TRUST INFECTION CONTROL COMMITTEE

SECTION: 18 INFECTION CONTROL POLICY/PROCEDURE: 18.17 NATURE AND SCOPE: SUBJECT: POLICY AND PROCEDURE - TRUST WIDE PEST CONTROL This Policy has been produced in line with the Infection Control requirements that govern the Trust s duties and management responsibilities for control of pests on premises occupied by the Trust. DATE OF LATEST RATIFICATION: 14 JUNE 2016 RATIFIED BY: TRUST INFECTION CONTROL COMMITTEE IMPLEMENTATION DATE: JUNE 2016 REVIEW DATE: MAY 2019 ASOCIATED TRUST POLICIES AND PROCEDURES: Trust Health Safety and Welfare Policy - 16.01 Control of Substances Hazardous to Health (COSHH) - 16.06 Management of Waste - 16.08 Infection, Prevention & Control - 8.05 ISSUE 1 JUNE 2016 1

UNOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST UPEST CONTROL UCONTENTS 1.0 Scope 2.0 Introduction 3.0 Policy Principles 4.0 Definitions 5.0 Duties & Responsibilities 5.1 Chief Executive 5.2 Infection Prevention and Control Teams 5.3 Heads of Estates and Facilities 5.4 Estates/Facilities Managers 5.5 Contractors (Local and Forensic Services) 5.6 Trust Staff 5.7 Helpdesk (Local and Forensic Services) 6.0 Basic Pest Prevention & Control Principles 7.0 Implementation/Monitoring Compliance 8.0 Guidance/Procedural Documentation 9.0 Training 10.0 Target Audience 11.0 Review Date 12.0 Consultation 13.0 Equality Impact Assessment 14.0 Champion & Expert Writer 15.0 Legislation Compliance 16.0 References/Source Documents Appendix 1 Information on Common Pests Appendix 2 Vermin Control Proforma Appendix 3 Record of Changes Appendix 4 Record of Employee having read the Policy ISSUE 1 JUNE 2016 2

UNOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST UPEST CONTROL Pest Control 18.17 1.0 USCOPE 1.1 This policy covers all Trust owned, leased or informally occupied premises, these can be solely occupied or shared with other organisations. Where properties are not owned by the Trust, the Duty Holder with regards to Pest Control will ensure that the Landlord fulfils their obligations under the NHS Management Executive Pest Control Management for the Health Service HSG(92)35. 2.0 UINTRODUCTION 2.1 The presence of pests can be offensive, present infection, contaminate foodstuffs, damage materials and structure or be a nuisance. Once established, pests can be difficult and costly to deal with. Satisfactory standards of Pest Control in both clinical and non-clinical areas are an integral part of providing an optimum environment for the delivery of good quality patient care. Nottinghamshire Healthcare NHS Foundation Trust recognises its legal obligation to take necessary measures to prevent the risk of pest infestation in all food storage, distribution and catering areas and to ensure good standards of Pest Control in all other areas of its sites. 3.0 UPOLICY/PROCEDURE PRINCIPLES 3.1 Prevention is better than control, and the Trust and its contractors will adopt procedures to rid Trust premises of existing infestation and thereafter, by pro-active work, maintain this position. 3.2 The policy should be read in conjunction with the appropriate local procedures. 3.3 The Trust recognises its legal obligation to take necessary measures to prevent the risk of pest infestations in all food storage, distribution and catering areas, and to ensure good standards of Pest Control in all other areas of its sites. 4.0 UDEFINITIONS 4.1 Trust Premises - applies to all buildings, sites, work areas and grounds owned by the Trust. 4.2 Landlord Hosted Premises - applies to all buildings sites, work area and grounds where Trust staff occupy through a lease or informal basis (including Health Partnerships). 4.3 Pests Insects or animals that may constitute a threat to infection Prevention & Control within the Healthcare environment including, but not limited to rodents, insects and birds. 4.4 Pesticide A chemical used to destroy insects and other pests such as rodents. 4.5 Insecticide A chemical used specifically to destroy insects. 4.6 Rodenticide A chemical used specifically to destroy rodents. 4.7 Harbourage A refuge or shelter for pests. 4.8 Infestation An invasion of unwanted pests. 4.9 Pest Control Contractor Nominated contractor who will adopt procedures to prevent Trust owned and leased premises becoming infested. ISSUE 1 JUNE 2016 3

