GUIDELINES FOR CLEANING TOYS

Policy Details
NHFT document reference ICPg004
Version 2
Infection Prevention and Control Operational Group on the
Date of approval rd
23 October 2014
Infection Prevention and Control Strategic Group on the
Ratified by th
12 November 2014
st
Implementation Date 1 January 2015
Director of Quality and Professional Development and
Responsible Director
Acting Executive Nurse
Review Date Extended to Oct. 18
ICP000 - Infection Prevention and Control Assurance
Framework
ICP001 - Hand Hygiene Policy
Related Policies & other documents ICP002 - Standard Precaution Policy
ICP003 - Cleaning and Disinfection Policy; ICP008 -
Infection Prevention and Control Outbreak Policy
ICP - 009 Isolation Policy.
Freedom of Information category Guidelines

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 1 of 16 Implementation Date: 01/01/2015

 TABLE OF CONTENTS

1. DOCUMENT CONTROL SUMMARY .................................................................. 3

2. INTRODUCTION ................................................................................................. 4
3. PURPOSE ........................................................................................................... 4
4. DEFINITIONS ...................................................................................................... 4
5. DUTIES ............................................................................................................... 4
6. PROCESS ........................................................................................................... 5
6.1. Hand Hygiene ............................................................................................. 5
6.2. Audit, Monitoring and Risk Assessment ..................................................... 5
6.3. Management ............................................................................................... 6
6.4. Toy Selection .............................................................................................. 6
6.5. Cleaning/Decontamination Procedures ...................................................... 6
6.5.1. Soft Toys ........................................................................................ 6
6.5.2. Hard Surface Toys ......................................................................... 7
6.5.3. Mechanical/Electrical Toys ............................................................. 7
6.5.4. Books ............................................................................................. 7
6.5.5. Ball Pools ....................................................................................... 7
6.5.6. Dressing Up Clothing ..................................................................... 7
6.5.7. Distraction Boxes ........................................................................... 8
6.5.8. Preparation Toys ............................................................................ 8
6.5.9. Second Hand Toys ........................................................................ 8
6.5.10. Individual Play Therapy .................................................................. 8
6.5.11. Play Dough .................................................................................... 8
6.5.12. Play Sand....................................................................................... 8
6.6. Additional Cleaning Measures .................................................................... 8
6.7. Toy storage ................................................................................................. 9
7. TRAINING ........................................................................................................... 9
7.1. Mandatory Training ..................................................................................... 9
7.2. Specific Training not covered by Mandatory Training ................................. 9
8. MONITORING COMPLIANCE WITH THIS DOCUMENT ................................. 10
9. REFERENCES AND BIBLIOGRAPHY ............................................................. 11
APPENDIX 1 - EQUALITY ANALYSIS REPORT ...................................................... 12
APPENDIX 2 - TOYS AND PATIENT EQUIPMENT CLEANING CARE PLAN/CHECK
LIST ……………………………………………………………………………………… 15

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 2 of 16 Implementation Date:

1. DOCUMENT CONTROL SUMMARY

Document Title Guidelines for Management of Toys

Document Purpose (executive brief)
Status: - New/Update/ Review
Areas affected by the policy
Policy originators/authors
Consultation and Communication
with Stakeholders including public
and patient group involvement
Archiving Arrangements and register
of documents
Equality Analysis
(including Mental Capacity Act 2007)
Training Needs Analysis
Monitoring Compliance and
Effectiveness
Meets national criteria with regard to
NHSLA
NICE
NSF
Mental Health Act
CQC
Other
Further comments to be considered
at the time of ratification for this
policy (i.e. national policy,
commissioning requirements,
legislation)
If this policy requires Trust Board
ratification please provide specific
details of requirements
To ensure that all staff working in areas
where toys are kept for public use or
who use toys in their day to day work
are aware of the correct procedures for
their selection, handling and cleaning to
minimise infection risk.
Review
Trust-wide
Head of Infection Prevention and
Control - Harriet Ddungu
Members of the Infection Prevention
and Control Operational Group and the
Infection Prevention and Control
Strategic Group.
The Risk Department is responsible for
this policy and will hold archived copies
of this policy on a central register
See Appendix 1
See section 7
See section 8
Yes - Outcome 8
N/A
N/A
N/A
N/A
Health and safety act 1974, HSE 2003
and COSHH 2005.
Health and Social Act 2008(10) code of
practice for health and social care on
the prevention and control of infections
and related guidance.
Not required

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 3 of 16 Implementation Date:

2. INTRODUCTION
Toys may be implicated in the transmission of potentially harmful pathogens and the
development of infections in a vulnerable client group. Steps must be taken to
ensure that toys are maintained in a safe and usable state by regular inspection,
scheduled cleaning and appropriate storage.

