Waste & Sharps Audit - Care Homes

Evidence to check

• • Current waste management policy is available and reviewed
• • Policy covers clinical waste, offensive/hygiene waste, sharps, medicines waste, domestic waste and recycling
• • Policy explains local colour coding, segregation, storage, collection, contractor arrangements and incident response
• • Staff can explain the waste procedures relevant to their role

Evidence to check

• • Named IPC lead, housekeeping lead, maintenance lead, medicines lead or registered manager is documented
• • Responsibilities include waste segregation, sharps safety, contractor records, audits, training and escalation
• • Deputy arrangements are in place
• • Lead can explain current waste risks, recent audit findings and contractor arrangements

Evidence to check

• • Waste and sharps themes are reviewed in IPC, health and safety or governance meetings
• • Audit findings and incidents are discussed with actions recorded
• • Actions have owners and deadlines
• • Repeat issues are escalated through the risk register or QIP

Evidence to check

• • Current waste contractor agreements are available
• • Waste carrier licence details are retained
• • Clinical waste, sharps and pharmaceutical waste routes are clearly defined
• • Service frequency and emergency collection arrangements are documented

Evidence to check

• • Recent waste transfer notes and consignment notes are available
• • Records include waste type, quantity, collection date, carrier details and disposal route where required
• • Records are retained in line with legal and provider requirements
• • Missing or incomplete notes are followed up promptly

Evidence to check

• • Training records show relevant staff have completed waste and sharps training
• • Training includes local colour coding, clinical waste, offensive waste, sharps bins, spill kits and needle-stick response
• • Refreshers are completed where required
• • Staff competence is checked through observation or spot questions

Evidence to check

• • Risk assessments cover body fluids, sharps, chemical exposure, manual handling and waste storage
• • COSHH assessments are available for spill kits, disinfectants and related products
• • PPE requirements are clear
• • Assessments are reviewed after incidents or process changes

Evidence to check

• • Domestic, recycling, offensive/hygiene, clinical/infectious, sharps and pharmaceutical waste streams are defined
• • Bins and bags match the correct waste stream
• • Staff do not mix waste streams unnecessarily
• • Spot checks confirm correct segregation in bedrooms, bathrooms, clinical areas and communal areas

Evidence to check

• • Correct colour-coded bags and bins are available where needed
• • Signage supports correct disposal
• • Staff understand local colour coding
• • Inconsistent bin or bag use is corrected promptly

Evidence to check

• • Clinical waste is used for infectious or clinically contaminated waste as defined by policy
• • Non-infectious hygiene waste is not routinely disposed of as clinical waste without reason
• • Incorrect clinical waste use is monitored because of cost and compliance implications
• • Staff understand the difference between infectious and offensive/hygiene waste

Evidence to check

• • Non-infectious pads and continence waste are disposed of through the correct offensive/hygiene waste stream where applicable
• • Bins are available in appropriate locations
• • Waste is bagged, stored and collected safely
• • Staff understand when the waste stream changes due to infection risk

Evidence to check

• • Continence products and pads are handled privately
• • Soiled items are not carried exposed through communal areas
• • Waste disposal protects dignity and reduces odour
• • Residents are not embarrassed or publicly identified through waste handling

Evidence to check

• • Food waste and domestic waste bins are clearly separate
• • Kitchen waste does not enter clinical waste routes
• • Clinical waste is not stored near food preparation or clean storage areas
• • Waste routes prevent cross-contamination

Evidence to check

• • Sharps bins are available in medication areas, treatment rooms or wherever injections or lancets are used
• • Staff do not carry used sharps unnecessarily
• • Sharps bins are positioned safely and securely
• • Residents who self-administer have safe disposal arrangements

Evidence to check

• • Sharps bins match the waste type, such as sharps only or medicinally contaminated sharps
• • Bins are assembled correctly with lids secure
• • Bins are labelled with location, date opened and responsible person where required
• • Incorrectly assembled or unlabelled bins are replaced

Evidence to check

• • Used needles, lancets and other sharps are placed directly into a sharps bin
• • Sharps are not left on medication trolleys, bedside tables, trays, pockets or ordinary bins
• • Observation confirms safe disposal practice
• • Unsafe practice is treated as a serious risk and addressed immediately