5.0 UDUTIES & RESPONSIBILITIES 5.1 UThe Chief Executive Has overall responsibility for Health and Safety and shall ensure that this policy is implemented to ensure the Trust meets its obligations under the Health & Safety at Work Act 1974 and associated legislation. 5.2 UInfection Prevention & Control (Local Services, Forensic & Health Partnerships respectively) The Infection Prevention and Control Teams ensure that Pest Control protocols are implemented and that audit processes include Pest Control and possible infestation risks in accordance with The Health & Social Care Act (2008): Code of Practice for the Prevention & Control of Healthcare Associated Infections (HCAI). (eg care setting process improvement tool 201.) 5.3 UHeads of Estates and Facilities (Local Services, Forensic & Health Partnerships respectively) Responsible to the Executive team for ensuring the implementation of the Policy. 5.4 UEstates/Facilities Managers 5.4.1 A Manager will be identified as the Authorised Officer in respect of the Pest Control Contract for each division. 5.4.2 The Manager will be responsible for monitoring the performance of the Pest Control Contractor to ensure that the contract specifications and standards are being met and that the Trust is receiving an efficient service. 5.4.3 Develop the specification for Pest Control services. 5.4.4 For Landlord hosted sites, monitoring and auditing of Landlord s procedures, including management of Pest Control Contractor. 5.4.5 Will notify the Estates Department of any structural repairs required to eradicate pests. 5.5 UContractors (Local Services & Forensic) 5.5.1 Shall carry out Pest Control services as per specification in any Contract with Nottinghamshire Healthcare. 5.5.2 COSHH instructions must be given to the Nominated Manager for Pest Control. This is a requirement of the Control of Pesticides Regulations 1986. 5.5.3 Shall adhere to the requirements of this policy. 5.6 UTrust Staff 5.6.1 For the purposes of this document bank/agency staff and students/trainees are considered to be Trust staff. 5.6.2 All staff employed within Nottinghamshire Healthcare are responsible for reporting sightings or any other evidence of the presence of pests to the appropriate helpdesk (Local Services and Forensic). ISSUE 1 JUNE 2016 4

5.6.3 In Landlord hosted sites (Health Partnerships) adherence to the relevant Landlord s procedures and reporting mechanisms shall be carried out. 5.6.4 Housekeeping is important and may need to be reinforced by maintenance work to deny access to pests and remove possible harbourage. 5.6.5 All staff are responsible for reporting defects or damage that may encourage infestation. 5.6.6 Undertake training as necessary in their role if relevant to Pest Control. For example catering and food preparation. Induction with Hotel Services. 5.7 UHelpdesk (Local Services & Forensic) 5.7.1 Shall obtain the following information from all reporters: Location i.e. ward, department, site. Precise location i.e. room number, bathroom etc. Type of pest if known. Approximate numbers of pests present. 6.0 UBASIC PEST PREVENTION AND CONTROL MEASURES 6.1 Food should be covered or stored in air tight pest proof containers. 6.2 Spillages should be promptly removed. 6.3 Waste should be stored in a manner suitable to prevent access by pests. 6.4 Waste containers should be cleaned regularly to prevent a build-up of soil which may attract flies. 6.5 Accumulations of static/stagnant water should be avoided, for example in house plants and flowers. 6.6 Buildings should be of sound structure and well maintained. Drains should be covered; leaking pipework repaired and damaged surfaces made good. Defects should be reported to the appropriate Estates Helpdesk. 6.7 Cracks in plaster and woodwork, unsealed areas around pipework, damaged tiles and badly fitted equipment are all likely to provide excellent harbourage and therefore should be maintained in a stable condition. 6.8 Where fitted fly screens should always be closed when windows are open. 6.9 Doors to food preparation areas should always be kept closed. 6.10 Food kept in ward beverage bays should be regularly checked, discarded if out of date, and stored in appropriate containers. 6.11 Treatment with insecticides and rodenticides is seldom sufficient; attention must be paid to good hygiene and structure maintenance. 7.0 UIMPLEMENTATION/MONITORING COMPLIANCE U(Nominated Estates & Facilities Managers Local Services & Forensic) 7.1 To appreciate the significance of the prevalent pests and the problems associated with them. ISSUE 1 JUNE 2016 5

