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					Document name:           Food Hygiene Policy



Portfolio                Infection control

Document type:           Policy

Staff group to whom it   All staff within the Trust
applies:

Distribution:            The whole of the Trust



How to access:           Intranet and ward folder



Issue date:              October 2008



Next review:             October 2010



Approved by:             Executive Management Team



Developed by:            Janet Marsh



Director leads:          Alan Davis



Contact for advice:      Janet Marsh, Food Hygiene Trainer
                         Joanne Bastow, Facilities Monitoring
                         Co-ordinator
                         Jackie Storer, Support Services
                         Manager
                         Alison Perring, Senior Infection
                         Prevention Practitioner
Food Hygiene
Policy
Additional information




   October 2008
INTRODUCTION

High standards of hygiene are important in relation to the production and
service of food. This is particularly important when dealing with vulnerable
people as a food poisoning outbreak could be extremely serious and fatalities
could occur.

This policy defines the standards required within all food areas of Trust
premises. It also provides a comprehensive risk assessment, identifying
potential hazards involved in handling foods and effective controls to be
adhered to. It is acknowledged that not all areas within the Trust have facilities
to provide all sections (1 – 15) referred to in this policy. Any addition to current
practices in your area should be in consultation with the Trust Food Hygiene
Team (see page 3).

It is a legal requirement that all staff involved in food handling will receive food
hygiene training commensurate with their food handling duties. Refresher
training must be sought every eighteen months to two years. The manager of the
area will be responsible for ensuring that training records are kept and are
updated for their staff.

The manager of the area will be responsible for ensuring that agreed standards
of hygiene are maintained at all times within kitchen areas and adopt standards
within this policy relevant to current practice. This policy applies to all staff
engaged in the service of food and shall be read and understood by those staff.

Each individual will be required to certify in writing that they have read
and understood the policy by completing the pro forma on the next page.
All staff must sign to certify that they have read and understood the food
hygiene policies.



   DATE               NAME (PRINTED)                   SIGNATURE
                       DESIGNATION




IT IS THE RESPONSIBILITY OF THE WARD/HOME/DEPARTMENT
MANAGER TO ENSURE ALL STAFF READ AND UNDERSTAND THE
ABOVE POLICIES.

PLEASE KEEP THIS DECLARATION AT THE FRONT OF THE FOOD
HYGIENE POLICIES.
CONTENTS                                                   Page No.

1.    Legal Requirements                                       1

2.    Personal hygiene                                         4

3.    Health of food handlers                                  7

4.    Cleaning and maintenance                                 10

5.    Pest control                                             13

6.    Use of Refrigerators and Freezers                        16

7.    General Purchase and Storage of Food Products            20

8.    Service User Meals from the Main Catering Provider       26

9.    Food Brought in by Carers and Friends                    45

10.   Guidance notes for Service Users making Beverages        46

11.   Take-away Foods                                          47

12.   Barbecues                                                48

13.   Pureed and Softened Foods and the Use of Blenders        54

14.   Parties and Functions                                    62

15.   Use of Microwave Ovens                                   65

16.   Microbiology                                             66

Appendices

1.    Hand Washing Techniques
2.    Kitchen Cleaning Schedule
3.    Fridge/Freezer Temperature Record
4.    Emergency Food Thawing Sheet
5.    Food Service Monitoring Record Sheet
1.    LEGAL REQUIREMENTS


All kitchens within Trust premises and the activities undertaken within them
will comply with standards as defined by current legislation.


Registration of Premises

All premises handling food will be registered with the local Environmental
Health Department in accordance with the Food Safety Act 1990.

The Facilities Monitoring Co-ordinator will be responsible for ensuring that
premises are registered following notification by the manager of the area.


Responsibilities

The manager of the area will be responsible for ensuring that agreed standards
of hygiene are maintained at all times within the kitchen area. However all staff
have a responsibility for ensuring that the standards are maintained by their own
actions in accordance with this policy.


Risk Assessment

The principal aim of the Risk Assessments included in this policy are to ensure
that all of the Trust’s food premises conform to Regulation 4 of The Food
Safety (General Food Hygiene) Regulations 1995. In legal terms the
assessment is known as Hazard Analysis and Critical Control Point (HACCP).

HACCP is a comprehensive assessment which is carried out to ensure food safety.
It identifies the potential hazards involved in handling foods that should be
implemented, maintained and reviewed on the basis of the following principles:

  Analysis of the potential food hazards.

  Identify the points where food hazards occur.

  Decide which of the points identified are critical to ensure food safety.

  Identify and implement effective controls and monitoring procedures at those
   critical points.

                                         1
  Review of the analysis of food hazards, the critical control points (CCPs) and
   the control and monitoring procedures periodically and whenever the
   operation changes.


The HACCP documents have been compiled as a baseline for Managers of the
area to follow. They are necessary to work towards safer working practices and
meet legislative requirements. Bacteria causing spoilage of food have not been
detailed in this Risk Assessment due to their non-pathogenic nature.

It is the responsibility of this manager to update current practices and carry out
further assessments not detailed within this document. The assessments will be
checked and advised upon during kitchen hygiene inspections. Alternatively,
further assistance or advice regarding assessments can be gained by contacting
one of the following team members:

Trust Food Hygiene Trainer                   Tel: 01924 327056

Facilities Monitoring Co-ordinator           Tel: 01924 327686

Support Services Manager                     Tel: 01924 327339

Infection Control Personnel (Appropriate Locality).

The implementation of the system will also aid in establishing a 'due diligence'
defence in the case of proposed legal action by the Environmental Health
Department.


It is of paramount importance that individual managers and staff are aware
of this policy and ensure that this system is followed.




                                        2
It is essential that before any changes are made to the function of any kitchen
the Trust’s Food Hygiene Team is contacted. Before any procedures are
changed they must be submitted to the Trust Food Hygiene Team for
assessment and approval.

The Trust Food Hygiene Team members include:
Food Hygiene Trainer                         Infection Control Nurse
South West Yorkshire M.H. Trust              Mid Yorkshire Hospital Trust
Fieldhead Hospital                           Dewsbury
Tel: 01924 327056                            Tel: 0844 811 8110 Ext. 3221

Facilities Monitoring Co-ordinator           Infection Control Nurse
South West Yorkshire M.H. Trust              Calderdale & Hudd Foundation Trust
Fieldhead Hospital                           Calderdale Royal Hospital
Tel: 01924 327686                            Tel: 01422 357171 Ext. 2376

Support Service Manager                      Infection Control Nurse
South West Yorkshire M. H. Trust             Calderdale and Hudd Foundation Trust
Fieldhead Hospital                           Huddersfield Royal Infirmary
Tel: 01924 327339                            Tel: 01484 342000 Ext 2447

Infection Control Nurse
South West Yorkshire M.H. Trust
Fieldhead Hospital
Wakefield
Tel: 01924 327063


Advisers to the Trust Food Hygiene Team include:

Consultant Microbiologist
Pinderfields General Hospital
Tel: 0844 811 8110 Ext. 2655

Consultant Microbiologist
Dewsbury and District General Hospital
Tel: 0844 811 8110 Ext. 83205

Consultant Microbiologist
Pathology Laboratory
Huddersfield Royal Infirmary
Tel: 01484 342000 Ext. 2427




                                         3
2.      PERSONAL HYGIENE


Facilities

Sufficient suitable facilities for ensuring the personal cleanliness of food
handlers shall be provided within each kitchen area. Facilities will include wash
hand basins with suitable and sufficient supply of hot and cold running water,
suitable sufficient supply of liquid soap (and dispensers) and suitable sufficient
supply of clean disposable paper towels. These items are to be used solely for
securing the personal cleanliness of food handlers and nothing else.


Handwashing

Hands are the main route for transferring food poisoning bacteria and must
therefore be kept scrupulously clean at all times.

All staff and service users handling food must wash their hands regularly
throughout the working day and especially:

      on entering the food room
      after visiting the toilet
      before handling any food or equipment
      in between handling raw and cooked food
      after combing or touching hair
      after eating, smoking, coughing or blowing their nose
      after handling waste food or refuse
      after handling cleaning chemicals
      after their break


The correct hand washing procedure is essential. The hands should be wet and a
liquid soap applied. A good lather is required and the wrists, forearms and in
between the fingers should all receive attention. See appendix 1 for hand
washing technique.

The hands should be thoroughly rinsed and dried using disposable paper towels.


                                        4
Cuts and Lesions

Persons with minor cuts/lesions, burns or sores must fully cover the wound with
a clean, coloured, waterproof dressing. Waterproof dressings may need to be
changed throughout the working day. They must not be changed in the food
area.

Protective Clothing
Clean, disposable or washable protective aprons shall be provided for use by
personnel handling food to reduce the risk of contamination of food.


Additional Information

As a feature of good practice and a legal requirement:

    Smoking will not be allowed in the food area
    Eating is only permitted in designated dining facilities
    Nails must be short and clean, nail varnish and false nails must not be
     worn
    Single use nailbrushes should be available in designated areas for single
     use only
    Food handlers must not wear jewellery, the only exception is a single
     plain band. Rings that contain stones are not permitted

All Practices should comply with the Hazard Analysis Section 2 – Personal
Hygiene (page 6).




                                       5
                                                  HAZARD ANALYSIS - PERSONAL HYGIENE

    HAZARD                 CONTROL                 CCP (S)   CRITICAL LIMITS                 CORRECTIVE              MONITORING           RESPONSIBILITY
                                                                                               ACTION
Contamination of   Health screening.              Yes        Satisfactory health        Food handlers suffering      Health               All staff and
products by poor                                             screening.                 from any food poisoning      questionnaire.       managers
personal hygiene   Provision of clean                                                   symptoms must be
practices.         protective aprons.                        All staff to be suitably   excluded from handling       Training records     Trust Hygiene Team.
                                                             trained in food safety.    food.
                   Provision of first aid                                                                            Regular
                   facilities.                               Strict adherence to        They must refrain from       inspections.
                                                             personal hygiene           food handling duties for
                   Limit jewellery, nail                     procedures.                48 hours after the           Manager to
                   varnish and other potential                                          symptoms have ceased.        regularly monitor.
                   contaminants.
                                                                                        Medical clearance must be
                   Adequate facilities for hand                                         approved.
                   washing.
                                                                                        Staff to be suitably
                   Food safety training. Staff                                          trained.
                   awareness of personal
                   hygiene practices.                                                   Counselling/re-training of
                                                                                        staff.




                                                                              6
3.       HEALTH OF FOOD HANDLERS


Food handlers suffering from possible infectious conditions likely to give rise to
food poisoning must report symptoms to their supervisor immediately and leave
the food handling area. If experiencing any of the following they must not
handle food:

        Boils
        Skin lesions or cuts
        Discharges from the eyes, ears or nose
        Diarrhoea and/or vomiting
        Heavy colds and coughs


Responsibilities

Staff with any of the above symptoms must report them to their supervisor
immediately whether on duty or off. The supervisor should then notify the
Occupational Health Department and refer the member of staff so that advice
regarding returning to work and/or exclusion from food handling duties can be
given. It is initially very difficult to be certain whether an episode of diarrhoea
or vomiting is infectious. If there is only one bout in a 24-hour period and it is
not associated with fever then it is reasonable to presume that it is not infectious
and the person may resume food-handling duties. For the clinical management
of individual cases and for public health protection appropriate investigations
such as stool sampling may be necessary. This will be co-ordinated by the
Occupational Health Department or the individual’s GP. If a member of staff’s
family have symptoms of food poisoning they must inform their supervisor who
may consult the Occupational Health Department for advice regarding food
handling duties.

The Consultant Microbiologist will notify the Consultant in Communicable
Disease Control (Proper Officer) immediately by telephone if the member of
staff involved in food handling has a positive stool specimen.

Staff suffering from symptoms of food poisoning MUST be excluded from
food handling whilst symptomatic. On occasion medical clearance may be
required from their GP/Occupational Health Department or where formal
exclusion procedures have been introduced by the Local Authority,
Environmental Health Department.
In any case, exclusion from food handling duties must continue until the
member of staff has been asymptomatic for a full 48 hours.

                                         7
There are some causes of diarrhoea which require special consideration, for
example, typhoid fever, paratyphoid fever, verocytotoxin - producing
Escherichia Coli and Hepatitis A. The investigation and management of these
individuals is usually carried out by the local authority and the Proper Officer.
It may require that food handlers remain off work for longer than previously
suggested.

If someone is unable to work because of infection but is not off sick they may
be put on medical suspension with pay.

For cases of food poisoning or suspected food poisoning, Local Authority
Environmental Health Officers will contact the member of staff to obtain a food
history in an attempt to ascertain the source of the food poisoning.


