Deficiencies in Kitchen Hygiene and Food Storage Practices
Penalty
Summary
The facility failed to ensure proper hygiene practices were followed by staff working in the kitchen, specifically in the dishwashing area. Observations revealed that staff members handling soiled dishes did not wash their hands or change gloves before handling clean and sanitized dishes. This was observed on multiple occasions over several days, with staff members moving directly from handling soiled items to clean items without appropriate hand hygiene. The Dietary Manager was present during some of these observations but did not intervene to correct the staff's actions. Additionally, the facility did not adhere to proper food safety and storage procedures for a resident. The resident was observed with rotten fruit on her bedside table for two days, which she intended to eat later. The Director of Nursing acknowledged that the resident was difficult and did not allow staff to remove the food, but stated that the staff should have reported the situation to a nurse or to her. The facility's policy requires nursing staff to discard perishable foods within three days or before the expiration date, and to discard any food showing signs of potential foodborne danger. The facility's policies on dishwashing and handwashing were not followed, as evidenced by the lack of handwashing between handling soiled and clean dishes. The Dietary Manager provided policies that outlined the need for maintaining dishwashing machines in a clean condition and for staff to practice good handwashing to minimize the risk of foodborne illness. However, these policies were not adhered to during the observed incidents, contributing to the deficiencies noted in the report.
Plan Of Correction
On the Certified Dietary Manager (CDM) provided education to the identified dietary staff on proper hygiene when working in the dish room with dirty/soiled and clean dishes. This included proper glove use and washing before putting gloves on or after taking gloves off. The Certified Dietary Manager (CDM) initiated education on hygiene and proper glove use with the other dietary staff. In addition, dietary staff were provided information about the dish machine that included the facility has a low temperature, chemical sanitizing dish machine. The education was completed by The Registered Dietician reviewed and provided input for updates related to the facility policy for Handwashing for Dietary Staff. The Certified Dietary Manager/designee is doing a minimum of 3 observations per week for 12 weeks related to dietary staff hygiene compliance when they are working with dirty/soiled dishes and clean dishes while in the dish room. The Certified Dietary Manager/designee will review the observations with the monthly Quality Assurance Performance Improvement (QAPI) Committee for three months. The Quality Assurance Performance Improvement committee will evaluate the outcome of the audits and if necessary, amend the improvement plan and continue to monitor until substantial compliance has been determined by the committee. On , Resident #14 was assessed for any potentially hazardous food at bedside. No adverse effects noted. On , all resident rooms were assessed to ensure that there was no potentially hazardous food at bedside. No additional areas of concern identified. On , the current policy related to Storage of Foods Brought to Residents by Family/visitors was reviewed and updated. The Director of Nursing (DON)/designee initiated education for Department Heads, nursing, and housekeeping staff related to food storage at bedside/in the resident room. The education was completed by The Director of Nursing/designee will complete 10 observations each week for 12 weeks to ensure that there is no potentially hazardous food being stored at bedside in a resident's room. The Director of Nursing/designee will review the audits with the monthly Quality Assurance Performance Improvement (QAPI) Committee for three months. The Quality Assurance Performance Improvement committee will evaluate the outcome of the audits and if necessary, amend the improvement plan and continue to monitor until substantial compliance has been determined by the committee.