IUSS HEALTH FACILITY GUIDES

Transcription

1 IUSS HEALTH FACILITY GUIDES Catering Services for Hospitals Gazetted 30 June 2014 Task Team: B:03 Supported by:

2 Document tracking Version Date Name Discussion draft 1 25 October 2013 Deon Steyn Discussion draft rev 2 12 November 2013 Deon Steyn Development draft March 2014 Deon Steyn Edited development draft 13 March 2014 Deon Steyn Language edit 18 March 2014 Beverley van Reenen Front pages updated Proposal V2 13 May 2014 Peta de Jager Formatting Proposal V2 4 July 2014 Sheldon Bole Gazetted 30 June 2014 National Health Act,2003(Act no.61 of 2003) INFORMATION NOTES Form: Health facility guides Status: Gazetted, 30 June 2014 Title: Original Title: Description: Catering Services for Hospitals Catering Services Reference: CSIR 59C1119 B: Authors: IUSS N and S task group B:03 Stakeholders: National Department of Health, Provincial Departments of Health and Public Works

3 Accessing of these guides This publication is received by the National Department of Health (NDoH), IUSS Steering Committee Chairman, Dr Massoud Shaker and Acting Cluster Manager: Health Facilities and Infrastructure Management, Mr Ndinannyi Mphaphuli. Feedback is welcome. The CSIR and the NDoH retain the moral rights conferred upon them as author by section 20(1) of the Copyright Act, No. 98 of 1978, as amended. Use of text, figures or illustrations from this report in any future documentation, media reports, publications, competition entries and advertising or marketing material is solely at the discretion of the Health Infrastructure Norms Advisory Committee and should clearly reference the source. This publication may not be altered without the express permission of the Health Infrastructure Norms Advisory Committee. This document (or its updates) is available freely at or the forthcoming Department webportal. Application and development process These IUSS voluntary standard/ guidance documents have been prepared as national Guidelines, Norms and Standards by the National Department of Health for the benefit of all South Africans. They are for use by those involved in the procurement, design, management and commissioning of public healthcare infrastructure. It may also be useful information and reference to private sector healthcare providers. Use of the guidance in this documentation does not dissolve professional responsibilities of the implementing parties, and it remains incumbent on the relevant authorities and professionals to ensure that these are applied with due diligence, and where appropriate, deviations processes are exercised. The development process adopted by the IUSS team was to consolidate information from a range of sources including local and international literature, expert opinion, practice and expert group workshop/s into a first level discussion status document. This was then released for public comment through the project website, as well as national and provincial channels. Feedback and further development was consolidated into a second level development status document which again was released for comment and rigorous technical review. Further feedback was incorporated into proposal status documents and formally submitted to the National Department of Health. Once signed off, the documents have been gazetted, at which stage documents reach approved status. At all development stages documents may go through various drafts and will be assigned a version number and date. The National Department of Health will establish a Health Infrastructure Norms Advisory Committee, which will be responsible for the periodic review and formal update of documents and tools. Documents and tools should therefore always be retrieved from the website repository or Department webportal (forthcoming) to ensure that the latest version is being used. The guidelines are for public reference information and for application by Provincial Departments of Health in the planning and implementation of public sector health facilities. The approved guidelines will be applicable to the planning, design and implementation of all new public-sector building projects (including additions and alterations to existing facilities). Any deviations from the voluntary standards are to be motivated during the Infrastructure Delivery Management Systems (IDMS) gateway approval process. The guidelines should not be seen as necessitating the alteration and upgrading of any existing healthcare facilities.

4 Acknowledgements This publication has been funded by the NDoH. AUTHOR: Deon Steyn M Arch MBA Pr Arch Pr CPM SCION ARCHITECTS and PROJECT MANAGEMENT CO-AUTHORS: Brigid Boltmann (initial draft) LEAP ARCHITECTS Steve de Kock B.Sc Eng mech Pr Eng PRIVATE CONSULTANT

5 CONTENTS CONTENTS... 1 LIST OF FIGURES, LAYOUTS AND TABLES... 9 PART 1 - GENERAL PLANNING CONSIDERATIONS CATERING SERVICES DEPARTMENT IN A HOSPITAL LOCATION and RELATIONSHIP TO OTHER DEPARTMENTS VEHICULAR ACCESS FOR DELIVERIES AND COLLECTIONS TYPES OF CATERING SERVICES Conventional food system Cook-freeze food system Cook-chill food system PART 2 FUNCTIONAL REQUIREMENTS ACTIVITY SPACES IN THE CATERING SERVICE UNIT WORKFLOW THROUGH A CATERING SERVICE UNIT PART 3 GENERAL DESIGN CONSIDERATIONS IMPROVED HYGIENIC CONDITIONS OCCUPATIONAL HEALTH AND SAFETY CHANGE AND TECHNOLOGY SHARED SERVICES ERGONOMIC AND USER-COMFORT CONSIDERATIONS MAINTENANCE AND CLEANING PEST CONTROL STRUCTURE AND LAYOUT (EXISTING VS FUTURE EXTENSIONS) PLANT AND SERVICES PART 4 CATERING SERVICES AREA DETERMINATION DETERMINANTS OF SIZE AND LAYOUT Determining factors external to the catering department Determining factors internal to the catering department CATERING SERVICES AREA DETERMINATION PART 5 INDIVIDUAL SPACE REQUIREMENTS A1 Delivery and reception area A1.1 Location and relationship A1.2 Function A1.3 Requirements

