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Food Safety Policy

V1.0

January 2016

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Summary The Food Safety Act 1990 outlines the requirements for all establishments serving food to ensure the safety of their customers. For the Royal Cornwall Hospital it is imperative that we ensure the food served to patients, visitors and staff meets and exceeds the requirements of the Food Safety Act 1990 and its associated policies and guidance documents. The aim of this policy is to provide instructions on storage, handling and cooking of food in order to prevent incidents and outbreaks of food poisoning on Royal Cornwall Hospital Trust premises. Food hygiene regulations must be taken seriously, outbreaks of food poisoning in hospital premises are notify-able by law to the Consultant in Communicable Disease Control (CCDC). Trust’s Accountable Officer is responsible for:

Ensuring that the Facilities Management provider complies with the contract for Catering Services and associated legislation, guidance and advice for the receipt, storage, handling, preparation, dispensing and transportation of food and beverages.

Ensuring that changes to legislation, guidance or advice are appropriately implemented by the contract provider.

Reporting to the Trust Board any deviations or incidents relating to the provision of Catering Services where a risk to patients, visitors or staff has been identified.

The Facilities Contract Director/Managers (MITIE) is responsible for:

Ensuring that the Catering Services provision at the Trust meets or exceeds the requirements and standards in the contract, and any legislation, guidance and advice.

Ensuring that the staff employed in the any role relating to the receipt, storage, handling, preparation, dispensing or transportation of food and beverages have received adequate and appropriate training in food safety to a level commensurate with their role.

Ensuring that any supplier meets or exceeds the requirements and standards as detailed in the Facilities Management Contract.

Reporting to the Accountable Officer any deviations or incidents relating to the receipt, storage, handling, preparation, dispensing and transportation of food and beverages where a risk, immediate or perceived, to patients, visitors or staff has been identified.

All staff members are responsible for:

Ensuring that they report any risk or incident relating to food safety using the Trust incident reporting system.

Keeping their mandatory training in relation to food safety current and relevant to their role.

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Table of Contents

Summary ............................................................................................................................. 2

1. Introduction ................................................................................................................... 5

2. Purpose of this Policy/Procedure .................................................................................. 5

3. Scope ........................................................................................................................... 5

4. Definitions / Glossary .................................................................................................... 5

5. Ownership and Responsibilities .................................................................................... 6

5.2. Role of the Director of Strategy ............................................................................. 6

5.3. Accountable Officer ............................................................................................... 6

5.4. Role of the Facilities Contract Director/Managers (MITIE) .................................... 6

5.5. Role of the Cornwall Food Production Unit Operations Manager .......................... 6

5.6. Role of the Chair of the HACCP Group ................................................................. 7

5.7. Role of Department & Ward Managers .................................................................. 7

5.8. Role of Volunteer Co-ordinator .............................................................................. 7

5.9. Role of the Health & Safety Advisors ..................................................................... 7

5.10. Role of Environmental Health Officers, Cornwall Council (EHO) ....................... 7

5.11. Role of the Health & Safety Committee ............................................................. 7

5.12. Role of Individual Staff ....................................................................................... 8

5.13. Role of Learning & Development ....................................................................... 8

5.14. Role of Infection, Prevention & Control .............................................................. 8

6. Standards and Practice ................................................................................................ 8

6.1. Food Safety Act 1990 (as amended) ..................................................................... 8

6.2. Hazard Analysis & Critical Control Points (HACCP) .............................................. 8

6.4. The Food Chain ..................................................................................................... 9

6.5. Sources of Bacteria ............................................................................................... 9

6.6. Food Hygiene Do’s and Don’ts ............................................................................ 10

6.7. Personal Hygiene ................................................................................................ 11

6.8. Cleaning and Monitoring ...................................................................................... 12

6.9. Temperature Control ........................................................................................... 13

6.10. Service - Meals ................................................................................................ 13

6.11. Cold Foods ....................................................................................................... 14

6.12. Bulk Meal Service ............................................................................................ 15

6.15. Food Allergens ................................................................................................. 16

6.16. Stock Rotation .................................................................................................. 17

6.17. Provisions ........................................................................................................ 17

6.18. Guidelines for Staff Bringing their Own Food into Work ................................... 18

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6.19. Bringing in Food for Friends and Family in Hospital, ........................................ 18

7. Dissemination and Implementation ............................................................................. 19

7.1. Training ............................................................................................................... 19

7.2. Dissemination ...................................................................................................... 20

8. Monitoring compliance and effectiveness ................................................................... 20

9. Updating and Review .................................................................................................. 20

10. Equality and Diversity .............................................................................................. 20

10.2. Equality Impact Assessment ............................................................................ 20

Appendix 1 Governance Information ................................................................................. 21

Appendix 2 Initial Equality Impact Assessment Form ........................................................ 23

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1. Introduction

1.1. The Food Safety Act 1990 outlines the requirements for all establishments serving food to ensure the safety of their customers. For the Royal Cornwall Hospital it is imperative that we ensure the food served to patients, visitors and staff meets and exceeds the requirements of the Food Safety Act 1990 and its associated policies and guidance documents. 1.2. Provision of food within the Trust is managed by a third party contractor, this contractor must ensure that all the food and beverages receipted, stored, handled, prepared, dispensed and transported for and supplied to patients, visitors and staff meets or exceeds those standards.

