SPECIAL REPORT: The great care home laundry clean up

The laundry room that should be the front line for a care home’s infection control, but is all too often the source of contamination as soiled linen comes into contact with clean. What are the experts doing to clean-up the situation? Care Home Professional investigates.

It is the first duty of every care home professional to keep their residents safe, but a brand new survey conducted by Electrolux Professional has discovered that almost a quarter of all staff in the sector do not feel their laundry is managed in a way that completely avoids contamination.

The same study found that almost a third of care home operators fear their staff do not fully understand the difference between visual and hygienic cleanliness, and a similar proportion do not feel their laundry system is managed in a way that completely avoids contamination.

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Small wonder then that the study found that one in 20 of the 160 people surveyed by Electrolux said that they had knowingly experienced an infection outbreak in their home that could be traced back to laundry procedures.

The Care Quality Commission told Care Home Professional that there are no specific regulations concerning how laundry is managed. Instead, it inspects homes for general hygiene and infection control and, if there is a problem, will most certainly investigate whether laundry mismanagement is contributing to the issue. It will then issue guidelines on how to improve.

In the absence of specific rules by the CQC, Electrolux has taken a proactive step and issued its own advice in a special report entitled Infection Prevention – a report on the important role of laundry cycle management in UK care homes. The company advocates an eight-step process that ensures every element of the laundry cycle is monitored in order to significantly reduce the risk of contamination.

The process highlights some key areas that can often be forgotten by care home operators such as the proper packaging and transportation of dirty laundry via dedicated routes, and the correct storing of clean linen to protect it from damage by micro-organisms.

Even care homes that have not created a barrier system within their laundry, which ensures dirty laundry cannot come into contact with clean items, can apply the Electrolux recommendations to dramatically improve their system.

“The fact that nearly half of operators admit they don’t think staff in their facility understand the difference between visual and hygienic cleanliness is a huge concern that the industry needs to address. There is a high probability that residents within a care environment are being put at risk of serious illness and this is a risk that needs to be eliminated before a severe outbreak occurs,” warns Amanda Dufrane, care segment manager at Electrolux Professional.

The barrier system may not be essential, but it is certainly highly recommended by all commercial laundry suppliers. “One of the most effective ways to prevent contamination of clean laundry is to use a barrier watching system – designed so linen is loaded into the machine on the dirty side and them removed on the clean side, with a wall providing a barrier between the dirty and the clean sides. This means that, provided the operator adheres to the appropriate health and safety hygiene procedures when loading and unloading the machines, there should be no opportunity for recontamination,” Dufrane explains.

Miele Professional points to Ministry of Health guidelines that, while created with hospitals in mind, are just as relevant to care homes. The latest advice is contained in Choice Framework for local Policy and Procedures 01-04 (CfPP 01-04) – Decontamination of linen for health and social care: Guidance for linen processors implementing BS EN 14065. BS EN 14065 describes a management system for assuring the microbiological quality of processed textiles used in specifically defined sectors in which it is necessary to control microbiological contamination. “The Department of Health encourages the adoption of this standard for those operating laundries both in a commercial setting and within the NHS,” the MOH paper says.

All its commercial laundry equipment and system have been designed to operate in accordance with the guidelines, Miele says. “Where your customers are potentially at risk of vulnerable, it is even more important to have end-to-end oversight of the laundry process in order to have full confidence that your laundry is being processed with the CfPP 01-04 guidelines,” says Les Marshall, sales and marketing director at Miele Professional.

“Our machines meet the rigorous temperature and time standards of CfPP 01-04 while offering excellent value for money over the long term through high quality and reliable machines that also decrease running costs and environmental impact,” Marshall adds.

The UK’s third major commercial laundry equipment supplier is Girbau, which manufactures a full range of washing, drying and finishing equipment, and operates a direct sales, installation and service model for care home groups throughout the UK. “We have a national direct service operation and can maintain any brand of commercial laundry equipment anywhere in the UK. Our service work is second to none and is recognised to be both highly efficient and very competitively priced,” claims Robert Pell, national accounts manager for Girbau UK.

Care Home Professional asked all manufacturers to give a guide price for installing a laundry solution for a 50-bed care home. Girbau says it will work on a tailored solution for any home, but suggested a the equipment to support a 50-bed home could be provided for less than £10,000 capital outlay, or as little as 13p per day per resident.

