LAUNDRY
Recommended treatment to ensure disinfection of infected linen: Linen in this category should not be sorted, other than in a red, water-soluble bag — this is then placed in an outer polyester or nylon carriage bag. Infected linen may be stored in different bags in other parts of the UK, for example, clear with red stripes are used in parts of Scotland, so it is important that the local policy is checked and adhered to. The inner bag should be removed from the outer bag only at the point of transfer to the washer-extractor, then followed by the outer bag.
A care home could be placed into special measures or shut down if an inspection finds that they aren’t meeting the HTM 01-04 standards and a resident or staff member has been harmed because of this. In extreme cases, CQC can prosecute.
HTM-01-04: HTM-01-04 superseded the CFPP-01-04 in 2016. The main update and changes to this legislation is the definition of linen, and guidance on climate change and the environmental impact of laundry processes. Definition of linen —ʻlinen’ means all reusable textile items requiring cleaning/ disinfection via laundry processing including: bed linen, bibs, blankets, canvases, curtains, hoist slings, patient clothing, staff clothing and towels.
Under section 2a of the NHS Constitution, ‘patients have a right to expect care to be provided in a clean and safe environment that is fit for purpose, based on national best practice’. This includes the range of support services such as the provision of a linen and laundry service that reduces the risk of cross infection and enhances the patient experience.
“A care home could be placed into special measures or shut
down if an inspection finds that they aren’t meeting the HTM 01-04 standards.”
Traditionally, linen has been disinfected using heat. One of the advantages of this method is that time–temperature relationships can easily be set and monitored. However, disinfection by heat may not be suitable for some materials, either because they cannot tolerate high temperatures or because specialised coatings may be damaged by a thermal process. Whichever process is selected, effectiveness at decontaminating items contaminated with heat-resistant organisms such as Clostridium difficile, may need to be considered.
Essential Quality Requirements (EQR): Regardless of the technology used, linen should be processed using a disinfection cycle, thereby achieving at least the defined level of reduction in microorganism contamination. It is essential that all healthcare linen processors validate their disinfection processes and have a detailed plan on how the provision and processing of such linen will move towards best practice.
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For general healthcare and care home linen, the prime task of linen processing is to kill or remove microbial contamination derived from the previous user.
A logbook of any service and repair visits should be kept for all washing machines and dryers.
“Water in your laundry cycles
should reach a temperature at or above 65C for no less than 18 minutes, or 71C for no less than 11 minutes.”
Best practice and enhanced process: Firstly, an industrial/ commercial-type washing machine capable of meeting the disinfection requirements ― 71C for at least three minutes or 65C for at least ten minutes, should be installed.
If a hot wash is not appropriate, a chemical disinfection process may be adopted as long as it meets the requirements of ‘Disinfection of Linen’.
The process changes when triggers are identified which relate to the possibility of infectious linen or clothing being generated. When this is the case, care homes must implement the enhanced process for laundry. Example triggers which indicate the need for the enhanced process include:
• Unexplained diarrhoea and vomiting, confirmed infection, unexplained rashes, confirmed cases of scabies/lice, unexplained fever.
• During the enhanced process, the laundry must perform a sluice cycle.
• Heavily soiled items should also have a pre-wash/sluice cycle selected.
Water Regulatory Advisory Scheme (WRAS): Fluid category five. Fluid which represents a serious health hazard because of the concentration of pathogenic organisms, radioactive or very toxic substances, including any fluid which contains – faecal material or other human waste.
Machines listed with a Break Tank or ‘Type A Air Gap’ will have the break tank installed internally to the machine. This does not affect the machine's performance, operation or dimensions.
Alternatively, a ‘reduced pressure zone valve’ (RPZ valve – a type BA device) can be used to maintain water pressure from the feed pipe.
To provide fluid category five protection, only a break tank with a type A air gap is adequate.
Well trained staff and stringent processes and procedures adhering to all regulations within your laundry room, will ensure a fully compliant operation that protects residents and employees alike, so you can focus on providing the very best residential care.
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