Therapeutic Kitchen Environment Policy

Therapeutic Kitchen Environment Policy Who Should Read This Policy Target Audience Occupational Therapists working within designated Therapeutic Kitchen Environments Other staff working within designated Therapeutic Kitchen Environments Version 2.0 July 2015

Ref. Contents Page 1.0 Introduction 4 2.0 Purpose 4 3.0 Objectives 4 4.0 Process 4 4.1 Employment of Staff Providing Interventions to Patients within 4 Therapeutic Kitchen Environments 4.2 Personal Hygiene 5 4.3 Protective Clothing 5 4.4 General Food Handling Process 5 5.0 Procedures Connected to this Policy 12 6.0 Links to Relevant Legislation 12 6.1 Links to Relevant National Standards 13 6.2 Links to Other Key Policy/s 13 6.3 References 14 7.0 Roles and Responsibilities for this policy 15 8.0 Training 16 9.0 Equality Impact Assessment 16 10.0 Data Protection Act and Freedom of Information Act 16 11.0 Monitoring policy s effectiveness 17 Appendices 1.0 Declaration Form 18 2.0 Procedure for Dealing with Food Handling Staff Reporting Illness 19 2.1 Food Handlers Agreement to Report Illness 20 3.0 Ayliffe Hand Washing Technique 21 4.0 Microwave Oven Guidelines 22 5.0 Colour Coded Cutting Boards 23 6.0 Allergen Information for Loose Foods 24 7.0 National Colour Coding Scheme for Hospital Cleaning Materials and 25 Equipment 8.0 Example Internal Audit Form for Therapeutic Kitchen Environment 26 Version 2.0 July 2015 2

Explanation of terms used in this policy Therapeutic Kitchen Environment - An environment used solely for the preparation of food and drink by patients ADL - Activities of Daily Living OT - Occupational Therapy/Occupational Therapist Food Handler - A person who handles or prepares food and drinks whether open (unwrapped) or packaged within the Trust. They would require Level 1, 2 or 3 Food Safety Training as appropriate Dysphagia - Term used to describe difficulties arising during the eating, drinking and swallowing process Water Management - A suitable and comprehensive regime of maintenance and management of water systems to meet legislative requirements, without risk to people or the environment EHO - Environmental Health Officer Version 2.0 July 2015 3

1.0 Introduction Therapeutic Kitchen Environments (formerly referred to as Activities of Daily Living Kitchens) are predominantly used by Occupational Therapists to provide assessment and therapeutic intervention in both inpatient and designated community settings. This policy does not cover interventions in service users homes or other community venues. This policy provides direction for correct use of Therapeutic Kitchen Environments including: purchase, delivery and transportation of food items, storage, food preparation, cooking, serving of food, cleaning and food waste. It gives practical guidance for staff members on food safety, risks and hygiene practices to protect themselves, service users and visitors against the risk of food poisoning and hazards linked to contaminated food. 2.0 Purpose The aim of this policy is to ensure safe and consistent practice across Therapeutic Kitchen Environments within Black Country Partnership Foundation Trust. 3.0 Objectives The key objectives of this Policy are to: Provide practicable and consistent guidance for all staff using Therapeutic Kitchen Environments Provide a framework of risk assessment and control of potential hazards within Therapeutic Kitchen Environments to ensure the safety of all staff, service users and carers whilst carrying out assessment and therapeutic interventions Ensure that each stage of the general food handling process used in Therapeutic Kitchen Environments complies with current legislation and guidance 4.0 Process This section describes the process/procedure and course of action required to implement and comply with the policy. 4.1 Employment of Staff Providing Interventions to Patients within Therapeutic Kitchen Environments 4.1.1 Pre-employment Checks All food handlers must have a health check approved by the Occupational Health provider for the Trust. This applies to: staff, bank and agency staff, volunteers and students. In the case of student health checks, those carried out pre-course assessment or by the educational establishment are acceptable. 4.1.2 On Appointment It is the responsibility of team leaders to ensure that all new food handlers are: given a copy of the Therapeutic Kitchen Environment Policy and read and sign a declaration that they have received and understood this (Appendix 1). The member of staff must then evidence an up to date and appropriate food safety qualification or be booked on to suitable training as soon as possible. Food handling cannot be undertaken until training has been successfully undertaken (see section 8.0). The team leader must ensure that all new food handlers follow the set procedure for reporting illnesses (Appendix 2.0), including their agreement to report illness (Appendix 2.1). Version 2.0 July 2015 4

