Kitchen Layout

After gaining enough experience and capital from my previous restaurant employment, I have decided to start my own restaurant offering Authentic Italian dishes. Stated below are the highlights of my idyllic Italian restaurant. My restaurant shall have six large tables complete with basic table amenities such as pepper, salt and a variety of well-picked sauces.   Tables will be large due to the prominence of Italian food and culture for entertaining families or large groups. Another four small tables however will be added for small companies or pairs. In compliment to this, the interior shall be well-ventilated and equally lighted for maximum space utilization. For my restaurant’s menu, I shall adapt the menu of the Via Carducci because they give special importance to pasta dishes, which are the marker s of Italian food.   Their menu, including wine choices are offered at very affordable yet reasonable prices, but not sacrificing the quality and the over-all effect of the products. Their specific cuisine is the Rustic Southern Italian which originated from the owner’s home town, Calabria. Their type of cuisine specializes in organic and fresh ingredients perfect for medium to heavy diets. My Kitchen shall adapt the open G-shaped layout. This consists of four walls, two pair of walls opposite each other; the, the sink, the refrigerator and the cooktop are located at one of the pairs such that creating an imaginary work triangle with the three as points.   This layout enhances the use of the three basic elements of the kitchen mentioned above. It also gives ample space for other cooking equipments to be located at the other pair of walls. The cleverness of the layout allows for even-trafficking in the work triangle. The said layout also makes room for one or two additional cooks for more efficient service.   The kitchen shall be open for the customers to view the brilliance of the cook(s). To add, a large over head mirror shall be ingeniously placed also for maximized viewing. I have only three specific kitchen equipments to mention (1) the World Cuisine’sLillo pasta machine: able to produce different kinds of pasta from any type of flour, with or without the use of eggs. The product comes with four durable pasta attachments for Spaghetti, Tagliatelle, Penne, and Macaroni. The item is ideal for fast-paced kitchens with just enough working space. The lillo pasta machine is also recommended for Italian kitchens serving quality pasta. (2) The Silex line of Knives. Qualities include; purity of metal achieved through the secondary melting process it underwent, unique hardness provided by the strength of the material used, the fineness and precision comparable to a surgical scalpel, special resistance to corrosion, easy to sharpen blades given by the hardness and purity, and the extraordinary length of time it remains sharp. Its handle is designed for comfort in working for long periods of time. It also has a polymer-based handle which is anti-bacterial. This line of cutlery provides proficiency in the work place due to its efficiency, durability and cleanliness in the workplace. This is ideal for busy restaurant kitchens which specialize in salads and fresh sauces. The next item (3) would be the World Cuisine’s Large oval cast-iron grill. This product is ideal for indoor-grilling. The heavy ridged cast iron surface preserves heat which equally and quickly grills. The item is suggested for class gourmet meals. Other kitchen equipments which were not mentioned will also be hand-picked with care. Costs shall also be given much attention. The above mentioned factors and elements were cautiously selected taking into consideration the availability, efficiency, monetary cost, and over-all quality. This, for me, is the ideal kitchen layout together with the visualization of the ideal Italian restaurant. References: Atlanta Home improvement, Kitchen Layouts, August 8 2007 From: http://www.homeimprovementmag.com/Articles/2004/04Dec_k&b_layouts.html         

Help Children Who Are Chronic Liars Tell the Truth

Help Children Who Are Chronic Liars Tell the Truth Special educators will undoubtedly meet and teach students who seem to have difficulty telling the truth. Some of them may blame others to avoid getting in trouble, while some children may embroider elaborate stories as a means to join conversations. For other children, chronic lying may be part of an emotional or behavioral disorder. Behaviors and Coping Mechanisms The child who exaggerates, tells lies, or distorts the truth does so for a variety of reasons. A behavioral (ABA)  approach will always focus on the function  of the behavior, which in this case, is the lying.  Behaviorists identify four basic functions for behavior: avoidance or escape, to acquire something they want, to get attention, or for power or control. The same is true of lying. Often, children have learned a specific set of coping mechanisms. These are learned to avoid bringing attention to the childs inability to perform academically. These coping mechanisms also may come from children being raised by families that have poor coping mechanisms, mental health issues, or addiction problems. Children That Have Difficulty Telling the Truth Avoidance or escape. Students will often lie to avoid or escape a task they dont want to do or to avoid consequences that come with not completing an assignment or homework. If a student comes from a punitive home or has only experienced school as a punitive environment, it is common for students to lie. They do this to avoid the kind of punishment or shaming they have experienced at home or in a general education classroom, such as a teacher screaming. Acquire something they want. Everyone sometimes  shades the truth to get something they want. Children from homes that cannot or will not provide coveted items often steal, and then lie, in order to get items they would not generally have access to. This may include bright pencils, erasers in fun shapes, or highly desirable toys or games, such as Pokemon cards.   Attention. Chronic lying often falls in this category, though what a child may exhibit is, in  fact, poor social skills and the desire to command the attention of other students. They may create elaborate or fantastical stories that have no basis in truth but are a response to something the teacher or another student has said. Whether the purpose is to get attention by making extraordinary claims (my uncle is a movie star), or fantasy (I went to Paris with my cousins), positive attention for real accomplishments will reinforce correct and truthful behavior.   Power. Students who feel powerless or out of control may use lying in order to control the teacher, his or her peers, or another significant adult. Students may want to get their classmates in trouble, sometimes breaking or ruining something in the classroom on purpose. Chronic or habitual liars rarely feel good about themselves. It is recommended to look for patterns in the childs lying. Consider if the lying only occurs at specific times or in specific situations. When one has identified the function or purpose of the behavior, they can plan appropriate interventions.   12 Interventions and Tips Always model telling the truth and avoiding little white lies.In small groups, role-play with students on the value of telling the truth. This will take time and some patience. Identify telling the truth as a classroom value.Role-play the potentially devastating consequences of lying.Do not accept excuses for lying, as lying is not acceptable.Children should understand the hurtful consequences of lying and whenever possible, they should apologize for lying.Logical consequences need to be in place for the child who lies.Children will lie to protect themselves from the punishment of scolding. Avoid scolding but maintain a calm demeanor. Thank children for telling the truth. Apply a lesser consequence for a student who takes responsibility for their actions.Do not punish students for accidents. Cleaning up or apologizing should be the most appropriate consequence.Children need to be part of the solution and consequences. Ask them what they are prepared to give or do as a result of the l ie. Teachers can explain to the child that what he or she did is the problem. Teachers should reinforce that its not the child, but what he or she did that is upsetting, and explain why the disappointment is there.Catch the chronic liar telling the truth and commend them.  Avoid lectures and quick, irrational threats.