1.3. The Royal Cornwall Hospitals NHS Trust also operates the Cornwall Food Production Unit and supplies cook-frozen, cook-chill and ready-to-eat products to the Royal Cornwall Hospital and other public sector or commercial customers. The Cornwall Food Production Unit also adheres to or exceeds the requirements of the legislation.

1.4. This version supersedes any previous versions of this document.

2. Purpose of this Policy/Procedure 2.1. The aim of this policy is to provide instructions on storage, handling and cooking of food in order to prevent incidents and outbreaks of food poisoning on Royal Cornwall Hospital Trust premises. Food hygiene regulations must be taken seriously, outbreaks of food poisoning in hospital premises are notify-able by law to the Consultant in Communicable Disease Control (CCDC). 2.2. The local council Environmental Health Officers are empowered to investigate such occurrences. This can result in prosecution not only of Royal Cornwall Hospital Trust and MITIE Facilities management but of individual Royal Cornwall Hospital Trust and MITIE Facilities employees. Such action may lead to fines or even imprisonment.

3. Scope 3.1. All staff, including those working for any third-party contractor, and volunteers who have a responsibility for receiving, processing, cooking or serving food and beverages to patients, visitors and staff.

4. Definitions / Glossary Soft Facilities Management Contract held with for the provision of Catering

Services at the Royal Cornwall Hospitals Trust. RCHT Royal Cornwall Hospitals NHS Trust RCH Royal Cornwall Hospital, Treliske WCH West Cornwall Hospital, Penzance SMH St Michaels Hospital, Hayle, CFPU Cornwall Food Production Unit, Redruth HACCP Hazard Analysis Critical Control Points

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5. Ownership and Responsibilities 5.1. The Chief Executive Officer of the Royal Cornwall Hospitals NHS Trust retains overall responsibility and accountability for food hygiene, safety and welfare of all persons on the Trust’s premises.

5.2. Role of the Director of Strategy

The Director of Strategy is responsible for ensuring that the Facilities Management provider for Catering Services at the Trust adheres to and works within the contract for Soft Facilities Management.

The Director of Strategy has delegated responsibility to the Trust’s Accountable Officer for the contract.

5.3. Accountable Officer

The Trust’s Accountable Officer is responsible for: Ensuring that the Facilities Management provider complies with the contract for

Catering Services and associated legislation, guidance and advice for the receipt, storage, handling, preparation, dispensing and transportation of food and beverages.

Ensuring that changes to legislation, guidance or advice are appropriately implemented by the contract provider.

Reporting to the Trust Board any deviations or incidents relating to the provision of Catering Services where a risk to patients, visitors or staff has been identified.

5.4. Role of the Facilities Contract Director/Managers (MITIE)

The Facilities Contract Director/Managers are responsible for: Ensuring that the Catering Services provision at the Trust meets or exceeds the

requirements and standards in the contract, and any legislation, guidance and advice.

Ensuring that the staff employed in the any role relating to the receipt, storage, handling, preparation, dispensing or transportation of food and beverages have received adequate and appropriate training in food safety to a level commensurate with their role.

Ensuring that any supplier meets or exceeds the requirements and standards as detailed in the Facilities Management Contract.

Reporting to the Accountable Officer any deviations or incidents relating to the receipt, storage, handling, preparation, dispensing and transportation of food and beverages where a risk, immediate or perceived, to patients, visitors or staff has been identified.

5.5. Role of the Cornwall Food Production Unit Operations Manager

The Operations Manager is responsible for: Ensuring that the Cornwall Food Production Unit operates in adherence to

legislation, guidance and advice as detailed in the Cornwall Food Production Unit operational procedures and Hazard Analysis & Critical Control Points Policy.

Reporting to the Divisional General Manager for Clinical Support Services & Cancer where any risk, immediate or perceived, to patients, visitors or staff has been identified.

Ensuring that the Cornwall Food Production Unit continues to maintain its formal accreditation with the relevant external assessment bodies.

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5.6. Role of the Chair of the HACCP Group

The Chair of the HACCP Group is responsible for: Chairing the Cornwall Food Production Unit HACCP Group Offering independent advice on food safety at the Cornwall Food Production

Unit Regular food safety audits at the Cornwall Food Production Unit

5.7. Role of Department & Ward Managers

Department & Ward Managers are responsible for: Ensuring that members of staff are trained to the appropriate standard in food

safety for the roles undertaken. Ensuring that the Ward Kitchens and food service is carried out in line with this

policy and all legislation, guidance and advice. Reporting any adverse trends or risks, immediate or perceived, to patients,

visitors or staff to the Facilities Contract Management team and the Trust Accountable Officer.

5.8. Role of Volunteer Co-ordinator

The Volunteer Co-ordinator is responsible for: Ensuring that all volunteers are trained to the appropriate standard in food

safety for the roles undertaken, this could include serving drinks and biscuits to visitors and patients, to offering supportive feeding to patients.

Reporting any adverse trends or risks, immediate or perceived, to patients, visitors or staff to the Trust Health & Safety Advisors.

5.9. Role of the Health & Safety Advisors

The Health & Safety Advisors are responsible for: Advising the Trust on all aspects of Health & Safety, including, where

appropriate matters relating to food safety or referring to and liaising with an industry expert.

