A leaking ceiling, dirty mugs and extractor vents, concerns over the temperature of served food, and a need for staff training all contributed towards hospital ward kitchens receiving a one-star food hygiene rating.

Watford Borough Council has released the environmental health officer's report following an inspection of the ward kitchens at Watford General Hospital in November.

As revealed in last week's Observer, the kitchens were given just one star out of five.

The report lists actions West Herts Hospitals Trust had to take immediately, and over the following months, in response to issues the officer found during her inspection.

What issues did the officer find?

Temperature control

At the time of inspection, some high risks foods being stored in hospital fridges were found to be warmed than 8oC. Foods on a trolley in a ward were also found to be above 8oC.

The officer said a "robust and consistent system" is needed across all the ward to ensure staff are accurately determining the temperature of high risk foods. She said all high-risk foods, which can include cooked meat, fish, soup, dairy products, and cooked rice, must be kept at 8 degrees celcius or colder.

Lack of cleaning material

The officer noted in her report that at the time of inspection, no cleaning materials were readily available to housekeepers to effectively clean the ward kitchen for food safety purposes.

She said suitable cleaning materials including chemicals and cloths must be readily available in all ward kitchens.

Leaking ceiling

The officer witnesses water leaking from the ceiling in the corridor outside contractor Mitie's main kitchen which is the route used by the housekeepers to collect food and take it back up to patients on the wards.

The officer said all food and trollies must be adequately protected so it is not at risk of contamination from the dripping water.

Dirty floor

The floor under the cupboards in a ward was not clean. The officer said the floor needed to be cleaned and thoroughly maintained.

Dirty mugs

The wash hand basin in one of the units was being used to store dirty mugs.

The officer said the basin must be emptied, kept clean, and available for use at all times for washing hands.

Dirty extractor vent

The extractor vent in one of the kitchens was dirty.

The officer said the vent must be thoroughly cleaned and maintained by December 13 2019.

Damaged worktop

A worktop in a kitchen was damaged and therefore it could not be adequately cleaned.

The officer said the worktop needed to be repaired or renewed by January 30.

Lack of suitable documented food safety management system

Any business that provides high-risk food must have a documented food safety management system based on the principals of the hazard analysis critical controls points.

The officer was shown a ward kitchen food hygiene sheet (WKFHS) but she said the sheet was not adequate to meet the requirements of the management system.

The officer based the above after witnessing the following:

  • The WKFHS requires dishwasher temperatures to be a wash temperature of 60 degrees celcius and a rinse cycle of 80-82 degrees. Dishwashers in the kitchens operated at a maximum of 70 degrees – but the officer was not able to establish if this was rinse or wash temperature. All of the dishwashers were set to a 45 degree program.
  • The WKFHS states that wash hand basins must not be used for any other purpose than washing hands - dirty mugs were seen in a basin.
  • The WKFHS states that no plastic bags are to be stored in fridges – but there was a bag of food belonging to a particular patient in a fridge.
  • No consistent implemented procedure for taking the temperature of foods in the fridges.
  • One member of staff knew that the fridge was too warm in a unit and a new fridge had been ordered but no action had been taken to ensure that foods were safe – they were still being kept at too high temperatures.
  • The target time for the service of food is 15 mins on posters on the ward kitchens. No checks to see if this is happening and no consideration of the fact that it can take up to an hour to complete service on some wards.
  • A fridge had broken – no one had realised and foods were too warm.
  • There are a number of different people and departments responsible for food safety issues on the wards – there is a lack of clear overall control and responsibility.

Training

The officer said it became apparent in her inspection that the level of food hygiene awareness amongst staff was "inadequate".

She gave the following examples:

  • a volunteer did not known about the wash hand basin use
  • a housekeeper thought Mitie took the food temperatures in the fridge
  • staff on all four wards were not aware of how to take food temperatures
  • staff had not taken action to make sure foods out of temperature control were adequately dealt with and/or disposed of
  • although staff did seem to have overall general knowledge of food hygiene, they did not have an adequate understanding of the controls and procedures they should be implementing to keep food safe on the wards

How has the trust reacted to the issues raised following the inspection?

The trust says temperature checking of patient food is a practice carried out across all wards and food is temperature checked when it leaves the main kitchen and at the point of service. Each ward has been provided with a food thermometer and appropriate training.

The trust says regular checks on the ward kitchens are being carried out by managers. The trust's facilities team is also carrying out regular audits.

The ceiling which was leaking has been repaired.

The extractor fan has been cleaned.

Work to improve the kitchen with the damaged worktop is underway as part of a larger programme of kitchen repairs.

The trust says contractor Mitie is responsible for ensuring cleaning products are available in the kitchens. The facilities team is carrying out audits. The ward kitchens are managed on a day-t-day basis by the ward housekeepers and overseen by the ward managers.

With regards to the documented food safety managements system, the trusts says there is now a folder on each ward which gives clear guidance on each procedure and process along with details of who to contact if support is required.

The trust says all housekeepers and kitchen staff are already trained in food safety.

The trust is working with the Chartered Institute of Environmental Health to create a bespoke training programme suitable for all staff. A specialist consultant is on site looking at all elements of the patient catering process, providing guidance and advice where changes and improvements can be made.

The trust's director of environment, Paddy Hennessy, said: "We are very disappointed with this rating which does not meet the high standards of care we hold for our patients. Since the inspection we have replaced equipment and implemented checks and audits to ensure the food handling environment is safe for our patients.

"We are also providing enhanced training for all staff who handle food so there are strong food safety management procedures in place.

"I would like to reassure the public that our patient food is safe and we look forward to the next inspection where we can demonstrate the improvements and the progress we have made."

If you would like a copy of the environmental health officer's report, email envhealth@watford.gov.uk