Use of Symbols in Sir Gawain and the Green Knight

Use of Symbols in Sir Gawain and the Green Knight â€Å"Sir Gawain and the Green Knight† is an ancient poem that tells the story of the exchanges between Sir Gawain and a mysterious Green Knight. Sir Gawain is a blood relative of King Arthur and a brave knight while the Green Knight is a disguised character who sets out to test his opponent. â€Å"Sir Gawain and the Green Knight† was authored in an unknown date in the late 1300s by an anonymous author.Advertising We will write a custom research paper sample on Use of Symbols in â€Å"Sir Gawain and the Green Knight† specifically for you for only $16.05 $11/page Learn More The unknown author who wrote â€Å"Sir Gawain and the Green Knight† is also associated with three other poems that were found in the manuscript that contained this poem. The setting of the poem has always been believed to be Northern England. The author of this poem (referred to as the Gawain-poet in this paper) uses several stylistic devices that make this poem an outstanding work of literature. The poet uses several symbols in the poem to the benefit of the readers. The symbols that are used in â€Å"Sir Gawain and the Green Knight† help the Gawain-poet to instill deeper meanings to this literary piece. This essay explores the symbols that are used in Sir Gawain and the Green Knight and how they contribute towards the revelation of the poem’s meaning. The poem begins by narrating the events that are going on in King Arthur’s court during the new-year festivities. A mysterious character, the Green Knight, arrives at the King’s court albeit uninvited. The Green Knight proceeds to offer a challenge to all the feast attendees; any brave knight who is present at the court will have the opportunity to strike the Green Knight with an axe but in one year and a day’s time the volunteering knight would have to withstand a similar challenge. King Arthur steps forward and accepts the challenge but Gawain intercepts the King and takes up the challenge himself. Gawain carries on the challenge by striking the Green Knight’s head with an axe and manages to severe it. However, in a strange turn of events the Green Knight bends down and picks up his severed head. The Knight then reminds Gawain to honor his end of the deal by showing up to the Green Chapel to receive a similar challenge. Approximately a year after this encounter, Sir Gawain leaves for the Green Chapel to honor his end of the deal. The Gawain-poet details the adventures of Gawain throughout his journey in the rest of the poem.Advertising Looking for research paper on british literature? Let's see if we can help you! Get your first paper with 15% OFF Learn More One of the most prominent symbols that are used in this poem is Gawain’s shield and pentangle. The shield is a tool of protection especially for people who engage in armed combat. The pentangle that is contained in the shield is specific to the wearer (Sir Gawain). Therefore, the pentangle is a symbol of the virtues and values that are held by Gawain in the course of his Knighthood. According to the poem, the pentangle is a five-pointed-star that traces its origins to King Solomon. In most ancient texts, the pentangle is often a symbol of truth or a magical seal (Green 123). The interlocking nature of the pentangle symbolizes the complexity of human virtues. In the context of the â€Å"Sir Gawain and the Green Knight†, the pentangle brings together the influence of â€Å"the five virtues, the five wounds of Christ, the five senses, the five joys of Mary the mother of Jesus, and the five fingers (Besserman 220). Consequently, it is apparent that as a knight, Gawain also seeks his moral, physical, and spiritual strengths from other places. Gawain’s strengths and virtues are interwoven like the triangles in the pentangle. The endless pattern that is found in the pentangle echoes the perfection of Gawain ch aracter. For instance, when all the other knights are afraid of the Green Knight’s challenge he voluntary rescues the King from possible failure or humiliation. Solomon is said to have used the pentangle as a personal magic seal. However, later on Solomon became a symbol of wisdom, kingship, and might. The similarities between Solomon and Gawain’s use of the pentangle are that both personalities had flaws. At the end, Solomon turned away from God and eventually lost his kingdom while Gawain refused to honor a promise he made to his host. The Gawain-poet emphasizes the significance of the connection between Gawain and the pentangle. According to Professor Burrow, several lines in the poem are dedicated to establishing this connection. For example, the poet mentions that the pentangle is a symbol of fidelity or ‘trawpe’ that associates Gawain with the traits of faithfulness and fidelity. The poet then concludes that the object is befitting for the main chara cter (Morgan 779). The symbol of the pentangle helps in developing the themes of bravery and selflessness. These two concepts are presented from a Christian point of view and hence the pentangle is a symbol of fidelity and faithfulness.Advertising We will write a custom research paper sample on Use of Symbols in â€Å"Sir Gawain and the Green Knight† specifically for you for only $16.05 $11/page Learn More Color green is a symbol with several possible interpretations. The main antagonist in â€Å"Sir Gawain and the Green Knight† is the Green Knight. The Green Knight is presented by the poet as a mystical character with striking features. This character is noted to be green in color. In addition, the