To reduce the risk of cross infection, all toys and equipment must be made of a
material that where possible allows effective cleaning and decontamination.

3. PURPOSE
To ensure that all staff working in areas where toys are kept for public use or who
use toys in their day to day work are aware of the correct procedures for their
selection, handling and cleaning to minimise infection risk.

4. DEFINITIONS
NHFT: - Northamptonshire Healthcare NHS Foundation Trust.

Cross Infection: - the transfer of organisms from one person to another; this may or
may not lead to illness or disease.

Cleaning: - a process that physically removes contamination, but does not

necessary destroy micro-organisms

Disinfection: - is a process used to reduce the number micro-organisms but which

may not destroy bacteria spores or some viruses. Disinfection is considered to
reduce the number of micro-organisms to a level that is safe for the purpose for
which the piece of equipment is intended.

5. DUTIES
Chief Executive
The Chief executive has overall responsibility for the strategic and operational
management of the Trust.

The Director of Infection Prevention and Control (DIPC)

The Director of Quality and Professional Development and Acting Executive Nurse
who is the DIPC for the Trust oversees development and implementation of infection
prevention and control policies in accordance with the Infection Prevention and
Control Strategy.

Assistant Director of Nursing

The Assistant Director of Nursing chairs the Infection Prevention and Control
Strategic Group, which will formally review and approve policies, guidelines and
reports to the Governance Committee.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 4 of 16 Implementation Date:

Infection Prevention and Control Team (IP&CT)
Responsible for:
 Ensuring that the guidelines comply with all legal, statutory and good practice
guidance requirements.
 Providing clinical leadership with this guideline implementation.
 Supporting the operational implementation of this guideline by providing advice
and training.
 Improve and spreading best practice.
 Review the guideline in light of the outcomes from the periodic audits and
monitor its effectiveness during routine activities.

Service Managers
Service Managers are responsible for:-
 The operational implementation of this guideline.
 Ensuring that staff are aware of their responsibilities including the requirement
to attend infection prevention and control training.
 Taking appropriate action should any breach of this guideline arise.
 Audit of the guideline and monitoring its effectiveness during routine clinical
activities and planned audit programmes as agreed by the Infection Prevention
and Control Groups.

Staff
All staff employed by NHFT are responsible for adhering to this guideline regardless
of their role, band, discipline or service area.
 Handle toys in a responsible manner
 Ensure toys are decontaminated between patients uses according to the
Cleaning and Disinfection Policy ICP003.
 Perform a risk assessment when handling toys to reduce the risk of preventable
infections.

6. Process
6.1. Hand Hygiene
It is important to maintain a good hand hygiene following the handling of
contaminated toys accordance with the NHFT Hand Hygiene Policy (ICP001)
and the Standard Precaution Policy (ICP002).

6.2. Audit, Monitoring and Risk Assessment

 All settings where toys are used are subject to an audit by the IP&CT.
 Risk assess the suitability and clean ability of toys prior to purchase. For
instance fabric toys should be avoided as they are not easy to clean
between patients.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 5 of 16 Implementation Date:

 6.3. Management
 The overall responsibility for designating the cleaning of toys will be
assigned to the matron/department manager.
 Staff must take the responsibility for cleaning toys and they must be aware
of the cleaning requirements.
 A cleaning schedule must be devised and kept in an accessible place.
 A record must be kept of all cleaning activity.

6.4. Toy Selection

Careful consideration must be given to how toys will be kept clean before they
are purchased and adjustments must be made to facilitate effective cleaning.

Procedures must be established to guide the on-going cleaning procedures.