4.2 Personal Hygiene 4.2.1 Hands Hands should be washed with liquid soap and in running water (Appendix 3), and thoroughly dried on disposable paper towels. Wash hand-basins should be used for hand washing only, not for food or food equipment. Hands must not be washed in food sinks. 4.2.2 First Aid First aid procedures must be followed. Staff working in a Therapeutic Kitchen Environment with a minor abrasion must have it covered with a blue waterproof dressing. 4.2.3 First Aid Boxes First aid boxes can be located in Therapeutic Kitchen Environments provided there is a trained first aider to use them. Where a first aid intervention is undertaken by a trained first aider, appropriate ward staff should then be informed and a record made of the first aiders actions. 4.3 Protective Clothing Aprons should be worn by staff and patients during food and drink preparation (material with a plastic coating that can be wiped down after each use). Disposable aprons should not be worn as these can be melted via various heat sources within the kitchen. Ligature risks must be taken into consideration when selecting aprons for patients. 4.4 General Food Handling Process Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Purchase Delivery Storage Preparation Meal Service Food Waste and Cleaning This section clarifies legislative requirements and good practice at each stage of the handling process. 4.4.1 Step 1 - Purchase Food should be purchased through the Trust s procurement department or from reputable supermarket outlets. This allows for easier tracking of food if there is a problem. Using Horticulture as a therapeutic medium is of increasing importance in healthcare and the growing of food by patients should not be discouraged. It is important that food is grown using organic principles and therefore no harmful substances are used, and that the soil is deemed safe for the growth of food items. During the purchase or on receipt of food purchased on line, food must be carefully examined for any signs of spoilage. Food showing signs of spoilage must not be purchased or if delivered be discarded. The Best Before and Use By dates must be checked to ensure each food/drink item is within date. Version 2.0 July 2015 5

4.4.1.1 Advice on Food Allergen Labelling Careful consideration must be given to patients dietary requirements which include food allergies and intolerance. Staff must follow the advice on food allergen labelling provided by the Food Standards Agency- food.gov.uk in order to purchase food safely for patients who have a food allergy or intolerance. There are 14 major allergens which need to be declared by manufacturers when used as ingredients (Appendix 6). 1. Celery 2. Cereals containing gluten 3. Crustaceans 4. Eggs 5. Fish 6. Lupin 7. Milk 8. Molluscs 9. Mustard 10. Nuts 11. Peanuts 12. Sesame seeds 13. Soya 14. Sulphur Dioxide Please note that patients may have other allergies or intolerances not listed, therefore, fact finding prior to Therapeutic Kitchen Environment interventions is essential. 4.4.1.2 Records Records must be kept of purchases made. This is to meet food safety legislation in case there is an outbreak of food poisoning, but also to maintain a financial record of items purchased. Supermarket receipts and online purchase records should be retained within Teams as financial records and will also suffice as health and safety records. 4.4.1.3 Dysphagia Dysphagia issues must be taken into consideration when planning interventions for patients. Dysphagia is the term used to describe difficulties arising during the eating, drinking and swallowing process. Dysphagia can arise in any stage of the swallowing process: the oral, pharyngeal and/or laryngeal stages. Advice and further assessment must be sought from speech and language therapy and dietetics services when there are concerns. 4.4.2 Step 2 Delivery Transport of items must be timely to prevent food products becoming too warm. This will increase the danger of food poisoning (harmful bacteria growing to dangerous levels). This applies both to a supermarket delivery service (purchase online) and to transportation by staff from supermarket to the Therapeutic Kitchen Environment. Chilled goods cannot exceed 8 C, and frozen products -18 C. Consideration must be given to food allergens when transporting food to ensure that different products do not come into contact. 4.4.3 Step 3 Storage Only food which is frozen at the point of purchase can be placed into a freezer. The date when placed into the freezer must record on the outer packaging. Version 2.0 July 2015 6

Fresh and frozen poultry represent the greatest single hazard in the catering process; therefore, extreme care must be taken when handling these items. Consideration must be given to food allergens and contamination prevented. Eggs must be stored in the refrigerator. Food Item Storage Temperature Other Guidelines Chilled Food 0-8 C Food must be protected from contamination at all times The vehicle used to transport goods must be clean (Applies to all food items) Frozen Food Frozen Meat -18 C -18 C Should be avoided if possible Fresh Meat 0-8 C Must be effectively wrapped to prevent dripping Storage in enclosed container below all other food items All products must be consumed within 24 hours of purchase Fresh Poultry 0-8 C As for Fresh Meat Frozen Poultry Ice Cream & Ice Cream Products -18 C Should be avoided if possible -18 C Must be effectively wrapped and show no signs of poor storage Defrost process: poultry must be removed from its outer wrapping and defrosted in a container with a tight fitting lid to prevent spillage and contact with other food. This must be carried out naturally without heat addition When temperature reaches 3 C remove giblets (if applicable) Cook within 24 hours Should be wrapped or boxed effectively and must be stored in a deep freeze operating at Version 2.0 July 2015 7