Green Knight has a green horse, green skin, a green beard, green clothes, a green-gold axe, and green hair. The portrayal of a completely green knight highlights the peculiar nature of Green Knight’s presence. In addition, the Green Knightâ €™s color uniformity suggests that he is a uniform character. Several analysts have debated about the symbolism of color green as used by the Gawain-poet. Some scholars have proposed that the Green Knight is a symbol of the god of vegetation and nature. According to Basserman, the green color of the Green Knight symbolizes the â€Å"dying and rising vegetation god† (220). Other medieval texts have also made references to green men. In some instances, a green man symbolizes a ‘wild man’ while at other times he symbolizes the ‘evil man’. The Gawain-poet combines both symbols because at the beginning of the poem the Green Knight is portrayed as a character with evil motives. However, by the end of the poem the Green Knight is portrayed as a straightforward character. Most scholars are in agreement over the fact that in traditional-English folklore the color green mostly symbolizes fertility and rebirth. In the poem, green is presented as a pure colo r except for the green-gold girdle. The mixture of green and gold is a symbol of change in the form of passing youth. The green color used in the girdle first serves a symbol of immortality. When Gawain is humiliated by his behaviors, he adorns the green girdle as a symbol of cowardice and shame. However, the Camelot knights finally adorn the green girdle as a symbol of honor. All these changes elaborate the ambiguity of color green as a literary symbol. The poem also employs the symbol of an axe that is held by the Green Knight during his entry to the king’s court. During the medieval times, the axe was a symbol of execution. Consequently, when the Green Knight is holding an axe he symbolizes the executioner. When the Green Knight enters the palace, he is holding an axe but he offers to be executed first.Advertising Looking for research paper on british literature? Let's see if we can help you! Get your first paper with 15% OFF Learn More This makes the Green Knight a strange and an unusual executioner. When the Green Knight picks up his severed head and rides away, it becomes clear that he is an extraordinary executioner, one who cannot die. In medieval texts, death is known as the only executioner who cannot die (Besserman 220). Apart from the axe, the Green Knight is also holding a holly bob. In medieval England hollies were constantly associated with death and ghosts who would often come back to haunt their former residences. Some medieval sources claim that it was â€Å"a well known fact within the English tradition that a holly bob carried into a house before Christmas foretells death in the coming year† (Krappe 214). Therefore, when the Green Knight enters holding an axe and a holly bob, his symbol as the executioner who foretells death is complete. The green girdle is another symbol that has ambiguous characteristics. The symbol of the girdle is like the one of color green and it keeps changing through out the poem. At first, the Gawain is given the girdle by his host’s wife with the promise that it has magical elements and it will make him immortal. However, when the identity of the Green Knight is revealed to be that of Gawain’s former host, the girdle instantly symbolizes cowardice and shame. Gawain resolves to wear the girdle for the rest of his life as a symbol of his shameful and cowardly act. However, when Gawain arrives at Camelot he finds all the other knights wearing the girdle as a symbol of triumph and honor (Tolkien 121). Given the poem’s religious undertones, the Gawain-poet might have used the symbol of the girdle as a parallel to the crown of thorns that was worn by Jesus during crucifixion. Jesus’ crown of thorns was a symbol of both humiliation and triumph. Furthermore, the crown of thorns signified the victory of Jesus after he had gone through turbulent times. Gawain goes through tough experiences that are similar to the ones that Je sus went through and in the end he receives a symbolic girdle. A thorough analysis of the symbols that are used in â€Å"Sir Gawain and the Green Knight† reveals that this poem contains several hidden meanings. These symbols also reveal that the Gawain-poet employs a strong religious theme. The poem also lacks a sole and definite meaning. Instead, the Gawain-poet chooses to indulge the readers in dual-meaning symbols. Symbols are also used to portray the weaknesses of mankind in the face of tribulations. Most of the symbols in this story dwell on the subjects of death, human triumph, defeat, temptation, and honor. The dual meanings in some of the symbols that are used in this poem suggest that the poet is not ready to pass judgments. A thorough analysis of â€Å"Sir Gawain and the Green Knight† indicates that symbols are prevalent in the poem and the Gawain-poet intended to use these symbols as tools of hidden meanings. Besserman, Lawrence. The idea of the Green Knigh t. ELH 53.2 (1986): 219-239. Print. Green, Hamilton. Gawains Shield and the Quest for Perfection. ELH 29.2 (2002): 121- 139. Print. Krappe, Alexander Haggerty. Who Was the Green Knight?. Speculum 13.2 (1938): 206-215. Print. Morgan, Gerald. The significance of the pentangle symbolism in Sir Gawain and the Green Knight. Modern (The) Language Review London 74.4 (1979): 770-790. Print. Tolkien, John and Norman Davis. Sir Gawain and the green knight, London, United Kingdom: Oxford University Press, 1967. Print.