Liaising with the Environmental Health Officers and other relevant regulatory bodies in relation to any risks, food poisoning or incidents that occur on Trust premises.

5.10. Role of Environmental Health Officers, Cornwall Council (EHO)

The EHOs are responsible for: Inspection of all catering facilities at the Trust to offer public assurance that the

facilities meet all current legislation in relation to food safety. Enforcing food safety legislation through advice, improvement notices,

prohibition orders and in extreme circumstances, closure notices.

5.11. Role of the Health & Safety Committee

The Health & Safety Committee is responsible for: Receiving assurance that food safety in the Trust is properly managed. Acting on and escalating any risks, perceived or immediate, relating to food

safety.

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5.12. Role of Individual Staff

All staff members are responsible for: Ensuring that they report any risk or incident relating to food safety using the

Trust incident reporting system. Keeping their mandatory training in relation to food safety current and relevant

to their role.

5.13. Role of Learning & Development

Learning and Development are responsible for: Ensuring that relevant training is available on food safety, and that the training

is kept current in line with available legislation, guidance and advice.

5.14. Role of Infection, Prevention & Control

Infection, Prevention & Control are responsible for: Supporting the Trust in the event of a Food Poisoning incident attributed to

RCHT. Yearly audits of Ward Kitchens as part of the Infection, Prevention & Control

audit, with findings reported back to the Estates and MITIE.

6. Standards and Practice

6.1. Food Safety Act 1990 (as amended)

6.1.1. This legislation extends the responsibility for maintaining good food hygiene standards from the catering department to the clinical areas. The Food Safety Act 1990 (as amended) require that all food businesses apply food safety management procedures based on the principle of Hazard Analysis and Critical Control Point (HACCP) to their business wherever the service is delivered and whoever is involved in that service. 6.1.2. All employees in Royal Cornwall hospital Trust and Subcontracted organisations that are involved in food handling at any stage of the process need to be aware of good food hygiene practices and the need to handle food in a safe, clean environment.

6.2. Hazard Analysis & Critical Control Points (HACCP)

6.2.1. HACCP is a widely accepted food safety management system which suits all types and sizes of business. The main aim of HACCP is to focus on critical points in the operation and to take measures to ensure that the problems do not occur. HACCP system which includes a series of procedures to control the process and sensitive points in the food chain, with the ultimate goal of foods used in the state and in a way that is safe for his health. 6.2.2. This must include: Training; Personal hygiene; Cleaning; Temperature Control; Cross contamination; Pest Control; Waste Control; Maintenance; Stock Control; Monitoring of compliance with the rules; Record keeping.

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6.2.3. This policy relates to food hygiene and safety in clinical areas. The catering service MITIE will have its own policy.

6.3. Food Hygiene and Food Poisoning – The Principles of Prevention Food hygiene is more than just cleanliness; it includes all practices involved in:

Protecting food from risk of contamination, including harmful bacteria, poisons and foreign bodies;

Preventing any bacteria present multiplying to an extent which would result in the illness of consumers or the early spoilage of food;

The destruction of any harmful bacteria in the food by thorough cooking or processing.

6.4. The Food Chain

6.4.1. The ways in which employees outside the Catering Department are involved in the food chain are as follows:

Delivery of food to the ward; Serving of food – plated service or bulk service; Safe storage of patient therapeutic foods; Feeding of patients; Food preparation in the ward kitchen e.g. bread & butter, toast,

formula feeds; Making beverages, e.g. tea, coffee; Washing of patient’s crockery.

6.5. Sources of Bacteria

6.5.1. In order to protect food from contamination by food poisoning bacteria, it is essential to know where bacteria come from. 6.5.2. Food must be handled in such a way to avoid the risk of contamination from any of the sources below.

People (food handlers/patients); Raw foods; Insects/ Rodents/ Cats/ Birds; Refuse/Waste food; Air/Dust.

6.5.3. Food poisoning is an unpleasant, sometimes fatal illness that follows the consumption of contaminated food. The symptoms include vomiting, diarrhoea, abdominal pain and fever. 6.5.4. To live and grow, bacteria require to have the following optimum conditions; Food – Moisture – Warmth – Time – pH concentration – Presence of oxygen.

6.5.5. Foods that encourage and allow bacteria to grow are referred to as “high risk” foods e.g.:

All cooked meats and poultry; Egg products, e.g. mayonnaise; Foods with meat bases, e.g. soup, gravies & made up dishes e.g.

pate.

