During this ongoing pandemic, cleaning frequency of the environment should be increased across all categories. A minimum of 4 hours should have elapsed between the first daily clean and the second daily clean.  Where a room has not been occupied by any staff or residents since the first daily clean was undertaken, a second daily clean is not required.

It is the responsibility of the person in charge to ensure that the care environment is safe for practice (this includes environmental cleanliness/maintenance). The person in charge must act if this is deficient.

The care environment must be:

• visibly clean
• free from non-essential items and equipment to facilitate effective cleaning
• well maintained and in a good state of repair

Ideally rooms which are carpeted should be avoided when carrying out consultations in healthcare facilities.

The cleaning frequency and use of general purpose detergent for cleaning in the Medium Risk pathway as per the NHS Scotland National Cleaning Services Specification is sufficient with the exception of isolation/cohort areas where individuals with a known or suspected infectious agent are being cared for.  These areas require to be cleaned twice daily with a chlorine releasing agent containing 1000ppm av chlorine.

Environmental cleaning in the high risk category should be undertaken using either a combined detergent/disinfectant solution at a dilution of 1000 ppm available chlorine or a general purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1000ppm. A minimum of 4 hours should have elapsed between the first daily clean and the second daily clean – see table 6 for cleaning requirements.  Where a room has not been occupied by any staff or patient/individuals since the first daily clean was undertaken, a second daily clean is not required.

Cleaning across the categories is summarised in table 6.

Table 6: Environmental cleaning determined by category

	Medium risk category (Amber)	High risk category (Red)
Frequency	At least daily as per NHS Scotland National Cleaning Services Specification.	At least twice daily 1st clean - Full clean 2nd clean - * Touch Surfaces within clinical inpatient areas
Product	General purpose detergent**	Combined detergent/disinfectant solution at a dilution of 1000 ppm av chlorine or general purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1000ppm av chlorine.

*High risk touch surfaces as a minimum should include door handles/push pads, taps, light switches, lift buttons.  Resident areas should include the bedroom and treatment areas and staff rest areas.

**Cleaning in the medium risk pathway should be carried out with chlorine based detergent for rooms where the individual is known to have any other known or suspected infectious agent and following an AGP .

Any areas contaminated with blood and body fluids (including saliva) across any of the three categories require to be cleaned as per Appendix 9 of the National Infection Prevention and Control Manual.

7.7.1 Cleaning practice points

NHS healthcare facilities will be cleaned by NHS domestic services who will adhere to the National Cleaning Specification Standards. For all other health and care facilities (excluding patient/individuals own home) the following good practice points apply:

• Use disposable cloths/paper roll/disposable mop heads, to clean and disinfect all hard surfaces/floor/chairs/door handles/reusable non-invasive care equipment/sanitary fittings in the room.
  
  
• Clean, dry and store re-usable parts of cleaning equipment, such as mop handles.
  
  
• For carpeted floors/items that cannot withstand chlorine-releasing agents, consult the manufacturer’s instructions for a suitable alternative to use following, or combined with, detergent cleaning.
  
  
• Decontamination of soft furnishings may require to be discussed with the local HPT/ICT. If the soft furnishing is heavily contaminated, you may have to discard it. If it is safe to clean with standard detergent and disinfectant alone then follow appropriate procedure.
  
  
• If an item cannot withstand chlorine releasing agents staff are advised to consult the manufacturer’s instructions for a suitable alternative to use following or combined with detergent cleaning.

When an organisation adopts practices that differ from those recommended/stated in this national guidance with regards to cleaning agents, the individual organisation is fully responsible for ensuring safe systems of work, including the completion of local risk assessment(s) approved and documented through local governance procedures.