-20 C & the storage period must not exceed 1 month Milk, Dairy & Fat Products 0-8 C Keep milk, yoghurts and cream which are high risk foods separate from all raw products Store fats away from strong smelling foods that could taint them Fresh Fruit & Vegetables 0-8 C Store in a well-ventilated area away from other foods. Storage in a fridge will prolong life of the product Prepared vegetables must be kept in a covered container or sealed food bag in the fridge Bread & Other Bread Products Cool, well ventilated store, covered bread bin. Check for moulds Use within manufacturer s date on packaging Canned Goods Dry storage Check for blown, badly dented, seam damaged and that within use by date Flour & Cereals Damp free After opening store in container with tight fitting lid. Check regularly for signs of contamination and infestation Ensure use by date is recorded on container Eggs 0-8 C in refrigerator Check use by date on each egg 4.4.3.1 Refrigeration Growth of common food poisoning bacteria is arrested at temperatures of 0-8 C. However, moulds and some spoilage bacteria may still be able to grow even if at a reduced rate. Refrigeration will not keep food indefinitely nor will it kill bacteria Check refrigerators daily to ensure no food is unfit for consumption or in the case of packaged goods, past its use by date Refrigerators must be capable of operating between 0-8 C. The temperature gauge must be placed in the warmest part of the fridge to ensure effective monitoring. The temperature must be checked and recorded daily by a responsible person(s) and if the temperature falls below 0 C or above 8 C, the food must be thrown away and the appropriate manager informed Refrigerators must be sited away from any heat source, including sunlight, and placed in a well-ventilated position. All surfaces and surrounding area must be Version 2.0 July 2015 8

accessible for cleaning purposes. The back of the refrigerator (cooling units) must not be placed directly next to a surface to ensure a good external circulation of air The refrigerator must be cleaned on a weekly basis in keeping with Trust practice in inpatient settings. Over stocking must be avoided in order to ensure efficient circulation of air Open cans must always be decanted prior to storage into sealed containers and dated All items taken from their original packaging must be covered and labelled, identifying the date. Any item not used after 24 hours must be thrown away If the same refrigerator has to be used, the uncooked items (i.e. uncooked meat, fish and vegetables) must be placed on the lower shelves and never above highrisk food 4.4.3.2 Storage by Freezer Frozen food must be stored at 18 C or below On delivery frozen food must be transferred to the freezer immediately Frozen food must be wrapped to prevent freezer burn A freezer is intended for the storage of food already in a frozen state or food suitable to be frozen on day of purchase Once thawed frozen food must never be refrozen A recorded check of the operating temperature of the freezer must be taken once a day by the responsible person(s). Any reading that is higher than -20 C must be reported to the supervisor and remedial action taken In the event of a freezer breakdown, the temperature of stored foods must be checked. If the temperature has not exceeded -13 C the food must be placed into an alternative freezer. Any food above this temperature must be immediately disposed of 4.4.3.3 Storage of Dry Products Food stores must not be over-stocked as this hinders cleaning, makes stock rotation more difficult, and can encourage pests All food items must be stored off the ground on racks or shelving made of an impervious material Food storage areas must be dry, cool, clean, well lit, well ventilated and proofed as far as possible against rodents and other pests 4.4.4 Step 4 Preparation 4.4.4.1 Food preparation Prior to commencing food preparation with patients whether on a 1:1 or group basis, the food handler(s) must have obtained an allergen history. Patients should as a rule prepare food for their own consumption. Service Managers must give permission for patients to prepare therapeutic meals as a group If baking products are prepared these again should only be consumed by the patient preparing them. If these products are shared with other patients then all allergen information must be considered and shared Prior to preparing meals or baking, an ingredients list must be produced with any allergens identified. Standard recipes may be useful both for meals and for baking Separate utensils must be used for raw and cooked food, or if this is not possible, they must be thoroughly sanitised between each use. Raw foods must always be Version 2.0 July 2015 9

kept separate from food to be served. Colour coding of preparation boards is essential as a standard. The Trust colour scheme is (Appendix 5): Red Blue Green Yellow Brown White Raw meat Raw fish Salad and fruit Cooked meat Vegetables Bakery and dairy In small units with limited workspace it may be necessary to use worktops for more than one purpose. In this case the work surfaces will need to be sanitised between each use and colour coded preparation boards used Ensure hands are clean at all times All fresh fruit, salad and vegetables to be washed in cold running water prior to use Food must be kept covered until needed and in the correct storage conditions High risk foods must not be prepared too far in advance of cooking and consumption Ideally raw meat should not be washed prior to cooking due to risk of contamination around the sink area. However, if this is completely contra to a patient s usual practice then the risks must be explained and they must be supported to clean around the sink area after they have washed the meat Such foods can be classified under the following headings: Meat Poultry Seafood Dairy Products Other Food Beef, lamb, pork, rabbit, ham, tongue, pressed meats, stock, stew, minces, curries, sausage, pies and pate etc. Chicken, turkey, duck and game, eggs, pate, and similar products made with poultry or eggs etc. Prawns, mussels, shrimps, cockle, crabs, smoked fish etc. Milk, cream, soft cheeses, mayonnaise, ice cream, custard, raw shell eggs, and pasteurised egg etc. Gelatine and glazes, rice, pulses, root vegetables, gravies and sauces etc. 4.4.4.2 Cooking of Food Food with a high-risk of contamination must be cooked in a carefully controlled way, which will provide sufficient heat to reduce microbial contamination to an acceptable level. 4.4.4.3 The Digital Probe Checks using a digital probe thermometer must be made at regular intervals to ensure that the recommended temperatures are reached in all parts of the item being cooked and temperature maintained for a minimum of 20 minutes. The digital probe must always be kept clean and be sanitised with a probe wipe prior to insertion into the food. Time must be allowed for the readout to stabilise before the temperature is recorded. When not in use the probe should be stored in a clean drawer or washable container, to prevent unnecessary contamination. The probe thermometer must be formally calibrated by the Hotel Services Manager on a monthly basis. It is the responsibility of the OT team leader or other lead staff, to make arrangements for this. Version 2.0 July 2015 10