7.2 To monitor the performance of the Pest Control Contractor to ensure that the contract specification and standards are being met and that the Trust is receiving an efficient service. 7.3 To receive, investigate and initiate appropriate action on all reports of pest evidence or sightings of pests. 7.4 To assess the contractors reports and to note:- The action taken to combat pest infestation since the contractors last report An assessment of the current situation, including any works required to be done to eliminate harbourage and improve hygiene. Any proposals for further action by the contractor. 7.5 To form the main link between the Trust staff and the Contractor in respect of Pest Control issues. 7.6 To have a knowledge of Pest Control and National Conditions of Contract for Pest Control. 7.7 To provide technical advice in respect of local requirements during the preparations of contract specifications and adjudication of tenders. 7.8 To liaise with Pest Control Contractor, Environmental Health Officer of the relevant Local Authority, and appropriate personnel within the Trust on matters relating to Pest Control. 8.0 UGUIDANCE/PROCEDURAL DOCUMENTATION 8.1 To provide information and guidance to support this policy there is associated documentation that can be accessed through the relevant Local or Forensic Services Estates Departments. 8.2 Staff in Landlord hosted premises shall refer to policy and procedure of the Landlord for guidance. 8.3 In the treatment of pests and/or infestation, the use of weapons, dogs or gas shall only be carried out in adherence to legislation, procedures and after completion of risk assessment ( Appendix 4, Proforma example) 9.0 UTRAINING 9.1 The Trust shall ensure that their staff are fully trained and competent to undertake the tasks assigned to them in the pursuance of complying with this policy and procedures. They will ensure that persons only work in the sphere of responsibility in which they have the appropriate knowledge, experience and understanding. 9.2 The Trust will provide sufficient information and training to ensure understanding of the hazards to health posed by pests and the importance of the control measures provided. Information will also be given to others who may be affected. 10.0 UTARGET AUDIENCE 10.1 The target audience for this policy is anyone involved in the Control of Pests within the Trust including contractors, staff and site managers. The Trust shall provide sufficient information, instruction and training to ensure the safety of all contractors, staff, patients and visitors to ensure the health, safety and wellbeing of anyone visiting or residing in Trust premises and Landlord hosted premises. 11.0 UREVIEW DATE 11.1 This policy will be reviewed in 3 years or in light of organisational or legislative changes. ISSUE 1 JUNE 2016 6

12.0 UCONSULTATION 12.1 Executive Leadership Council. 12.2 All Equality & Diversity Champions. 13.0 UEQUALITY IMPACT ASSESSMENT 13.1 This policy has been assessed using the Equality Impact Assessment Screening Tool, The assessment concluded that the Policy would have no adverse impact on, or result in the positive discrimination of, any of the diverse groups detailed. These include the strands of disability, ethnicity, gender, gender identity, age, sexual orientation, religion/belief, social inclusion and community cohesion. 14.0 UCHAMPION AND EXPERT WRITER The Champion of this policy is Dr Julie Hall, Executive Director of Nursing. The Expert Writer is David Smith (Monitoring Service Manager). 15.0 ULEGISLATION/COMPLIANCEU 15.1 The Trust has a legal responsibility to comply with a variety of legislation, including but not limited to: Control of Substances Hazardous to Health (COSHH) Regulations 2002. The Control of Pesticides Regulations (COPR) 1986 (as amended 1997). Food Safety Act 1990. Health & Safety at Work Act 1974. Prevention of Damage by Pests Act 1949. English Nature. Wildlife & Countryside Act 1981. Health & Social Care Act 2010. 16.0 UREFERENCE/SOURCE DOCUMENTSU HBN 00-09, Infection Control in the Built Environment ISSUE 1 JUNE 2016 7

UINFORMATION ON COMMON PESTS UAPPENDIX 1 9.1 House Flies USignificance Houseflies can transmit intestinal worms or their eggs and are potential vectors of disease such as dysentery, gastro-enteritis, typhoid, cholera and tuberculosis. They will frequent and feed indiscriminately on any liquefiable solid food, putrefying material or food stored for human consumption. UControl Flies have rapid, prolific breeding habits and high mobility. In order to break the life-cycle, control measures should be directed against larval and adult flies. UHygiene/Management Satisfactory hygiene is necessary to limit potential breeding sites and food sources. Entry of flies into buildings can be prevented by 1.12mm mesh fly screen, air curtains, bead screens or selfclosing door equipment with rubber seals. 9.2 Cockroaches UDistribution Cockroaches are common in premises associated with the production of handling of food. Gregarious and nocturnal they spend the day hiding in cracks and crevices around areas such as sinks, drains, cookers, the backs of cupboards and in refrigerator motor compartments. They favour buildings with service ducts and complex plumbing installations which allow them to travel freely. USignificance Cockroaches are potential vectors of disease such as dysentery, gastroenteritis, typhoid and poliomyelitis, hair, leather, parchment, wallpaper faeces and food for human consumption. The latter may be contaminated either by the mechanical transfer of causative agents of disease from the insects body, or by transmission in the faeces. UControl Monitoring and control is essential although successful control of cockroaches is a complex subject, and depends very much upon tailoring control measures to the species concerned. Infestations can be difficult to control as cockroach eggs are poorly penetrated by insecticides. Consequently surveillance of the area by the Pest Control contractor may need to be prolonged. UHygiene/Management A high standard of hygiene will deny sources of food and hiding places. ISSUE 1 JUNE 2016 8