This must identify when items should be cleaned and with the appropriate
cleaning products dependant on the manufacturers’ guidance.

Where children engage in the use of toys as part of their individual therapy, soft
toys may be used for that episode of care but they must be machine washed
held at 71°C for 3 minutes or 65°C for 10 minutes after use to achieve thermal
disinfection and thorough drying.

6.5. Cleaning/Decontamination Procedures

To reduce the risk of cross infection, all toys and equipment must be made of a
material that where possible allows effective cleaning and decontamination.

All equipment and toys should be cleaned, on a weekly basis, however where
possible toys should be cleaned between each session. (It is recognised that
some sessions include more than one child, cleaning is only necessary at the
end of these sessions).

Should any toy or piece of equipment become contaminated with blood or body
fluids these will require cleaning then disinfecting using a chlorine releasing
agent (10,0000 parts per million) , rinsing and drying (see guidance below).

6.5.1. Soft Toys

Soft toys must not be kept for general use in healthcare settings because
they are porous, support microbial growth and can be difficult to
decontaminate.

There may be occasions when soft toys form an essential part of a therapy
session where this is the case soft toys must be subject to machine
washing after each episode of care and thorough air/tumble drying
(according to the manufacturer’s instructions). Repeated decontamination
of soft toys can compromise the integrity of the fabric and create a choking
hazard, therefore ensure thorough checking takes place before and after
and discarded if needed.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 6 of 16 Implementation Date:

 Children must not be discouraged from bringing their own soft toys to
hospital but they must be used only by them and then taken home. When
a child is an inpatient the toy should be labelled as belonging to that child.

New soft toys given to the patient in hospital are acceptable with the same
single rule as their own toy. The toy may be taken home with the child or
destroyed on discharge.

6.5.2. Hard Surface Toys

All toys must have a smooth, non-porous surface that is easy to clean.

Toys with moving parts or openings can harbour dirt and germs in the
crevices must be washed and scrubbed using soap and warm
water/detergent wipes before thorough rinsing and drying.

Small items such as stickle bricks should be soaked for a period of 5

minutes in a Chlorine based solution (10,000 parts per million) e.g. Milton
and air dried following use by a child with a transmissible organism.

6.5.3. Mechanical/Electrical Toys

Mechanical/electrical toys must have the surface wiped weekly using a
damp colour coded cloth that has been rinsed in warm soapy water or
detergent wipes followed by thorough drying.

6.5.4. Books
Books must be inspected weekly and the surfaces wiped using a
disposable cloth that has been rinsed in warm soapy water/detergent
wipes followed by thorough drying. As they have a potential of soaking up
water, books with signs of dampness or mildew must be discarded. They
may require frequent replacement.

6.5.5. Ball Pools

These should be inspected daily for cleanliness, debris and foreign items.
Routine cleaning must be carried out on a monthly basis using warm water
and neutral detergent and then dried thoroughly.

6.5.6. Dressing Up Clothing

Dressing up can form an important part of a child’s therapy or
rehabilitation, however, only use when necessary for therapy and the
following should be taken into consideration.

For use in outpatient setting/cases of one to one therapeutic or

preparatory play: - All clothes must be washable and washed at a
temperature of 60°C for 10 minutes. If kept together in a bin or on a rail all
the clothes must be laundered weekly. The storage bins must also be
washed at least weekly. Clothes that are visibly soiled must then be
removed and washed at the correct temperature.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 7 of 16 Implementation Date:

 For inpatient use: - Dressing up clothing are only to be used on an
individual basis where one to one therapeutic or preparatory play requires
their use. The must also be labelled by the trust sewing room and sent to
trust laundry service after each use and must also be stored out of general
use.

6.5.7. Distraction Boxes

These are the responsibility of all staff and should be checked and
cleaned as described earlier following each individual use or on a weekly
basis (if not in use). These should not be stored with other general toys.

6.5.8. Preparation Toys

These toys must be regularly inspected and cleaned using an appropriate
cleaning method as described earlier in this document.

6.5.9. Second Hand Toys

Following a risk assessment those second hand toys accepted for use
must be cleaned as described earlier prior to distribution to ward and
department areas.