Beef Core temperature of joint when cooked 75 C Lamb Core temperature of joint when cooked 85 C Pork Core temperature of joint when cooked 85 C Poultry Core temperature of joint when cooked 85 C Ham Core temperature of joint when cooked 85 C Stews, casseroles, gravy, 75 C at centre for at least 2 minutes sauces, custard, stocks and similar dishes Hold all cooked foods at temperatures between 0-8 C if to be eaten cold or above 63 C if to be eaten hot to prevent bacterial growth. If food is to be refrigerated after cooking it must be allowed to cool first. This must be placed into a refrigerator within 90 minutes. To make this possible a joint must be kept below 5-6lbs (2.5kgs) in weight. 4.4.4.4 Microwave Oven Guidelines Microwave oven guidelines should be followed as agreed the Hotel Services Manager (Appendix 5). 4.4.5 Step 5 Meal Service Food must be protected from contamination at all times. The time between the cooking and service of a food must be kept to an absolute minimum. Cold food should be kept in the refrigerator until service. This should include sandwiches as fillings may contain certain high-risk foods. Ice cream should always be served frozen and must never be frozen once it begins to thaw. 4.4.5.1 Meal Service Checklist Wash your hands before commencing service Check for crockery/cutlery to ensure cleanliness and no chipping or cracks in crockery Any items not up to standard should be removed and disposed of 4.4.6 Step 6 Cleaning and Food Waste 4.4.6.1 Daily Cleaning Schedules The organisation and monitoring of cleaning is co-ordinated using a Cleaning Schedule which should be displayed within the Therapeutic Kitchen Environment. The schedule defines: what is to be cleaned frequency of cleaning materials to be used method to be used safety precautions to be taken who is to do the cleaning Version 2.0 July 2015 11

4.4.6.2 General Cleaning Guidance The National colour coding scheme for hospital cleaning materials and equipment Back 2 Basics initiative should be used (Appendix 7). Hotel Services will support with this. Use paper towels or paper roll for drying utensils. Air dry where possible but utensils must not be stacked. Cleaning equipment, materials and detergents when not in use must be stored in a separate room or cupboard and must not be left in and around the kitchen. Cleaning detergents can be poisonous and must never be stored beside items of food. Water for cleaning and/or mop buckets must never be emptied down wash-up or food preparation sinks. Use the cleaners cupboard sluice. All structural surfaces less than 2 metres above the floor must be cleaned at weekly intervals. Special attention must be paid to cleaning corners and junctions between walls and floors and behind and under fixed equipment. Mops must be washed and wrung out after each use and not left standing in water. Ideally these should be laundered after use. Disposable cleaning cloths must be used for all cleaning duties. They should be used for one task only and discarded. 4.4.6.3 Mechanical Dishwashing Waste must be scraped into the waste disposal unit or black bin bag and the article rinsed prior to washing. Articles must be placed in the appropriate rack so they do not overlap, and then placed in the machine and the wash cycle started following the manufacturers instructions (hot cycle minimum of 65 C). When the cycle is completed, remove the racks and allow the articles to air-dry before being stacked. If necessary use disposable paper towel/roll to finish the drying. 4.4.6.4 Refuse Disposal All food waste should be placed into a well maintained, closed container that can be easily cleaned, and disposed of via the waste disposal unit, or double black-bagged and kept externally with the rest of the refuse awaiting collection. Refuse must be removed at regular intervals, never stored in the Therapeutic Kitchen Environment over- night. 5.0 Procedures connected to this Policy There are no standard operating procedures connected to this policy. 6.0 Links to Relevant Legislation Health & Safety at Work Act 1974 The Health and Safety at Work Act 1974 is the primary piece of legislation covering occupational health and safety in Great Britain. The Health and Safety Executive, with Version 2.0 July 2015 12

