Issue Date: 9 August 2011
Ref: DIV11/11
Lancashire Teaching Hospitals NHS Foundation Trust has adopted a number of products from Diversey The Trust is based across two sites, the Royal Preston Hospital and the Chorley and South Ribble Hospital, and serves over one million people in Lancashire and Southern Cumbria.
Widespread use of Diversey products supports improved cleaning operations
In recent years the Lancashire Teaching Hospitals NHS Foundation Trust has adopted a number of products from Diversey, including ultra microfibre systems, floor care machinery, building care products and hand soaps, to create something close to an integrated cleaning and hygiene operation. In doing so the Trust has made significant improvements in cleaning performance, simplifying processes and reducing overheads as part of a wider programme to deliver better quality outcomes and services.
“We have a good relationship with Diversey and it’s like we’re all part of a team providing a service,” says April Deravairere, Domestic Services Manager at Royal Preston Hospital. “The products are very good at what they do and this leads to high user acceptance. We get the advice and innovation we need and have confidence in our cleaning processes.”
The Trust is based across two sites, the Royal Preston Hospital and the Chorley and South Ribble Hospital, and serves over one million people in Lancashire and Southern Cumbria.
The Jonmaster ultra microfibre system was introduced in 2009, shortly after the cleaning operation was brought in-house from an external contractor. The cleaning team wanted a set of tools to allow it to work in areas such as wards and treatment rooms while patients, visitors and staff are present. Cleaning performance and efficiency were paramount but the entire operation also had to be seen to be well-organised. The ability of Jonmaster to support these objectives was one of the criteria which Jonmaster performed highly against.  The cloths, pads and other tools that comprise the integrated system are known to remove 99.99 per cent of micro organisms from hard surfaces when used with water alone. This greatly simplifies cleaning operations and reduces reliance on chemicals. The Trust carried out on-site trials and before-and-after swabs to demonstrate the efficacy of ultra microfibre.
In the wards flat mops are used for cleaning floors while cloths are used for all other hard surfaces. Colour coding - red, blue, green, yellow - helps staff to identify and restrict cloths for different tasks. Separate cloths are used to clean each patient’s area to minimise the risk of cross infection. The unique properties of the ultra microfibre ensure it traps and removes dirt, dust and micro organisms. The reduction in dust has had a big impact on perceptions of cleanliness and hygiene among patients and visitors. Overall the Trust has saved costs although these are difficult to quantify because of changes in the organisation and processes made during the same period. Both sites use fewer products. In areas where Jonmaster is used, for example, only toilet cleaner and floor maintainer is needed.
“Jonmaster is all we use on the wards,” explains April Deravairere. “It’s easy to use, saves times and we’re not using as many chemicals.”
The Trust invested in a new laundry at Preston serving both sites to ensure proper care of the cloths. This is optimised for microfibre and helps isolate the cloths from other linen to eliminate any risk from cross-contamination. Dirty cloths and mops from each ward are segregated into colour-coded net bags. They are washed and dried in dedicated machines using fabric care products supplied by Diversey. The cloths are guaranteed for a minimum of 500 washes as long as they are laundered to the manufacturer’s specifications. In daily rotation, three sets of cloths (one in use, one in the wash, one on shelf) will last for around five years. The operation is very efficient and Diversey believes it is one of the best organised hospital microfibre laundries in the UK or even Europe.
Elsewhere floors in operating theatres, specialist treatment facilities, public areas and corridors in both hospitals are cleaned with high performance TASKI floor care equipment. The machines, which are restricted to unique areas in line with infection control requirements, include battery powered walk-behind and ride-on models operating with floor care products from Diversey’s extensive range. One of the big advantages of scrubber driers in hospitals is their ability to clean a surface and eradicate dirt and water. The dirty solution is retained inside the machine’s tank until it can be disposed of safely at a convenient location. The machines leave the floor dry and ready to be used almost immediately which is ideal in busy areas and anywhere with frail or vulnerable occupants.
“Patient choice is important and we need to demonstrate we are clean and hygienic,” says Debbie Shattock, Assistant Domestic Services Manager at Chorley Hospital.
Diversey has for some years supplied catering chemicals including products from its Safe Pack range for the Trust’s catering operations. Its hand care products are used by staff at the Chorley site. One of the main benefits of sourcing the majority of products from a single company is the simplified contact between the supplier and customer. Diversey interfaces with the Trust through a team led by account manager, Ita Hicks. The single sourcing approach also helps avoid possible confusion over who should take responsibility for an issue, a particular risk whenever multiple suppliers are involved, which means issues are resolved quickly.
“On a regular basis we have some very open and realistic conversations on how best to move forward and improve standards,” says Ita Hicks. “It’s very much a working partnership.”
The relationship between the two organisations is very established and has developed through stability within the respective teams. Diversey adds value through an integrated approach to training and support. Its products are designed to work with each other which reduces technical issues during use and optimises performance. Technical resources and support for the various aspects of the operation are provided by specialists with relevant expertise. The account management team is co-ordinated to resolve issues and can call on deeper resources through the UK business or, when required, in Europe or further afield in the company’s global operation. 
“It’s good to have a contact point because you know who you’re dealing with,” says Debbie Shattock. “In our experience if we have a problem Diversey are able to respond quickly giving good sound advice.”  
Training is arranged to make the best use of resources on both sides to reduce the length of implementation. With Jonmaster, for example, the 800+ members of the Trust’s cleaning team were trained in small groups. Otherwise training is provided to supervisors who then cascade knowledge to their teams. Jonmaster was introduced after a major organisational change at the Trust. The cleaning team recognises that the support provided by Diversey during its transition was very important. This helped promote confidence in the system, even among long serving team members who were sceptical about cleaning without chemicals, that led to the user acceptance and ownership that followed. Chris Jeffs, a Diversey building care champion, continues to visit the hospitals regularly to audit Jonmaster use and provide any support and assistance required.
“This was one of the smoothest and quickest roll-outs of Jonmaster because of the joint preparation we did with the Trust,” says Ita Hicks. “A lot of this can be attributed to the commitment and ownership of both April and Debbie to fully supporting and rolling out the Jonmaster system. This, combined with the education, training and support we provided, helped the roll out run so smoothly.”
The Trust adheres to a highly efficient cleaning programme that ensures all areas are cleaned in accordance to the National Cleaning Standards.  Routine daily monitoring and regular audit checks are carried out by the senior teams to help ensure the highest standards are maintained across both sites.  Domestic services are an integral part of the Trust strategy to ensure any infection outbreaks are dealt with in a controlled and co-ordinated way, thus reducing the need to close a ward.
The cleaning team’s performance has had a significant impact on the perceptions of cleanliness and hygiene among patients and visitors that has contributed to the overall reputation of the Trust. Domestic service staff are working towards NVQ Level 2 in cleaning within a Health Care Environment while supervisors are working towards IOSHH Working Safely Cert and will be involved in a more technical bespoke course in the near future. The achievement of these qualifications reflects the increasing professionalism among NHS staff. This high level of competence and the new products and processes employed across both hospitals ensure they are able to perform their daily cleaning tasks more efficiently and are better equipped to deal with any unexpected events.
“Cleaning with the NHS is a high priority ,” says April Deravairere. “The standards we have to achieve have increased dramatically.”