Statistics Minitab Assignment Example | Topics and Well Written Essays - 500 words

Statistics Minitab - Assignment Example Then analyse the variability in the designed experiment. Then the results would be interpreted. The paired-t test has been selected because we needed to test whether the two samples had difference means and if these differences were significant. We therefore needed to pair these two samples and test the differences at 95% confidence level. As can be seen, p > .05 therefore the differences are not significant. The chi-square analysis was run for the categorical values as were in the table. The chi-square tested the hypothesis that there is no association between caffeine consumption (column factors) and marital status (raw factors). The results show that the chi-square statistic was 51.656. The p value is < .001 which suggests that we reject the null hypothesis of no association between marital status and caffeine consumption in favour of the alternative that there is indeed an association between them. Thus, marital status affects caffeine consumption. The reason for this association could be attributed to the fact that we had more married participants in the sample and hence the results may be biased towards the same. As can be seen, there were 3029 married participants out of the 3888 participants in total. I recommend that to improve results, same number of samples should be selected from the marital status categories for the

Benefit Law Advice Case Study Example | Topics and Well Written Essays - 2000 words

Benefit Law Advice - Case Study Example Also included in the conclusion is a finality point emphasizing that social services can have positive impacts or negative impacts on the social lives of those who live with disabilities. Obtaining benefits for DLA or Attendance Allowance can be tricky and confusing for many, especially when it comes to understanding what the different eligibility requirements associated with AA and the possible benefits are. Physical limitations are actually categorized in various ways, which often depend on what the Commissioner confirms as applicable for benefits of AA or not. Obtaining an AA varies from case to case (as was stated) but legislative law in Britain does recognize people as being eligible to receive it if they have a terminal illness, mental handicap, physical limitation, and are otherwise incapacitated due to a terminal prognosis that also included surgical procedures which could lead to limitations in their former routines. However, anyone age 65 or older who has received a prognosis of a terminal illness and only have on average 6 months to live is eligible for AA according to the Benefit's agency (Nosowska 2004, p. 284). Nevertheless, there have been cases where people have actually died while awaiting approval from the Commissioner for AA or DLA assistance (Nosowska 2004, p.286). The case that is being referred to is in regards to 22 elderly women who were diagnosed with terminal cancer. The Commissioner approved them for AA but the wait was so long and the financial burden so heavy that as was stated, a number of them died while waiting for approval to receive the care they needed (Nosowska 2004, p.284). It would seem that the Commissioner could have used a "common sense" perspective to process these 22 women's claims faster, yet did not. Also, one would think that it should have also been obvious that these elderly women were suffering from forms of dementia along with their terminal prognosis which limited their abilities to "function independently". A physical limitation or lack of competence is normally enough for the Commissioner to approve AA, which in these 22 cases it was approved but again the delay in achieving it is what lead t o the adversities in health for some of the women (Ariotti 1999, p. 216). When the view switches to individual assessments on personal capabilities in regards to lifting and muscle strength there are also an innumerable amount of variables that are weighed and considered. The Commissioners decision to change the original "lift and carry" assessment has proven to make a great difference when professionals are trying to determine whether an individual has the ability to perform work related duties or not. There have been specific cases in the past that have affected the Commissioner's decision to reform article 8 in the personal capability assessment procedures (Benefits and Work UK 2004). For example, due to a historic case known as "Howker", definite changes were found to be needed because some of the physical assessments in the testing were shown to have placed individuals in far worse conditions than before they were even assessed (Benefits and Work UK 2004). Also, it would appear that the wrong questions were

Literature Review and Proposal Essay Example | Topics and Well Written Essays - 1750 words

Literature Review and Proposal - Essay Example However, things did not turned out as expected and it was found that other nations were actually overtaking the national sports of England with relative ease and it was more evident in the last 40 years. According to the fundamental hypothesis it can be stated that foreign influences has much to do with it. This is where the question becomes extremely important. Football is not only the national sports of England it is also an immensely popular sports in the country. It is fundamentally a heritage of England and the current degradation of this sport is a crisis of the national level and it is important to understand the reason behind this. A Qualitative method of study differs from the usual quantitative methods (used in the study of pure sciences) in the sense that it tends to be far more subjective. This is in sharp contrast to the methods used in pure sciences which are exclusively objective. The research methods for marketing are a combination of both quantitative and qualitative methods. Being open to qualitative methods of study also allows social scientists to incorporate non-quantitative data (i.e. non-numerical data, such as words, images, gestures, impressions etc.) in their study. Since human beings tend to operate in terms of such data and not in terms of the terminology used in ordinary sciences this broader outlook is far more applicable in the study of social sciences. In keeping with the methodology employed in marketing researches the theories too are formulated and used keeping in mind that they aren't necessarily applicable to all conditions. Be it psychology, history, political science or economics human events are most likely to influence the rules which define the basic theories of a marketing subject. Success in the field of marketing researches can therefore be achieved if and only if it is understood that the subject has no space or opportunity for water-tight methodologies or theories. (Berkowitz, 2004) It can always be stated that Qualitative research is a process that includes interpretative paradigm under the measures of theoretical assumptions and the entire approach is based on sustainability that is depended on people's experience in terms of communication. It can also be mentioned that the total approach is based on the fact that reality is created on the social formulations. It can also be mentioned that the basic target of qualitative research is instrumented towards social context under normal circumstances where it would be possible to interpret, decode and describe the significances of a phenomenon. The entire process is operational under the parameter of interpretative paradigm that can minimize illusion and share subjectivity under contextualization, authenticity and complexity of the investigation. The basic advantages of qualitative measures are multi fold. Firstly, it presents a completely realistic approach that the statistical analysis and numerical data used in research based on quantitative research cannot provide. Another advantage of qualitative measures is that it is more flexible in nature in terms of collected information interpretation, subsequent analysis and data collection. It also presents a holistic point of view of the investigat

Principles infection control Essay Example for Free