For care homes in the UK, Girbau’s workhorse products are the HS 6 Series high spin washers, ED Series Eco Dryers, the PS Series ironer range the GMP range of smaller ironers. “The Girbau 6 Series  of washers (in 9, 14 and 19kg capacities) have been designed to be very energy efficient and offer spin speeds of up to 1000 rpm. They provide excellent washing performance with reduced cycle times and come supplied with a comprehensive range of programs for all commonly-laundered fabrics and items,” Pell describes.

Miele also focuses on the running costs of its machines – including the cost of labour to operate them, the running costs and the reliability to reduce downtime. “Miele understands that reliability and speed are both important factors and any downtime has to be minimised. But businesses are increasingly interested in lifetime running costs and purchasing machines that last longer. Miele Professional’s ethos is ‘forever better’, and all our products are designed to last an operational lifespan of over 30,000 hours,” states Marshall.

Its key innovation this year is the Miele NeQis Independent Validation System that records temperature and detergent usage in real time, and allows care homes to check that equipment is performing consistently.

The system operates with Miele’s most popular range for care homes, the Little Giants, which are designed for small laundry rooms. “The PWT 6089 is a stackable unit that stands less than two metres tall and has a footprint of just one metre square. These machines can fit into almost any laundry and can wash and dry high volumes at a consistently excellent quality,” Marshall says.

Electrolux recommends a complete Laundry Cycle Management solution that focuses as much on training operators as installing the right equipment. “Getting the right equipment will go a long way, however, without backing up a purchase with in-depth training of why best practice procedures need to be adopted, care homes risk endangering residents and undermining significant capital investment as there will be no guarantee for total hygienic cleanliness,” urges Dufrane.

Robust Laundry Cycle Management can be achieved without implementing a barrier system, but Electrolux does recommend it. “Barrier wahers are an ideal solution for the care industry. Electrolux Professional’s Line 5000 series of barrier washers are perfect for the care sector and can go a long way to helping encourage LCM best practice due to the physical separation between dirty and clean linen,” Dufrane says.

Electrolux believes care homes should install their own professional laundry rooms, but there is a growing trend to outsource the process to companies that simply collect, wash, dry, finish and return all laundry for homes.

Berendsen has been offering an outsourcing service for decades – mainly to NHS hospitals, which have tighter regulations than care homes. Its laundry facilities are certified to BS EN 14065 standards and are compliant with the DoH’s CfPP 01-04 guidelines.

Outsourcing for care homes has until recently been more difficult than for hospitals because residents have their own clothing that needs washing, and this was much tougher to track than bulk loads of towels, sheets and uniforms.

Berendsen says it has cracked the problem this year, which is why it is actively targeting the care home sector. “We have invested in advanced tracking technology that enables us to trace each individual item of clothing throughout the entire laundry process and to be able to link it directly back to the resident and their care home,” explains Jerry Richardson, business development director for care homes at Berendsen.

Outsourcing has other attractions, says Berendsen, including wiping out the cost and hassle of installing an in-house laundry; training staff to manage the process professionally; and guaranteeing a service without breakdowns.

“Laundry is a time-intensive process and every minute that a member of staff spends on laundry is a minute not spent caring for residents. But handing laundry to an external provider, care home staff have more time to provide the best possible care. In addition, the space used for an in-house laundry could be better used instead as additional facilities for residents or operational activities,” says Richardson.

Berendsen wouldn’t give figures for the cost of outsourcing laundry for a 50-bed care home, but Grosvenor Contracts, which competes in London and the home counties, says that a typical service can be as little as £350 per person per year. The company agrees with Berensden about the benefits of outsourcing. “We offer a risk-free, CfPP 01-04-compliant service,” explains Mark Godley, executive director at Grovesnor Contracts.

The company also says it has cracked the issue of tracking individual items through its process using RFID tags and barcodes. Plus it offers linen for hire, which has the potential to reduce capital expenditure for homes.

Grovesnor makes it sounds like handling laundry requires the sort of skills required by biological weapons scientists. That is over-stating the risks and compliance issues, but there are complexities and costs that make outsourcing attractive. “Quite often the existing launcry may be near to kitchens or other service areas. This creates a huge risk of cross-contamination by airborne bacteria and thus a cross-infection risk. Drainage often has to be rerouted and sealed to prevent cross-contamination,” Godley explains.

Whether care homes manage their own laundry or outsource it to a growing number of service providers, they face a series of challenges to ensure a safe, reliable and cost-effective solution. The UK’s leading manufacturers like Electrolux, Miele and Girbau are offering increasingly compelling stories on lifetime ownership, compliance and environmental impact, while industrial scale outsourcers like Berendsen and Grosvenor offer to take all the pain away.

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