For additional information, please contact:

Leeds and South West Yorkshire
Occupational Health Department            Tel: 01977 605585/605586

Consultant Microbiologist
Mid-Yorkshire NHS Trust                   Tel: 0844 811 8110 Ext. 2655 and ICDs

Duty Professional
West Yorkshire Health Protection Agency
Seacroft Hospital
Leeds
LS14 6UH                                  Tel: 0113 2840606

Infection Control Nurse
Fieldhead Hospital                        Tel: 01924 327063
Dewsbury District Hospital                Tel: 0844 811 8110 Ext. 83221
Huddersfield Royal Infirmary              Tel: 01484 342000 Ext 2447
Calderdale Royal Hospital                 Tel: 01422 357171 Ext 2376



All practices should comply with the Hazard Analysis Section 3 – Staff
Health (page 9)




                                           8
                                                  HAZARD ANALYSIS - STAFF HEALTH

    HAZARD                 CONTROL               CCP (S) CRITICAL LIMITS               CORRECTIVE             MONITORING           RESPONSIBILITY
                                                                                          ACTION
Contamination of   Health screening.             Yes    Satisfactory health        Food handlers suffering    Health               All staff and
products by poor                                        screening.                 from any food poisoning    questionnaire.       manager.
personal hygiene   Provision of first aid                                          symptoms must be
practices.         facilities.                          All staff to be suitably   excluded from handling     Training.            Trust Hygiene Team.
                                                        trained in food safety.    food.
                   Adequate facilities for                                                                    Regular
                   handwashing.                         Strict adherence to        They must refrain from     inspections.
                                                        personal hygiene           food handling duties for
                   Staff awareness of personal          procedures.                48 hours after the         Manager to
                   hygiene practices through                                       symptoms have ceased.      regularly monitor.
                   food safety training and
                   Trust Infection Control                                         Medical clearance must
                   policies.                                                       also be approved.

                                                                                   Staff to be suitably
                                                                                   trained.

                                                                                   Counselling/Re-training
                                                                                   of staff.




                                                                          9
4.    CLEANING AND MAINTENANCE


Cleaning

Kitchens must be kept clean and tidy at all times. The individual must clean up
any spillages as they occur. Areas which are noted by staff to be less than
satisfactory must be brought to the attention of the manager of the area for
action. A suitable and sufficient supply of approved cleaning materials shall be
provided for use. Single-use wiping cloths must be disposed of after each use
and must not be left to stand in sinks or on work surfaces. Green scouring pads
must be discarded at the end of each day. All cleaning materials in use in the
kitchen will be colour coded in accordance with Trust Infection Control Policy.
This will include: mops, buckets, cloths and household gloves.

Cleaning substances available shall be strictly controlled in accordance with the
current COSHH policy and associated information (available from the line
manager). Cleaning substances must be stored separately from food items
preferably in a separate room or cupboard. Careful storage will eliminate the
risk of chemical contamination of food. Mops must be kept separate for use
only in food areas. Crockery and utensils shall be washed appropriately and left
to air dry. Cleaning shall be in accordance with the cleaning schedules as
specified in the Domestic/Housekeeping Services Contract (see appendix 2 –
Cleaning Schedule Guidance).

All items of equipment used in food service must be washed by an approved
method.


Maintenance of Equipment

Defects arising within the kitchen shall be reported immediately to the
Facilities/Estates Department for rectification. In the case of private properties,
these defects should be reported to the Landlord. The responsibility for ensuring
defects are reported and completed satisfactorily lies with the Manager of the
area. Written records of reported defects must be available.

The Facilities/Estates Departments will make annual checks on all electrical
equipment within the kitchen as a planned programme.

Contacting the on-call engineer through the usual procedure provides services
out of normal hours.



                                        10
                                                          HAZARD ANALYSIS – CLEANING

    HAZARD                   CONTROL                CCP(S)   CRITICAL LIMITS                CORRECTIVE             MONITORING           RESPONSIBILITY
                                                                                                ACTION
Contamination of      Provision of a                Yes      Staff to be suitably      Advise and re-train staff   Regular checks by    All staff.
the products or       comprehensive cleaning                 trained in cleaning       to increase awareness.      manager, Trust
ingredients by:       schedule.                              standards and use of                                  Hygiene Team         Monitoring staff.
                                                             chemicals.                                            and spot checks by
Using dirty
                      Instruction and training of                                                                  the Facilities       Service Manager
containers or dirty
                      staff in cleaning standards            Always follow advice.                                 Monitoring           (Facilities)
equipment which
                      and the use of chemicals.                                                                    Officers.
comes into contact
                                                             Strict adherence to
with food.
                      Clean up any spillages                 cleaning procedures.
                      immediately.
Dirty surfaces.
                                                             Cleaning chemicals to
                    Clean as you go.                         be stored in a separate
Chemical
                                                             cupboard.
contamination of
food through misuse Never wash utensils
of chemicals.       in the wash hand basin.
                    Always use
                    dishwasher/wash up sink.

                      Never use bleach or bleach
                      products in the kitchen.

                      Store cleaning chemicals
                      separate food.




                                                                              11
                                          HAZARD ANALYSIS – STRUCTURE AND EQUIPMENT
    HAZARD                   CONTROL             CCP(S)   CRITICAL LIMITS               CORRECTIVE           MONITORING        RESPONSIBILITY
                                                                                           ACTION
Physical or           Ensure planned             Yes      Report any faults (eg    Discuss with Facilities   Kitchen hygiene   Manager.
chemical              preventative maintenance            equipment/ structural)   Department and            inspections.
contamination of      programme is in place –             to the Facilities        individual.                                 All staff.
products or           regular checks on                   Department/Estates                                 All staff.
ingredients by the    equipment.                          Department.              Isolate and discard                         Trust Hygiene Team
premises and/or                                                                    affected food.
equipment not
maintained in sound
condition and good
state of repair.




                                                                          12
5.      PEST CONTROL


Sufficient measures must be taken to prevent pests accessing food areas and to
minimise the risk of pest infestation.

Effective measures should be provided to control pest activity within the
premises.

      An electronic fly killing unit should be suitably located and installed
       within the food areas as appropriate. (Ultra-violet tubes should be
       replaced annually to ensure their efficiency).

      Fly screens on opening windows and doors should be installed.

      Sufficient pest-proof storage facilities must be provided.

      Good housekeeping practices must be maintained.

Written records of reported problems with pest infestation must be available.
All staff must report any concerns to the Facilities/Estates Department.

For advice and information on pest control, please contact:

Monitoring Office
Facilities Department,
Fieldhead Hospital                      Tel: 01924 327338

Estates Department
Dewsbury and District Hospital          Tel: 0844 811 8110 Ext. 84156

Domestic Services
Huddersfield Royal Infirmary            Tel: 01484 342730

Catalyst Department
Calderdale Royal Hospital               Tel: 01422 224602


Disposal of Waste Food

Waste food must be disposed of immediately after each meal or snack using the
waste disposal unit or other suitable method. Waste food must not be left with
dirty crockery in the kitchen sink nor should it be left to stand in the waste
disposal unit.



                                         13
Where a waste disposal unit is not available food must be put into a lined,
lidded container. The container must be emptied at the end of each meal service
and the contents must be double bagged and then transported to a specified area
for collection/disposal. No waste food must be kept as swill or for any other
purpose.

Waste packaging must not be left to accumulate within the kitchen and must be
removed frequently. Foot operated waste bins with good fitting lids should be
provided for the temporary storage of waste materials. However, these should
be emptied when two-thirds full or at least daily as required. Hands must
always be washed after handling waste.




                                      14
                                                             HAZARD ANALYSIS – PEST CONTROL

    HAZARD                      CONTROL                     CCP(S)   CRITICAL LIMITS                 CORRECTIVE              MONITORING            RESPONSIBILITY
                                                                                                        ACTION
Contamination of       Buildings to be adequately           Yes      All areas are proofed as   Inform Facilities/Estates   Visual checks of       All staff.
the products or        proofed. Use of fly screens and               necessary.                 Departments.                incoming products.
                       insectocutors to keep premises
ingredients by:        free of flying insects.
                                                                     All food deliveries to     Monitor contractor.         Checks and reports
Infestation of the
                       Report any signs of infestation to            be checked for pest                                    by the contractor
premises by pests.     the manager of the area.                      contamination.             Reassess situation and      every 6 weeks.
Poor storage of                                                                                 arrange for re-treatment
refuse and waste       Visual checks for pest
                       contamination of delivered
                                                                     Ensure the contractor      accordingly.                Additional visits on
resulting in the       products.                                     has carried out all                                    request.
harbouring of pests.                                                 treatments.
                       Open packets of food to be                                                                           Undertake and sign
Chemicals used for     stored in pest-proof containers.                                                                     for all work by
treatment of pests.                                                                                                         contractor.
                       Clean up any food spillages.
                       Discard any leftover food in the
                       waste disposal unit.

                       Adequate provision for the
                       storage and disposal of refuse
                       and waste.
                       Empty and store waste bags in
                       the appropriate areas on a
                       regular basis.

                       Employment of competent
                       persons to carry out surveys and
                       treatments.

                       Food safety training. Staff
                       awareness of hazards from pest
                       infestations.



                                                                                      15
6.      USE OF REFRIGERATORS AND FREEZERS


Refrigerators

Refrigerators should be sited in a well-ventilated area preferably away from
heat sources and direct sunlight. They should be in good repair without cracks
to the linings, corroded shelves or damage to the cabinet. Door seals must be
clean and in good condition (not split, broken or torn). The door to the
ice-making compartment (if present) should be closely fitting and in good
repair. Refrigerators must operate between 0ºC and 4ºC and should contain an
indicating thermometer.

The operating temperature of the refrigerator should be checked daily and the
reading recorded on the Fridge/Freezer Temperature Record sheet (see appendix
3). Records should be kept for three months and can then be discarded.
Refrigerators should be defrosted on a weekly basis to ensure their efficient
operation and cleaned as per work schedule (see appendix 2).

Kitchen refrigerators are only to be used for the storage of food items and cold
beverages.

Food stored in the refrigerator must meet with the following criteria:

      It is within its date code.
      It is kept in a clean, airtight container or impervious wrapping.
      It is labelled with the name of the owner and the date that it was put into
       the refrigerator.

      It will not taint nor contaminate other foods in the refrigerator.
      It is fit for human consumption.
      It does not remain in the refrigerator for over 48 hours Unless it is
       unopened and within its use by date.

The refrigerator should not be overloaded with food. It must be remembered
that cold air within the refrigerator needs to circulate around the food to keep it
cool.

If the temperature within the refrigerator exceeds 4ºC a further check must be
made after the door has been closed for one hour. Any concerns regarding the
efficiency of the refrigerator to maintain temperatures must be reported to the

                                          16
Facilities/Estates Department without any delay. Written records of reported
inefficient refrigerators must be available for inspection.


Freezers

Freezers should be sited in a well-ventilated area away from heat sources and
direct sunlight. They should be in good repair without cracks to the linings,
corroded shelves or damage to the cabinet. Door seals must be clean and in a
good condition (not split, broken or torn).

Freezers must operate at or below -18°C and should contain an indicating
thermometer. The operating temperature of the freezer must be checked daily
and the reading recorded on the Fridge/Freezer Temperature Record sheet (see
appendix 3). Records should be kept for 3 months and then can be discarded.
Freezers should be defrosted and cleaned on a regular basis to ensure their
efficient operation.

Thawed or partially thawed food must be destroyed if not used
immediately. Food must never be re-frozen.

Faults on freezers must be reported immediately to the Facilities/Estates
Departments.

ALL foods stored in the freezer must display a date code. This will be
either:

    An expiry date on the product or

    A label displaying the date the product was placed into the freezer (used
     for fresh produce).

When defrosting fresh frozen produce, an additional date should be displayed,
stating when the product was taken from the freezer. Such foods should be used
within a 24-hour period. Frozen products must be held in accordance with the
freezer manufacturers guidelines.




                                        17
Equipment Breakdown

In the event of a power cut or refrigerator/freezer equipment breaking down a
Risk Incident form should be completed and the relevant Facilities/Estates
Department contacted. Specialised equipment/parts may be required and the
work may need to be carried out by specialist engineers.


Freezer Breakdown

If there is any evidence that a freezer may be faulty it is important that the
following procedure is followed.

During normal working hours (0800 - 1630 hrs)

1.    Faults should be reported to the Facilities/Estates Departments. An
      engineer will attend to the fault as soon as possible and if the fault
      cannot be dealt with a commercial contractor will be contacted.

