Old Chestnuts
Everyone is still getting to grips with the new CQC Key Lines of Enquiry (KLOEs) – CQC inspection teams as well I would venture. It is interesting to see what has been learned by inspection teams and how this has informed the new look KLOEs. Having been involved in a fair few inspections, my instinct, based on experience, tells me there is a whole basket of the same old chestnuts which will crop up every time either a CQC visit is announced or someone in the practice needs to place an order for supplies. One of these relates to consulting and treatment room curtains.
There is an almost divine acceptance that all material curtains must be replaced with paper curtains in order to “pass” a CQC inspection. If you believe this and follow religiously then you’re mistaken – or, to continue with the theme of religion, you’re worshipping at the feet of an empty idol.
You might be surprised to know the CQC has no specific guidance about practice curtains so, when it comes to curtains on a visit, CQC inspection teams look for:
- Visibly clean curtains, together with an established system to clean or change them once every 6 months as a minimum
On the face of it, this is simple and easy to achieve. However, there is more than just the curtains question to consider in order to feel sufficiently confident about practice cleanliness and the associated necessity for the control of infection at all times. This is really about your practice operating embedded systems that work and perform consistently in order to produce failsafe cleanliness and control of infection.
The CQC advises following existing guidance in The Health and Social Care Act 2008, Code of Practice on the prevention and control of infections and related guidance which requires practices to “provide and maintain a clean and appropriate environment in managed premises that facilitates the prevention and control of infections.” More guidance is provided by the broad and all-encompassing “the environmental cleaning and decontamination policy should specify how to clean all areas, fixtures and fittings”. This is about demonstrating effective practice systems with curtains representing nothing more than a single element for which the system is responsible.
Taking on board that keeping fabric or disposable curtains clean is part of a whole practice system. Going back to the curtains chestnut where we began, the NPSA guidance on infection control describes “visibly clean” in more detail stating helpfully – and adding in blinds for good measure to make sure the reader is paying attention – “curtains/blinds should be visibly clean with no blood or body substances, dust, dirt, debris, stains or spillages” as well advising that both curtains and blinds are to be cleaned or changed at least every six months.
So here is what the CQC’s Nigel Sparrow refers to as “simple pragmatic guidance based on best practice” in the Mythbusters (and this is what can be copied, pasted, laminated and displayed if it will help – and, of course, without fail and critically, evidenced) which leaves nothing to interpretation or the imagination:
- If disposable curtains are used, the date should be clearly entered and they should be replaced six monthly
- If re-usable curtains are used, they should be taken down and cleaned at 60 degrees at least six-monthly and immediately when soiled
- They should be vacuumed weekly as part of the general cleaning schedule
- They should be well maintained, free of tears and clear of the floor