Principles infection control Essay Explain employees’ roles and responsibilities in relation to the prevention and control of infection ANSWER As an employee the Health and Safety At Work Act 1974 state that I have a duty and responsibility to ensure that I as an employee have a duty to be responsible in showing reasonable care for my own safety. I have the responsibility of my own safety in terms of cleanliness and hygiene observation and practice; I am responsible for cooperating and following the health and safety guidelines and expectations of my employer; I am responsible for maintaining and taking care of all hygiene equipment and materials and to report when there is a faulty; I am responsible for using PPE appropriately and attending the necessary training in health and safety, keeping my skills up to date; I have a responsibility of to monitor the hygiene practices of my staff as a senior care support worker making sure that they observe practices such as wearing appropriate PPE and washing hands appropriately as well as updating their training. I must be of the attitude that when it comes to infection prevention and control that all individuals (including myself) are high risk and practice my control of hygiene accordingly. This means wearing PPE such as gloves and aprons when assisting a service user to toilet or wash; disposing of the PPE appropriately afterwards and washing my hands thoroughly. It includes using new clean PPE between attending to different service users; making sure pads and soiled linen are bagged and disposed correctly; disinfecting and wiping down areas when necessary; storing foods to correct temperatures; preparing foods to correct temperatures before serving; using clean food implements and equipment and following the instructions of the use and storage of substances hazardous to health. I must also keep my personal hygiene up to standards at work by wearing appropriate clean clothing and  keeping my hair tidy and tied away for my face, no jewellery or dangling parts and sensible foot wear. Wearing inappropriate clothing such as clothes with tassels can drop into food and cause cross contamination; shoes that will cause imbalance and cause me to topple over would be dangerous especially if carrying food, waste or assisting a person to manoeuvre. Not wearing appropriate PPE would increase the chance of cross contamination as substances such as bodily fluids, chemicals and other foreign particles such as hair etc can be easily transferred to ingest or inhale in some way. Reporting faulty equipment is essential as if a dish washer or washing machine breaks down then this increases the risk of the items they would process to not be processed properly or sit around harbouring bacteria for longer thus increasing the risk to cross contamination. Updating my knowledge in subjects such as health and safety and food safety is vital as it reinforces knowledge and practice and informs me of any legislation and practices that have changed. If a service user develops an infection then I must record and report this straight away making sure that the home nurse or manager is aware and that it is handed over to the staff team with instructions of how to provide care. The service user must receive medical attention from the home nurse or a GP. These types of infections must also include reporting to necessary bodies such as RIDDOR at the local authority by the GP, especially in circumstances of food poisoning or contagious infections such as Healthcare Associated Infections (e.g. MRSA, MSSA, C. Difficile and E. Coli which are all very contagious bacteria). If a member of staff has an infection and they pose a risk to others of cross contamination then they should seek medical attention and not come into work advising me by phone call of what the issue is so that I can alert the manager or home nurse and we can check for any risk of cross contamination. This staff member (including myself it affected) should not return to work unless the risk had gone and it is medically safe to do so. A certificate from my (or staffs) GP must be provided in these cases. Continue on a separate page if necessary QUESTION- ( 1.2 ) Explain employers’ responsibilities in relation to the prevention and control of infection ANSWER Employers have a great duty to ensure that health and safety regulations (HASAWA 1974) are met in the prevention and control of infections because they also have a duty of care to ensure it is prevented and/ or kept under control and terminated. Health and safety legislation states that employers must protect employees from danger and harm as far as reasonably possible so the work premises that they provide for service users to dwell and staff to work in must be safe and free from danger. In terms of infection control, all substances that are hazardous to health including bodily fluids, chemicals and wastes must have provisions so that they can be stored, handled, cleaned, processed and disposed of safely with minimal risk to individuals. Risk assessments must be carried out in the work place to ensure that any risks are identified, minimised and monitored as a way of limiting and controlling the risk of infection. Risk assessment of stored and used substances including COSHH and biohazard substances and risk assessments of working procedures including risk assessments in serviced users care plans must be carried out and updated. Employers must provide the means for staff to access training so that their employees knowledge and skills are up to date; they must provide the means to PPE so that employees can protect themselves and others whilst they work with hazardous substances and they must ensure that regular health and safety checks are carried out so that any issues can be identified and corrected in the building and in the resources. Employers must also provide the necessary infection prevention and control in policies and procedures so that I and my staff team can access the necessary information on how we carry out our work. The main source of Health Care Associated Infections (HCAIs) are transferred via hand contact therefore it is vital that my employer provides that  adequate resources for myself and staff to wash our hands and dry our hands regularly, appropriately and to procedure. The facilities to wash with warm water and use a WC should be clean and safe (not damaged and kept clean) provided with necessary hand wash, disposable hand towels and pedal bins. Such resources are vital to the control and prevention of infections. Continue on a separate page if necessary QUESTION- ( 2.1 ) Outline current legislation and regulatory body standards which are relevant to the prevention and control of infection ANSWER As well as the Health and Safety At Work Act 1974 that stipulates that each employee and employers have a responsibility of showing reasonable care for ourselves and others and to provide a safe place to work respectively; other acts that state more specifically how the prevention and control of infections must be met in my work place and these include Control of Substances Hazardous to Health (2002) or COSHH and the Reporting of Injuries, Diseases and Dangerous Occurences Regulations 1995 or RIDDOR. A hazardous substance is any substance or material with the potential to cause illness or injury to the people whom come into contact with it and are likely to come in the forms of liquids, dust, fumes, gases and living organisms. The control of these substances involve the prevention of accidents and ill health and therefore COSHH stipulates that such hazards must be identified; risk assessed; prevent exposure to or control exposure to and staff should be regularly check if they are continuously working with some high risk substances. COSHH also requires that people at work handling substances should follow the instructions or be trained to handle the substances; know what control measures to take and how to take appropriate action in an emergency In a care home environment the employer must make sure that the storage of any substances is safe and legally adequate i.e. in  correct containers, in suitable room, in suitable temperatures, dry area, off of the floor, locked securely etc; all chemical substances should have their data sheets listing the ingredients; storage rooms sign posted appropriately and