Food poisoning is a commonly used term to describe illness caused by consuming food infected with bacteria, viruses or parasites such as Campylobacter, Salmonella, E. coli and Listeria. Illnesses caused by food poisoning are usually short lived but can make people very sick indeed. Fit and healthy adults usually recover quickly. However, for vulnerable people, including those who are elderly or who have certain health conditions, food poisoning can be serious. Martin Hodgson suggests 10 food safety tips that can be used in both residential adult social care and in home care settings.
1. Know the causes of food poisoning
All adult social care providers should know the causes of food poisoning.
The most common cause is contamination of foodstuff by bacteria and viruses. This generally happens because of:
poor food preparation techniques leading to the cross-contamination of ingredients
poor food storage
unclean kitchen surfaces and equipment
failure to cook hot food thoroughly
failure to keep chilled food cold
poor personal hygiene by cooks and food handlers.
Knowing the causes means that managers and staff can take suitable steps to promote proper food safety.
Public health and food safety experts agree that it is highly unlikely that there is a serious risk of Covid-19 being passed on through food or food packaging and causing illness. Covid-19 is a respiratory virus and needs a live host to grow. In addition, adequate cooking is likely to kill the virus. Despite this, those responsible for food businesses must ensure that they take appropriate action to reduce any possible risk of coronavirus transmission.
2. Have suitable food hygiene policies and food safety management systems in place
Depending whether the service is a care home or a domiciliary care service, policies should include areas such as:
the safe storage, preparation, cooking and serving of food
food hygiene for food handlers
cleaning and washing-up procedures
handling food waste
action to take is a food handler is ill
the maintenance of kitchens, food stores and catering equipment
Find some useful template policies:
Food Safety and Hygiene in Residential Care
Policies should be supported by a documented food safety management system based on the principles of the Hazard Analysis and Critical Control Point (HACCP). This is a legal requirement.
3. Make sure that kitchens and food storage areas are well maintained and kept clean
Kitchens and other food preparation, storing and serving areas in a care home must be kept clean, well maintained and in good condition at all times.
The design should support staff to carry out their work hygienically. A maintenance plan should cover essential repairs and improvements. Work should be checked to ensure it is completed properly.
Kitchen cleaning should be carefully planned, monitored and inspected to ensure adequate standards are being maintained. Extractor fans and filters should be checked frequently to make sure they are working properly and are free from grease and dirt. Fridges and freezers should be cleaned regularly and their temperatures checked and recorded.
Pests such as mice, cockroaches and flies should be controlled as necessary.
During the Covid-19 pandemic all areas of a setting such as a care home should be subject to more frequent cleaning than usual, including kitchens and dining areas. This is to prevent the virus being passed on indirectly through touch.
Ideally, care home laundry facilities should always be kept separate from kitchens. This helps to prevent harmful bacteria spreading from laundry to food.
4. Store food properly and avoid using out of date produce
The proper storage of food is a critical part of maintaining high catering standards and reducing the risk of food poisoning. All foods have limits on their storage time. Staff should always follow storage instructions and be aware of “use by” dates. Some foods must be stored in the fridge and eaten within a short space of time.
Cooks and staff responsible for food ordering in a care home kitchen should maintain a strict stock control regime. In most cases, domiciliary care staff providing food services in a person’s own home will not be responsible for food storage or purchase. However, they should always try to support service users in following good practice guidelines as far as is possible, such as disposing of out-of-date food.
Effective food storage in fridges is particularly important. Milk and dairy products should always be refrigerated. To avoid cross-contamination, raw foods should be stored away from other foods, especially cooked foods and ready-to-eat foods (such as salads, fruit, cooked meats, cheeses, bread and sandwiches). Raw meat and poultry should ideally be kept in clean sealed containers on the bottom shelf of the fridge so it cannot touch or drip onto other food.
5. Avoid cross-contamination and prepare, cook or chill foods properly
Staff involved in the preparing of food in both care homes and in domiciliary care should take all reasonable, practical steps to avoid the risk of contamination of food or ingredients.
Cross-contamination is the transfer of bacteria from one food to another, either directly when one food touches another or indirectly through contaminated hands, equipment, cutting boards, surfaces, cloths, etc.
To control cross-contamination:
watch out for cross-contamination risks in HACCP assessments
always separate raw and ready-to-eat food
use colour-coded equipment, cloths and protective clothing
clean and disinfect food-contact and hand-contact surfaces between tasks
use single use disposable cloths for cleaning and for drying hands
manage cleaning, pests, and waste
separate clean and dirty processes
always practice safe methods of food storage, particularly in fridges
practice high standards of personal hygiene in kitchen areas with effective hand hygiene at all times.
The prevention of cross contamination is especially important when handling or storing raw meat, poultry, and seafood. Food handlers and cooks should always keep these foods and their juices away from already cooked or ready-to-eat foods and fresh produce.