Evidence to check

• • Temporary closure mechanism is used between uses where applicable
• • Bins are fully closed before movement or collection
• • Bins are stored upright to prevent spillage
• • Residents and visitors cannot access open sharps bins

Evidence to check

• • Sharps bins are replaced at the fill line
• • Overfilled bins are not used
• • Replacement process is clear and timely
• • Monitoring is included in medication room, clinical room or IPC checks

Evidence to check

• • Sharps bins are kept in secure clinical areas, locked rooms or safe wall brackets where appropriate
• • Bins are not accessible to residents at risk of harm or tampering
• • Storage arrangements consider dementia, confusion and visiting children
• • Unsecured bins are escalated immediately

Evidence to check

• • Safety-engineered needles or lancets are used where available and appropriate
• • Staff are trained in safe device use
• • Procurement considers sharps injury reduction
• • Non-safety devices are risk assessed where still used

Evidence to check

• • Training covers safe sharps handling, no recapping, immediate disposal and reporting
• • Needle-stick procedure is accessible
• • Staff know first aid, reporting, occupational health and follow-up steps
• • Agency and bank staff receive relevant local instruction

Evidence to check

• • Needle-stick incidents are recorded promptly
• • Occupational health or medical advice is sought where required
• • RIDDOR consideration is documented where applicable
• • Investigation identifies learning and support for affected staff

Evidence to check

• • Visiting professionals are informed of sharps disposal arrangements
• • Sharps bins are not left unsecured in resident rooms or communal areas
• • Concerns about visiting clinician practice are escalated appropriately
• • Agreements or communication with community teams are documented where needed

Evidence to check

• • Clinical waste bins are foot-operated where required by local policy or IPC risk
• • Bins have lids and liners appropriate to the waste stream
• • Lids remain closed when not in use
• • Bins are cleaned and not overfilled

Evidence to check

• • Waste bags are securely tied before removal
• • Bags are labelled or tagged where required
• • Bags are not overfilled, split or leaking
• • Staff know how to respond to leaking or damaged bags

Evidence to check

• • Waste routes avoid kitchens, clean linen routes and clean storage areas where possible
• • Waste is transported in appropriate containers or trolleys
• • Dirty and clean flows are separated
• • Waste movement does not create odour, spill or contamination risk

Evidence to check

• • Gloves and aprons are worn where required
• • Eye protection is available where splash risk exists
• • PPE is changed between dirty and clean tasks
• • PPE is disposed of into the correct waste stream

Evidence to check

• • Staff clean hands after waste handling
• • Handwashing or sanitising facilities are accessible
• • Hand hygiene signage is available where needed
• • Observation confirms compliance

Evidence to check

• • Waste holding areas are locked or access controlled
• • Areas are clean, ventilated and free from odours, leaks and pests
• • Spill containment or cleaning materials are available where needed
• • Cleaning schedule for waste stores is completed

Evidence to check

• • Clinical, offensive, sharps, domestic and recycling storage is separated where required
• • Signage is clear and current
• • Waste containers are not mixed or stored incorrectly
• • Staff understand storage arrangements

Evidence to check

• • External bins are lidded and secure
• • Clinical waste stores are locked
• • Storage prevents access by wildlife, pests, residents, visitors or the public
• • Overflow or loose waste is not present

Evidence to check

• • Collection frequency prevents overflow, odour and infection risk
• • Sharps bins are collected or exchanged before storage becomes unsafe
• • Collection schedule matches waste volume
• • Increased collections are arranged during outbreaks or high-volume periods

Evidence to check

• • Waste carrier licence is current
• • Service agreement or contract is available
• • Contractor collection records are retained
• • Contractor concerns are escalated and recorded

Evidence to check

• • Missed collections are logged
• • Contractor is contacted promptly
• • Temporary storage is risk assessed
• • Overflow, odour or infection risk is prevented

Evidence to check

• • Collection records are reviewed against contract expectations
• • Bin condition, waste store cleanliness and frequency are checked
• • Missed collections or documentation gaps are challenged
• • Contractor review informs renewal or escalation decisions

Evidence to check

• • Expired, discontinued or unwanted medicines are stored securely before return or disposal
• • Medication waste is not placed in domestic or clinical waste unless policy permits specific disposal route
• • Returns records are completed
• • Controlled drug destruction or denaturing processes are followed where required