have only authorised persons using them etc. The regulation should also explain of how to deal with spillages safely and this would include the spillage of blood and/or urine; how to dispose of sharps and dispose of soiled materials such as pads. RIDDOR (1995) covers the recording and reporting of dangerous occurrences and accidents in the workplace. I must ensure that these reports be kept for 3 years and they must be available for inspection by the Health and Safety Executive (HSE) as and when required. Work places should have a system of reporting injuries, diseases and dangerous occurrences as a result of accidents and incidents. An accident is something that happens that results in an injury or death and an incident is something that almost could have happened that might not have caused harm now but could cause an injury, ill health or a fatality in the future. I must report some incidents to the Health and Safety Executive (via RIDDOR) directly and these include: Death or a major injury Injury resulting in employees being 3 or more Poisoning days off of work Occupational cancers Occupational asthma or lung disease Skin condition such as (from asbestos) skin cancers or dermatitis Musculo-skeletal disorders including fractures Under the Health and Social Care Act 2008 a code of practice was established for the prevention and control of Health Care Associated Infections (HCAIs) setting out how the NHS will go about attempting to prevent HCAIs. 1 Systems to manage and monitor the prevention and control of infection. These systems use risk assessments and consider how susceptible service users are and any risks that their environment and other users may pose to them. 2 Provide and maintain a clean and appropriate environment in managed premises that facilitates the prevention and control of infections. 3 Provide suitable accurate information on infections to service users and their visitors. 4 Provide suitable accurate information on infections to any person concerned with providing further support or nursing/ medical care in a timely fashion. 5 Ensure that people who have or develop an infection are identified promptly and receive the appropriate treatment and care to reduce the risk of passing on the infection to other people. 6 Ensure that all staff and those employed to provide care in all settings are fully involved in the process of preventing and controlling infection. 7 Provide or secure adequate isolation facilities. 8 Secure adequate access to laboratory support as appropriate. 9 Have and adhere to policies, designed for the individual’s care and provider organisations that will help to prevent and control infections. 10 Ensure, so far as is reasonably practicable, that care workers are free of and are protected from exposure to infections that can be caught at work and that all staff are suitably educated in the prevention and control of infection associated with the provision of health and social care. The Department of Health 2010 ‘The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance’. My employer has to show how it is implementing these codes as best suited to the organisation and assessed and inspected by the Care Quality Commission. The Public Health Control Of Diseases Act 1984 and the Public Health (infectious Diseases) Regulations provides information about disease which are risks such as Dysentery, cholera, diphtheria and food poisoning etc . It explains how an outbreak should be handled, recorded and reported and the responsibility of informing the environmental health officer of the outbreak so that an investigation can be carried out. Continue on a separate page if necessary QUESTION- ( 2.2 ) Describe local and organisational policies relevant to the prevention and control of infection ANSWER Policies that cover the prevention and control of infection at my work place include those of: Hand washing technique procedure: To wash hands thoroughly after assisting service users (for example after assisting them to use the toilet, change their pad or even after dressing them or feeding them) it is of paramount importance that I (and my staff team) follow the established method of hand washing. Transference of bacteria via hand to hand contact is the most common way of the spread of infections and pathogens that cause them so it is vital that I carry this out throughout my working practice. My work place has this method displayed in appropriate places (i.e. above hand wash basins) so that it is there to guide me and my staff team. It is a process that should take no more than 15 to 30 seconds and it is a process that is carried out frequently, even if disposable or non disposable gloves are used – hand washing technique is still necessary. The facilities must be available and this includes the basin with hot water, soap and disposable towels. My work place has policies and procedures outlining what to do in the event of the outbreak of infection. It will outline a procedure of recording and reporting on the necessary forms not only for our records but also for RIDDOR. It will direct me to report and outbreak or the suspicion of an outbreak to the home manager or nurse so that they can report to the Environmental Health authorities. If needed a GP will be called in to tend to the service user and will also advise to or report to the local  environmental health inspector for RIDDOR of a notifiable disease such as dysentery, cholera, MRSA, MSSA, C, Difficile or E, Coli (to name a few). The policy will outline the various circumstances of which to notify the Environmental Health Authorities because even though sickness like diarrhoea and influenza are quite common and most people can overcome them with over the counter medications, for elderly people these can pose more of a threat an cause pneumonia or even death if they are not supported straight away because of their weakened immune system or if they already have a chest condition. The procedures outline what to do if there is an outbreak in the home depending on what the suspected infection is i.e. best practice in cases of influenza should instruct along the lines of making the conditions present indicate the threat i.e. The signs and symptoms of influenza e.g. Onset of fever, headache, myalgia, cold or runny nose, sore throat etc; symptoms like these in 2 or more individuals in the home within a 3 day period and the preventative treatment that needs to be put into place as a result. Policies of storage and use of substances that are hazardous to health also cover chemical products that are used throughout the work place (i.e. detergents, cleaners, disinfectants, aerosols etc) and the routine and schedule of cleaning areas particularly areas such as bathrooms, wet rooms, toilets and kitchens. Policy and procedure are also provided on how to dispose of items such as sharps and soiled pads; Soiled pads should disposed of in yellow sanitation bags which can be disposed of in the clinical waste bin; needles and other forms of sharps during drug administration or phlebotomy must be disposed of in special sharps containers that are collected and incinerated. Some service user may have to use certain aids to help them in their day to day lives and these can also require care and attention so as to reduce infection and spread of infection. Such items as catheters need to be cleaned and the service user would need to clean or assistance to clean their most intimate areas so as to prevent infections. Procedure advice on how to clean and care for the aids and how to protect ourselves with appropriate PPE before tending to them. All new catheter bags will be  inside of sterile packaging and we must ensure that these are kept sealed and renew according to care plan. Policy and procedure instructing on care of service users stoma bags would also be another example of such aids where infection prevention and control is of great importance. Continue on a separate page if necessary QUESTION- ( 3.1 ) Describe procedures and systems relevant to the prevention and control of infection ANSWER My work place also has guidance in the form of policies of when to use Personal Protective Equipment such as gloves, aprons or gowns, masks and eye protection. These are vital as a protective barrier against transference of