfaces are free from dust and cobwebs.

• Equipment is free of tapes/plastic, etc., which may compromise cleaning.

• Furniture has no unpleasant or distasteful odour.

• Shelves, bench tops, cupboards and wardrobes/lockers are clean inside and out and free of dust, litter or stains.

• Internal plants are free of dust and litter.

• The Local Policy must determine who has responsibility for cleaning patient equipment, especially when stained with body fluids.

5.1 Damp Clean
Wearing colour coded protective gloves, damp clean using disposable paper or disposable cloth immersed in hand hot water containing correctly measured cleaning solution and wring out as dry as possible. Change cleaning solution when dirty and at least once per 15 minutes and prior to moving to different location/area.
This process applies to dado rails, window ledges, door frames, vents, partition ledges, pipes and skirtings and any other surface which might attract dust, graffiti and any form of spillage.

REQUIRED OUTCOME MEASURES

• Internal and external walls and ceilings are free of dust, grit, lint, soil, film, graffiti and cobwebs.

• Walls and ceilings are free of marks caused by furniture, equipment or users of the Organisation Site.

• Light switches are free of fingerprints, scuffs and any other marks.

• Light fittings are free of dust, grit, lint and cobwebs.

6.1 Clean wall surfaces, ledges, cabinets, furnishings, pipes, direction signs and curtain rails
Use either suction cleaner or dust mop with appropriate attachments. Clean all accessible dry surfaces, including edges and corners. In sanitary areas, dust mop down to tile level and damp clean tiled area.
Include high level internal glass surfaces.
This process applies to window ledges, partition ledges and any other surface which might attract dust, and any form of spillage.

REQUIRED OUTCOME MEASURES

• Internal and external walls and horizontal surfaces are free of dust, grit, lint, soil, film, graffiti and cobwebs.

• Walls and ceilings are free of marks caused by furniture, equipment or site users.

7.1 Damp Clean
Wearing colour coded protective gloves, damp clean using disposable paper or disposable cloth immersed in hand hot water containing correctly measured cleaning solution and wring out as dry as possible. Remove all soil.

REQUIRED OUTCOME MEASURES

• Telephone is visibly clean

8.1 Remove Marks
Wearing colour coded protective gloves, damp clean using disposable paper or disposable cloth immersed in hand hot water containing correctly measured cleaning solution and wring out as dry as possible, remove all forms of soiling and graffiti. Change cleaning solution when dirty and at least once per 15 minutes and prior to moving to different locations.

REQUIRED OUTCOME MEASURES

• Internal and external doors and doorframes are free of dust, grit, lint, chewing gum, soil, film, fingerprints and cobwebs.

• Doors and doorframes are free of marks caused by furniture, equipment or staff.

• Air vents, grilles and other ventilation outlets are kept unblocked and free of dust, grit, soil, film, cobwebs, scuffs and any other marks.

• Door tracks and door jambs are free of grit and other debris.

9.1 Clean
Wearing colour coded protective gloves damp clean using disposable cloth/paper immersed in hand hot water containing cleaning solution. Rinse and wring out cloth/paper in clean water and wipe area as dry as possible. Remove smears with dry disposable cloth/paper. Report cracked/broken glass to appropriate responsible person.

REQUIRED OUTCOME MEASURES

• Glass partitions, panels and ceramic wall tiles should be free from dust, soil, smears, finger finger prints and have a polished finish.

• External and internal surfaces of glass are clear of all streaks, chewing gum, spots and marks, including fingerprints and smudges.

• Window frames, tracks and ledges are clear and free of dust, grit, marks and spots.

10.1 Change Bed/Trolley Screens

10.2 Change Bed/Cubicle Curtain

10.3 Change Window Curtains

10.4 Shower Curtains - Damp Wipe

10.5 Shower Curtains - Remove and Change

10.6 Net Curtains - Remove and change

REQUIRED OUTCOME MEASURE

• Curtains, blinds and drapes are free from stains, dust, cobwebs, lint. Cords shall be clean and knot free.

11.1 Suction Clean
Remove dry dust and soil using suction clean complying with three stage filtration In-patient areas.

11.2 Remove and Clean
Source specialist clean - to be performed in accordance with local policy.

11.3 Opening and Closing mechanism

REQUIRED OUTCOME MEASURE
Curtains, blinds and drapes are free from stains, dust, cobwebs, lint. Cords shall be clean and knot free.

12.1 Replenish Consumable Supplies
Ensure sufficient supplies to cover requirements until next routine clean or check. Supplies include liquid hand soap, paper hand towels, paper rolls, toilet tissue and toilet rolls.

REQUIRED OUTCOME MEASURE

• Consumable items are in sufficient supply.

13.1 Empty and Clean
Wearing colour coded protective gloves clean using damp paper and neutral detergent in solution. Dry.

REQUIRED OUTCOME MEASURE

• Ashtray is visibly clean.