local authorities (and other enforcing authorities) is responsible for enforcing the Act and a number of other Acts and Statutory Instruments relevant to the working environment. The Act covers: controlling risk; consulting employees; providing training and information; providing the right workplace facilities; first aid, accidents and ill health. Food Safety Act 1990 The Food Safety Act 1990 provides the framework for all food legislation in Britain similar legislation applies in Northern Ireland. The main responsibilities for all food businesses under the Act are: to ensure you do not include anything in food, remove anything from food or treat food in any way which means it would be damaging to the health of people eating it to ensure that the food you serve or sell is of the nature, substance or quality which consumers would expect to ensure that the food is labelled, advertised and presented in a way that is not false or misleading 6.1 Links to Relevant National Standards Food Hygiene Regulations 2006 This is aimed at bringing up to date, combining and simplifying all the past EU food hygiene laws and regulations. It places an obligation on all food businesses to make sure that their activities are carried out in a hygienic way, and makes it an offence to supply food which is unsafe to be consumed and harmful to human health. All proprietors should ensure that an appropriate level of public health protection is in place. They must do this by identifying food safety hazards and risks relevant to their business, and by putting in place control measures to prevent problems. Its main aim is preventing illness resulting from food and waterborne diseases. 6.2 Links to other key policy/s Hand Hygiene Policy The aim of this policy is to prevent the spread of infection via the hands by removing transient organisms, or reducing them to a level where they no longer pose a threat to the next person or surfaces touched. Health & Safety Policy This policy aims to promote and enable an organisational and systematic approach to the development of Health and Safety procedures and protocols throughout the Trust and to set out the requirements of the Trust to demonstrate and achieve legislative compliance. Fire Safety Management Policy The aims and purpose of this policy are to outline the Trusts strategic aims, objectives and duties for the successful management of fire safety to secure the health, safety and welfare of service users, staff, visitors, contractors and any person who maybe affected by our activities. Version 2.0 July 2015 13

Water Management Policy The aim of this policy is to ensure a framework for the good practice of water management exists to help employees and contractors of the Trust meet the legislative requirements. The Trust recognises its legal and moral obligations in relation to water management and whilst meeting the requirements of issued guidance, takes into account any local constraints. The Trust has a duty of care and will ensure, so far as is reasonably practical, that the staff comply with the protocols in this policy. 6.3 References The Management of Health & Safety at Work Regulations (1992) Food Safety (General Food Hygiene) Regulations 2006 Public Health (Infectious Diseases) Regulations (1988) Dysphagia Diet Food Texture Descriptors National Patient Safety Agency (2011) COSHH Procedures (2002) Food Standards Agency Food Handlers: fitness to work Regulatory Guidance and Best Practice Advice for Food Business Operators The Food Law Code of Practice (2014) Allergen information for loose foods ( 2014) Version 2.0 July 2015 14

7.0 Roles and Responsibilities for this Policy Title Role Responsibilities Director of Nursing, AHPs and Governance AHP Professional Lead Professional Advisory Group OT Team Leaders/ Ward Managers/Deputy Modern Matrons Infection Control Lead Nurse Head of Estates and Facilities Management Hotel Services Manager Occupational Therapists and any other staff designated to work within Therapeutic Kitchen Environments Executive Lead Implementation Lead Monitoring - Lead responsibility for the implementation of this policy - Allocation of resources to support the implementation of this policy - Any serious concerns regarding the implementation of this policy are brought to the attention of the board of directors - Lead responsibility for the day to day implementation of this policy - Maintain the central list of Therapeutic Kitchen Environments with Estates, and establish a plan of regular checks using an internal audit form - Support any Therapeutic Kitchen Environment found not to be functioning to the required standards to develop an improvement plan - Oversee the implementation of a systematic and consistent approach - Approve all policies and procedures that relate to their subject matter or area of practice Operational - Responsible for the day to day implementation of this policy Specialist Advice - Provide specialist advice to operational managers and staff as necessary Food Safety Lead Operational Food and Safety Lead Adherence - Operational Food Safety lead to ensure that adequate food safety standards are maintained within the Trust and that action is taken upon receipt of Environmental Health Officers (EHO s) reports - Maintain the central list of Therapeutic Kitchen Environments with AHP Professional Lead, and establish a plan of regular checks using an internal audit form - Work with the lead Occupational Therapists and Infection and Control Team to ensure that Therapeutic Kitchen premises and equipment comply with legislation, and that practices do not fall below standard - Ensure that they have received the required level of food safety training for their role (Level 1, 2, 3) - Maintain safety through: the monitoring of risk, the management of sharps and Control of Substances Hazardous to Health (COSHH) - Encourage patients to implement food safety practices. Clinical judgement should be used in relation to valuing personal choice, which may conflict with strict adherence to food safety guidelines - Maintain sensitivity with regard to patients cultural and spiritual beliefs in connection with food and drink preparation - Check fridge and freezer on a daily basis to ensure compliance with correct temperatures (0-8 C for the fridge and 18 C for the freezer) and that all food is within use by/best before date and correctly labelled - Clean Therapeutic Kitchen Environments appropriately following use - Check Therapeutic Kitchen Environment equipment regularly, and remove all defective items immediately - Purchase all food items from reputable sources i.e. well known supermarket outlets - Monitor food preparation by patients throughout and provide appropriate guidance and practical support to ensure patient and staff safety - Dispose of waste food items in accordance with Trust regulations - Store sharp equipment and COSHH items in designated locked areas and return following use with patients. (There should be local guidelines for the safe use and storage of sharps and COSHH items, including use of an inventory for Version 2.0 July 2015 15