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Cooked rice; Custard and dairy produce, i.e. milk, butter, spread; All raw meats, fish and shellfish

6.5.6. Moisture Bacteria needs moisture and can grow only in food that contains moisture. It is important to remember when reconstituting powdered foods, e.g. milk, by adding liquid, moisture is re-introduced allowing the bacteria to grow and multiply. 6.5.7. Warmth Bacteria that cause food poisoning will grow most quickly at a temperature around 37ºC, but as long as food is warm, i.e. at room temperatures between 5ºC and 63ºC, they will continue to grow. The temperature range, between 5ºC – 63ºC, is known as the “DANGER Z0NE”. Time given the right conditions of food, moisture and warmth some bacteria can divide into two every ten minutes. This is why “high risk” foods should not be left in the “danger zone” for longer than is necessary. 6.5.8. pH Concentration Most bacteria will not grow in food with a pH below 4.5 allowing lower processing temperatures to be used in preservation techniques. 6.5.9. Oxygen Some bacteria require oxygen to grow and these are known as aerobic. Others flourish in the absence of oxygen. These are called anaerobes. 6.5.10. If one of these conditions is removed bacteria can still survive but will not grow & multiply

6.6. Food Hygiene Do’s and Don’ts

6.6.1. Do’s Do dispose of unlabelled/undated food; Do discard food deemed unacceptable due to contamination. This is

very important if pests or foreign bodies are discovered; Do take drinking water from a designated drinking water port only; Do clean up food spillages immediately and leave kitchens clean and

tidy at all times Do check and record fridge and freezer temperatures twice daily, refer

to local procedures for information on what to do if there’s a problem; Do keep all relevant recording forms for a period of three months; Do cover, date and label all patient and staff foods held within the

fridge; Do wear appropriately coloured disposable green plastic aprons when

food handling, preparing and serving; Do store food and fluids in covered pest proof containers; Do remove food waste from the kitchen after every meal;

6.6.2. Don’ts

Do not handle food if you have a diarrhoeal illness sickness or Vomiting, uncovered cuts or boils.

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Do not store hot food from trolley or tray service for later use; Do not reheat patient or resident meals. If food temperatures are not

satisfactory then the supplying kitchen MITIE must be contacted immediately so that a substitute meal may be supplied;

Do not use wooden implements or chopping boards within the kitchens;

Do not keep raw food in ward refrigerators; Do not store medical items within the kitchen fridge. Most food

poisoning outbreaks are caused by negligence. Do not store staff food in the same fridge as patient food.

6.7. Personal Hygiene

6.7.1. Personal Hygiene for Food Handlers Failure to observe the basic principles of good personal hygiene may result in direct contamination of food. 6.7.2. Food handlers have a moral and legal responsibility to ensure that food poisoning organisms and other contaminants are not introduced into the food chain. Therefore any employee of Royal Cornwall Hospital Trust who works in a food-handling environment must maintain a high degree of personal hygiene and cleanliness.

6.7.3. Food handlers must wear clean and appropriate protective clothing/uniform that must not be worn as part of an employee's clothing for travelling to or from work.

6.7.4. Disposable green plastic aprons will be worn on each occasion while serving or handling food and beverages. All visitors to food preparation areas such as kitchens must observe the same stringent hygiene rules.

6.7.5. Employees have a legal obligation to notify their supervisor if they know or suspect they are suffering from (or are a carrier of) any food borne disease or condition that will expose food or their colleagues to risk. Staff that may have been in close contact with any person who has a diarrhoeal illness must notify their supervisor/manager immediately.

6.7.6. Anyone whose work involves handling food should maintain high levels of personal hygiene:

Routinely wash their hands before, during and after food handling; Use liquid soap and disposable hand towels for hand hygiene; Report any illness especially infected wounds, skin infections,

diarrhoea or vomiting to their Line Manager or Supervisor without delay. Anyone suffering from skin conditions should wear gloves when handling food;

Long hair must be tied back; Cover cuts and abrasions with waterproof plasters (blue, if in

catering); Remove all hand jewellery and wrist watch – one plain wedding band

is acceptable; Nail varnish and false nails should not be worn.

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6.7.7. Hand Hygiene & hand washing techniques should be referred to the Trust Hand Hygiene Policy. Training and details on hand hygiene and skin care can be found in the relevant policy. 6.7.8. Hands should be washed using liquid soap. Staff must remember that thorough drying of the hands is an important aspect as organisms multiply and transfer more effectively on wet surfaces.

6.8. Cleaning and Monitoring

6.8.1. Cleaning Schedules 6.8.1.1. A detailed cleaning schedule for each area of work must be in place and this will be provided by Facilities Management MITIE. 6.8.1.2. The Cleaning Schedules for Ward/Departmental kitchens outline the frequency, the responsible person for carrying out the cleaning, the materials to be used including chemicals, the method to be used and the standards to be achieved.

6.8.1.3. The persons responsible for cleaning the Ward or Departmental Kitchens will be the Domestic Assistants and Housekeepers.

6.8.1.4. All staff should familiarise themselves with the local cleaning schedule and records. It is, therefore, essential that employees who are asked to carry out such tasks are made aware of the Schedules’ contents and that these can be accessed at Ward/Department level.

6.8.1.5. The Senior Charge Nurse is responsible for providing a safe environment and to demonstrate that he/she is required to countersign cleaning and monitoring records on a weekly basis as a minimum. If the Senior Charge Nurse is concerned about the level of service this should be dealt with promptly through appropriate communication routes in the first instance through the MITIE Helpdesk and escalated to the RCHT Contract Management where there is no resolution.

6.8.1.6. Monitoring Cleaning and Hygiene Practices Particular attention should be paid to the general condition and cleanliness of: Food preparation and serving areas and equipment; Floor tiles/surfaces; Paint and tiles on floors, walls and ceilings; Equipment used to keep food hot or cold i.e. hot plates, bain maries; Fridges/freezers etc.; Waste disposal systems; Waste bins; Electrical lights, fittings and appliances; Ventilation/extraction systems. All contact points, such as door handles.