9.3 Ants UBlack Ants Foraging worker ants cause a nuisance as they travel widely in search of food, following welldefined trail and clustering around the food source. Sweet foods are preferred. They are obviously an unpleasant sight and may damage food for human consumption. UPharaohs Ants These 2mm omnivorous light brown ants are half the size of the black ants. They cannot breed without artificial heat, are very persistent and pose a serious cross infection risk in hospitals. The ants may be found in wall cavities, heating pipes, behind sinks and ovens and therefore in laundry, linen rooms, clinical and residential areas. UHygiene/Management Although frequently inaccessible and difficult to destroy, ant s nests must be eradicated. If infestation is to be successfully controlled, hormone treatment is required which sterilizes the female ant. 9.4 Wasps Wasp stings cause pain and distress. Some individuals are particularly sensitive. Wasp nests are only used for one season, so it may be possible to put up with the problem temporarily. They are often found in cavities in brickwork, in air bricks and roof vents. The nest can be treated by the Trusts Pest Control contractor; such work can cause problems. Particular attention should be paid to areas around rubbish bins that should be kept in a hygienic condition. 9.5 Bees Bees are not actually considered a pest as they are essential pollinators. However they may cause a nuisance when they swarm or establish themselves in your property. A sting from a bee is not only painful but can also cause, for some unfortunate people, anaphylactic shock that can prove fatal. Any bee issues should be reported to the relevant helpdesk where specific advice regarding responsibility for removal can be obtained. 9.5 Other Insect Pests There are many other insect pests that occur sporadically in hospitals. The most common of these being flies of various species, crickets, silverfish and the stored product insects and mites which can be found infesting dried foods such as flour weevils. 9.6 Mice and Rats These are the vertebrates with greatest potential for damage to food stocks and building fabric in hospitals. Modern rodenticides are extremely efficient in the eradication of mice and rats from hospitals. The Trust will notify the relevant local authority of any infestation of its land or buildings by rats and mice in substantial numbers as required by the Prevention of Damage by Pests Act 1949. Rodents have been known to gnaw through electric cables and cause fires. All sightings and other evidence of their presence should be reported to the Authorised Officer. The Trust will take reasonable steps to ensure that its buildings are rodent proofed by, for example, fitting collars where pipes pass through walls and by filling gaps in the building fabric, etc. All food and organic waste shall be kept in rodent proof containers. ISSUE 1 JUNE 2016 9