Title Role Responsibilities sharps and availability of COSHH information sheets) Practice Placement Supervisor Practice Placement Lead - Ensure students facilitating domestic activities are competent with regard to food safety Volunteers Supplementary - Must have acquired level of Level 1 or 2 Food Safety Therapeutic Kitchen Environment Policy 8.0 Training What aspect(s) of this policy will require staff training? 4.1.2 On Appointment (Level 1,2 or 3 Food Safety) 4.4 General Food Handling Process Which staff groups require this training? Occupational Therapy staff and other staff working with patients in Therapeutic Kitchen Environments Occupational Therapy staff and other staff working with patients in Therapeutic Kitchen Environments Is this training covered in the Trust s Mandatory and Risk Management Training Needs Analysis document? If no, how will the training be delivered? Who will deliver the training? No Externally Food Safety Training Provider No Internally OT Team Leader and Ward Managers/ Hotel Services/Food Safety Training Provider How often will staff require training On a three yearly basis As required Who will ensure and monitor that staff have this training? AHP Professional Lead AHP Professional Lead 9.0 Equality Impact Assessment Black Country Partnership NHS Foundation Trust is committed to ensuring that the way we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group. The Equality Impact Assessment for this policy has been completed and is readily available on the Intranet. If you require this policy in a different format e.g. larger print, Braille, different languages or audio tape, please contact the Equality & Diversity Team on Ext. 8067 or email EqualityImpact.assessment@bcpft.nhs.uk 10.0 Data Protection and Freedom of Information This statement reflects legal requirements incorporated within the Data Protection Act and Freedom of Information Act that apply to staff who work within the public sector. All staff have a responsibility to ensure that they do not disclose information about the Trust s activities in respect of service users in its care to unauthorised individuals. This responsibility applies whether you are currently employed or after your employment ends and in certain aspects of your personal life e.g. use of social networking sites etc. The Trust seeks to ensure a high level of transparency in all its business activities but reserves the right not to disclose information where relevant legislation applies Version 2.0 July 2015 16

11.0 Monitoring this policy is working in practice What key elements will be monitored? (measurable policy objectives) Where described in policy? How will they be monitored? (method + sample size) Who will undertake this monitoring? How Frequently? Group/Committee that will receive and review results Group/Committee to ensure actions are completed Evidence this has happened Training Appendix 8- Internal Audit Form For Therapeutic Kitchen Environment Therapeutic Kitchen Environment meets Environmental Health Standards Environmental Health Officer Reports are acted upon in a timely manner 4.4 General Food Handling Process Appendix 8- Internal Audit Form For Therapeutic Kitchen Environment Appendix 8- Internal Audit Form For Therapeutic Kitchen Environment Audit of each Therapeutic Kitchen Environment and associated food handlers Therapeutic Kitchen Environment checks (internal audit) and PLACE visit feedback (or other monitoring visit) AHP Lead will receive copies of all EHO reports OT Team Leader/Ward Manager and Infection Control Team OT Team Leader/Ward Manager and Infection Control Team AHP Lead Twice a year Twice a year for each kitchen As they are received Professional Advisory Group (PAG) and Group Quality and Safety Committees Professional Advisory Group (PAG) and Group Quality and Safety Committees Professional Advisory Group (PAG) and Group Quality and Safety Committees Professional Advisory Group (PAG) and Group Quality and Safety Committees Professional Advisory Group (PAG) and Group Quality and Safety Committees Professional Advisory Group (PAG) and Group Quality and Safety Committees Minutes of PAG meetings and sign off of action plans arising from audit findings Minutes of PAG meetings, sign off of action plans arising from audit findings and PLACE visit feedback Minutes of PAG meetings Version 2.0 July 2015 17

Appendix 1 Declaration Form for Food Handlers Working within Therapeutic Kitchen Environments I have read and had explained to me and confirm that I understand the Trust s Therapeutic Kitchen Environment Policy. Signed: Dated: Name in full: Manager s/supervisor s Signature: (This form is to be photocopied by the Ward/Department team leader) Duplicate copy to be retained by the employee and a copy placed in the personal file Version 2.0 July 2015 18

Appendix 2.0 Procedure for Dealing with Food Handling Staff Reporting Illness On appointment and prior to carrying out food handling tasks, the requirements and systems to report illness as noted overleaf should be explained to all members of staff, required to handle food or beverages The form overleaf should be signed by the member of staff and counter signed by the Supervisor to confirm they have understood the requirement to report illness On receipt of a report of illness, the Supervisor/Manager must ring the Trust s Occupational Health Department for guidance The member of staff should be advised to see their own GP Until guidance is received from Occupational Health or the GP, the member of staff should not be allowed to handle food or beverages Version 2.0 July 2015 19

