policies and procedures

 by Gillian Robinson

Moving and Handling in residential age care

Moving and Handling and the Health and Safety Act

Thanks to Jessie Snowdon, Physiotherapist for contributing the below article – 

 

All managers will be acutely aware of the Health and Safety at Work Act 2015 (HSWA) and the responsibilities of, and potential penalties, for PCBUs (persons conducting a business or undertaking).

The HSWA requires businesses to ensure, as far as reasonably practicable, the health and safety of its workers. This includes safe systems of work, equipment, training and monitoring the health of workers. These processes are all included in the policies and procedures designed specifically for residential aged care facilities by HCSL.

Within the residential care industry staff are exposed to significant hazards daily in terms of patient handling and manual handling for kitchen/laundry staff.  Moving and handling is a hazardous task – it is repetitive, can involve high force (heavy residents) and frequently involves awkward postures. The likelihood of injury for both care staff and residents is high and the consequences can be serious, meaning that moving and handling is a high risk activity.

When we consider moving and handling in this light, managers need to be confident that they have safe systems. Consider how each resident’s transfer abilities are assessed. How is this documented and communicated? How do you know you have the correct equipment on site and how do you ensure that you have enough equipment in order for staff to be able to access it when they need it?

Our experience shows that often if the equipment is not available many staff will do an unsafe transfer in order to save time.  How do you ensure new staff are competent prior to undertaking moving and handling tasks? How do you ensure that existing staff are up-skilled? How do you implement the New Zealand guidelines? And how do you monitor your systems, equipment and training? These are questions all managers should be able to answer.

‘On the Go Physio’ carries out Moving and Handling training in over 15 facilities in Canterbury and offer training to representatives from many others. We offer tailored packages which can include up-skilling your whole team, or training your own moving and handling trainers and assessors. We can review your training and orientation systems and assist in equipment trials. If you are interested in discussing your facilities requirements to help you ensure your staff, and resident’s, health and safety contact us here.

For residential care specific policies and procedures related to safe moving and handling, along with related forms for use, contact HCSL here.

 

Contributed by: Jessie Snowdon (Senior Physiotherapist and Director)

‘On the Go Physio Ltd’

PO Box 32 004, Christchurch 8147

Ph: 0800 000 856 or Mobile: 021 030 9061

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 by Gillian Robinson

Food Safety in residential aged care

Cooling and Reheating Meals

Thanks to Liz Beaglehole – Registered Dietitian for contributing the below article –

 

With the introduction of the Food Act 2014 and the requirement for most aged care facilities to have registered their food control plan (FCP) by March 2018, I thought I would write this article on a common kitchen practice that will require review. This relates to one important key component of food safety.

FCP’s are included in the policy and procedure documentation provided by HCSL specifically designed for residential care facilities.

In many facilities the main meal is served in the middle of the day and the tea meal served at night.  The main cook of the day will prepare the tea meal earlier in the afternoon, and then finish his or her shift.  The tea meal will be reheated by the afternoon staff and served to the residents.

The process of cooking, cooling and reheating requires careful control of the food safety risk.  Many tea options are protein or carbohydrate based; macaroni cheese, egg dishes, savoury mince, chicken options – all of which are high risk foods for bacteria growth.

Foods need to be cooled quickly to avoid time and temperature abuse, which may allow bacteria growth.  The guidelines state that when cooling hot cooked foods, the food must cool to at least 21° within the first two hours, and then cool to below 5° in four more hours.  Overall, the food must be out of the danger zone (between 5°C and 60°C) within six hours.

A functioning chiller should allow cooked foods to cool within this timeframe.  Using domestic fridges that are overcrowded, may mean the cooling guidelines are not met.  Using shallow dishes rather than large deep dishes will also allow foods to cool faster.

The food control plan will specify the process the site kitchen must follow with regards to cooling of cooked food.  Temperatures during cooling will need to be checked and recorded to ensure the time / temperature targets are met.

Prior to serving, the food must be reheated to above 75°C.

Some sites choose to hold the prepared food hot until service.  Food must be held hot at a temperature of at least 60°C, usually in a bain-marie or oven at 70°C.  Any food held below 60°C for more than 2 hours, must be thrown out.  Note that holding foods hot for this period of time may affect the food quality.

Main Points:

  • Food safety risk with cooling and reheating foods must be managed with FCP
  • Cool cooked food to below 21°C in 2 hours and below 5°C in 4 hours
  • Reheat foods to above 75°C before service
  • Hold hot prepared foods at 60°C or more
  • Document food temperatures and any corrective action
  • Review corrective action implementation to ensure they have been effective

 

Article contributed by:

Liz Beaglehole

NZ Registered Dietitian

Canterbury Dietitians

Email: liz@canterburydietitians.co.nz

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 by Gillian Robinson

Village Manager – Chatswood Retirement Village

I have found that having Gillian’s (the HCSL) system available has been a huge help to our village. Documents are easily accessible at my fingertips and it hasn’t taken long to memorise some of the codes for the more frequently used ones.