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6.9. Temperature Control

6.9.1. Fridge Management 6.9.1.1. Never overload your fridge. 6.9.1.2. Overloading a fridge can reduce cold air circulation thereby reducing efficiency. Opening the door as little as possible and closing it again quickly will help to retain optimum temperatures.

6.9.1.3. Never place hot foods in a fridge or freezer. 6.9.1.4. Fridge/Freezer Thermometer is a simple and effective means of monitoring the temperature in a fridge or freezer. The thermometer probe should be placed in the warmest part of the fridge.

6.9.1.5. Without picking up the thermometer read the temperature, if the temperature is not between 0-5 degrees centigrade for a refrigerator or below -18oC for a freezer, then adjust the thermostat downwards, ensuring sufficient time is allowed before taking another reading.

6.9.1.6. Re-check the temperature and if it is still above the required temperature then refer to the MITIE Helpdesk.

6.9.1.7. The fridge temperature should be checked twice daily and recorded on the cold storage temperature record form. If fridges are not of the automatic defrost type, and not holding temperature. Refer to MITIE Management system. 6.9.1.8. Fridge Safety Checklist Aim to keep the coldest part of the fridge between 0 - 5°C; Where applicable keep the fridge thermometer in the warmest part of

the fridge (top shelf); Check and record the temperature of the fridge twice daily; Keep the most perishable foods in the coldest parts of the fridge; Return perishable foods to the fridge or freezer as soon as possible; Never overload the fridge; Never put hot food in the fridge, Do not keep food beyond its ‘use by’ date - all use by and best before

dates must be checked daily and discarded if they are past; Part-used cans are never to be stored in a fridge. Contents of opened

cans should be emptied into a suitable container and covered. The container should be labelled and dated.

Raw meat, uncooked foods and shell eggs must not be stored in clinical fridge.

6.10. Service - Meals

6.10.1. To maintain food quality & prevent moisture loss, plated meals must be served immediately. Hot Food must not under any circumstances be consumed after a period of 60 minutes from when the trolley arrives on the ward. Hot food should NOT be served to patients if the temperature has fallen below 63°C and Cold food should NOT be served if the temperature

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has exceeded 5°C. All Hot and cold foods leaving the kitchen are temperature checked prior to dispatch and at point of service as are the Food trolley Temperatures. 6.10.2. All meals provided by the kitchen are provided for that meal time only any un-used foods must be returned to the kitchen on the food trolley.

6.10.3. MITIE will be responsible for surveys at the point of serving to ensure the food served is at the correct temperature. Food in the Catering Department is monitored to ensure it is above 75oC at cooking stage and prior to plating. Any food not within the safe zone (under 5°C or above 63°C) will be withdrawn from service. 6.10.4. Hands should be washed prior to serving food and a green plastic apron should be worn.

6.10.5. Food must not be taken from the food trolleys and be stored at ward level; the exception to this rule is of date-stamped, pre-packed products, e.g. sandwiches, rolls, yoghurts which are provided for special diets. These items should be stored in the ward refrigerator.

6.10.6. If a patient is away from the ward at meal times the Catering Department should be notified as soon as possible and an alternative meal will be provided. 6.10.7. Employees should only pick up knives and forks by their handles, cups by the handles and plates by the edges.

6.10.8. Microwave ovens must not be used at ward level for “reheating” patient’s food.

6.10.9. Food must not be removed from the refrigerator until required for serving.

6.10.10. Patients or their relatives must not be allowed to prepare or heat any food in the ward kitchen, they must not be allowed access to ward kitchens at any time the only exception to this is where patients prepare food as part of their rehabilitation.

6.10.11. The kitchen must be kept clean and tidy at all times.

6.10.12. After each meal, all surplus food is to be disposed of via the waste disposal unit as soon as possible.

6.11. Cold Foods

6.11.1. All cold foods should be placed in a refrigerator immediately on arrival. If sufficient space is not available in a refrigerator then the food should be left in the storage container it arrived in, until required for use. A storage container is defined as the container the food arrived in from the central kitchen.

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6.11.2. Cold foods should never be stored on top or near hot food storage appliances or facilities, i.e. plated salads/cold meats on top of Bain-Marie.

6.11.3. Cold foods that are not consumed at the dedicated mealtime for whatever reason must be covered, labelled, dated and refrigerated. Thereafter they must be consumed within 12 hours. Any foods not consumed within 12 hours are to be disposed of.

6.11.4. Food normally required to be stored between 0°C-5°C may be kept above 5°C for a single period of up to one hour after which it must be discarded.

6.12. Bulk Meal Service

6.12.1. Temperature Recording Guidelines. 6.12.1.1. High-risk patient meal temperatures should be checked at each meal. 6.12.1.2. The temperatures should be recorded on the patient meal service, temperature record form.. This is a legal requirement.

6.12.1.3. While every effort will be made to serve meals above 63°C, some foods are unable to retain heat without spoiling. The tables below give temperatures at which food can be served and consumed. These must be adhered to. Main meals should be served at 75+°C.