Appendix 2.1 Food Handlers Agreement to Report Illness I agree to report to my immediate Supervisor/Manager prior to commencing work and by telephone if necessary: 1. If I am suffering from diarrhoea and/or vomiting 2. If I have infected lesions of the skin, eyes or mouth 3. If I have a scaling, weeping or discharging lesion on an exposed part of my skin (face, neck, hands, arms or scalp) which cannot be covered adequately 4. If I have a weeping or pustule lesion of the eyes, ears, mouth and/or gums 5. If anyone at home is suffering from diarrhoea or vomiting 6. If any of your family suffered gastro-intestinal illness whilst on holiday I have had explained to me, and confirm that I understand, the requirements to report illness to my supervisor. Signed: Date: Name in full: Manager s/supervisor s Signature: (This form is to be photocopied by the wards/departments) A duplicate copy to be retained by the employee and a copy placed in the personal file Version 2.0 July 2015 20

Appendix 3 Version 2.0 July 2015 21

Appendix 4 Microwave Oven Guidelines 1. Follow the manufacturer s instructions on any bought food. 2. DO NOT use metal or foil containers. 3. ALWAYS use a deep-sided bowl or jug for liquids. 4. NEVER stir liquids with a metal spoon. 5. ALWAYS take extreme care when removing liquids from the oven, as there is often little or no visible sign that a liquid is on the point of boiling over. Oven gloves are appropriate to use. 6. ALWAYS allow food to stand at the end of the heating time and again on completion. 7. Whenever possible stir food halfway through heating time and again on completion. 8. Food MUST attain a centre temperature of 75 C to destroy listeria and salmonella. 9. Visual and temperature checks MUST always be made prior to eating. 10. If the food is in its own sealed container, slightly pierce the top film with a fork to allow the excess steam to escape. 11. During heating lightly shake the container to stir any sauce. CLEANING Always leave the microwave CLEAN after your use. Version 2.0 July 2015 22

Appendix 5 Version 2.0 July 2015 23

Appendix 6 Version 2.0 July 2015 24

Appendix 7 Version 2.0 July 2015 25

Appendix 8 Internal Audit Form for Therapeutic Kitchen Environment KITCHEN SITE DATE TIME PRESENT 1.0 Purchase - Indicate date of session audited: Was food purchased from a national supermarket chain? Were food allergies checked & documented? If eggs used are they within use by date on box? 2.0 Delivery There is evidence of temperature recording of products on arrival/receipt? Products are delivered within the correct receipt temperature e.g. frozen products? Temperatures within acceptable limits? There is evidence that packaging is assessed and if damaged food is discarded? A reject system is in place for comments/actions? 3.0 Stock control & rotation All food items are stored appropriately? All opened food is labelled with date first used & expiry date and stored in sealed pest proof containers? All food containers are visibly clean? Rotation of stock is in evidence all expiry dates are clearly visible (using a permanent pen)? Verification Yes No N/A Comments Version 2.0 July 2015 26

All food items are in date? 4.0 Storage Fridges/Freezers Fridge/freezer temperatures are recorded daily or at every session? All food in refrigerator is covered or stored in plastic air tight containers? If raw meat is stored, is this in the lower section of the refrigerator? Is food stored in the refrigerator dated when opened and have a use by date? Does every refrigerator have a thermometer in it? Are the recorded operating temperatures within recommended guidelines? (0-8C fridge/-18c freezer)? Temperature records are available for all fridges & freezers? Is there evidence that the fridge is cleaned weekly & freezer has been cleaned once a month? There are NO open cans being stored in the refrigerator? 5.0 Preparation (pre-cooking) Indicate date of session audited: Are all persons in session wearing suitable aprons (wipe down)? Are hand washing guidelines being adhered to (before food preparation and when changing from raw to cooked food)? Are utensils clean before use? Are separate colour coded chopping boards available for use? Verification Yes No N/A Comments Verification Yes No N/A Comments Version 2.0 July 2015 27

No evidence of use/presence of wooden utensils? Are fresh foods (vegetables/salads/fruit) thoroughly washed before use? Are frozen foods defrosted in a refrigerator before use (where applicable)? Are work surfaces cleaned before use and between preparation of raw & cooked foods? 6.0 Cooking Indicate date of kitchen session audited: If convenience food used, was it cooked according to the manufacturer s instructions? If eggs used are they cooked thoroughly? Is there a food probe available in the kitchen? Was the food probe used to ensure food is properly cooked/re-heated? Temperatures recorded prior to service? 7.0 Food Probes Records are available for current calibration? Calibration has been checked within last 12 months? 8.0 No re-heating Indicate date of kitchen session audited: Food may NOT be re-heated in kitchens at the Trust is this standard being adhered to? 9.0 Food Consumption Indicate date of ADL Kitchen session audited: High risk food is consumed immediately after the session or disposed of? Records are kept of all patients/staff who took part in the session, the food prepared & consumed along with temperature recording? 10.0 Safety & Security Indicate date of ADL session audited: Verification Yes No N/A Comments Verification Yes No N/A Comments Version 2.0 July 2015 28