2.    In the meantime ensure the door is kept closed at all times. This
      will assist in maintaining product temperature until the engineer
      arrives. After 2 hours, product temperatures should be checked and
      recorded at hourly intervals.

3.    Where product temperatures start to rise above -15°C (-15º to -13ºC) food
      should be transported to a nearby freezer. If this is in a different location,
      insulated containers or cool bags should be used to maintain temperature
      control.

4.    On arrival at this storage destination food temperatures should be checked
      and recorded using a food thermometer probe. The end of the probe
      should be placed between the packs of frozen products so that the end is
      clearly touching the surface of the product. If the temperature is -13°C or
      warmer then the food should be transferred to a refrigerator and brought
      up to a chilled state (+3°C). Temperatures must be recorded on the
      Emergency Food Thawing sheet (see appendix 4). The food must be
      cooked immediately or used within 24 hours.




                                        18
Out of hours service

1.    In the event of a break down out of normal working hours
      (1630 – 0800hrs and at weekends) the on-call engineer should be
      contacted.

2.    The person reporting the fault will be required to provide as much
      information as possible regarding the breakdown. This will enable the
      engineer to assess the fault and where necessary attend to the call.

2.    In the meantime ensure the door is kept closed at all times. This
      will assist in maintaining product temperature until the engineer
      arrives. After 2 hours, product temperatures should be checked and
      recorded at hourly intervals.

3.    Where product temperatures start to rise above -15°C (-15º to -13ºC) food
      should be transported to a nearby freezer. If this is in a different location,
      insulated containers or cool bags should be used to maintain temperature
      control.

4.    On arrival at this storage destination food temperatures should be checked
      and recorded using a food thermometer probe. The end of the probe
      should be placed between the packs of frozen products so that the end is
      clearly touching the surface of the product. If the temperature is -13°C or
      warmer then the food should be transferred to a refrigerator and brought
      up to a chilled state (+3°C). Temperatures must be recorded on the
      Emergency Food Thawing sheet (see appendix 4). The food must be
      cooked immediately or used within 24 hours.

It is advisable to avoid overstocking. This will assist in maintaining the quality
of the food and avoid waste in the event of a breakdown.




                                        19
7.    GENERAL PURCHASE AND STORAGE OF FOOD
      PRODUCTS


All food items shall be purchased from a reputable supplier and stored under
appropriate conditions so as to maintain the safety and quality of food. Stock
should be rotated and any new stock should be placed at the back of existing
stock. Stock levels must be monitored and over-stocking rectified. All goods
should be stored above floor level. The cleaning of storage areas should be
undertaken as part of the routine work schedule.

It is a legal requirement that all products bearing use by dates must be used by
the end of the day on which the date code expires. The use by date on perishable
food items is considered to be a guide as to the safety of food and an offence is
committed if they are used after this date.

All products bearing best before dates should be used before the date printed
on the packaging. This is used on longer life products and is considered to be a
guide to the quality of the food. It is important that effective stock control is
exercised at all times. Food past its best before date must be disposed of.

High Risk foods are foods that are ‘ready to eat’ (will be eaten without cooking
or other treatment that would destroy food poisoning bacteria) and require
refrigeration after purchase. They are usually moist and are high in protein.
High Risk foods include cooked meats and poultry, cooked meat products,
cream, cooked egg and custard products. (This list is not exhaustive.)


Dry Goods

Prior to purchase or on delivery check that packaging is intact and that products
are within date code. Products with damaged packaging or out of date products
should not be purchased or if received as part of a stores delivery should be
returned to the suppliers.

All open packets of dried food items such as cereals and biscuits, etc. must be
stored in clean pest proof containers which are labelled with the products expiry
date. Containers should be washed before refilling. Bread should be stored in
bread bins with closely fitting lids, which should not be over stocked so that the
lid cannot fit properly in its place. Defective storage containers must be
replaced. Stocks should be checked daily for date codes and any signs of
spoilage. Out of date stock or spoiled /damaged products must be disposed of.


                                       20
Canned Products

Prior to purchase or on delivery canned products must be checked for damage,
e.g. dents, bulges or rust and checked that they are within date code. Damaged
or out of date stock should not be purchased or if received as part of a stores
delivery should be returned to the supplier. Canned products must be checked
prior to use to ensure they are within date code. Food from part used cans
should be decanted into lidded containers, labelled with the date of opening and
placed into a refrigerator. Opened products must be used within 48 hours. Out
of date stock or damaged products must be disposed of.


Dairy Products

On delivery check that packaging is intact and that products are within date
code. Products with damaged packaging or out of date products must be
rejected and the catering contractors should be contacted for replacements.
Milk and dairy products must be refrigerated immediately after delivery.

Nutritional supplements, once opened, shall be used for immediate
consumption. Part used sachets/packets must be discarded. Butter kept at room
temperature for softening must be kept in a lidded dish, not in its wrapper. Fats
must be stored away from strong-smelling foods which may taint them.

Stock should be checked daily for date codes and signs of spoilage. Out of date
stock or spoiled/damaged products must be disposed of.


Fresh Fruit and Vegetables

Salad items should be stored in the lower part of the refrigerator where possible
in the appropriate salad container. Stocks of fresh fruit and vegetables should be
checked daily for any signs of spoilage or damage. Out of date stock or
spoiled/damaged products must be disposed of.




                                        21
                                          HAZARD ANALYSIS – AMBIENT DRIED/TINNED PRODUCTS
      RECEIPT OF DRIED/TINNED PRODUCTS FROM NHS SUPPLIES
    HAZARD           CONTROL        CCP(S) CRITICAL LIMITS                                   CORRECTIVE            MONITORING           RESPONSIBILITY
                                                                                                 ACTION
Contamination          Visual checks on packaging       No.     All packaging to be     Do not accept products     Visual checks.       All staff.
through damaged        must be carried out. Do not              sealed and intact.      that are damaged, out of
packaging allowing     accept dried products if the box                                 date or undated.
or indicating pest     or packaging is damaged, out             All canned products to
infestation.           of date or undated.                      be undamaged.          Inform/return damaged
                                                                                       products to supplier.
Contamination          Do not accept tinned products            All products to be
through damaged        if can is blown, dented, rusted,         within date code.
can.                   out of date or undated.

Out of date products

      PURCHASE OF DRIED/TINNED PRODUCTS FROM SUPERMARKET
    HAZARD          CONTROL        CCP(S) CRITICAL LIMITS                                    CORRECTIVE            MONITORING           RESPONSIBILITY
                                                                                                 ACTION
Contamination          Purchase from reputable            No.   All packaging to be     Do not purchase products   Visual checks at     All staff.
through damaged        supermarket.                             sealed and intact.      that are damaged, out of   the point of sale.
packaging allowing                                                                      date or undated.
or indicating pest     Visual checks on packaging               All canned products to
infestation.           must be carried out. Do not              be undamaged.          Use a different
                       purchase dried products if box
                                                                                       supermarket if
                       or packaging is damaged, out
Contamination          of date or undated.                      All products to be     products are outside the
through damaged                                                 within date code.      critical limits.
can.                   Do not purchase tinned
                       products if can is blown,
Out of date products   dented, rusted, out of date or
                       undated.


                                                                              22
                                                      HAZARD ANALYSIS – AMBIENT DRIED/TINNED PRODUCTS

     STORAGE OF DRIED/TINNED PRODUCTS
HAZARD       CONTROL              CCP(S)                             CRITICAL LIMITS           CORRECTIVE                  MONITORING       RESPONSIBILITY
                                                                                               ACTION
Bacterial               Visual checks on packaging must       Yes.   All packaging to be       Discard damaged packets,    Visual checks.   All staff.
contamination           be carried out. Do not use                   sealed and intact.        damaged cans and out of
                        products if packaging or can is
through broken or       damaged.
                                                                                               date products.
open packaging.                                                      All canned products to
                        Dry goods are stored in low                  be undamaged.
Mould/ bacterial        humidity areas. Use well-
growth or can           ventilated dry storage.                      All products to be
corrosion through
                                                                     within date code.
high humidity or        Part used cans must be decanted
dampness.               into lidded containers, labelled
                        with date of opening and stored in           Products to be stored
                        the refrigerator.                            as per manufacturer’s
Pest infestation with
                                                                     specification.
risk of                 Open packets must be decanted
contamination of        into pest-proof containers labelled
                        with expiry date. Do not top up              Contents of opened        Discard contents of open
product with
                        pest-proof containers. All contents          cans to be decanted in    cans stored over 48 hours
bacteria.               should be used and the container             to lidded containers
                        washed and dried before refilling.           and stored in fridge.
Out of date
                                                                     Products must be used     Report signs of pests
products.               Maintain good stock rotation
                        ensuring that products are used              within 48 hours of        immediately.
                        within date code. Do not use                 opening.
Chemical                products that are out of date or
contamination.          undated.                                     Products to be stored     Advise/retrain staff of
                        Store cleaning chemicals separate
                                                                     using stock rotation.     correct practice if
                        from food.                                                             inappropriate action
                                                                     Cleaning chemicals to     taken.
                                                                     be stored in a separate
                                                                     cupboard.


                                                                                    23
                                                              HAZARD ANALYSIS – DAIRY PRODUCTS
         RECEIPT OF DAIRY PRODUCTS FROM MAIN HOSPITAL KITCHEN

    HAZARD                    CONTROL                  CCP(S)   CRITICAL LIMITS              CORRECTIVE             MONITORING      RESPONSIBILITY
                                                                                                 ACTION
Presence of food      Clean vehicles are used for      Yes.     Maximum delivery        Reject/do not accept       Visual checks.   Delivery driver.
poisoning bacteria    transporting milk and dairy               time 1 hour.            products outside of the
in or on dairy        products.                                                         critical limits.                            Housekeeping and
products.                                                       Milk and dairy                                                      Ward Orderly staff.
                                                                products must be        Inform suppliers of
Growth of food        Milk and dairy products to be             stored in the           findings. Request                           Nursing staff.
poisoning bacteria    delivered to ward/unit within             refrigerator            replacements ensuring
due to inadequate     1 hour of leaving distribution            immediately.            date codes are monitored
temperature control   area.                                                             when received.
during
transportation.

Contamination         Visual checks on packaging                All packaging to be
through damaged       must be carried out. Do not               sealed and intact.
packaging.            accept products with
                      damaged packaging.
Out of date
products.             Do not accept out of date or              All milk and dairy
                      undated products.                         products to be within
                                                                date code.




                                                                             24
                                                               HAZARD ANALYSIS – DAIRY PRODUCTS
         STORAGE OF DAIRY PRODUCTS

     HAZARD                    CONTROL                  CCP(S)   CRITICAL LIMITS               CORRECTIVE               MONITORING            RESPONSIBILITY
                                                                                                  ACTION
Growth of food        Refrigerator temperatures are     Yes.     Dairy products are        Report any adverse          Refrigerator           All staff.
poisoning bacteria    checked and recorded daily.                stored below 5°C.         findings to the             temperature record
due to inadequate                                                                          manager/deputy of the       sheets.                In the event of a
temperature control                                              Refrigerator              area.                                              breakdown the
during storage.                                                  temperatures to be                                    Product test records   responsibility lies
                                                                 checked and recorded      In case of refrigerator     in event of a          within the
Cross -               Raw products are stored                    daily, ensuring that      failure and constant high   breakdown.             manager/deputy of
contamination from    separately from dairy                      units are operating at    temperatures, contact an                           the area.
raw products to       products.                                  between 0°C and 4°C.      engineer. Check product     Visual checks.
dairy products.                                                  Report faults if          temperature, if above
                                                                 temperature is above      8°C use within 4 hours
Cross -               Food safety training. Staff                4°C.                      of the temperature rising
contamination         awareness of personal                                                above 8°C. If you are
though physical       hygiene procedures, hand                   Store raw products        unsure, discard the
contact (e.g. dirty   washing between tasks and                  such as salad items       product. The product
hands, dirty          food safety hazards.                       separate from dairy       should be labelled
equipment,                                                       products.                 indicating time limit to
packaging).                                                                                be used.
                      Stock rotation on a daily basis            All products to be        Inform manager/deputy
Out of date           ensuring products are used                 within date code.         of the area.
products.             within date code. Do not use               Always use oldest
                      out of date or undated                     stock first.              Discard out of date
Chemical              products.                                                            products.
contamination.                                                   Cleaning chemicals to
                      Store cleaning chemicals                   be stored in a separate
                      separate from dairy products.              cupboard.


