Care and nursing homes are, by their very nature, hotbeds for the potential spread of infection.

Risks are increased due to the sharing of dining rooms and living accommodation, and the fact that residents are generally more susceptible to infection. Age, underlying medical conditions, lower immunity and the use of devices like catheters and feeding tubes all greatly increase your chances of picking up a potentially life-threatening infection.

That’s why care homes regularly ask DDC Dolphin for advice on how to best equip and use their sluice/dirty utility rooms to help break the chain of infection in these settings.

There are two important factors to take into consideration: how to optimally design your sluice room to minimise the risk of cross infection in your home, and how your staff operate within that environment to keep both themselves and your residents safe.

CQC inspectors need to know how well staff and people living in care homes are protected by infection prevention and control.

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Sluice Room Design Guidelines

The layout of a sluice room is actually as important as the equipment within it. The ultimate aim is that anyone and anything entering the room should exit it clean and/or disinfected.

The room should be laid out is such a way that the user moves around the room in an efficient workflow, disposing of hazardous waste first and foremost, then moving on to disposing of their protective clothing, storing and/or retrieving clean waste utensils, and finally making sure they properly disinfect their hands before exiting the room.

The first piece of equipment the user comes to should be the slop hopper, which is used as a temporary collection point for soiled/ hazardous items, a back-up disposal method in the event of power or mechanical failure, and as a facility for filling and emptying cleaners’ buckets.

The next piece of equipment will depend on what your nursing or care home uses.

If you use reusable commode pots and/or bedpans, you will have your automatic washer disinfector. This can wash and thoroughly disinfect several items at a time with water heated to 80°C to kill or denature 99% of harmful microbes found in human waste.

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If you use single-use/disposable bedpans and/or commode pots, you will have your medical pulp macerator. This is often used as an alternative or even alongside a bedpan washer as they greatly reduce the risk of infection and save staff time. The pulp utensil and its contents can be placed inside the macerator which chops the container and its contents into a fine slurry, depositing it into the sewage system.

Some of your residents may also need to use incontinence products. These were traditionally disposed of via yellow waste bags, which are unhygienic and an infection risk. The modern alternative is an incontinence product macerator, which works in a similar way to the pulp product macerator, where the pad is chopped into small pieces and deposited into the sewage system.

Make sure you've got all the equipment you need with our Ultimate Sluice Room Checklist.

Next you should have a foot-operated clinical waste bin to dispose of personal protective equipment such as gloves and aprons which may have become contaminated.

Then you will have various storage cupboards, racks and shelving, for storing clean and dry utensils, both reusable and single-use. You may also have a work surface and a general use sink.

Near to the door you should have a stainless-steel wash basin designated for hand washing only, with a lever or sensor operated soap dispenser and taps to prevent the spread of infection. You will also need a paper towel dispenser and another foot operated bin for disposal.

Other important considerations for a well-designed sluice room include lighting, ventilation to encourage laminar flow, as well as floors and walls which can be easily cleaned.

Finally, the location of the sluice room itself is also incredibly important. It’s recommended that you have one room per floor of your home, or one per 15 residents. This is to minimise travelling distances for staff from residents’ rooms and bathrooms and avoid soiled items being carried up and down stairs, past kitchens or communal areas, risking potential spillages and an increased chance of cross contamination.

For more information on how to design your sluice room for optimum infection control, take a look at our Sluice Room Checklist infographic.

Sluice Room Usage Guidelines

To minimise the risk of infections spreading from a patient to staff, other patients, and anyone else they come into contact with, it’s vital that staff follow these guidelines.

Always make sure you follow the directional flow of the room as outlined in the above sluice room design guidelines: slop hopper, waste disposal equipment, protective equipment disposal, storage/work surfaces, hand wash.

Personal Protective Equipment (PPE) should always be worn when handling unsanitised products, cleaning up body fluid spillages or cleaning the sluice/dirty utility room to prevent microorganisms from contaminating skin and uniforms. Disposable gloves and plastic aprons must be worn when there is any possibility that your hands my come into contact with any body fluids and disposed of immediately afterwards, before contact with anything else occurs. Mouth and eye protection is less commonly used in care home settings but may be required in the case of a flu pandemic.

Hand hygiene is one of the most important defences in the fight against infection. It is important that all staff are trained in how to effectively disinfect their hands. It is also a good idea to display a hand washing visual guide near sinks to serve as a handy reminder. Ideally, liquid soap dispensers and taps will be hands-free operated. Hands should be washed vigorously for 10-15 seconds with soap and water to ensure harmful microbes are removed. Whilst alcohol hand gels are useful for killing many types of bacteria, they are unfortunately ineffective against Norovirus and Clostridium difficile (C.diff).

Hands should be washed:

• When you arrive at and leave work
• Before preparing, handling or eating food
• After using the toilet
• Before and after giving personal care to residents
• Before putting on and after removing PPE
• Before preparing medications
• After handling any body fluids
• After handling laundry
• Whenever they are visibly dirty

A cleaning schedule should be drawn up and strictly adhered to. It should have a clear breakdown of who is responsible for cleaning which area (not just for the sluice room, but residents’ rooms, bathrooms, communal areas, etc. too), how frequently these areas/items should be cleaned, and clear cleaning instructions for each item, detailing the type of cleaning product to be used. All surfaces, including the outer surfaces of your waste disposal equipment, walls and floors should be cleaned daily.

Many nursing and care homes will also use their dirty utility/sluice room for storage of cleaning equipment. It is best practise in all healthcare settings to adopt a colour code for all items used for cleaning, including reusable and disposable cloths, mops, buckets, aprons and gloves. Most healthcare settings use the following colour code:

• Blue – day rooms and general areas
• Red – sanitary areas and body fluid spills
• Green – kitchens and food preparation areas
• Yellow – isolation rooms

Any spillages of body fluids, including blood, urine, faeces and vomit should be cleaned up immediately as they are hazardous to health. You should always wear PPE, and use a waste bag, disposable towels or a scoop, disinfectant solution or granules, warm water and general purpose detergent.

If you’re updating your sluice room’s waste disposal equipment, redesigning an existing dirty utility room or even designing a new care home, DDC Dolphin can help.

Our extensive knowledge in all aspects of sluice/pan/dirty utility room design and equipment gives us a unique understanding of how these integral parts of a hospital or care home need to work. We can advise on any particular requirements, making the most of the space available, promoting not only the best ergonomic design, but also helping to avoid cross contamination and complying with infection control guidelines.

Take a look at our sluice room checklist