Special care should be taken when preparing raw chicken. Due to the risk of the presence of Campylobacter the Food Safety Agency recommends that raw chicken is not washed. They warn that splashing water from washing chicken can spread the bug to other surfaces and foods. Utensils, chopping boards and surfaces used to prepare raw chicken should be washed and the chicken cooked thoroughly to ensure any Campylobacter present are killed.
Frozen foods should be properly thawed before cooking. Salads must be washed and meat thoroughly cooked or reheated, especially poultry. Cooking hot food properly will ensure that harmful bacteria are destroyed.
Wherever possible, food should be served immediately. Foods kept hot before serving must be cooked thoroughly first and then held above 63°C. Foods that need to be chilled should be held at 8°C or below. Food that needs to be chilled should not be left standing around at room temperature.
6. Ensure that food handlers maintain high standards of personal hygiene
Food handlers in both care homes and home care should observe high standards of personal hygiene, especially hand washing.
All staff working with food should wash their hands properly:
when entering the food handling area, e.g. after a break or going to the toilet
before preparing food
after touching raw food, such as meat/poultry and eggs
after handling food waste or emptying a bin
after blowing their nose.
In care homes, there must be separate handwashing facilities to those used to wash and prepare food. Sinks must be kept clean and soap and towel dispensers well stocked.
In domiciliary care, food handling staff will usually use the service user’s facilities to wash their hands. They may find it necessary to carry their own liquid soap and paper towels for hand drying. Where sanitary handwashing facilities are not available they may find it useful to carry antibacterial hand sanitiser gel.
Hand hygiene and what is referred to as “respiratory hygiene” are particularly important in the current coronavirus pandemic. Covid-19 is principally spread via sneezes and coughs. It is therefore important that food handlers use tissues, wherever possible, and clean their hands more regularly than usual by hand washing or by using an alcohol-based hand sanitiser. Used tissues should be disposed of.
7. Send food handling staff home if they become ill
Adult social care managers must not allow anyone to handle or prepare food if they:
are suffering from, or carrying, a disease likely to be transmitted through food
have infected wounds, skin infections, sores, etc
have diarrhoea or vomiting.
Any staff who are affected by any of the above and are likely to come into contact with food through work must tell their manager immediately about the illness or symptoms and, if possible, what has caused them. Failure to do so may lead to diseases being inadvertently passed on through the touching and contaminating of foodstuffs.
Staff with diarrhoea or vomiting should not return to work until they have had no symptoms for 48 hours.
All catering and food handling staff in a care setting must understand the fitness to work policy under which they operate and should be aware of any updates that have been made in relation to Covid-19. Any food handling staff who have symptoms of the virus (high temperature, a new continuous cough and/or loss or change of sense of taste or smell) should not come to work. Instead they should inform their line manager and follow the latest government advice relating to self-isolation and testing.
COVID-19: management of staff and exposed patients or residents in health and social care settings contains further details, including return to work criteria.
8. Provide staff with effective training and instruction
All staff who might be involved in food preparation or food handling should be appropriately trained and supervised. Food hygiene training must be designed to promote food safety and raise awareness about the dangers of poor food handling.
Additional training may be required for cooks. While there is currently no legal requirement to attend a formal training course or get a qualification, many care providers require food handling staff to complete accredited training courses.
All food hygiene training should stress the importance of proper handwashing techniques. In care home kitchens this can be reinforced by displaying posters in toilets and by sinks.
9. Take action to prevent the spread of infection
Food poisoning bugs such as Norovirus (the winter vomiting bug) are highly contagious and easily spread by infected people through diarrhoea and vomit, particularly in group living settings such as care homes. This winter, the problems may be exacerbated by the coronavirus pandemic which remains a serious threat, especially to care home residents.
Advice should be sought from local health protection teams immediately symptoms of an outbreak are detected.
The spread of infection can be limited by taking effective infection prevention action. In particular, staff should wash their hands in-between person contacts and use disposable aprons and gloves when caring for sick service users or when cleaning up bodily fluids. Environmental cleaning programmes should be stepped up, especially in toilets and bathrooms.
In some cases, the isolation of residents may be necessary to prevent further cases of infection. In addition, it may be necessary to limit visitor’s access.
Further details about the infection prevention measures necessary to control the risks of Covid-19 can be found in the Coronavirus toolkit.
10. Support any food poisoning investigations
If a food poisoning incident occurs the organisation should be open and honest and do its best to support any investigation to get to the bottom of the cause. It should cooperate fully with public health staff from local authorities. Lessons should be learnt and changes made where any food preparation or cooking processes are identified as unsafe. Suspect foodstuffs should be immediately withdrawn from use.
An investigation should not be about finding fault or apportioning blame. It should be about learning from what went wrong so that the organisation can ensure that it does not happen again.
See the following topics in your Croner-i for more information:
The Food Standards Agency (FSA) publishes guidance which adult social care providers can use to ensure high standards in food safety. This includes:
The FSA also publish a food safety supplement for care homes.