                                                                               25
8.     SERVICE USER MEALS FROM THE MAIN CATERING
       PROVIDER


This section is relevant to the Trust Premises listed below:

Calderdale Locality
Dales Unit

Dewsbury Locality
Priestley Unit

Huddersfield Locality
All service user areas on the St Luke’s Hospital Site

Wakefield Locality
All service user areas on the Fieldhead Hospital Site



Cook-chill, cook-freeze and chilled ready to eat food should be handled and
serviced in accordance with current Department of Health guidelines.
Staff must always wear protective clothing to reduce the risk of physical
contamination.


Training

Staff involved in food handling duties i.e. regeneration and serving of cook-chill
and cook-freeze food, preparation and serving of snacks, sandwiches and salads
and serving of ready to eat foods must hold the Level 2 Award in Food Safety in
Catering certificate (formerly the Foundation Certificate in Food Hygiene).
Staff must attend food safety refresher training every 18 months to 2 years in
order to keep their Food Safety certificate valid. Where staff allow a period of
over 3 years to lapse without attending food safety refresher training the Food
Safety certificate will no longer be valid and they will be required to attend the
Food Safety certificate course again.

Staff involved in minimal food handling duties i.e. serving of beverages and
biscuits are not required to hold the Level 2 Award in Food Safety in Catering
certificate but must attend a food safety refresher training course every 18
months to 2 years.


                                        26
Receiving Cook-Chill Food

All cook-chill food received from the Catering Contractor should be recorded
using the Food Service Monitoring Record sheet (see appendix 5). These
records must be kept for 3 months.

This sheet is a legal document as defence of ‘due diligence’ in food
poisoning outbreaks as identified in Food Safety training sessions.

Appropriate members of Trust staff involved in the process of receiving food
must check the food received and must record the information on the Food
Service Monitoring Record sheet as they check the food.


The procedure below must be followed for the receipt of cook-chill food:

    Ensure that the insulated container is clean and that packaging of
     products is intact (covered/sealed). Food should be delivered within 1
     hour of leaving the main distribution area.

    Quantities of food items should be checked against the list of items on the
     ward/unit master order sheet. Check use-by dates and record all
     information on the Food Service Monitoring Record sheet.

    Check the temperature of each container of food using a food
     thermometer probe. Clean the probe prior to testing each food type using
     a food grade probe wipe.

    Probe each container of food at the densest point. (The tip of the stainless
     steel probe must be inserted approximately half way into the depth of
     food being probed to obtain an accurate measurement).

    Cook-chill products above 8ºC must be rejected.

    Record all temperatures on the Food Service Monitoring Record sheet.

    Contact the Catering Contractor to have replacements despatched directly
     to ward/unit for any:

         a) Shortfall items
         b) Damaged/uncovered/out of date food
         c) Food that has been received above 8ºC


                                       27
    In areas where cook-chill food is stored after delivery for a second meal
     service, it is essential that correct temperature control is maintained and
     food should be placed in a refrigerator or where a refrigerator is not
     available kept in the insulated container.


Receiving Cook-Freeze Food (e.g. Ready Frozen Meals)

All cook-freeze food received from the Catering Contractor should be recorded
using the Food Service Monitoring Record sheet (see appendix 5). These
records must be kept for 3 months.

This sheet is a legal document as defence of ‘due diligence’ in food
poisoning outbreaks as identified in Food Safety training sessions.
Appropriate members of Trust staff involved in the process of receiving food
must check the food received and must record the information on the Food
Service Monitoring Record sheet as they check the food.

Clean insulated boxes should be placed in the chiller overnight in order to
transport food in the appropriate conditions. (This is the suppliers
responsibility).

The procedure below must be followed for the receipt of cook-freeze food:

    Ensure that the insulated container is clean and that packaging of
     products is intact (covered/sealed). Food should be delivered within 1
     hour of leaving the main distribution area.

    Quantities of food items should be checked against the list of items on the
     ward/unit master order sheet. Check that food is within its date code and
     that there are no signs of pest infestation or freezer burn. Record all
     information on the Food Service Monitoring Record sheet.

    Frozen food that is going to be regenerated immediately does not need to
     be probed and can be recorded as ‘frozen’ on the Food Monitoring
     Record sheet.

    Frozen food that has thawed or is partially thawed must be rejected.




                                      28
    Contact the Catering Contractor to have replacements despatched directly
     to the ward/unit for any:

         a) Shortfall items
         b) Damaged/uncovered/out of date food
         c) Food that been received thawed or partially thawed

    In areas where frozen food is stored after delivery for a second sitting at a
     meal service, it is essential that correct temperature control is maintained
     and food should be placed in a refrigerator or where a refrigerator is not
     available kept in the insulated container.

    In areas where frozen food is stored after delivery for the next meal
     service, it is essential that correct temperature control is maintained and
     food must be placed in a freezer immediately.



Receiving Chilled/Ready to Eat Products

All ready to eat food that is received from the Catering Contractor should be
recorded using the Food Service Monitoring Record sheet (see appendix 5).
These records should be kept for 3 months.

This sheet is a legal document as defence of ‘due diligence’ in food
poisoning outbreaks as identified in Food Hygiene training sessions.

Appropriate members of Trust staff involved in the process of receiving food
must check the food received and must record the information on the Food
Service Monitoring Record sheet as they check the food.

The procedure below must be followed for the receipt of ready to eat food:

    Ensure that the insulated container is clean and that the packaging of
     products is intact (covered/sealed). Food should be delivered within 1
     hour of leaving the main distribution area.

    Quantities of food items must be checked against the list of items on the
     ward/unit master order sheet.

    Check use-by dates and record all information on the Food Service
     Monitoring Record sheet.
     Chilled items made up by the contractor i.e. sandwiches, salad items or
     portions of cold pudding items e.g. gateaux, that are not labelled with a
                                       29
      manufacturers label or use by date, must be used at that particular meal
      and any unused items must be discarded after the meal service.

    Products must be stored in the refrigerator as soon as possible after
     delivery to maintain temperature control and kept under these conditions
     until required.

    Any chilled products must be used in date order by the use by date and
     any new products should be placed to the back of any existing stock.

    Contact the Catering Contractor to have replacements despatched directly
     to the ward/unit for any:

         a) Shortfall items
         b) Damaged/uncovered/out of date food



Receiving Hot Pre-Cooked Food

All pre-cooked food received from the Catering Contractor should be recorded
using the Food Service Monitoring Record sheet (see appendix 5). These
records should be kept for 3 months.

This sheet is a legal document as defence of ‘due diligence’ in food
poisoning outbreaks as identified in Food Hygiene training sessions.

Appropriate members of Trust staff involved in the process of receiving food
must check the food received and must record the information on the Food
Service Monitoring Record sheet as they check the food.

The procedure below must be followed for the receipt of pre-cooked food:

    Ensure that the insulated container is clean and that the product is
     covered.

    Quantities of food items must be checked against the list of items on the
     ward/unit master order sheet.

    Check the temperature of each container of food using a food
     thermometer probe. Clean the probe prior to testing each food type using
     a food grade probe wipe.


                                     30
    Probe each container of food at the densest point. (The tip of the stainless
     steel probe must be located approximately half way into the depth of food
     being probed to obtain an accurate measurement).

    Pre-cooked products below 64ºC must be rejected.

    Record all temperatures on the Food Service Monitoring Record sheet.

    Contact the Catering Contractor to have replacements despatched directly
     to the ward/unit for any:

         a) Shortfall items
         b) Damaged/uncovered food
         c) Food that has been received below 64ºC



Regeneration/Cooking of Food

Cook-chill and cook-freeze food should be regenerated under carefully
controlled conditions in particular time and temperature control. Regeneration
equipment should be provided to reflect this. All regenerated food must be
temperature checked before it is served and the temperatures recorded on the
Food Service Record sheet (see appendix 5). These records must be kept for 3
months.

This sheet is a legal document as defence of ‘due diligence’ in food
poisoning outbreaks as identified in Food Safety training sessions.

Appropriately trained staff and not service users must carry out regeneration of
cook-chill/cook-freeze food. Staff involved in this food process should always
wear protective clothing to reduce the risk of physical contamination and hold
the Level 2 Award in Food Safety in Catering certificate (formerly the
Foundation Certificate in Food Hygiene).

The Regeneration of cook-chill and cook-freeze food is a very specialised
process and must be separate from rehabilitation cooking at all times.

Cook-freeze and cook-chill food should be handled and serviced in accordance
with current Department of Health guidelines.




                                       31
The following procedure must be followed for regenerating/cooking of food:

   1. If applicable, preheat the hostess trolley 30 minutes prior to completion of
      the regeneration cycle.

   2. Pre-heat the regeneration oven.

   3. Regenerate the food following the manufacturer’s instructions for
      working the oven.

   4. On completion of the cooking cycle check the temperature of each
      container of food using a food thermometer probe. Clean the probe prior
      to testing each food type using a food grade probe wipe.

   5. Probe each container of food at the densest point ((the tip of the stainless
      steel probe must be located approximately half way into the depth of the
      food being probed to obtain an accurate measurement) to ensure that
      temperatures are in excess of 75ºC for 30 seconds.

   6. Always probe for areas which may not have reached the required
      temperature (‘cold spots’), e.g. at the sides or in the middle of each
      container.

   7. Record all temperatures on the Food Service Monitoring Record sheet.

   8. Foods not reaching 75ºC for 30 seconds MUST undergo further
      regeneration for 5-10 minutes until the correct temperature is reached.
      Any food not reaching 75ºC for 30 seconds after a maximum of 3
      ‘boosting’ periods should be discarded. The incident must be reported in
      the comments section of the Food Service Monitoring Record sheet.


Re-heating Ambient Tinned Products

Tinned products (e.g. baked beans) should be emptied into a clean pan and
reheated using a hot plate. The above procedure for cooking food should be
followed from point 4 onwards.

Any reheated product which is unused should be discarded immediately after
food service.




                                        32
Serving/ Hot Holding Food

It is important that time and temperature factors are controlled to ensure that
food remains safe. Staff serving food should always wear protective clothing to
reduce the risk of physical contamination and hold the Level 2 Award in Food
Safety in Catering certificate (formerly the Foundation Certificate in Food
Hygiene).

The procedure below must be followed when serving/hot holding food:

    Hot food must not be served below 64ºC.

    Food service should commence within 15 minutes of completion of the
     regeneration/cooking process to maintain quality of the food.

    If commencement of food service has exceeded 15 minutes a temperature
     check of the food items should be made. If the food is found to be below
     64ºC at this point, the affected food must be discarded and the incident
     reported in the comments section of the Food Service Monitoring Record
     sheet (see appendix 5).

    All food should be served within 45 minutes of the commencement of
     food service.

    If an incident occurs on the service user area which delays/interrupts food
     service once the food is in the hostess trolley, it can remain in the
     hot/switched on hostess trolley until the incident is over. Food should be
     re-probed before serving to service users to ensure that it has kept at 64ºC
     or above

    In order to maintain temperature control and prevent physical
     contamination ensure that plated food is covered when transporting to
     service users that are eating in different areas.


Unused Food

The procedure below must be followed for any food not used during the meal
service:

    All cook-freeze/cook-chill food not consumed during the meal service
     must be discarded at the end of the meal service.


                                       33
   All sandwiches and salads that have been made up at ward level must
    be discarded after each meal service.

   All 24 hour sandwiches that have been out on display must be
    discarded after each meal service.

   24 hour sandwiches are provided by the catering contractors in sealed
    plastic cartons that have a use-by date printed on the packaging. Provided
    these sandwiches have not been out on display and have been kept in the
    refrigerator they can be used as follows:

         24 hour sandwiches that are delivered for the lunch time meal
          service can be served at the lunchtime meal or at the evening meal.
          These sandwiches must be discarded after the evening meal
          service.

         24 hour sandwiches that are delivered for the evening meal service
          can either be served at the evening meal or used during the night.
          These sandwiches must be discarded after the breakfast meal
          service.

   All high risk ready to eat products (e.g. fresh cream cakes, trifles, egg
    custards) must be discarded after each meal service.

   Any yoghurts and jellies that have been out on display must be
    discarded after each meal service.

   Any yoghurts and jellies that have been kept under refrigeration can be
    stored in the refrigerator until their use-by date.

   Any unopened low risk confectionery (e.g. cake bars, muffins) may be
    saved up to their Best-Before date. These products must be stored in pest
    proof containers.


Calibrating of Food Probes

Temperature probes will be calibrated at least every 3 months by the
Facilities/Estates Department.