9.7 Bats Bats are protected by The Conservation of Habitats and Species Regulations 2010. The penalties for contravention are severe. If bats are discovered in any of the Trusts buildings or on any of its land they must not under any circumstances be killed, expelled, stopped from gaining access, touched or disturbed. Contractors must be prevented from doing work anywhere near them. English Nature should be contacted for advice. 9.8 Birds The nuisance of birds can be controlled in the first instance by preventative measures, eg blocking of nesting holes and the application of devices to discourage perching. Netting and trapping can also be considered with the aim of immediate release away from the area/location of capture. As a last resort birds may be culled by shooting with the approval of the Trust Chief Executive and local police authority. No attempt should be made to poison them. Whichever method is employed it should take into account whether the birds are currently in a nesting season or whether they are protected by law. Advice should be sought from the Royal Society for the Protection of Birds (RSPB) 9.9 Squirrels The most serious damage in urban areas arises where the squirrel enters the roof spaces of buildings by climbing the walls or jumping from nearby trees. Once inside, they chew woodwork, ceilings, and insulation on electrical wiring or tear up the loft insulation to form a nest. The best method of control is to proof the building/loft. Prevention is better than cure. If a cure is required the best form of control is trapping with the use of a squirrel trap. 9.10 Foxes Foxes in this country may occasionally spread disease such as toxocara and leptospirosis but the risk is believed to be small. More significantly foxes do cause nuisance in a number of ways. During the mating season the noise of barks and blood-curdling screams proliferate and in addition to the feed in habits described above there is damage to grounds and gardens caused when digging for food and of course the indiscriminate depositing of faeces. Killing foxes in urban areas is both unnecessary and unlikely to provide a long-term solution as other foxes move into vacant territories. 9.11 Badgers Badgers in this country may occasionally spread disease but the risk is believed to be small. More significantly Badgers do cause nuisance in a number of ways. Their feeding habits cause damage to grounds and gardens caused when digging. Badgers are protected by the Protection of Badgers Act 1992 and the Conservation (Natural Habitats Regulations 1994. The penalties for contravention are severe. If badgers are discovered on any of the Trusts land they must not under any circumstances be killed, expelled, stopped from gaining access, touched or disturbed. Contractors must be prevented from doing work anywhere near them. English Nature should be contacted for advice. 9.12 Rabbits Rabbits can cause great damage by burrowing under buildings and putting at risk the foundations of buildings, however there are strict guidelines on their removal so please contact the authorised officer for advice. This also applies to any suspected myxomatosis cases. 9.13 Moles ISSUE 1 JUNE 2016 10

Moles are a widespread species and are not protected by conservation legislation, with basic protection from cruelty under the Wild Mammals Protection Act 1996. The mole is a common British mammal and, although not often seen, the results of its tunneling are well known and may cause damage in a range of situations. In gardens and amenity areas, molehills and tunnels can be a nuisance. In agriculture, contamination of grass by soil may lead to poor quality silage being produced. There is also a risk of damaging grass-cutting machinery. Mole runs may disturb roots and adversely affect plant growth. Before carrying out any mole control, it is important to consider if such action is warranted or if the molehills and tunnels can be tolerated. Where control measures can be justified, there are two main methods, trapping or poisoning with aluminum phosphide. Please note that strychnine hydrochloride can no longer be legally purchased or used for mole control in the UK. 9.14 Deer Since October 2007, all wild deer with the exception of muntjac (muntiacs reevesi) are protected by a close season. The best long-term solution to reduce the damage caused by deer is to achieve an adequate cull each year and so reduce the local deer population. This best achieved through a wider, cocoordinated cull undertaken by a local Deer Management Group rather than on an ad-hoc basis by individuals. However, legislation makes provisions for actions that can be taken in exceptional circumstances where problems cannot readily be resolved through normal deer management. ISSUE 1 JUNE 2016 11

UAPPENDIX 2 UVERMIN CONTROL PROFORMA Request for the use of Gas, Dogs & Ferrets Name: Designation: Signature: Date: Date and Time of Cull: Exact areas for Cull to take place: All site Pest Control Engineers Escorting staff have been issued with P.P.E. and safe working instructions : Y / N The Engineer s signatures are confirmation that the risk assessments have been forwarded to the hospital and will be adhered to. Number of Dogs: Engineer s Sig. Engineer s Sig. Engineer s Name. Engineer s Name. Nominated Supervisor Name : Security Liaison Nurse Name: Approved by Estates & Capital Services Manager Name: Signature: Date Approved by Head of Security Name: Signature: Date Approved by Forensic Director Name: Signature: Date Time of entry into hospital Time of Exit Approx. numbers culled Completed form to be sent to Security Admin ISSUE 1 JUNE 2016 12

UAPPENDIX 3 Policy/Procedure for: Pest Control Issue: 01 Status: Author Name and Title: APPROVED David Smith (Monitoring Services Manager, Local Services) Issue Date: 22 JUNE 2016 Review Date: MAY 2019 Approved by: Distribution/Access: TRUST INFECTION CONTROL COMMITTEE Normal URECORD OF CHANGES DATE AUTHOR POLICY/ PROCEDURE DETAILS OF CHANGE ISSUE 1 JUNE 2016 13

UAPPENDIX 4 EMPLOYEE RECORD OF HAVING READ THE POLICY/PROCEDURE UTitle of Policy/ProcedureU: Pest Control I have read and understand the principles contained in the named policy/procedure. 0BPRINT FULL NAME SIGNATURE DATE ISSUE 1 JUNE 2016 14