14.1 Collect and Dispose
Collect and dispose of refuse from holders, and containers in accordance with local policy.

14.2 Clean Holders/Containers
Wearing colour coded protective gloves damp clean outside and then inside of holder/container with disposable paper or disposable cloth immersed in correctly measured solution of neutral detergent and wring out as dry as possible, removing all forms of soiling and graffiti and dry. Change solution when dirty and at each change of location.
Large enclosed type receptacles will require to be specially cleaned in accordance with local policy. Report mechanical failures e.g. broken lids / foot pedals to the appropriate responsible person,

14.3 Replace Disposable Liners/Containers
To be performed in accordance with local policy.

REQUIRED OUTCOME MEASURES

• Waste/rubbish bins or containers are clean inside and out, free of stains and mechanically intact.

• Waste is removed in accordance with the Service Standards of the Waste Management Service Level Specification or local policy.

15. KITCHEN, FIXTURES, FITTINGS AND APPLIANCES
Cleaning materials for use in food preparation areas must be dedicated for the purpose and stored in the area. All equipment should be cleaned with reference to manufactuers recommendations.

15.1 Clean Spillages

15.2 Damp Clean External Surfaces
To be performed in accordance with local policy

15.3 Defrost Refrigerator and Clean
Switch off appliance. Remove all contents and store at appropriate temperature. Wearing colour coded protective gloves remove ice trays and shelves and wash and dry. When completely defrosted, empty drip tray. Clean outside of fridge with hand hot water and neutral detergent. Damp clean inside of fridge and inside door paying special attention to seals. Re-assemble trays and shelves in fridge and switch on. Re-stock fridge when appropriate temperature has been achieved (1°C - 4°C). Wash and dry equipment.

15.4 Defrost Deep Freeze and Clean
Switch off appliance. Remove stock and store at appropriate temperature. Wearing colour coded protective gloves wash trays/shelves in solution of correctly measured neutral detergent, rinse and dry. Clean outside of deep freeze with solution of correctly measured neutral detergent. Once defrosted damp clean inside of deep freeze and inside of door paying special attention to seals. Rinse and dry.
Re-assemble trays and shelves in deep freezer, switch on and when appropriate temperature has been achieved ( - 18°C - 22°C) re-stock.

15.5 Icemakers
Reference Local Standard Operating Procedure.
1) The storage compartment should be cleaned weekly to prevent the build up of bacteria.
2) To clean the icemaker minimum frequency 26/52.
a) remove all ice from the storage compartment.
b) wash the ice storage compartment with a solution of general purpose neutral detergent and a disposable cloth or paper.
c) Rinse the compartment with clean potable water
d) Using a solution of sodium hypochlorite 125ppm, rinse compartment again.
e) Rinse with clean potable water and dry thoroughly.
3) The ice that has been removed from the machine to allow for cleaning should be disposed of and it SHOULD NOT be returned to the ice machine.
4) The exterior surfaces of the ice machine, particularly the door/hatch of the ice storage compartment, must be kept clean.

15.6 Strip and Clean Cooker
Wearing colour coded protective gloves, switch off cooker at power point, remove spillage tray, oven trays, grill tray, pan rests and soak in solution of correctly measured neutral detergent. Clean inside and outside of cover/grill including internal and external doors, removing all debris and build-up of dirt. Rinse and dry. Clean hob, burners/rings and controls using solution of correctly measured neutral detergent, rinse and dry. Clean spillage tray, oven tray, grill trays, pan rests. Rinse and dry.
Re-assemble components of cooker. Switch on cooker at power point.

15.7 Clean behind and under appliances

15.8 Clean shelves and interior of cupboards
Damp clean as per furniture and fittings ensuring cleaning material is suitable for food use area.

15.9 Other Kitchen Appliances (To include food processor/mixer, toasters, water boilers, milk refrigerators, for example)
To be performed in accordance with local policy.

15.10 Clean Heated Cabinets /Hot cupboards /Regen Trolleys
Power supply must be switched off for this task. Wear colour coded protective gloves.
Cabinets Damp clean using appropriate disposable cloth/paper product, hand hot water and detergent. Use pad to remove any build-up. Rinse and allow to dry.
Cupboards As with cabinets, but daily power cannot go off and so beware of 'Burns Hazard'. At agreed interval arrange for engineers to switch off.
Scrub thoroughly.
Regen Trolley Ensure the trolley has cooled down completely and is isolated from the electric supply before cleaning. Pay close attention to manufactures instructions for cleaning. Remove all grids and wash in hand hot water and detergent solution. Remove fan shield, wash, rinse and air dry. Wash inside of oven rinse, air dry and re-assemble. Remove door gasket, wash, rinse and air dry.

15.11 Clean Microwave Oven
Wear colour coded protective gloves. Damp clean inside of cooker - remove and clean turntable/tray as appropriate. Use appropriate disposable cloth / paper product, hand hot water and detergent pay close attention to manufacturer's instructions for cleaning.