 

If we are having trouble finding a document or we want to make any adjustments, Gillian is always very accommodating and helpful. She is easily contacted by telephone or email and if she is busy, always gets back to me as soon as she is able to. I particularly like that if I want to type into a document, Gillian makes this available.

 

When the documents are due for updating, Gillian takes care of this, printing all of the documents and putting them into new folders for us. She even delivers them personally, which is always a pleasure. I find Gillian very approachable and extremely knowledgeable and happy to share her knowledge.

 

Gillian assists us with our training requirements by coming to Chatswood and going through the annual compulsory subjects with myself and my staff. She is great at presenting and the passion about her work shows in the way she shares her own experiences with us.

 

I look forward to our continued working relationship.

Kyla Hurley – Village Manager

January 2017

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 by Gillian Robinson

Owner / Manager – Springlands Lifestyle Village

Being the Manager of a facility who does not have a clinical background, I have found Gillian to be of huge support. She has a great understanding of the Aged Residential Care industry and is a wealth of knowledge. She has been nothing but supportive since we introduced her (the HCSL) policies and procedures into the facility in 2012.  Having her expertise on hand has been hugely beneficial for the Village.

Gillian also visits the facility twice a year providing education sessions which are both informative and engaging.  Staff have commented positively on her ability to share real life experiences during these sessions which show her true passion for what she does and the service we are here to provide.

Gillian is respected by staff, management and Governance of Springlands Lifestyle Village and I would have no hesitation in recommending her to anyone who is looking for a healthcare consultant who is knowledgeable, understanding and professional. She is committed to helping you improve the service you provide to your Residents.

 

Naomi Nailer

Village Manager

Springlands Lifestyle Village

Blenheim

January 2017

in Testimonials
 by Gillian Robinson

Falls – When is a fall not a fall?

Is a slip off a chair or off the side of the bed onto the floor a fall?  Is a ‘controlled lowering’ by a staff member of a resident to the floor a fall?

When recording adverse events such as falls, it’s important for the purposes of consistent reporting and bench-marking that the same definition is used to define a ‘fall’.  We suggest using the definition provided by the World Health Organisation (WHO) which states “A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.”  The WHO falls prevention guidelines also report that “Globally, falls are a major public health problem. An estimated 424 000 fatal falls occur each year, making it the second leading cause of unintentional injury death, after road traffic injuries.”  

Working in aged care related services means you are interacting on a daily basis with those in the high risk category for falls. WHO also report for example, in the United States of America, 20–30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. The Health Quality and Safety Commission New Zealand report “for every fall in hospital, there are five in aged residential care and another 40 at home and in the community. Between 2010 and 2012, a total of 200 people fell while in hospital care and broke their hips.”

The HCSL QA online bench-marking includes tracking of falls and falls related injuries so educating your staff to become familiar with the definition is important in ensuring data collected is accurate. Accurate data measurements also allow you to be aware of your start point for quality improvement projects which can then be measured at the end of a project to measure the degree of improvement.

In answer to the questions posed at the start of this article, if we apply the WHO definition, then both should be classified as falls.  For those of you using the HCSL policy and procedure system, refer to the Falls Prevention Programme (document CS19) for more information on falls prevention.

in News
 by Gillian Robinson

Pressure Injuries – ACC may be able to help

‘Pressure injury’ according to ACC can be classified in some instances as a ‘treatment related injury’ and therefore you may have the option of gaining support / assistance from ACC in relation to treatment of the pressure injury. In their 2011 fact-sheet, ACC noted “Pressure areas are a significant source of treatment injury claims and impact on both patient morbidity and mortality (1). Between July 2005 and March 2011, ACC accepted 506 claims for pressure areas, and notified 45 as adverse events to the Ministry of Health”.

As pressure injuries are a key focus for Ministry of Health (MoH) this year, auditors will be looking closely at the documentation around identification, management, treatment / care planning and evaluation of these events. Ensure you have comprehensive evidence of your clinical management processes.

Also remember when you log a pressure injury into the adverse event reporting system, you include the stage of the pressure injury. In the HCSL QA online system click ‘pressure injury’ in the ‘type of event’ box and then in the box directly under that, you can record the additional detail of the stage of the pressure injury.

The required MoH notification forms can be found here.  You will need the resident GP to complete a ACC45 form. Then contact ACC and rather than asking for what you want, ask what they can do to help. If you ask first, you may be missing out on something they could have provided access to.

For more information on seeking support contact Assistant ACC directly or the ACC Contracts Manager – CDHB Email: Leanne.davie@cdhb.health.nz

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 by hcsl

Testimonial – Shoshannim Care of the Elderly – Canterbury

After well over 20 years, I’m retiring and moving on to new ventures.  I just wanted to say a huge thank you for being there when I needed you and being a close colleague and work support. Your systems kept us on track meaning audit was always so much less stressful than it used to be. It does mean a lot to me to know you’re there at the end of the phone.

Thank you

your friend

Trudy Doreen Stevens (Owner – Shoshannim Care of the Elderly (Ohoka, Canterbury)

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