6.5.10. Individual Play Therapy

Prior to use children’s hands must be cleaned before and after use and
skin lesions must be covered.

6.5.11. Play Dough

This must be single patient use only and must not be shared with other
children.

6.5.12. Play Sand

Sand pits are not to be used for general play purposes. However, for
individual play therapy, sand may be used for that child and discarded
after use.

6.6. Additional Cleaning Measures

If toys become contaminated with any blood/body fluids they need to be
removed immediately from the area and cleaned using a chlorine releasing
agent (10,000 parts per million). If uncertain seek guidance from the Infection
Prevention and Control Team.

Where toys have been contaminated with specific micro-organisms for example
during an outbreak, additional decontamination procedures may be required.

Wash items with Chlorine releasing agent (10,000 parts per million) e.g. Milton
and air dry thoroughly.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 8 of 16 Implementation Date:

 6.7. Toy storage
There must be a designated storage area for toys.

For areas with no designated play area, such as outpatients; there must be a
designated storage box for toys which is washable. It must be washed and
dried weekly and a record entered onto a cleaning schedule.

It is the responsibility of the ward/department to ensure that dirty toys are

cleaned and removed from circulation e.g. dirty toy box (if appropriate for the
area).

7. Training
7.1.Mandatory Training
Training required to fulfil this guidelines will be provided in accordance with the
Trust’s training needs analysis. Management of training will be in accordance
with the Trust’s statutory and mandatory training policy.

7.2.Specific Training not covered by Mandatory Training

Ad hoc training sessions based on an individual’s training needs as defined
within their annual appraisal or job description.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 9 of 16 Implementation Date:

8. MONITORING COMPLIANCE WITH THIS DOCUMENT
The table below outlines the Trusts’ monitoring arrangements for this document. The Trust reserves the right to commission
additional work or change the monitoring arrangements to meet organisational needs.

Group or committee
Aspect of compliance Group or committee or individual
Individual responsible
or effectiveness being Method of monitoring Monitoring frequency who receive the responsible for
for the monitoring
monitored findings or report completing any
actions
Duties To be addressed by the monitoring activities below.
Management of Toys Cleaning Audit Matron Quarterly Matron Matron
IP&CT IP&CT IP&CT
IP&CG
Awareness of the Guidelines Matron Ad hoc - on starting Matron Matron
importance toy Local induction IP&CT work IP&CT IP&CT
management Learning and IP&CG
Development Yearly Learning and
Development
mandatory training Training will be monitored in line with the Statutory and Mandatory Training Policy.
Where a lack of compliance is found, the identified group, committee or individual will identify required actions, allocate responsible leads, target completion
dates and ensure an assurance report is represented showing how any gaps have been addressed.

Guidelines for Management of Toys Page 10 of 16 Implementation Date: 01.09.2012

 9. REFERENCES AND BIBLIOGRAPHY
DH (2010) The Health and Social Care Act 2008: code of practice for health and
adult social care on the prevention and control of infections and related guidance.
www.dh.gov.uk/uk/en/Publications and statistics/Publications/Publications
PolicyAndGuidance/DH110288

DH (2006) Essential Steps to Safe, Clean Care: Reducing Healthcare Associated

Infections: Department of Health.
http://.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuid
ance/DH4136212

Merriman E, Corwin P & Ikram R, (2002) Toys are a potential source of cross
infection in general practitioner’s waiting rooms. British Journal of General Practice
52; 138 - 140

Health Protection Agency (HPA) (2003) Infection Control and Communicable

Diseases Guidelines for Early Years and Child care. London: HPA

National Public Health Service for Wales/CPHVA/ICNA (2006) Mind the Germs!
Infection Control Guidance for Nurseries, Playgroups and other Child care Settings.
Cardiff Welsh Assembly Government
APPENDIX 1 - EQUALITY ANALYSIS REPORT

Equality Analysis Report

Name of function Guidelines for cleaning toys
Date 11th November 2014
Harriet Ddungu – Head of Infection Prevention and
Assessing officers
Control
Description of policy including the aims and objectives of proposed: (service
review/resign, strategy, procedure, project, programme, budget, or work
being undertaken):

To ensure that all staff working in areas where toys are kept for public use or who
use toys in their day to day work are aware of the correct procedures for their
selection, handling and cleaning to minimise infection risk.
Evidence and Impact - provide details data community, service data,
workforce information and data relating specific protected groups. Include
details consultation and engagement with protected groups.