6.12.1.4. Main meals that must be temperature checked: All Soups; All Beef, Chicken, Pork, Lamb: Stews, Casseroles, Hot Pots, Curries,

Minces and Sausages; All Roast Meats or Poultry served in gravy or sauces; All Meat Burgers, Baked Ham, Gammon Steaks; All Pies, Sausage Rolls, Bridies, Cornish Pasties etc; All Hot Egg Meals including Baked, Omelette, Scrambled or Savoury; All Vegetable Meals served in a sauce All Fish meals. All Rice Dishes including, Boiled, Fried, Risotto's or Savoury Rice; All Milk Puddings including, Custard, Sago, Semolina and Rice.

6.13. Automated Dishwashing 6.13.1. The machine must be used according to the manufacturer’s instructions. In addition to cleaning the machines are also a highly efficient means of disinfecting items. The sequence for using a dishwasher is as follows:

Remove excess food; if necessary pre-soak or spray unless the machine is fitted with a pre-wash cycle;

Pack articles in a neat orderly fashion so that items do not overlap; Articles are cleaned during the wash cycle, using a detergent solution

and water at 49 - 60°C; Articles are rinsed at 82 - 88°C, within the injection of rinse aid; After the dishwashing cycles are complete, disinfected articles may be

accessed;

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Clean items should be allowed to drain and evaporate dry prior to storage.

6.13.2. To ensure that the best results are obtained, it is important that the machines are serviced regularly, operated in accordance with manufacturer instructions and that:

Utensils are washed as soon as possible after becoming soiled; The correct detergent for the level of water hardness is used; The detergent dosing equipment is working properly and detergent

rinse levels are properly adjusted; Spray arm jets are clear from obstruction and strainers are in place.

Both should be cleaned daily.

6.14. Food Labelling 6.14.1. Legislation states that all foods are correctly labelled as not to confuse the consumer. The two main terms that should be referred to in the first instances are: ‘Use By’ ‘Best Before’ ‘Use By’: This is commonly referred to as date marking and is used primarily where perishable foods are involved and if the date is exceeded a food safety risk may occur. 6.14.2. Foodstuffs such as meat products and ready-made meals fall in to this category.

6.14.3. It is an offence to sell food beyond its use by date. ‘Best Before’: Foodstuffs carrying the ‘Best Before’ date marking does not mean that the food will be dangerous if the date is exceeded. It means the food will no longer be at its best beyond this date. Even canned, frozen and dried foodstuffs will deteriorate in the end. The instructions placed on the packaging by the manufacturer should be followed as accurately as possible, in particular the storage instructions.

6.14.4. It is not an offence as such to sell food after its best before date, subject to the general requirement to ensure food meets the 'food safety requirement'.

6.15. Food Allergens

6.15.1. There are 14 potential food allergens that may present a risk to human health. The allergens are:

Cereals containing gluten Crustaceans, for example prawns, crabs, lobster and crayfish Eggs Fish Peanuts Soybeans Milk Nuts, such as almonds, hazelnuts, walnuts, pecan nuts, Brazil nuts,

pistachio, cashew and macadamia (Queensland) nuts Celery (and celeriac) Mustard Sesame Sulphur dioxide, which is a preservative found in some dried fruit

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Lupin Molluscs, for example clams, mussels, whelks, oysters, snails and

squid 6.15.2. Food labelling will include lists of known allergens contained within the products, or used in the manufacturing environment. This should be shown bold within the ingredient list. 6.15.3. Food allergies can result in a severe reaction in the event of contact with the allergen, leading to anaphylactic shock and in some instances can be fatal. 6.15.4. It is important that patients are asked about any allergies or intolerances they may have on arrival and that this is documented correctly in the patient notes.

6.15.5. The Ward must inform the Catering Department through the MITIE helpdesk if a patient has declared any known food allergens.

6.15.6. For more information, please refer to the Trust’s Procedure for Allergies or Idiosyncrasies to Medicines and Food.

6.16. Stock Rotation

6.16.1. The simplest way of managing stock rotation and ensuring food is used before reaching critical points is to maintain food stocks efficiently, especially if food can be delivered regularly by suppliers, thereby ensuring any perishable food stored on the premises is kept to a minimum. 6.16.2. If this is not feasible, stock rotation is important to ensure that older foodstuffs which remain inside their ‘best before or use by’ dates are consumed before newer products.

6.16.3. It is strongly recommended that foods should not be opened and decanted from their original packaging as this decreases the shelf life. Where foods have been decanted or the wrapper has been removed, a simple labelling system should be introduced at all levels of the food chain. The 'use by or best before' date should be clearly identified. Foods should be used within 72 hours of opening. If the food is for a specific patient then their name should be clearly identified on the packaging. Food products that have exceeded their shelf life should be considered a risk to health and should be discarded and disposed of in the correct manner.

6.17. Provisions

6.17.1. All foods provided must be stored correctly as soon as possible after arrival. Provisions include butter, jam, cereals, biscuits, bread etc; 6.17.2. All foods provided must be stored in suitable containers to ensure freshness, i.e. salads in plastic containers, bread in breadboxes and biscuits in tins;

http://www.rcht.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Pharmacy/AllergyPolicy.pdf

http://www.rcht.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Pharmacy/AllergyPolicy.pdf

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6.17.3. Either the manufacturer or staff must label all foodstuffs. All food should be used on a ‘first in, first out’ stock rotation. Staff are required to check the date labelling and check ‘Use by’ or ‘Best Before’ dates and act accordingly i.e. discard food that is out of date.

6.17.4. Note: If you are in doubt as to the condition of the food you are about to serve to patients/clients you are to seek clarification before proceeding. On no account are you to put the health and safety of patients/clients at risk.

6.17.5. Record Keeping MITIE Facilities Service will carry out a full kitchen audit on a periodic basis, which will include checking documentation.

6.17.6. The following record forms are to be kept up to date and made available for inspection at any time. They are to be kept for a period of three months. Ideally they should be stored within a folder for easy reference.

Patient Meal Service Temperature Record Cold Storage Temperature Record Food Probe Temperature Check Food Probe Monthly Check Form and Annual Calibration.

6.18. Guidelines for Staff Bringing their Own Food into Work

6.18.1. Ensure all coffee, tea, sugar and biscuits are kept in closed containers. These should be stored on a separate shelf or cupboard and clearly labelled for staff use; 6.18.2. Items brought in for consumption should be covered and labelled with the date and name of the staff member.

6.18.3. Fresh foods stored in an area away from patient’s food.

6.18.4. Staff fridges must be kept clean and the temperature should be checked and recorded twice daily.

6.18.5. Staff must take responsibility to discard their un-used food following completion of their shift.

6.18.6. Food should only be consumed in designated dining areas.

6.19. Bringing in Food for Friends and Family in Hospital,

6.19.1. Visitors should be advised against bringing food or snacks (sandwiches/rolls) into Royal Cornwall Hospital. Royal Cornwall Hospital cannot accept responsibility if the person then becomes ill as a result of food poisoning. If a patient has particular dietary needs or “dislikes” this should be discussed with the MITIE Service and Dietician. If visitors insist on bringing in food for their relatives it is important that where the items are of a high-risk nature (sandwiches {except jam, honey etc}, trifles, fresh cream cakes etc), it is fully documented in the patient notes along with

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action taken to prevent this and the type of meals/snacks made available, on each occasion, to the patient by their visitors. Ideally the food should be consumed at the visiting time, but if it is not, it should be wrapped, labelled and stored within the patients’ refrigerator for no longer than twenty-four hours, after which it should be discarded. 6.19.2. If visitors bring in a plated meal for their relatives it must be suitable for consumption at the visiting time. There is strictly no reheating of patient’s food.

6.19.3. If the food requires refrigeration they should be stored in an airtight container labelled with the patient’s name, date received and discarded after 24 hours if not used. Inform the patient and their visitors of the policy.

6.19.4. This section may use more relevant wording and is used to provide details and information describing the practices, systems, and processes staff are expected to follow in order to comply with the procedural document.

7. Dissemination and Implementation

7.1. Training

7.1.1. People involved in the preparation, storage, distribution or processing of food may introduce contaminants that allow the multiplication of food poisoning bacteria. Royal Cornwall Hospital Trust recognises that there is a clear legal requirement for all food handlers, supervisors and managers to be trained to a level commensurate with their responsibilities. 7.1.2. Food handlers i.e. anyone who handles, prepares, cooks or serves food, will therefore be advised of their obligations in respect of hygiene and the training they will be expected to undertake, including mandatory attendance on courses.

7.1.3. Training needs require to be identified in all food handling departments within Royal Cornwall Hospital Trust by Catering Managers MITIE, Clinical Ward Managers and Heads of Departments. An assessment of both existing and newly appointed food handlers should be compiled and utilised to identify training needs.

7.1.4. Consideration must be given to the length of time since previous courses or the need for refresher training due to poor practises exhibited by a particular member of staff. The minimum requirement for food handlers will be to receive refresher training every year. Training and training records play an important part in demonstrating due diligence in respect of the Food Safety Act and the Food Hygiene regulations. Facilities Management MITIE, Clinical Ward Managers and Heads of Departments must keep comprehensive training records for each food handler under their control.

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7.2. Dissemination

7.2.1. Policy will be communicated via the Trust Document Library and to each Division, Ward and Department. 7.2.2. The policy will also be made available to MITIE and the Contract Management Team, and Accountable Officer.

8. Monitoring compliance and effectiveness

Element to be monitored

Compliance with regulations, legislation and guidance.

Lead Health & Safety Advisors

Tool Reports from Environmental Health Officers (Cornwall Council)

Frequency At least every six months or sooner where concerns have been raised.

Reporting arrangements

Reports to the Health & Safety Committee through the Divisional reporting, this includes a specific report from Mitie on Hotel

Services and a report from the Clinical Support Services & Cancer in relation to the Cornwall Food Production Unit

Acting on recommendations and Lead(s)

Actions will be attributed to the managing department accountable for the service provided.

Change in practice and lessons to be shared

Identified changes will be implemented with an agreed timescale of not more than two months at the Health & Safety Committee

9. Updating and Review 9.1. This policy will be review every three years or sooner where there has been an incident, new risk identified, changes to working practices, changes to legislation or changes to guidance.

10. Equality and Diversity

10.1.This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Diversity & Human Rights Policy' or the Equality and Diversity website.