                                     34
                     HAZARD ANALYSI – COOK-CHILL PRODUCTS FROM THE MAIN CATERING PROVIDER
       RECEIPT OF COOK-CHILL FOOD BY TRUST STAFF FROM MAIN HOSPITAL KITCHEN

   HAZARD                      CONTROL                  CCP(S)   CRITICAL LIMITS                 CORRECTIVE           MONITORING          RESPONSIBILITY
                                                                                                     ACTION
Presence of food      Clean, chilled insulated boxes    Yes      Maximum                   Reject/do not accept       Food service        Delivery driver.
poisoning bacteria    are used for transporting cook-            transportation time 1     products outside the       monitoring record
in or on food.        chill food in order to maintain            hour.                     critical limits.           sheets.             Housekeeping and
                      good temperature controls.                                                                                          Ward Orderly staff.
                                                                                           Inform supplier of         Visual checks.
Growth of food        Food is delivered to the
                                                                                           findings. Request                              Nursing staff.
poisoning bacteria    ward/unit within 1 hour of
                      leaving distribution area and              Temperature on            replacements ensuring
due to inadequate
                      must not exceed this time                  receipt to be no higher   product temperatures and
temperature
                      before being regenerated.                  than 8ºC.                 date codes are monitored
control during
                                                                                           when received.
transportation.
                      Temperatures are checked and               In areas where no
                      recorded on receipt of food.               refrigerated storage is
Contamination
                                                                 available, insulated
through damaged       Food boxes to remain                       boxes must remain
packaging.            unopened until required for                unopened until food is
                      food regeneration or food to be            to be regenerated.
Out of date           transferred to a refrigerator.
products.
                      Visual checks on packaging
                      must be carried out. Do not                All packaging to be
                      accept products with damaged               sealed and intact.
                      packaging.
                                                                 All cook-chill food to
                      Do not accept out of date or               be within date code.
                      undated products.



                                                                                35
                     HAZARD ANALYSIS – COOK-CHILL PRODUCTS FROM MAIN CATERING PROVIDER
       STORAGE OF COOK-CHILL FOOD FOR SECOND MEAL SERVICE

   HAZARD                    CONTROL                 CCP(S)   CRITICAL LIMITS                  CORRECTIVE           MONITORING          RESPONSIBILITY
                                                                                                   ACTION
Presence of food     In areas where refrigerated     Yes      Refrigerator               Reject/do not accept       Food service        Housekeeping and
poisoning bacteria   storage is available, food is            temperatures to be         products outside the       monitoring record   Ward Orderly staff.
in or on food.       stored at below 5ºC.                     checked daily              critical limits.           sheets.
                                                              ensuring units are                                                        Nursing Staff.
Growth of food       Refrigerator temperatures                operating at between       Inform suppliers of        Refrigerator
poisoning bacteria   to be checked and recorded               0 ºC and 4ºC. Report       findings. Request          temperature
due to inadequate    daily.                                   faults if temperature is   replacements ensuring      records sheets.
temperature                                                   above 4ºC.                 product temperatures and
control during       In areas where insulated                                            date codes are monitored
storage.             boxes are used for storage,              In areas where no          when received.
                     food is re-heated within 1               refrigerated storage is
                     hour of being received.                  available, insulated
                                                              boxes must remain
                     Chilled insulated boxes                  unopened until food is
                     remain unopened until                    to be regenerated.
                     required and then
                     temperatures of food                     Temperatures of food
                     products are checked prior               products must be
                     to loading the oven.                     checked prior to
                                                              loading the oven.
                                                              Reject products if they
                                                              are above 8ºC.
                                                              (Record time and
                                                              temperatures).



                                                                              36
                             HAZARD ANALYSIS – FROZEN FOOD FROM MAIN CATERING PROVIDER
       RECEIPT OF FROZEN FOOD FROM MAIN HOSPITAL KITCHEN

    HAZARD                   CONTROL                    CCP(S)   CRITICAL LIMITS                CORRECTIVE             MONITORING          RESPONSIBILITY
                                                                                                     ACTION
Presence of food     Clean, chilled insulated boxes     Yes.     Maximum                   Reject products outside     Food service        Delivery driver.
poisoning bacteria   are used for transporting                   transportation time 1     the critical limits.        monitoring record
in or on food.       frozen foods in order to                    hour.                                                 sheets.             Housekeeping and
                     maintain good temperature                                             Inform the Catering                             Ward Orderly staff.
Growth of food       controls.                                   Temperature on            supplier of findings.       Visual checks
poisoning bacteria                                               receipt to be no higher   Request replacement                             Nursing staff.
                     Temperature checks prior to
in thawed or         distribution and on receipt at              than -13ºC.               products ensuring product
partially thawed     the ward/unit area.                                                   date codes are monitored
products due to                                                                            when received.
inadequate           Do not accept thawed or
temperature          partially thawed products.
control during       Ensure that all products are
transportation.      frozen solid.

Dehydration of       Do not accept products
products stored      containing ice particles as this
                     is a sign of poor temperature
with damaged
                     control.
packaging.
                     Visual checks on packaging                  All packaging to be
Product              must be carried out. Do not                 sealed and intact.
deterioration if     accept products with
stored too long.     damaged packaging

Out of date          Do not accept out of date or                All frozen food to be
products.            undated products.                           within date code.


                                                                                37
              HAZARD ANALYSIS – CHILLED READY TO EAT PRODUCTS FROM MAIN CATERING PROVIDER
       RECEIPT OF CHILLED READY TO EAT PRODUCTS FROM MAIN HOSPITAL KITCHEN

   HAZARD                   CONTROL                CCP(S)   CRITICAL LIMITS                 CORRECTIVE       MONITORING          RESPONSIBILITY
                                                                                                ACTION
Presence of food     Clean, insulated chilled      Yes.     Maximum delivery          Reject/do not accept   Food service        Delivery driver.
poisoning bacteria   boxes are used for                     time of 1 hour.           products outside the   monitoring record
in or on food.       transporting chilled ready                                       critical limits.       sheets.             Housekeeping and
                     to eat food in order to                                                                                     Ward Orderly staff.
Growth of food       maintain good temperature                                        Inform suppliers of    Visual checks.
poisoning bacteria   controls.                              Chilled ready to eat      findings, request                          Nursing staff.
due to inadequate                                           products must be          replacements.
temperature          Food to be delivered to the            stored in the
control during       ward/unit within 1 hour of             refrigerator as soon as
transportation.      leaving distribution area.             possible.

Contamination        Food is delivered to the
through damaged      ward/unit as near to food
packaging.           service time as possible.

Out of date          Visual checks of packaging             All packaging to be
products.            must be carried out. Do not            sealed and intact.
                     accept products with
                     damaged packaging.
                                                            All ready to eat
                     Do not accept out of date              products to be within
                     or undated products.                   date code.




                                                                           38
             HAZARD ANALYSIS – CHILLED READY TO EAT PRODUCTS FROM MAIN CATERING PROVIDER
          STORAGE OF READY TO EAT PRODUCTS FROM MAIN HOSPITAL KITCHEN
     HAZARD                  CONTROL                  CCP(S) CRITICAL LIMITS               CORRECTIVE              MONITORING          RESPONSIBILITY
                                                                                              ACTION
Growth of food       Refrigerator temperatures to    Yes     Chilled foods are       Report any adverse            Refrigerator        All Staff.
poisoning bacteria   be checked and recorded                 stored at below 5°C.    findings to the               temperature record
due to lack of       daily.                                  Check and record        manager/deputy of the         sheets.             In the event of a
temperature and                                              fridge temperatures on area.                                              breakdown the
time control.        Sandwiches and salads are               a daily basis, ensuring                               Product test        responsibility lies
                     used within 2 hours of being
                                                             units are operating at  In case of refrigerator       records in event of with the
                     delivered. Discard all unused
                     sandwiches (except 24 hour              between 0°C and 4°C. failure and constant high        a breakdown.        manager/deputy of
Cross-
                                                                                     temperatures, contact an                          the area.
contamination from sandwiches) and salads after
                     the food service.                       Sandwiches (except      engineer. Place products      Visual checks.
raw products to
                                                             24 hour sandwiches)     on hold, inform
ready to eat foods.
                     Raw products are stored                 and salads are used     Manager/Deputy of the
                     separately to ready to eat              within 2 hours of       area.
Cross-               foods.
contamination                                                being delivered.        Check product
                                                                                     temperature, if above 8°C
through physical     Food safety training. Staff             Store raw products      use within 4 hours of the
contact (e.g. hands, awareness of personal
                                                             such as salad items     temperature rising above
dirty equipment,     hygiene procedures, hand
                                                             separate from ready to 8°C. If you are unsure,
packaging).          washing between tasks and
                     food safety hazards.                    eat products.           discard the product. The
                                                                                     product should be labelled
                     Stock rotation on a daily basis         All products to be      indicating time limit to be
Out of date
                     ensuring products are used              within date code.       used.
products.
                     within date codes. Do not use           Always use oldest
                     out of date or undated                  stock first.            Discard out of date
                     products.                                                       products.
                                                             Cleaning chemicals to
Chemical             Store cleaning chemicals                be stored in a separate
contamination.       separate from food.                     cupboard.

                                                                             39
              HAZARD ANALYSIS – CHILLED READY TO EAT PRODUCTS FROM MAIN CATERING PROVIDER
         PREPARATION OF READY TO EAT PRODUCTS FROM MAIN HOSPITAL KITCHEN

     HAZARD                     CONTROL                  CCP(S)   CRITICAL LIMITS                CORRECTIVE            MONITORING         RESPONSIBILITY
                                                                                                     ACTION
Growth of food         Limit exposure time at ambient    Yes.     Do not prepare food       Discard any food if left   Manager/Deputy     All staff.
poisoning bacteria     (room temperature) during                  too far in advance of     after a 2-hour period.     by observations.
due to lack of         preparation, return products to            food service. Limit to                                                  Manager/Deputy.
temperature control.   chilled storage immediately                be within the hour and
                       after preparation.                         in any event not
                                                                  exceed 2 hours.
Cross-                 Separate preparation areas for
contamination from     raw and ready to eat products.
                                                                  Strict adherence to
raw products to
                       Wash hands before handling                 procedures at all
ready to eat foods.
                       foods and between tasks.                   times.
Cross-
                       Keep handling to a minimum.
contamination
through physical       Prepare food with clean
contact (e.g. hands,   utensils and equipment. Use
dirty equipment,       colour coded equipment.
packaging).
                       Maintain a high standard of
Chemical               cleaning of food contact
contamination.         surfaces.
                       Keep cleaning chemicals away               Cleaning chemicals to
                       from food.                                 be stored in a separate
                                                                  cupboard.
                       Food safety training. Staff
                       awareness of preparation
                       hazards.


                                                                                 40
                                                                HAZARD ANALYSIS – HOT PRECOOKED FOOD
         RECEIPT OF HOT PRE-COOKED FOOD FROM MAIN HOSPITAL KITCHEN

    HAZARD                       CONTROL                 CCP(S)   CRITICAL LIMITS               CORRECTIVE          MONITORING         RESPONSIBILITY
                                                                                                    ACTION
Growth of food          Clean insulated boxes are        Yes.     Food to be delivered     Reject//do not accept   Food service        Delivery driver.
poisoning bacteria if   used for transporting hot pre-            to ward/unit             products outside the    monitoring record
temperature of hot      cooked food in order to                   immediately.             critical limits.        sheets.             Housekeeping and
food is not             maintain good temperature                                                                                      Ward Orderly staff.
maintained.             controls.                                                          Inform supplier of      Visual checks.
                                                                                           findings. Request                           Nursing staff.
Contamination           Food is delivered to the                                           replacements ensuring
through uncovered       ward/unit immediately after                                        product temperatures
food.                   leaving distribution area.                                         and date codes are
                                                                                           monitored when
Out of date food        Visual checks to ensure food              All food products to     received.
products.               is covered. Do not accept                 be covered.
                        products that are uncovered.
                                                                  All hot pre-cooked
                        Do not accept out of date or              food to be within date
                        undated products.                         code.

                        Food temperatures are                     Temperature on
                        checked and recorded on                   receipt to be no lower
                        receipt of food.                          than 64°C.

                        Hot pre-cooked food is
                        placed into pre-heated hostess
                        trolley.



                                                                                41
                           HAZARD ANALYSIS – REGENERATING COOK-CHILL/COOK-FREEZE FOODS

         RE-HEATING COOK-CHILL AND COOK-FREEZE FOOD FROM MAIN HOSPITAL KITCHEN

    HAZARD                    CONTROL               CCP(S)   CRITICAL LIMITS            CORRECTIVE           MONITORING          RESPONSIBILITY
                                                                                           ACTION
Survival of            Where possible, food is      Yes.     Food is cooked to a   Extend cooking time to    Food service        All staff.
pathogenic bacteria.   placed into pre-heated                minimum temperature   achieve a core            monitoring record
                       ovens.                                of 75ºC for 30        temperature of 75ºC for   sheets.
                                                             seconds.              30 seconds.
                       Food temperatures are
                       monitored and recorded to
                       a minimum core
                       temperature of 75ºC for 30
                       seconds.