Evidence base:

 NHFT Equality Information Report August 2012

 Northampton County Council :Northamptonshire Results: 2011 Census Data
Summary

East South
Corby Daventry Kettering N’pton W’Boro Northants England
Northants Northants
2001 53,400 72,100 76,600 82,200 194,200 79,400 72,500 630,430 49,449,700
2011 61,100 77,700 86,800 93,500 212,100 85,200 75,400 691,900 53,012,500
% rise 14.4 7.8 13.3 13.7 9.2 7.3 4.0 9.8 7.2

Ethnicity: 85.7% (White) and 14.3% (BME ) - 1.75% (dual heritage); 4.01%
(Asian); 2.5%(Black including British, African and Caribbean); 0.85 %
(Chinese); 6.05 % (white other EEA, polish, Gypsy & Traveller)

 Gender: 49.6% males; 50.4% females (including 1% transgender)

 Disabled people: 19% (including 3.5 % < aged under 18)
 Faith communities: 71% Christian; 29% minority faith: (includes Hindu,
Muslim, Sikh, atheists, non-belief)
 Sexual orientation (gay, lesbian or bisexual): 5 - 7% (Stonewall estimate)

Service Information: provide any relevant service data or information to

inform the Equality Analysis including service user feedback, external
consultation and engagements or research.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 12 of 16 Implementation Date:

 Equality Analysis Report
Name of function Guidelines for cleaning toys
Date 11th November 2014
Protected Groups STAGE 3: Consider the effect of our actions on
(Equality Act 2010) people in terms of their protected status?

The law requires us to take active steps to consider the

need to:

 Eliminate unlawful discrimination, harassment and

victimisation
 Advance equality of opportunity
 Foster good relations with people with and with
protected characteristic

Identify the specific adverse impacts that may occur due

to this policy, project or strategy on different groups of
people. Provide an explanation for your given response.

Age None

Disability None

Gender (male, female

and transsexual, inc.
None
Pregnancy and
maternity)

Gender reassignment None

Sexual Orientation
(inc. Marriage & civil None
partnerships

Race None

Religion or Belief
None
(including non-belief)
Equality Analysis outcome: Having considered the potential or actual effect
of your project, policy etc, what changes will take place?

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 13 of 16 Implementation Date:

 Action Plan
Date to be
Issue to be addressed Action Who
completed

None

Ratification - a completed copy of the Equality Analysis form must be sent to

Equality and Inclusion Officer to be approved.
Approving Officers
Date of completion

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 14 of 16 Implementation Date:

APPENDIX 2

TOYS AND PATIENT EQUIPMENT CLEANING CARE PLAN/CHECK

LIST
Depending on the use and function of the patient equipment in use, cleaning
requirements may be classified as either: -

 After patient contact

 Between patient contact
 On a daily basis
 On a weekly basis

All equipment should be assessed and cleaned thoroughly. The cleaning checklist
should be completed after each morning/afternoon use.

Equipment must be cleaned using detergent wipes. The exception to this is:

If a blood or blood-stained fluid spillage is identified, the area must

be cleaned immediately using a Spill Kit and staff must wear PPE
(disposable gloves and aprons) during this procedure

The toys must be soaked for a period of 5 minutes in a Chlorine

based solution (10,000 parts per million) e.g. Milton and air dried.

If any equipment is found to be in a poor state of repair, it must be taken out of use
and reported, repaired or replaced as soon as possible.

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 15 of 16 Implementation Date:

Base: ____________________________________________________________

Condition check and Cleaning Record for Toys and Play Equipment

Toy condition
Toys cleaned Checked
Date Checked Comments
Y/N by
Y/N

The current version of any policy, procedure, protocol or guideline is the version held on the NHFT
internet. It is the responsibility of all staff to ensure that they are following the current version

Guidelines for Cleaning Toys 16 of 16 Implementation Date: