How to Effectively Provide a Clean and Safe Environment in Care Homes

With recent government guidance indicating a rising number of cases of the Coronavirus, it’s clear that safety and hygiene is of paramount importance, especially in care homes where residents and staff are some of the most vulnerable in society. It’s imperative that care homes be given clear advice on providing clean and safe environments for staff and residents.

In addition to signage, social distancing measures and correct use of PPE, a focus on cleaning and infection control is critical. There should be an increase in frequency as well as a thoroughness of the regular cleaning routine, with an initial deep clean of the building to provide protection for staff and residents, specifically focusing on high-touch surfaces such as tables, handles, door buttons, arm rests and toilets as the virus can last up to three hours in the air and up to 72 hours on hard surfaces. This should be done following a three-step methodology: clean, disinfect and test.

Outsourcing the initial deep cleaning process to a professional company is advisable as they will have the products and training required to conduct a meticulous deep clean in addition to regular routines.

When completing a deep clean, the standard disinfecting process should be followed by ULV (Ultra Low Volume) fogging of the building. ULV foggers deliver the disinfectant product at droplet sizes ranging from 10-120 microns. For this reason, ULV foggers should only be used with products that are safe for use in the presence of people when adjusted to levels below 80 microns.

When deploying ULV fogging, it is important to follow manufacturers’ recommendations and take care to isolate areas which may be sensitive to the process, such as electrical equipment. Fogging is a beneficial extra step to take as the disinfectant treats entire areas and has greater surface contact time to destroy all present threats.

For small, enclosed areas, the use of UV (ultraviolet) lights can also be beneficial. UVC works at a high energy to destroy the genetic mate- rial inside viruses, and so can be used for disinfection. UVC has not been clinically tested against the virus which causes COVID-19, although it is proven to destroy related coronaviruses. Caution is required when using UVC, however, as it can cause damage to eyes and skin.

In the regular cleaning routine in care homes staff should first wash down surfaces using a PH-neutral detergent first, such as soap and hot water to remove ‘hidden’ bacteria and viruses in lingering dirt and dust.

Follow this with a disinfectant which has been certified to be effective in disabling similar coronaviruses. Virucidal disinfectants are stronger than their antibacterial counterparts but, in many cases, their effective- ness against coronaviruses is unproven, and so choosing the right disinfectant is crucial. As some virucidal disinfectants may contain potentially harmful ingredients, it’s important to follow manufacturer’s guidance on the correct ‘contact period’ and when to reapply the product.

Surgical spirits can also be used as an alternative to virucidal disinfectants as they can destroy the protein and RNA of viruses in as little as 30 seconds. To use surgical spirits, rub the liquid over the surface using a cloth. The spirit will then evaporate and does not need to be wiped away.

To verify that the rooms have been disinfected effectively, you should test surfaces for the presence of Adenosine Triphosphate (ATP), an indicator molecule for the presence of biological residues. This test works by wiping a swab across surfaces, inserting it into an active substance and then measuring the output on a hand-held device called a ‘luminator’, which will indicate how much residue is on the surface depending on light output.

ATP testing is strongly recommended to ensure the effectiveness of decontamination and to provide confidence that the cleaning regime is effective and should be extended to high touch areas throughout the care home.

It’s crucial that care home owners ensure that rigorous cleaning methods are included in daily cleaning routines with strong and effective disinfectants. Although a deep clean doesn’t need to be implemented every day, it should be done initially to provide a more thorough protection for staff and residents as we continue to aim for a safe return to ‘normal’ life.