10.2. Equality Impact Assessment

10.3. The Initial Equality Impact Assessment Screening Form is at Appendix 2.

http://www.rcht.nhs.uk/GET/d10268876

http://www.rcht.nhs.uk/GET/d10268876

http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/OurOrganisation/EqualityAndDiversity/HumanRightsEqualityAndInclusion.aspx

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Appendix 1 Governance Information

Document Title Food Safety Policy

Date Issued/Approved: Date signed

Date Valid From: January 2016

Date Valid To: January 2019

Directorate / Department responsible (author/owner):

Phil Bond / Bruce Cross Cornwall Food Production Unit

Contact details: 01209 312660

Brief summary of contents

The aim of this policy is to provide instructions on storage, handling and cooking of food in order to prevent incidents and outbreaks of food poisoning on Royal Cornwall Hospital Trust premises.

Suggested Keywords: Food, Safety, Hygiene, food-borne illness, food service, catering, hot food, cold food, allergens, personal hygiene.

Target Audience RCHT PCH CFT KCCG

Executive Director responsible for Policy:

Chief Operating Officer

Date revised: January 2016

This document replaces (exact title of previous version):

Food Hygiene Policy

Approval route (names of committees)/consultation:

Health & Safety Committee

Divisional Manager confirming approval processes

Director of Estates

Name and Post Title of additional signatories

Not Required

Name and Signature of Divisional/Directorate Governance Lead confirming approval by specialty and divisional management meetings

{Original Copy Signed}

Name: Phil Bond

Signature of Executive Director giving approval

{Original Copy Signed}

Publication Location (refer to Policy on Policies – Approvals and Ratification):

Internet & Intranet Intranet Only

Document Library Folder/Sub Folder

Chief Operating Officer

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Links to key external standards

The Food Safety Act 1990 (as amended) The General Food Law Regulation (EC) 178/2002 The General Food Regulations 2004 (as amended) The Food Hygiene (England) Regulations 2006 Food Standards Agency (www.food.gov.uk) Health & Safety Executive (www.hse.gov.uk) Health Protection Agency (www.hpa.org.uk) Department of Health (www.dh.gov.uk)

Related Documents:

Training Need Identified? Yes – Learning & Development have been informed

Version Control Table

Date Version

No Summary of Changes

Changes Made by (Name and Job Title)

Jan 2016 V1.0

New Policy to replace the Food Hygiene Policy including new format and update in light of changes to the provision of catering services.

Phil Bond, Governance Lead, Estates / Bruce Cross, Ops Manager (CFPU)

[Please complete all boxes and delete help notes in blue italics including this note]

All or part of this document can be released under the Freedom of Information

Act 2000

This document is to be retained for 10 years from the date of expiry.

This document is only valid on the day of printing

Controlled Document This document has been created following the Royal Cornwall Hospitals NHS Trust

Policy on Document Production. It should not be altered in any way without the express permission of the author or their Line Manager.

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Appendix 2 Initial Equality Impact Assessment Form

Are there concerns that the policy could have differential impact on: Equality Strands: Yes No Rationale for Assessment / Existing Evidence

Age X

Name of Name of the strategy / policy /proposal / service function to be assessed (hereafter referred to as policy) (Provide brief description):

Directorate and service area: Clinical Support Services & Cancer

Is this a new or existing Policy? Existing

Name of individual completing assessment: Phil Bond

Telephone: 01872 253249

1. Policy Aim* Who is the strategy / policy / proposal / service function aimed at?

The aim of this policy is to provide instructions on storage, handling and cooking of food in order to prevent incidents and outbreaks of food poisoning on Royal Cornwall Hospital Trust premises. Food hygiene regulations must be taken seriously, outbreaks of food poisoning in hospital premises are notify-able by law to the Consultant in Communicable Disease Control (CCDC).

2. Policy Objectives* To protect patients, visitors and staff in relation to food safety

3. Policy – intended Outcomes*

No food safety related incidents

4. *How will you measure the outcome?

Trust incident reporting system

5. Who is intended to benefit from the policy?

All staff, visitors, and patients.

6a) Is consultation required with the workforce, equality groups, local interest groups etc. around this policy? b) If yes, have these *groups been consulted? C). Please list any groups who have been consulted about this procedure.

No

7. The Impact Please complete the following table.

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Sex (male, female, trans-

gender / gender reassignment)

X

Race / Ethnic communities /groups

X

Disability - Learning disability, physical disability, sensory impairment and mental health problems

X

Religion / other beliefs

X

Marriage and civil partnership

X

Pregnancy and maternity X

Sexual Orientation, Bisexual, Gay, heterosexual, Lesbian

X

You will need to continue to a full Equality Impact Assessment if the following have been highlighted:

You have ticked “Yes” in any column above and

No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or

Major service redesign or development

8. Please indicate if a full equality analysis is recommended. Yes No X

9. If you are not recommending a Full Impact assessment please explain why.

No impact

Signature of policy developer / lead manager / director Bruce Cross

Date of completion and submission 4th January 2016

Names and signatures of members carrying out the Screening Assessment

1. 2.

Keep one copy and send a copy to the Human Rights, Equality and Inclusion Lead, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Knowledge Spa, Truro, Cornwall, TR1 3HD A summary of the results will be published on the Trust’s web site. Signed _______________ Date ________________

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