15.12 Clean Kitchen Trolleys Including Wheels
Trolleys must be damp cleaned after use, including edges and handles. Trays should be lifted out to facilitate the cleaning of edges.

15.13 Clean Waste Disposal Units
All splashes and food deposits must be cleaned off after each use.

REQUIRED OUTCOME MEASURES

• Fixtures, surfaces and appliances are free of grease, dirt, dust, deposits, marks, stains and cobwebs.

• Electrical and cooking fixtures and appliances are kept free from signs of use or non-use.

• Cooker hoods (interior and exterior) and filters are free of grease and dirt on inner and outer surfaces.

• When cleaning food preparation areas, fixtures or appliances, the requirements of the Royal Environmental Health Institute of Scotland or the Royal Institute of Public Health and Hygiene, as appropriate, must be satisfied.

• Motor vents, etc., are clean and free of dust and lint.

• Refrigerators/freezers are clean and free of ice build-up.

• Waste is removed in accordance with the Service Standards of the Waste Management Service Level Specification or local policy.

16. CLEANING EQUIPMENT
Includes all mechanical and hand equipment, cleaning trolleys, caution "cleaning in progress" signs

16.1 Remove all loose dust and soil.

16.2 Remove paper bag from suction cleaner and replace. As necessary replace filter to manufacturers recommendations.

16.3 Empty solution and collection tanks, clean with correctly measured solution of appropriate detergent, rinse and dry.

16.4 Wash Mop Heads, Buckets and Receptacles. Rinse, clean, dry and store, as per colour code segregation policy. Mop heads must be detachable and air dried after use. Full laundering and drying to ensure thermal disinfection must be carried out as per local policy.

16.5 Remove Attachments

Wash, rinse, dry and store as per colour code segregation policy.

16.6 Outer Casing
Damp wipe outer casing, handle, flex, with solution of correctly measured detergent, dry and store.

16.7 Report any faults or mechanical failures to the appropriate responsible person.

REQUIRED OUTCOME MEASURES

• Equipment should be clean, dry and serviceable

• Equipment should be stored correctly.

17. Definition of Clean and Check Clean

17.1 Clean
Indicates the thorough removal of adherent dust, soil, organic matter and the removal of stains from surfaces, furniture, fittings, floors, etc. to reach an acceptable standard using the agreed cleaning procedures.

17.2 Check Clean
This is a visual check of cleanliness, for spots, spillages, general debris etc. at a specified frequency throughout the day. Sufficient cleaning should be carried out to restore the area or item to an acceptable standard using the agreed cleaning procedures.

REQUIRED OUTCOME MEASURES

• See detail task group 1 thru 16.

18 .1 Remove Debris
Remove all litter, e.g. paper tissue, equipment packaging from floor.

18.2 Brush Sweep
Using designated brush and shovel remove all debris, e.g. dust, dirt from floor surface including floor edges and corners using designated equipment.

18.3 Wet Mop
Using designated mop and bucket, prepare approved cleaning solution, clean floor surface including floor edges and corners. If floor grossly contaminated, change cleaning solution at least once during process. Place 'Wet Floor' hazard sign next to door of vehicle until floor dry.

18.4 Spot Mop (Referred to as 'Check Clean' on Definition Sheet):
All spillages [including blood and body fluids] should be decontaminated using designated agent and paper towels, as soon as practicable. Area should be cleaned using designated mop and bucket and approved cleaning solution on return to base station.

18.5 Thorough Clean
Remove all movable equipment. Using designated mop and bucket, prepare approved cleaning solution, clean floor surface including floor edges and corners. If floor grossly contaminated, change cleaning solution at least once during process. Place 'Wet Floor' hazard sign next to door of vehicle until floor dry.

18.6 Suction Clean Soft floors
Using designated 'vacuum cleaner', remove all visible dust and debris. Replace dirt bag as required. Check filters and replace as per manufacturers instructions.

18.7 Remove Spots and Spillages Soft floors
All spillages [including blood and body fluids] should be decontaminated using designated agent and paper towels, as soon as practicable. Area should be valet cleaned on return to base station.

REQUIRED OUTCOME MEASURES

• The floor is free from dust, dirt, litter, etc.

• The floor edging and corners are free from dust, dirt, litter, etc.

• 'Wet Floor' hazard sign is displayed during cleaning process.

1. Colour Coding
   Adhere to National or Local Policy.

19.1 Disposable Cloths

19.2 Colour coded protective gloves

19.3 Mop heads
Minimum frequency to be determined.
Single Use mop heads to be utilised in any outbreak situations.

19.4 Hand equipment

20 Mop laundering
Adhere to Local Policy.

21 Reporting of Faults
All defaults relating to environmental surfaces, fittings and mechanical failures should be reported to the appropriate responsible person.