Evidence to check

• • Insulin needles, lancets and other medicinal sharps are disposed of immediately into the correct sharps bin
• • Sharps bins are available during medication rounds where needed
• • Staff do not recap needles
• • Residents who self-administer have clear and safe sharps arrangements

Evidence to check

• • Topical medicines are disposed of through the correct medicines waste route where required
• • Aerosols or pressurised containers are not disposed of unsafely
• • Risk of misuse or access by residents is considered
• • Disposal records are completed where required

Evidence to check

• • Cytotoxic or cytostatic waste route is identified where relevant
• • Correct sharps or pharmaceutical waste containers are used
• • Staff use appropriate PPE and understand exposure risks
• • Contractor arrangements include this waste stream if required

Evidence to check

• • Outbreak plans include waste arrangements
• • Extra bins, bags, PPE or collections are arranged where needed
• • Infected waste is segregated correctly
• • Waste stores are monitored more frequently during outbreaks

Evidence to check

• • Spill kits are available and stocked
• • Staff know how to manage blood, body fluid and clinical waste spills
• • PPE, disinfectant and disposal routes are used correctly
• • Spill incidents are recorded and reviewed where required

Evidence to check

• • Waste is bagged at point of use
• • Double-bagging is used if required by policy or risk assessment
• • Waste bins are appropriate and accessible in isolation areas
• • Staff understand isolation waste arrangements

Evidence to check

• • Staff understand waste controls for suspected or confirmed infections such as norovirus, C. difficile, COVID-19 or flu
• • Waste disposal reflects IPC guidance and local policy
• • Enhanced cleaning and PPE arrangements are linked to waste handling
• • Incorrect practice is corrected immediately

Evidence to check

• • Training matrix includes relevant waste and sharps training for different roles
• • Housekeeping and maintenance staff are included, not only care staff
• • Training covers local colour coding and safe routes
• • Role-specific knowledge is checked during audits

Evidence to check

• • Spot checks include day, night and weekend practice where possible
• • Checks include bin contents, sharps bins, storage areas, PPE and hand hygiene
• • Feedback and corrective actions are documented
• • Repeat errors are escalated

Evidence to check

• • Segregation errors are logged or noted in audits
• • Root causes are considered, such as signage, bin placement, training or stock availability
• • Actions go beyond simply reminding staff where errors repeat
• • Follow-up checks confirm improvement

Evidence to check

• • Agency induction includes waste segregation, sharps disposal and incident reporting where relevant to role
• • Agency staff know where sharps bins and clinical waste bins are located
• • Agency staff understand local colour coding
• • Unsafe agency practice is reported and followed up

Evidence to check

• • Residents who self-administer injections or blood glucose testing have safe sharps disposal arrangements
• • Visitors supporting residents with sharps understand disposal process
• • Personal sharps are not placed in domestic waste
• • Resident independence is supported safely

Evidence to check

• • Sample bins in bedrooms, bathrooms, medication areas, treatment rooms, sluices and communal areas are checked
• • Bag colours and bin types match waste stream
• • Contents of sampled bins are appropriate
• • Incorrect segregation is corrected during the audit

Evidence to check

• • Recent notes are available and complete
• • Records match collection schedule
• • Waste type and quantities are recorded
• • Carrier details and signatures are present where required

Evidence to check

• • Staff can describe immediate first aid and reporting steps
• • Staff know who to inform and how to access occupational health or urgent advice
• • Procedure is accessible in clinical, medication or staff areas
• • Previous needle-stick incidents show reporting, follow-up and learning

Evidence to check

• • Waste stores are locked or controlled
• • Clinical, offensive, domestic and recycling waste are appropriately separated
• • No overflowing bins, loose bags, leaks or strong odours are present
• • Cleaning and pest control arrangements are evidenced

Evidence to check

• • Audit includes walkaround, bin checks, sharps bin checks, staff questioning, documentation review and waste store inspection
• • Audit checks whether segregation is correct at point of use
• • Audit includes different areas and shifts where possible
• • Findings lead to practical actions and rechecks

Evidence to check

• • Waste and sharps findings inform IPC meetings, medicines governance, health and safety reviews and QIP actions
• • Needle-stick injuries, segregation errors and contractor issues are reviewed for trends
• • High-risk findings are escalated promptly
• • The home can evidence safer disposal practice and reduced repeat errors