A risk assessment has been undertaken and documented prior to the patient accessing the kitchen? Does staff footwear meet the required standards (no high heels or open toes)? Are local fire evacuation procedures displayed in the kitchen? Are knives and sharp utensils stored in locked storage? Is there an inventory of sharp items present in the kitchen? Is the inventory checked to ensure all items are accounted for at the end of each session? Prior to leaving the kitchen staff ensure that windows are shut and all appliances switched off? Is the kitchen locked when not in use? 11.0 Hygiene, cleaning & maintenance Aprons are available for use (wipe down)? Is there a separate hand washing facility available in the kitchen? At the hand wash sink soap and disposable paper towels are available? Is there a hand washing poster available near the hand wash sink? Is disposable paper roll available for drying dishes? Are blue waterproof dressings available in the first aid kit? (Where there is a first aider). Has all electrical equipment been PAT tested in line with Trust policy? Are both detergent & sanitizer available for cleaning work surfaces? Are cleaning materials stored in a locked cupboard? Verification Yes No N/A Comments Verification Yes No N/A Comments Version 2.0 July 2015 29

Is the fridge temperature and cleaning log displayed and records up-to-date? Is a cleaning checklist for therapeutic kitchens on display? Planned high level cleaning schedules are undertaken at least annually? 12.0 Pests Evidence of pest control system in operation? Records of all inspections and any action taken documented? Staff aware of protocol should infestation be suspected? Insectecutor in good working order? Insectecutor bulbs are replaced every 6 months (records seen)? 13.0 Food Handlers Records are available to demonstrate staff have attended Level 1, 2 or 3 Food Safety training within the first 3 months of employment? Training records are available for individual staff members? There is a system in place for staff suffering from gastro intestinal illnesses? How many reported cases of D/V has there been in the last 6 months? 14.0 Local Environment requirements Environment risk assessment is up-to-date? Maximum number of patients/staff appropriate to the kitchen is documented? Procedure for calling for assistance is available? Evacuation procedure available? Verification Yes No N/A Comments Verification Yes No N/A Comments Version 2.0 July 2015 30

Verification Yes No N/A Comments Location of the first aid kit is sign posted? (Where first aider is available). Colour coded chopping boards are available with clear guidelines for use e.g. poster? Name of responsible person/kitchen lead (for reporting and communication purposes)? 15.0 Structure/State of the Building There is regular maintenance? The ventilation system is adequate? There is adequate lighting? There is mains/storage tank water supply suitable for food processing? 16.0 Dining Area Clean and tidy? No inappropriate items stored? 16.1 Tables In a good state of repair? Clean? 16.2 Chairs In a good state of repair? Clean? 16.3 Cutlery In a good state of repair? Clean? 16.4 Crockery In a good state of repair? Clean? 17.0 Refuse & waste disposal Foot operated bins available internally? Verification Yes No N/A Comments Version 2.0 July 2015 31

Sufficient waste store/bins available outside? Waste storage area is secure from pests? Waste storage area is clean & well maintained? Staff demonstrate good hand decontamination after handling waste? Verification Yes No N/A Comments On completion of the audit where any standard is not achieved the action plan below MUST be completed within 4 weeks of the audit taking place. Audit results must be sent to Infection Control - infection.control@bcpft.nhs.uk and copy to Kath Lewis, AHP Professional Lead kath.lewis@bcpft.nhs.uk ACTION PLAN Kitchen: Action required Date: Person reporting Person responsible Deadline for completion Completed on Version 2.0 July 2015 32

Policy Details Title of Policy Unique Identifier for this policy State if policy is New or Revised Therapeutic Kitchen Environment Policy BCPFT-CLIN-POL-01 Revised Previous Policy Title where applicable Policy Category Clinical, HR, H&S, Infection Control etc. Executive Director whose portfolio this policy comes under Policy Lead/Author Job titles only Committee/Group responsible for the approval of this policy Month/year consultation process completed * ADL Kitchen Policy Clinical Executive Director of Nursing, AHPs and Governance Allied Health Professional Lead Professional Advisory Group April 2015 Month/year policy approved July 2015 Month/year policy ratified and issued July 2015 Next review date Implementation Plan completed * July 2017 (2 year review due to the likely changes to the Food Standards Agency allergen directives) Yes Equality Impact Assessment completed * Previous version(s) archived * Disclosure status Key Words for this policy Yes Yes B can be disclosed to patients and the public ADL kitchen, food hygiene, food Allergen, food storage, food preparation, food safety, food handling process, microwave oven guidance * For more information on the consultation process, implementation plan, equality impact assessment, or archiving arrangements, please contact Corporate Governance Review and Amendment History Version Date V2.0 July 2015 Details of Change Major review of policy, new title given as previously known as ADL Kitchens and aligned to the Trust s policy format V1.0 April 2012 New Policy for BCPFT Version 2.0 July 2015 33