pathogens from service user to me (or staff) and from me to service user. These must be worn when assisting the service user to toilet, change pads, wash, dress and a fresh set when preparing food. They should also be worn when changing bins or clearing up spillages, especially of hazardous substances. The gloves and aprons must be disposable as this reduces the harbouring of pathogens and cuts down the spread of infections. The procedures cover how to don and remove such items as carrying out such methods in sequence cuts down the risk of the spread of infections and transference of pathogens e.g. it may outline a process such as: Carry out hand hygiene immediately before and after donning and removing PPE. Don a gown Don a mask (if used) Don eye wear (if used) Don gloves. Such donning of protection must be carried out in this order as to put gloves  on firstly would make it difficult to tie and adjust other garments; also if hands are gloved it may encourage the user to touch things that may carry infection and then they would transfer when donning other PPE. Donning a mask or eye wear firstly would also be impractical as they would get in the way when donning other items. It is best to don the gown firstly as this has to be done up at the back and then the others (where applicable) and gloves lastly. The procedure will also outline how to don each item of PPE e.g. for donning gloves it may say to don them lastly by inserting hands into gloves and then making sure that the gloves also cover the wrists; and also how to (and in what order to) remove each item of PPE in order to cuts down the risk of the spread of infections and transference of pathogens. Cleaning of certain rooms and facilities in the care home require regular cleaning and decontaminating, disinfecting and sterilisation. Toilets, bathrooms, commodes, equipment such as hoists, bath chairs and handle rails all need to be cleansed in line with the procedure of the home. For example procedure in my care home stipulates that the commodes must be generally cleaned and decontaminated and disinfected after each use, as well as the resident’s toilets. Soiling may not be visible to the eye however the bacteria still persists so this must be cleaned and disinfected immediately. Similarly bathrooms and wet rooms must be cleaned and disinfected after each use as residue from the service users body would be left behind causing bacteria to build up, especially in a damp place. According to procedure I ensure that staffs or myself frequently check the resident’s toilets (hourly). A checking schedule is placed in the toilet where we tick off that it has been checked. In addition to this when we assist the service user to use the toilets after their use we used disinfecting wipes to clean down the seat area and a spate wipe to clean the flushing handle whilst applying disinfectant to the toilet bowl. If debris is in the toilet bowl, this must be scrubbed away using the toilet brush. Many service users need our assistance to use the toilet however some are able to use the toilet themselves and may not remember or be able to disinfect the toilet appropriately after use so we check the toilet hourly  for this purpose. After we finish assisting the service user, making sure that they wash their hands and they are made comfortable outside of toilet we change gloves to clean gloves (as to not cross contaminate from assisting them to other surfaces) and use cleaning materials that are stored in a secure cupboard in the toilet firstly applying toilet bowl disinfectant to the bowl and scrub bowl with toilet brush (if required); use a disinfecting wipe to clean top of bowl, a fresh one for the seat and another last wipe during the flush. We clean the flushing handle lastly using the wipe so as to not risk contamination after touching anywhere else. Where wipes are not used or have run out we use colour coded disposable cleaning cloths and liquid detergents (to remove physical debris) then liquid disinfectant to disinfect the surfaces. These are readily made up to the correct solutions (according to manufactures specifications) and are bottled in colour coded plastic bottles and labelled. For cleaning supplies used in toilets the spray bottles containing the detergent and disinfectants, cleaning cloths, mops and mop-buckets are all red. This gives a clear indication that these are the materials and equipment to be used in the toilet areas only and ensures that these are not used elsewhere in the home providing a procedural barrier against cross contamination. When using the liquid cleaners/disinfectants and cloths we clean and disinfect the flush handle firstly and then work our way down to the bowl to spread of infection from toilet bowl to flush handle. If there is a spillage of urine on the floor then we use water and detergent with a designated mop and mop-bucket (colour coded red) to clean away the spillage. After the physical debris has been removed then we use disinfectant to disinfect the area, ensuring that hazard warning signs are put in place whilst cleaning is taking place so as to warn others of slippery floor surfaces. We open the window so as to encourage quicker drying of the floor and monitor it for safety and remove signage when drying is complete. After cleaning these areas and supplies are securely pit away, we discard of our PPE in a specific manner which also acts as a procedural preventative  barrier against the spread of infection: gloves (turned inside out), apron and then hand hygiene. At the end of a residency and once the room has been voided and all belongings have been removed it is the procedure of our workplace that it should be cleaned and decontaminated, disinfected and sterilised. To do this we have a void team who remove any leftover items to throw away at a local authority refuse centre and get ready to refurbish the room. Wearing PPE we clean, disinfect and use a steam steriliser to sterilise the bed frame and commode (a new mattress is always ordered at the beginning of new residencies) and move these temporarily into a storage room. We also strip the windows of curtains and drapes to launder. The void team then remove the lino and sterilise the room walls and ceiling, skirting door and door frame and handles; repaint and lay new lino to flooring. We then replace the window dressings, bed frame and commode. Many other procedures are particular to our home some of which include: Daily, weekly and monthly cleaning of the kitchen and its contents. The storage and maintenance of products and equipment e.g. cleaning chemicals and the required documentation, food stores and the stock rotation, health aids particular to each service user (such as catheters, stoma bags, dressings and pads), hoists, commodes, stand and twists, transfer boards, PPE etc. Disposal of clinical wastes. Safe handling and disposal of sharps. Managing spillages of blood and bodily fluids products. How to report and record and manage occurrences or suspicions of an outbreak. How to report and record accidents and incidents. Best practice of hand hygiene. Handling and laundering of soiled clothes and linen. Continue on a separate page if necessary QUESTION- ( 3.2 ) Explain the potential impact of an outbreak of infection on the individual and the organisation ANSWER The potential impact of an outbreak of infection on the individual can be devastating because it not only means that they have to be cared for in isolation to limit the risk of infection to other service users but it also means that the infection poses great risk to the individual’s life as their immune system is usually compromised and an infection poses a greater threat to their life. The symptoms of having an infection can be very uncomfortable for them in the mean time as their body is trying to fight the infection they can suffer symptoms such as fever and weakened muscle pain. If their skin is fragile and they are bed bound extra care must be taken to make sure that they are cleaned well and turned often to limit the onset of bedsores that can lead to even more complications. In cases of their treatment using some antibiotics (particularly stronger antibiotics that can give risk to the onset of other bacterial infections such as C. Diff because these antibiotics