Infection Control - What to check the "Night before" a CQC inspection

1. Policy & Records: Precision and Accessibility

1. IPC Policy Review

   • Confirm that your policies matches the latest CQC guidance.

   • Ensure each staff member knows where to locate the policies and has signed to confirm they have read and understood them.

2. Audit and Checklists

   • Hand Hygiene Audits: Document frequency (e.g., weekly or monthly) and results. A simple spreadsheet or a CQC-compliant template can suffice.

   • Cleaning Schedules: Maintain daily, weekly, and monthly task lists, signed off by the person completing them. If possible, keep them visible in each clinical area.

   • Decontamination Logs: For equipment (e.g., autoclaves or sterilizers), include dates, times, and results of validations/test strips.

3. Scenario Example

   • “Show me your daily cleaning logs.”

     • Be ready to point inspectors to a clearly organised folder (digital or paper) that confirms each area has been cleaned on schedule and by whom.

TIP

Where possible, cross-reference NICE QS61 statements (e.g., on hand hygiene training or environment cleanliness) within your logs so inspectors see clear alignment to specific national standards.

2. Scenario-Based Practical Reminders

1. Sharps Bin “Gotcha”

   • Common Pitfall: Overfilled sharps bins, incorrect labelling, or bins not assembled properly.

   • Solution: Make sure each sharps bin is less than ¾ full, labeled with the opening date, location, and disposal route.

2. Cluttered Storerooms

   • Common Pitfall: Items stored on the floor or on overcrowded shelves, raising concerns about dust and contamination risk.

   • Solution: Implement a simple “floor is clear” rule and a labelling system for immediate retrieval of items.

3. Missing Expiry Dates

   • Common Pitfall: Out-of-date dressings, disinfectants, or single-use instruments.

   • Solution: Check all stock for expiry dates the night before and remove any items that are past their date.

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Train frontline staff to handle quick queries. For instance, if an inspector points to a partially full sharps bin, your staff should confidently explain how they manage it when it nears capacity.

3. Staff Training Evidence: Confidence & Competence

1. Training Records

   • Maintain a log showing who has completed IPC training and when (e.g., e-learning modules, in-house sessions).

   • Reference CQC or NICE QS61 training requirements in your records, ensuring staff are up to date on infection control essentials, including hand hygiene and PPE.

2. Practical Refresher Sessions

   • In the days leading up to the inspection, run short “huddle” sessions (even 10 minutes at the start of a day) covering:

     • Hand hygiene technique

     • PPE donning and doffing

     • Correct disposal of clinical waste

3. Scenario Example

   • “What if there’s a needle-stick injury?”

     • Staff should know the immediate response: wash the wound, report the incident, seek occupational health advice, and document fully.

   • “What if a patient vomits in the waiting area?”

     • Staff should be able to locate the spill kit, follow decontamination protocol, and document the incident.

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Inspectors often ask reception or junior staff about these scenarios. Being able to describe the procedure and show the policy fosters confidence in your IPC culture.

4. Detailed Compliance Cross-Check

Link each action to specific references or regulations. This helps inspectors see that your measures are systematically grounded in national standards:

• NICE QS61 Statement 1: Hand hygiene

  • Show how you ensure staff comply (e.g., audits, visual prompts, training logs).

• CQC ‘Safe Care and Treatment’ (Regulation 12): Cleanliness & infection control

  • Provide evidence of routine environmental cleaning, well-maintained equipment, and up-to-date staff guidance.

• Health and Social Care Act 2008: IPC is integral to meeting this Act’s requirements

  • Demonstrate how your practice approach meets the “Code of Practice on the prevention and control of infections.”

5. Beyond the Basics: Additional Preparations

1. Ventilation & Air Quality

   • If applicable, ensure air conditioning or ventilation systems are well-maintained. In some cases, open windows in communal areas can help meet recommended ventilation guidelines (particularly relevant post-COVID).

2. Legionella Risk Assessment

   • Inspectors may ask about how you assess and manage legionella risks in water systems (e.g., annual checks, flushing protocols for seldom-used taps).

3. COVID-19 & Respiratory Infection Guidelines

   • If relevant, show how you’ve adapted practice policies in line with CQC guidance on respiratory infections (e.g., signage for symptomatic patients, mask availability).

4. Staff Illness & Return-to-Work Protocol

   • Have a clear policy on staff who develop infections. They should know the reporting process, return-to-work criteria, and self-isolation measures if needed.

6. Final “Night Before” and “Morning Of” Checklist

1. Night Before

   • Clean & Tidy: Complete any outstanding cleaning tasks, focusing on patient-facing areas, floors, and surfaces.

   • Stock Check: Replenish soap, hand sanitiser, gloves, aprons, and other PPE in every clinical area.

   • Documentation: Gather or digitally store your completed logs (cleaning, PPE usage, hand hygiene audits) in one place.

2. Morning Of

   • Walk-Through: Arrive early, do a final check of reception areas, toilets, consulting rooms.

   • Staff Huddle: Quick refresher on top-line procedures: hand hygiene, sharps disposal, PPE usage, and what to do in common scenario questions.

   • Confidence & Culture: Remind staff that strong IPC is part of daily routine, not a “one-off.” Inspectors value seeing continuity and embedded practice.

Conclusion

A robust, comprehensive infection control setup for a UK GP practice involves much more than a quick tidy-up. By:

• Maintaining clear, accessible records that tie directly to CQC and NICE standards,

• Training and empowering staff with scenario-based know-how and up-to-date guidance,

• Covering broader aspects like ventilation, legionella, and staff illness policies,

…you not only prepare for an inspection but also foster a genuine culture of continuous improvement in infection prevention and control. This approach will reassure inspectors that your practice consistently meets, and potentially exceeds, regulatory requirements.

Key Resources & References

• CQC Guidance Infection prevention and control in general practice (CQC)

• NICE Guidance: NICE Quality Standard (QS61) for Infection Prevention and Control

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Legislation UK