                       Food cooked on hot plates
                       must be cooked thoroughly
                       and temperatures
                       monitored and recorded to
                       a minimum core
                       temperature of 75ºC for 30
                       seconds.




                                                                          42
                                       HAZARD ANALYSIS – AMBIENT DRIED/TINNED PRODUCTS

         RE-HEATING OF DRIED AND TINNED PRODUCTS

    HAZARD                    CONTROL                CCP(S)   CRITICAL LIMITS            CORRECTIVE           MONITORING          RESPONSIBILITY
                                                                                            ACTION
Survival of            Food reheated on hot plates   Yes.     Food is cooked to a   Extend cooking time to    Food service        All staff involved in
pathogenic bacteria.   must be cooked thoroughly              minimum temperature   achieve a core            monitoring record   cooking process.
                       and temperatures                       of 75°C for 30        temperature of 75°C for   sheets.
                       monitored and recorded to              seconds.              30 seconds.
                       a minimum core
                       temperature of 75°C for 30
                       seconds.




                                                                           43
                                                                  HAZARD ANALYSIS – SERVERY
       HOT HOLDING AND SERVICE OF COOKED FOOD
     HAZARD          CONTROL        CCP(S) CRITICAL LIMITS                                           CORRECTIVE           MONITORING          RESPONSIBILITY
                                                                                                         ACTION
Bacterial growth if     Cooked/re-heated food is placed    Yes.     Never place hot food        If food service has       Visual checks.      Trust staff who serve
temperature of hot      into pre-heated hostess trolley.            into a cold hostess         exceeded 15 minutes                           food.
food is not                                                         trolley. Pre-heat trolley   check temperature is      Food service
                        Food service to commence within             for at least 30 minutes
maintained.             15 minutes of completion of the                                         above 63ºC.               monitoring record   Manager/Deputy.
                                                                    before placing                                        sheets.
                        cooking/re-heating process to
                        ensure the quality of the food.             cooked/re-heated food
Contamination of                                                                                If temperature is below                       Food Hygiene Team.
                                                                    in/or ensure automatic
food with bacteria                                                  cycle is operational.       64ºC affected food must
                     All food to be served within 45
from dirty utensils. minutes of commencement of
                                                                                                be discarded.                                 Monitoring staff.
(See Hazard          food service.                                  Hot food to be held
Analysis–Cleaning).                                                 above 63ºC.                 Counselling/re-training
                        Use clean utensils and crockery.                                        staff.
Physical                                                            Food service to
                        Discard all unused food                     commence within 15
contamination.          immediately after food service.
                                                                    minutes of completed
                        Never re-heat or keep food after
                        food service.                               cooking process.

                        Staff to wear appropriate                   Maximum food serving
                        protective clothing.                        time 45 minutes from
                                                                    commencement of food
                        Food safety training. Staff                 service.
                        awareness of personal hygiene
                        procedures, hand washing                    Strict adherence to
                        between tasks and food handling             personal hygiene and
                        hazards.
                                                                    food safety procedures.




                                                                                     44
9.      FOOD BROUGHT IN BY CARERS AND FRIENDS


Relatives and visitors should be discouraged from bringing in high risk foods
for service users, for example, chicken portions, meat pies, cooked meats, cream
and custard preparations, meat sandwiches and egg products, etc. (This list is
not intended to be exhaustive).

However, where foods are brought in and need to be stored in the refrigerator,
they should all be:

      Placed into a clean, airtight container or wrapped in foil, cling film or a
       plastic bag.

      Labelled with the date, time and name of the service user.

      Consumed within 24 hours or by the use by date if less than this.



Service users and visitors should not be allowed access to the refrigerator unless
supervised.


If staff are aware that service users have consumed food brought in by the
relatives, details of the date and time of consumption should be documented in
the service users notes. This is to allow a food history to be taken should the
service user suffer from symptoms of food poisoning.


If the person in charge of the area considers the food unsuitable, the service user
and relative should be advised of this fact and discouraged from eating the food.
If the service user or relative insists that the food is eaten, this advice should be
documented in the service users notes.


If in any doubt, contact a member of the Trust Food Hygiene Team.




                                         45
10.    GUIDANCE NOTES FOR SERVICE USERS MAKING
       BEVERAGES


This policy defines the standards that need to be met where service users make
beverages.

The manager of the area is responsible for ensuring that a high standard of
hygiene is maintained at all times within the area.

Only persons who have the consent of this manager shall have access to
beverage kitchens. This would normally include all staff and those service users
who have been assessed to assure their safety in the kitchen area.

Beverage kitchens shall be kept clean and tidy at all times. All spillages should
be cleaned up as they occur by the individual creating the spillage.

Areas that are noted as being unsatisfactory should be brought to the attention of
the manager of the area.

Crockery and utensils must be washed under suitable conditions and dried
thoroughly before storage.

Provisions such as milk or fruit juice must be kept under refrigerated conditions
between 0°C and 4°C.

An indicator thermometer should be situated within the refrigerator. This must
be monitored and the temperature recorded daily on the Fridge/Freezer
Temperature Record sheet (see appendix 3).

Dried products e.g. coffee, sugar etc. should be stored in airtight containers.
These should be washed regularly and not simply refilled.

Used tea bags should be disposed of immediately in to the waste bin.




                                        46
11.   TAKE-AWAY FOODS


When dealing with service users it is important that staff are aware that they are
potentially susceptible to acquiring an infection.

The following advice must be adhered to:

    Food should be purchased from a reputable supplier.

    The food should be consumed immediately after purchase and on no
     account should food be reheated or saved.

    A record in the individual’s notes should be made of the food eaten, the
     date and time of consumption and from where it was purchased. This will
     allow a full food history to be taken in the event of an individual(s)
     suffering from symptoms of food poisoning.

    If service users insist food is saved/consumed against advice, this should
     also be documented in their notes.

    If all the service users have eaten a take-away meal from the same place
     this may be recorded in the diary of the area as a single entry or if it has
     replaced the normal meal provided by the catering provider, the Food
     Service Monitoring Record sheet (see appendix 5) can be used.

    The majority of take-away foods, both hot and cold are considered high
     risk.

    It is the responsibility of the manager of the area to ensure that adherence to
     this policy is maintained at all times.


If in any doubt, contact a member of the Food Hygiene Team.




                                         47
12. BARBECUES


This guidance relates to the practice of barbecue functions on Trust Property.

An individual must be identified as being responsible for organising the event.
This includes the purchase and storage of provisions and supervision of the
activity. This individual must hold a current Level 2 Award in Food Safety in
Catering certificate (formerly the Foundation Certificate in Food Hygiene).

Advice must be sought prior to organising the event from:

Food Hygiene Trainer, Tel: 01924 327056
Facilities Monitoring Coordinator, Tel: 01924 327686
Support Services Manager, Tel: 01924 327339
Infection Control Personnel (Locality)

The following advice must be adhered to:

    Provisions should be purchased from a reputable supplier on the same
     day as the event (preferably to arrive on the unit as near to the event as
     possible).

    Prior to purchase check that all packaging is sealed/intact and that
     products are within date code. Never purchase products that show signs
     of incorrect temperature control (e.g. condensation within packs, warm
     products or packs that are stacked above the refrigerator storage line).

    It is important that products maintain adequate temperature control and
     should be transported using insulated boxes or cool bags.

    Meats, salads and other perishable food must be stored in the refrigerator
     or kept in separate cool bags with ice packs until just before the food is
     ready to be cooked or eaten. Salads should be washed and then served at
     the last minute.


It is important that any food consumed is documented correctly. A written
record should be kept of all food purchased, cooked and served. An itemised
till receipt can be used as proof of where and when the food was purchased.




                                        48
All other details relating to the food must be recorded on the Food Service
Monitoring Record sheet (see appendix 5). These records must be kept for 3
months.

This is a legal document as defence of ‘due diligence’ in food poisoning
outbreaks as identified in Food Hygiene training sessions.


Cooking

    Light the barbecue well in advance. Make sure you use enough charcoal
     and wait until it is glowing red (with a powdery grey surface) before
     starting to cook.

    Keep raw and cooked food apart at all times.

    Don’t handle cooked food with utensils that have touched raw meats or
     put cooked or ready to eat food on plates that have held raw meats.

    Only those foods which can be cooked easily and thoroughly should be
     purchased. Raw poultry with bones in must not be used.

    Personnel involved in cooking food should have a minimum of Level 2
     Award in Food Safety in Catering certificate training.

    During cooking, turn food often. If it starts to burn on the outside raise
     the grill height or reduce the heat of the charcoal (dampen coals slightly
     or partially close air vents).

    Food must be cooked in batches relevant to the number of people
     attending.


Serving

    When the meat is ready to be served it should be examined to ensure that
     it is thoroughly cooked. Each meat product should be broken open using
     a knife and examined to ensure the centre of the meat is thoroughly
     cooked. All food types should be randomly probed (see procedure for
     probing cooked food page 31) to ensure the temperatures are in excess of
     75ºC for 30 seconds. The temperatures should be recorded on the Food



                                       49
   Service Monitoring Record sheet to ensure due diligence. Records
   should be kept for three months and then can be discarded.
   Foods not reaching 75ºC for 30 seconds must undergo further cooking
   until the correct temperature is reached.

 Proper hand washing facilities must be conveniently accessed nearby and
  used regularly.

 Use clean utensils and crockery that have not been in contact with raw
  food.

 Keep serving bowls covered to protect them from dust, insects and pets.

 All left over perishable food must be discarded in a proper manner.

 All waste food must be disposed of promptly in a proper manner.




                                   50
                                                              HAZARD ANALYSIS – BARBECUES
      PURCHASE AND TRANSPORTATION OF RAW MEAT
    HAZARD          CONTROL        CCP(S) CRITICAL LIMITS                                       CORRECTIVE                MONITORING             RESPONSIBILITY
                                                                                                    ACTION
Presence of food       Purchase from a reputable supplier.   Yes.   Suppliers display      Use a different supplier      Visual checks at the All staff.
poisoning bacteria                                                  cabinets to operate    if the products are           point of sale.
                       Clean insulated boxes/cool bags are
in or on food.         used to transport raw meat in order
                                                                    within temperatures of outside the critical limits
                       to maintain adequate temperature             -1°C to +1°C.          or the temperature            Keep records of
Growth of food         control.                                                            readouts are not              products purchased
poisoning bacteria                                                  All packaging to be    displayed on the              for at least 1 month.
due to inadequate      Check the temperature readouts on            sealed and intact.     cabinets.
                       display cabinets.
temperature control
during storage at      Do not purchase products in dirty            All raw meat to be
suppliers and during   refrigerators with signs of poor             within date code.
transportation.        temperature control (e.g.
                       condensation within packs, warm              Maximum
                       products, packs stacked above the
Contamination          storage line).
                                                                    transportation time 1
through damaged                                                     hour from time of
packaging.             Visual checks on packaging must              purchase.
                       be carried out. Do not purchase
Out of date            products with damaged packaging.             Raw meat to be stored
products.              Do not purchase products that are
                                                                    in refrigerator
                       out of date or undated.                      immediately.

                       Products to be purchased on the day          Products to be
                       as near to the event as possible.            purchased on the day
                       After purchasing, products should
                       be transported back to the unit
                                                                    of the event.
                       immediately and stored in the
                       refrigerator.

                       Record food purchased.



                                                                                  51
                                                              HAZARD ANALYSIS – BARBECUES
        STORAGE OF RAW MEAT

    HAZARD                    CONTROL                  CCP(S)   CRITICAL LIMITS                 CORRECTIVE             MONITORING          RESPONSIBILITY
                                                                                                   ACTION
Growth of food        Refrigerator temperatures are    Yes.     Raw products are           Discard products outside   Refrigerator         All staff.
poisoning bacteria    checked and recorded daily.               stored in refrigerator     of the critical limits.    temperature record
due to inadequate                                               at below 5°C.                                         sheets.
temperature control   Raw products to be placed in                                         Dispose of products
during storage.       covered containers and stored             Refrigerators              which have come into       Visual checks on
                      separately on the bottom shelf            temperatures to be         contact with raw meat      storage.
Cross-                of the refrigerator away from             checked daily              products or blood or raw
contamination from    high risk and ready to eat                ensuring that units are    product packaging.
raw to high risk or   foods or stored in cool boxes             operating at between
ready to eat foods.   and used within 1 hour of                 0°C. to 4°C. Report
                      being purchased.                          faults if temperature is
Contamination                                                   above 4°C.
through damaged       Products to be used on the
packaging.            day of purchase, as soon as               Raw products are
                      possible after purchasing.                stored in covered
                                                                containers separate
                      Visual checks on packaging                from high risk and
                      to be carried out. Do not use             ready to eat foods.
                      products with damaged
                      packaging.                                Raw products are used
                                                                on same day as
                      Left over products are to be              purchased.
                      disposed of.

                      Food safety training. Staff
                      awareness of storage hazards.


                                                                              52
                                                          HAZARD ANALYSIS – BARBECUES
      PREPARATION, COOKING AND SERVING OF MEAT
    HAZARD           CONTROL        CCP(S) CRITICAL LIMITS                                   CORRECTIVE             MONITORING         RESPONSIBILITY
                                                                                               ACTION
Cross-                Ensure that barbecue charcoal is   Yes.   Strict adherence to                                Food service        All staff.
contamination from    hot enough to cook raw meat               policies, guidance and                             monitoring record
raw to high risk or   (e.g. cobbles of charcoal should          procedures.                                        sheets.
ready to eat foods.   be grey).

                      Store raw meat away from any
Contamination of
                      high risk or ready to eat foods.
food through          Always ensure products are kept
physical contact      in covered containers prior to
(e.g. dirty hands,    cooking.
dirty utensils).
                      Separate utensils and crockery
Survival of food      to be used for raw and cooked
poisoning bacteria    products.                                 Food is cooked to a      Extend cooking time to
                                                                minimum core             achieve a core
                      Wash hands before handling
                                                                temperature of 75ºC      temperature of 75ºC for
                      products and between tasks.
                                                                for 30 seconds.          30 seconds.
                      Cooked food temperatures are
                      monitored and recorded to a               Food is to be served
                      minimum core temperature of               immediately after core
                      75ºC for 30 seconds.                      temperature is         Counselling/re-training
                                                                achieved.              of staff.
                      Food to be served immediately
                      after cooking.

                      Food safety training. Staff
                      awareness of cooking/handling
                      hazards.



                                                                             53
13. PUREED AND SOFTENED FOODS


High standards of hygiene are extremely important in relation to the production
and service of food. This is particularly important when foods are being pureed
or softened as they are often required by service users who are more susceptible
to infection.


PUREED FOODS

A pureed diet should only be used after consultation and agreement with the
dietician and as part of a care plan (Refer to Trusts Food and Nutrition policy).
Food must be pureed in a food processor, preferably with a hand blender which
can be easily cleaned and can withstand the dishwashing process. This
equipment must only be used when staff are satisfied that it is thoroughly clean.

Foods must be pureed immediately after cooking/regeneration and probing of
the food item. The task must be performed as quickly as possible to ensure safe
temperatures are maintained. This food should be served immediately after this
process (Refer to section 8 for the cooking and probing of food).

Please note that ready prepared pureed meals may be purchased from the
Catering Provider.


USE OF BLENDERS

Only blenders that can be thoroughly cleaned after use and are able to withstand
the dishwashing process should be purchased. This equipment should be ‘PAT’
tested by the Facilities/Estates Department prior to initial use.

In order to maintain safe temperatures a hand blender is preferred. Staff must be
satisfied that the blender is cleaned thoroughly prior to its use. Blenders should
be used, cleaned and maintained in accordance with the Manufacturer’s
Instructions.

Advice can be sought from:

Food Hygiene Trainer, Tel: 01924 327056
Facilities Monitoring Co-ordinator, Tel: 01924 327686
Support Services Manager, Tel: 01924 327339
Infection Control Personnel (Locality).


                                       54
SOFTENED FOODS

For the purpose of this policy, a soaking solution is a liquid (water, fruit juice
etc.) that is poured over food to alter the defined consistency without pureeing
the food.

Soaking of food items must be carried out by staff who have been trained in
food hygiene procedures and soaking techniques.

The following list outlines the procedure.

    Wash hands prior to preparing the liquid product and between tasks.

    Ensure utensils/crockery/plate covers are clean and easily available.
     Ensure work surfaces are clean.

    Make up the solution (125ml liquid to one level scoop of thickening
     powder) and pour the solution into a shallow dish.

    Place the food item into the solution for ten seconds, turning to
     thoroughly coat it. Then place onto a clean plate. Cover with a plate
     cover or cling film and label with the date and time. This will be served
     to the individual service user.

    Place the food into the refrigerator for two hours to allow to soften.
     Store on the top shelf of the refrigerator. Each food item should be
     individually portioned on to separate plates.

    If a number of portions of the same product are required, ie cake, this can
     be dipped into the same solution and individually plated, using the above
     procedure.

    New soaking solution must be made up for different food items, to reduce
     the risk of any potential cross-contamination between food products.

    Discard the soaking solution once used and make fresh for different
     products or different snack times.

    Any soaked food not served within four hours must be discarded.

NB This process must be completed within twenty minutes of
commencement.

                                       55
Only the following food items can be used with the thickening solution:

      Plain cake, ginger cake or marble cake
      Plain biscuits – digestive, shortbread, rich tea
      Sandwiches with meat paste, cheese spread or jam
      Cream crackers

Soaking solution can be made up using water, oxo/bovril, diluted/flavoured
water or flavoured supplement drinks.




                                      56
                                                               HAZARD ANALYSIS – PUREED FOODS
         PREPARATION AND SERVING OF PUREED FOODS

     HAZARD                     CONTROL                 CCP(S)   CRITICAL LIMITS            CORRECTIVE             MONITORING     RESPONSIBILITY
                                                                                                 ACTION
Growth of food          Food is pureed immediately      Yes.     Food is pureed         Discard food outside of   Visual checks   All staff.
poisoning bacteria if   after cooking to ensure safe             immediately after      the critical limits.
temperature of hot      temperatures are maintained.             cooking.
food is not
maintained.             Pureed food is served                    Food is served
                        immediately after processing.            immediately after
Cross                                                            pureeing.
contamination of        Food is processed using clean
food through            equipment.                               Strict adherence to
physical contact                                                 personal hygiene and
(e.g. hands, dirty      Food safety training. Staff              food safety
equipment).             awareness of personal                    procedures.
                        hygiene procedures, hand
Physical                washing between tasks and
contamination.          food safety hazards.




                                                                              57
                      HAZARD ANALYSIS - SOFTENING FOOD PRODUCTS USING SOAKING SOLUTION
         RECEIPT OF THICK ‘N’ EASY FROM N.H.S. SUPPLIES – CONTAINERS AND SACHETS

    HAZARD                  CONTROL               CCP(S)   CRITICAL LIMITS            CORRECTIVE             MONITORING      RESPONSIBILITY
                                                                                         ACTION
Contamination       Visual checks on packaging    Yes      All packaging to be   Do not accept products     Visual checks.   All staff.
through damaged     must be carried out. Do not            sealed and intact.    that are damaged, out of
containers or       accept products that are                                     date or undated.
sachets.            opened or damaged.                     All products to be
                                                           within date code.     Reject and return
Damaged packaging Do not accept products that                                    product to supplier.
allowing or       are out of date or undated.
indicating pest                                                                  Inform unit manager of
infestation.                                                                     findings.

Out of date
products.




                                                                         58
                        HAZARD ANALYSIS - SOFTENING FOOD PRODUCTS USING SOAKING SOLUTION
         STORAGE OF THICK ‘N’ EASY – CONTAINERS AND SACHETS

     HAZARD                    CONTROL              CCP(S)    CRITICAL LIMITS              CORRECTIVE               MONITORING          RESPONSIBILITY
                                                                                             ACTION
Bacterial             Visual checks on containers   Yes      All containers and        Discard products outside   Visual checks.       All staff.
contamination         and sachets must be carried            sachets to be             of the critical limits.
through damaged or    out. Do not use product if             undamaged.                                          Kitchen inspections
open packaging.       container or sachet is                                           Report any signs of pests by Trust hygiene
                      damaged.                                                         immediately.              team.
Mould or bacterial                                           Do not use products
growth from storage Store product in a cool, dry,            that have been stored
in high humidity or well ventilated area.                    in humid or damp
damp conditions.                                             conditions.

Pest infestation with Check for signs of pest                Do not use products
risk of bacterial     infestation.                           that show signs of
contamination or                                             pest infestation.
physical
contamination.
                                                             All products to be
Out of date           Store product using stock              within date code. Use
products.             rotation. Do not use out of            oldest stock first.
                      date or undated products.
Chemical                                                     Cleaning chemicals to
contamination.        Store cleaning chemicals               be stored in a separate
                      separate from food                     cupboard.




                                                                           59
                      HAZARD ANALYSIS - SOFTENING FOOD PRODUCTS USING SOAKING SOLUTION
          PREPARATION OF SOAKING SOLUTION – (THICK ‘N’ EASY ADDED TO WATER/FRUIT JUICE, ETC.)
     HAZARD                    CONTROL                CCP(S) CRITICAL LIMITS              CORRECTIVE           MONITORING       RESPONSIBILITY
                                                                                             ACTION
Growth of food       Soaking solution to be used      Yes    Strict adherence to     Discard opened dry       Observation by    All staff
poisoning bacteria   within 20 minutes of                    procedures at all times product after 3 months.  Unit Manager or
due to lack of       preparation.                                                                             deputy            Unit
temperature control.                                         Once soaking solution Any opened                                   Manager/deputy.
                     Separate preparation areas for          is made up, use as      supplementary drinks
                     raw and ready to eat products.
Cross                                                        required for soaking    used as liquid for
contamination from Wash hands before preparing               food products.          soaking solution must be
raw products         the soaking solution and                Discard any left over   discarded after use.
                     between tasks. Keep handling            soaking solution
Cross-               to a minimum.                           immediately after use. Discard all unused
contamination                                                                        soaking solution once
through physical     Prepare product with clean              Maximum time for        the food item is
contact (e.g. hands, utensils and equipment. Ensure          prepared soaking        prepared.
dirty equipment,     scoop is not stored in container        solution to remain at
packaging).          with the product. Food safety           room temperature 20
                     training. Staff awareness of            minutes.                Discard soaking solution
                     preparation hazards.                                            after 20 minutes.
Physical                                                     Use opened containers Make up fresh soaking
contamination.       Keep dry product in purchased
                                                             within 3 months.        solution as required.
                    packaging. Once opened use
                    within 3 months. Label with
                    date of opening.                        Do not allow dry
                                                            product to get damp.
                    Maintain a high standard of
Chemical            cleaning.                               Cleaning chemicals to
contamination.      Store cleaning chemicals away           be stored in a separate
                    from the made up soaking                cupboard.
                    solution.



                                                                          60
                            HAZARD ANALYSIS – SOFTENING FOOD PRODUCTS IN SOAKING SOLUTION
         SOAKING AND STORAGE OF FOOD ITEMS IN SOAKING SOLUTION
     HAZARD                       CONTROL                       CCP(S)    CRITICAL LIMITS               CORRECTIVE              MONITORING           RESPONSIBILITY
                                                                                                          ACTION
Growth of food         Limit exposure time at ambient           Yes      Strict adherence to        Report any adverse        Visual checks by      All staff.
poisoning bacteria     (room) temperature.                               procedures at all times.   finding to Unit Manager   Unit Manager or
due to lack of         Label the soaked food with the date
                                                                                                    or deputy.                deputy.               Unit
temperature control.                                                     Maximum time for                                                           Manager/Deputy.
                       and time before placing into the
                                                                         soaked food to remain at   Discard any soaked food   Kitchen inspections
                       refrigerator. Soaked food to be used
                       within 4 hours.                                   room temperature 20
Cross-                                                                                              that has remained at      by Trust hygiene
                       Refrigerator temperatures to be                   minutes.
contamination from                                                                                  room temperature in       team.
                       checked and recorded daily.
raw products.                                                            New soaking solution to    excess of 20 minutes.
                       Separate preparation areas for raw                be used for different                                Refrigerator
Cross-                 and ready to eat or high-risk                     food items.                Discard any soaked food   temperature record
contamination          products. Use colour coded                                                   if left after 4-hour      sheets.
through physical       equipment. Store raw and ready to                 Soaked food to be          period.
                       eat products separate in refrigerator.            served within 4 hours.
contact (e.g. hands,
dirty equipment,       New soaking solution to be used for
packaging).            different food items.                             Refrigerator
                                                                         temperatures to be
                       Wash hands before handling foods                  checked daily ensuring
                       and between tasks.                                that units are operating
Physical               Keep handling to a minimum.                       at between 0°C. to 4°C.
contamination.                                                           Report faults if
                       Prepare food with clean utensils                  temperature is above
                       and equipment.                                    4°C
                       Food safety training. Staff
                       awareness of hazards.
Chemical                                                                 Cleaning chemicals to
Contamination.         Maintain a high standard of                       be stored in a separate
                       cleaning. Store cleaning chemicals                cupboard.
                       away from foods.



                                                                                        61
14. PARTIES AND FUNCTIONS


The following policy is intended to promote the provision of safe food to
service users. It is intended to be used only when a special function or
party is to occur.

During the planning stages of the function, advice must be sought from:

Trust Food Hygiene Trainer, Tel 01924 327056
Facilities Monitoring Co-ordinator, Tel: 01924 327686
Support Services Manager, Tel; 01924 327339
Infection Control Personnel (Locality).


Purchase of Food for Service User Parties and Functions

    Food should be preferably obtained from the catering contractor as
     the food products are strictly monitored.

    When choice of food is not available from the normal catering
     contractor it must be purchased from a reputable supermarket.
     Food should be purchased on the same day as the event and
     wherever possible the temperature readouts on the refrigerator
     cabinets should be checked to ensure that chilled ready to eat
     products have been stored at below 5°C. Prior to purchase check
     that packaging is intact and that products are within date code. It is
     important that chilled ready to eat products maintain adequate
     temperature control and should be transported using insulated
     boxes or cool bags. Products must arrive at the ward/unit within
     one hour of leaving the supermarket and should be stored in the
     refrigerator immediately.
     A written record should be kept of all foods that have been
     purchased from supermarkets. An itemised till receipt can be used
     for this purpose.

    Due to potential for poor temperature and time controls no ‘home
     made’ foods will be permitted.

    High risk food must be refrigerated immediately after purchase.




                                    62
Suggested foods to be avoided:

       -   Dips
       -   Soft cheeses (i.e. those which have not been pasteurised)
       -   Paté
       -   Raw meat or raw fish

In certain areas it is not recommended to have high-risk foods due to
inadequate refrigeration storage space (i.e. domestic size refrigerator
which is unable to maintain a temperature of 4°C or below).

High risk foods are usually:

      Ready to eat and require no further cooking
      Moist
      High in protein
      Need to be stored in the refrigerator or kept hot above 63°C.

Examples of High Risk Foods include:

       -   Trifles,
       -   Fresh cream cakes/buns
       -   Sausage Rolls.
       -   Cooked Rice and pasta dishes
       -   Mayonnaise products such as coleslaw and potato salads.

This list is not exhaustive.


Purchase of Food for Staff Parties and Functions

    Food should be preferably obtained from the catering contractor as
     the food products are strictly monitored.

    Where outside catering contractors are used these must be chosen
     from the approved list of catering contractors. This list is available
     from:

       Education Centre Reception, Fieldhead Tel: 01924 327095

       Facilities Monitoring Co-ordinator
       Tel: 01924 327686

       Catering contractors who have not been approved by the Trust
       must not be used.


                                     63
    When choice of food is not available from the normal catering
     contractor it must be purchased from a reputable supermarket.

    High risk food must be refrigerated immediately after purchase.


Preparation and Serving of Food

An individual must be identified as being responsible for organising the
event. This individual must hold a current Level 2 Award in Food Safety
in Catering certificate (formerly the Foundation Certificate in Food
Hygiene).

    Hands must be thoroughly washed prior to handling of food.

    Prepared cold foods must be kept in the refrigerator until
     commencement of the function.

    Food must only be prepared in the kitchen area and then
     refrigerated or eaten immediately after preparation.

    A disposable colour coded apron must be worn.

    Food must not be prepared too far in advance and where
     reasonably practical should be prepared within the hour prior to the
     function. In any event, food must be eaten within a period of
     two hours from the end of preparation.

    Any person suffering sickness, diarrhoea, cold or skin conditions
     must not prepare food.

    Any food left over after the party/function must be immediately
     discarded.

    A list of all the food products consumed by the service users must
     be documented in the unit diary or nursing notes.




                                   64
15. USE OF MICROWAVE OVENS


The use of microwave ovens should be discouraged because of hygiene
and safety considerations. However it is accepted that in a ‘rehabilitation-
type setting’ in order to maintain and develop independent living skills,
microwaves may be required. The Kitchen Hygiene Team would approve
their use for service users in such areas.

    Microwaves in ward/unit kitchens and staff rooms must only be
     used for cooking or reheating food for staff.

    Microwave ovens must never be used for re-heating food
     provided by the catering contractor for service users under any
     circumstances.

    Microwave ovens must never be used to re-heat ‘takeaway’ foods
     for service users.


Cleaning

    All internal surfaces of the microwave oven, including the door
     should be cleaned thoroughly after each use.

    Particular attention should be paid to the door seals which should
     completely seal the oven when the door is closed.

    A mild detergent can be used to clean the microwave if necessary.

    The glass tray or turntable should be washed after use.

    The outside of the microwave, handles and hinges will also require
     regular cleaning.

    Never use scouring pads or other abrasives to clean the inside of
     the oven.




                                    65
16. MICROBIOLOGY


SALMONELLA

Incubation period:   12 to 72 hours

Common Symptoms:     Diarrhoea, vomiting, abdominal pain and fever.

Source:              Gastrointestinal tract of wild and domestic animals,
                     birds (especially poultry), reptiles, sewage and
                     occasionally humans.

Transmission:        Raw or undercooked poultry, meat and eggs,
                     unpasteurised milk. Person to person spread can occur
                     if personal hygiene is poor.

Other information:   Secondary cases are common in outbreaks.



CAMPYLOBACTER
Incubation period:   1 to 11 days (usually 2 to 5 days).

Common symptoms:     Abdominal pain, severe diarrhoea (which may be
                     blood stained), nausea and fever.

Source:              Gastrointestinal tract of birds (particularly poultry) and
                     animals, cattle, domestic pets and sewage.

Transmission:        Raw or undercooked meat (especially poultry),
                     unpasteurised milk, bird-pecked milk, contaminated
                     water and infected domestic pets. Person to
                     person if personal hygiene is poor.

Other information:   Campylobacter is the most common identified cause of
                     food poisoning.




                                 66
LISTERIA
Incubation period:   3 to 70 days.

Symptoms:            Symptoms can range from mild flu-like illness to
                     meningitis and septicaemia. In pregnant women,
                     miscarriage or birth of an infected child may occur.

Source:              Listeria is widely present in the environment. It is
                     found in soil, vegetation, raw milk, meat, poultry, soft
                     cheeses, patés, and salad vegetables. It is also found in
                     the guts of animals and humans.

Transmission:        Eating of contaminated food products.

Other information:   Unlike most other food poisoning bacteria, listeria can
                     grow at low temperatures and can grow in the fridge at
                     temperatures below 5°C. Thorough cooking of food and
                     pasteurisation of products will destroy Listeria. Listeria
                     can be life threatening for susceptible groups i.e. people
                     whose immune systems are compromised, young
                     children, old people and pregnant women. People in
                     these groups are advised to avoid certain foods, such as
                     soft cheeses and patés, because of the risk of severe
                     infection.



BACILLUS CEREUS
Incubation period:   1 to 16 hours.

Symptoms:            Abdominal pain, vomiting, diarrhoea and nausea.

Source:              Cereals, soil and dust.

Transmission:        Cereal products, rice and dried foods. Risks occur when
                     cooked foods have not been cooled quickly and
                     effectively prior to storage.

Other information:   Bacillus cereus can form spores. These are not easily
                     destroyed by heat and will survive cooking. If food is
                     cooled slowly or kept warm for some time before
                     serving, the spores will germinate and produce bacteria.
                     Bacteria can multiply rapidly at these temperatures and
                     produce a very heat resistant toxin, which will not be
                     destroyed by subsequent reheating.




                                 67
CLOSTRIDIUM PERFRINGENS
Incubation period:   8 – 22 hours (usually 12 to 18 hours)

Symptoms:            Diarrhoea and abdominal pain.

Source:              Gastrointestinal tract of animals, soil, dust, sewage,
                     animal manure, raw meat and raw poultry.

Transmission:        Cooked meat and poultry, meat products and gravy
                     that have been undercooked or subjected to inadequate
                     temperatures after cooking, during cooling, during
                     storage or during reheating.

Other information:   Clostridium perfringens can form spores. These are not
                     easily destroyed by heat and can survive cooking.
                     Clostridium perfringens also produce a toxin in the
                     human guts which causes illness.



ESCHERICHIA COLI 0157
Incubation period:   1 – 6 days.

Symptoms:            Diarrhoea may be bloody, stomach cramps, fever,
                     haemorrhagic colitis and haemolytic uraemic
                     syndrome.

Source:              The gastrointestinal tract of cattle and other farm
                     animals.

Transmission:        Contaminated foodstuffs – minced beef and beef
                     products (e.g. undercooked beef burgers), unpasteurised
                     milk and cheese. Contact with infected animals on
                     farms or in animal sanctuaries. Person to person
                     spread can occur if personal hygiene is poor,
                     particularly in households, nurseries and infant schools.

Other information:   Most of the E-Coli bacteria that are found in the human
                     intestine are harmless but E-Coli 0157 produce toxins
                     that can cause severe illness and death.




                                   68
NOROVIRUS

Incubation period:         24 to 48 hours.

Symptoms:                  Projectile vomiting, diarrhoea, abdominal pain, fever.

Source:                    Gastrointestinal tract of humans

Transmission:              Person to person by the faecal oral route or from
                           aerosols of projectile vomit, environmental
                           contamination and contaminated food and water.

Other information:         Norovirus were previously known as Norwalk virus or
                           Small Round Structured Viruses (SRSVs).



References

Health Protection Agency web page.
Foodlink web page.




                                       69
APPENDICES
Appendix 2
                                                              Appendix 2


                        KITCHEN CLEANING SCHEDULE


            ITEM                 TYPE OF CLEAN                 FREQUENCY

Cupboards                   Check clean                  Daily
                            Thorough clean               Weekly

Dishwasher                  Filters and door seals       Daily
                            Thorough clean               Weekly

Electric hob                Check clean                  After each use
                            Through clean                Weekly

Fixtures and Fittings       Check clean                  Daily
                            Through clean                Weekly

Food Probe Thermometers     Through clean                After each use

Floor                       Check mop                    After each meal service
                            Damp mop                     Daily
                            Scrub                        Weekly

Fridge                      Check clean                  Daily
                            Thorough clean               Weekly

Freezer                     Defrost and thorough clean   Periodically

Hostess Trolley             Check clean                  After each use
                            Through clean                Weekly

Microwave Oven              Check clean                  After each use
                            Thorough clean               Weekly

Oven                        Check clean                  After each use
                            Thorough clean               Weekly

Sinks                       Thorough clean               After each use

Walls                       Check clean                  Daily
                            Thorough clean               Weekly

Waste Bins                  Empty and check clean        After each meal service
                            Thorough clean               Weekly

Waste Disposal Unit         Thorough clean               After each use

Work Surfaces               Thorough clean               After each use
                                                                                                      Appendix 3
                                          South West Yorkshire Mental Health NHS Trust


                                           FRIDGE/ FREEZER TEMPERATURE RECORD


 Date            Fridge 1         Fridge 2         Freezer          Time          Signature   Corrective action taken
               Temperature      Temperature      Temperature




Operating temperatures must be checked daily.   Fridges must operate at between 0°C and 4°C
                                                Freezers must operate at or below -18°C
                                                                         Appendix 4
                   South West Yorkshire Mental Health NHS Trust


                EMERGENCY FOOD THAWING SHEET
DATE:


      Time                Temperature of Food                      Signature




All food should be checked for sign of thawing on arrival at storage destination.

Any food that shows signs of thawing should be transferred to a refrigerator and used
within 24 hours or cooked immediately.

Temperature on arrival at storage destination must be no higher than -13°C
                                                                                                                            Appendix 5
                                                    South West Yorkshire Mental Health NHS Trust


                                                FOOD SERVICE MONITORING RECORD
DATE:                                   WARD:                                                            NUMBER OF SERVICE USERS SERVED:

MEAL SERVICE:
       MENU ITEM                 Portions    Use by      Time       Temp       Serving     Serving    Unserved          Comments         Initials
                                 received     date      loading    loading      time        temp      portions




N.B. Reject chilled products received over 8˚C. Order replacements from kitchen. Record temperatures of replacements.
All food must be reheated to above 75˚C           Large Box = 6 Portions          Small Box = 3 Portions

				
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