can have the effect of killing the initial infection in the digestive tract but can also kill beneficial, naturally occurring bacteria essential to the health of the digestive system. The resultant imbalance can give rise to C. Diff (which also naturally occurs in the system) to multiply causing an imbalance by over population that is toxic to their system. The resulting symptoms include can give the side effect of diarrhoea and vomiting which in turn create aerosols and risk of airborne transmission. The isolation that follows when the individual needs to be cared for and treated separately from others so as to reduce the risk of spread of infections to others can also affect the individual’s emotional/ mental wellbeing as they may feel more lonely and depressed during this time and this can affect their self esteem. It is therefore essential that myself and members of staff visit the individual often to maintain social contact  with them and ensure support of their mental health. Visits to the individual from friends and relatives must be stopped until the outbreak has cleared so as limit the risk of cross contamination to the visitors and also protect the resident from bacteria the visitors may unwittingly bring with them. The potential difficulties that follow an infection outbreak for the individual are complex and life threatening. The impact of an infection out break on the organisation can also be devastating as it can be costly for the treatment that has to be implemented and the organisations reputation can suffer as if poor practice or negligence was discovered after an investigation of the outbreak then it is within the rights of the HSE to prosecute individuals and this can lead to a fine or imprisonment. QUESTION- ( 4.1 ) Define the term risk ANSWER A risk within a care setting applies to a number of possibilities that can involve the risk posed from use of equipments, the use of substances or the danger of a service user to themselves and others. In terms of infection prevention and control the term risk applies to the level of risk posed from biological hazards or biohazards to people (including service users, staff and visitors). Some biological hazards are those substances that come from living organisms such as people and they can be found in bodily fluids such as blood, vomit, waste matter, saliva etc. Organisms that exist in bodily fluids include HIV, MRSA, influenza, MSSA, C. Difficile, E. Coli and many others. Once a biohazard in my workplace has been identified then I must be able to identify the level of risk that it poses to all people which means at what rate and by what means can the organism spread? Is it likely to spread  without precautions put in place? What level of harm is posed to others if precautions are not implemented? I would need to rate the level of risk to these factors as low, medium or high. QUESTION- ( 4.2 ) Outline potential risks of infection within the workplace ANSWER In a care home setting the potential for the risk of infection greatly increases because the service users are more vulnerable to getting infection then most people. Their susceptibility to infection is increased by a great many factors that affect their immune system, such as their age. Very old people’s immune systems are weaker due to their age and therefore are more susceptible to getting infection. Service user’s may also be suffering from certain terminal illnesses and this may compromise their immune system or they may be receiving medication or treatment for a terminal illness and this may compromise their immune system e.g. chemotherapy for cancer weakens the immune system. When people are ill or are elderly and suffer from degenerative diseases such as dementia their diets can change and they can begin to eat less or not feel like eating at all. For instances if they undergo a major operation like a hip replacement or have part of their digestive tract removed and acquire a stoma then they may have lost their appetite or find it difficult to change their diet risking them of becoming malnourished. Their nutritional status becomes poor as a result hence compromising their immune system. If they have had surgery and have wounds, stitches or some kind of skin trauma as a result, this greatly increases the risk to infection as the skin has been breached and this is the body’s greatest defence barrier against infection. These areas of the skin are undergoing healing and must be kept cleansed regularly to reduce bacteria. Stomas for the exit of excrement via the bowl or urine, catheters for the drainage of urine from the bladder via the urethra and cannulas inserted into the service user’s arm for the administration of intravenously all give a way to entry directly into the body. This increases the risk to the  service user of infection not only as a direct passage but also if the bags, needles or tubing are not sterile when used or if they become blocked and bacteria can then quickly build up. As mentioned before the use of some drugs can increase a service user’s risk to infection e.g. strong antibiotics changing the levels of natural bacteria in the body and causing an imbalance creating C. Diff infection or chemotherapy drugs weakening the immune system exposing the service user to risk of infection. The service user in a weakened state also becomes at greater risk of carrying infections and can spread pathogens themselves. There are highly contagious blood borne diseases such as Hepatitis B, HIV or MRSA that can be transferred to others who have to interact with them such as myself and staff who are providing care. Friends and relatives and other visitors can also be exposed to these infections. Aerosols from air borne pathogens such as the norovirus or influenza can transfer to others from the carriers vomit. The same is true of outside visitors bringing in such pathogens and risking infection to the service users who have weakened immune systems and who would find it more difficult to fight off such pathogens and sometimes fatal. People coming into the care home environment from outside also include myself and the staff team. We must be aware of our own personal hygiene and health as we can also be carriers of air borne viruses such as colds, flu, diarrhoea and vomiting. As care workers staff and myself need to be even more vigilant about our personal hygiene, state of health and our infection control practice. We must be extra vigilant when working within the care home as we are tending to different service users so it is vital that we practice a high standard of infection control procedure and adhere the requirements as set out in our organisations procedures so as to prevent cross contamination and the spread of infections between potentially contagious and vulnerable service users. We must ensure that we are clean and tidy for work and that our personal hygiene and attire does not pose a risk of infection to the service users and we must be responsible for our health and monitor this as if we do have a cold or flu it is best that we do not enter the work place as these illnesses can be detrimental to our  service users. It is therefore vital that we follow our organisations procedure on our fitness for work and take the appropriate action and inform our manager of our state of health as this could save a person’s life. It is therefore essential that I and my staff treat all individuals as high risk in the light of potential risk factors of infection in a care home environment. The equipment that we use with the service users often come into contact with the service users. Equipment such as hoists, stand and turns, banana boards, commodes, walking frames, profiling beds all come into contact with service users who may be carrying infections or pathogens that will cause infections. In addition areas such as toilets, bathrooms, doors and door handles and stand rails are also areas where bacteria and pathogens can sit and survive. Some pathogens are very resistant and can survive in a dormant state until the conditions in their surroundings becomes right then they can multiply e.g. the spores of C. Diff. It is therefore essential that regular cleaning to the schedule is carried out thoroughly as to limit the opportunity for pathogens to harbour.