6 A1.4 Fixtures, fittings and equipment A1.5 Services B1 Pre-preparation area: fruits and vegetables B1.1 Location and relationship B1.2 Function B1.3 Requirements B12.4 Fixtures, fittings and equipment B1.5 Services B2 Removal of packaging material C1.1 Location and relationship C1.2 Function C1.3 Requirements C1.4 Fixtures, fittings and equipment C1.5 Services C1 Store: groceries C1.1 Location and relationship C1.2 Function C1.3 Requirements C1.4 Fixtures, fittings and equipment C1.5 Services C2 Store: daily supplies C2.1 Location and relationship C2.2 Function C2.3 Requirements C2.4 Fixtures, fittings and equipment C2.5 Services C3 Store: bread C3.2 Function C3.3 Requirements C3.4 Fixtures, fittings and equipment C3.5 Services C4 Cold room: general C4.1 Location and relationship C4.2 Function C4.3 Requirements C4.4 Fixtures, fittings and equipment

7 C4.5 Services C5 Cold room: dairy products C5.1 Location and relationship C5.2 Function C5.3 Requirements C5.4 Fixtures, fittings and equipment C5.5 Services C6 Cold room: meat C6.1 Location and relationship C6.2 Function C6.3 Requirements C6.4 Fixtures, fittings and equipment C6.5 Services C.7 Cold room: fresh vegetables and fruit C7.1 Location and relationship C7.2 Function C7.3 Requirements C7.4 Fixtures, fittings and equipment C7.5 Services C.8 Freezer room C8.1 Location and relationship C8.2 Function C8.3 Requirements C8.4 Fixtures, fittings and equipment C8.5 Services C.9 Store: fresh vegetables and fruit C9.1 Location and relationship C9.2 Function C9.3 Requirements C9.4 Fixtures, fittings and equipment C9.5 Services C.10 Store: cleaning materials and equipment C10.1 Location and relationship C10.2 Function C10.3 Requirements C10.4 Fixtures, fittings and equipment

8 C10.5 Services C11 Store: crockery, utensils and linen C11.1 Location and relationship C11.2 Function C11.3 Requirements C11.4 Fixtures, fittings and equipment C11.5 Services C12 Store: refuse C12.1 Location and relationship C12.2 Function C12.3 Requirements C12.4 Fixtures, fittings and equipment C12.5 Services D1 Preparation: vegetables and fruit D1.1 Location and relationship D1.2 Function D1.3 Requirements D1.4 Fixtures, fittings and equipment D1.5 Services D2 Preparation: fish and poultry D2.1 Location and relationship D2.2 Function D2.3 Requirements D2.4 Fixtures, fittings and equipment D2.5 Services D3 Preparation: meat D3.1 Location and relationship D3.2 Function D3.3 Requirements D3.4 Fixtures, fittings and equipment D3.5 Services D.4 Preparation: general D4.1 Location and relationship D4.2 Function D4.3 Requirements D4.4 Fixtures, fittings and equipment

9 D4.5 Services D5 Preparation: bread and sandwiches D5.1 Location and relationship D5.2 Function D5.3 Requirements D5.4 Fixtures, fittings and equipment D5.5 Services D6 Preparation: therapeutic (special) diets D6.1 Location and relationship D6.2 Function D6.3 Requirements D6.4 Fixtures, fittings and equipment D6.5 Services D7 Preparation: tube feed D7.1 Location and relationship D7.2 Function D7.3 Requirements D7.4 Fixtures, fittings and equipment D7.5 Services E1 Cooking area E1.1 Location and relationship E1.2 Function E1.3 Requirements E1.4 Fixtures, fittings and equipment E1.5 Services F1 Dishing up and garnishing F1.1 Location and relationship F1.2 Function F1.3 Requirements F1.4 Fixtures, fittings and equipment F1.5 Services K2 Wash-up: crockery K2.1 Location and relationship K2.2 Function K2.3 Requirements K2.4 Fixtures, fittings and equipment

10 K3 Wash-up: pots and pans K3.1 Location and relationship K3.3 Requirements K3.4 Fixtures, fittings and equipment K3.5 Services K4 Trolley wash area K2.1 Location and relationship K2.2 Function K2.3 Requirements K2.4 Fixtures, fittings and equipment K2.5 Services L.1 Parking area, crockery and tray racks L1.1 Location and relationship L1.2 Function L1.3 Requirements L1.4 Fixtures, fittings and equipment L1.5 Services L2 Parking area: food trolleys L2.1 Location and relationship L2.2 Function L2.3 Requirements L2.4 Fixtures, fittings and equipment L2.5 Services M1 Office: dietician M1.1 Location and relationship M1.2 Function M1.3 Requirements M1.4 Fixtures, fittings and equipment M1.5 Services M2 Office: food service manager M2.1 Location and relationship M2.2 Function M2.3 Requirements M2.4 Fixtures, fittings and equipment M2.5 Services M3 Office: food service supervisors

11 M3.1 Location and relationship M3.2 Function M3.3 Requirements M3.4 Fixtures, fittings and equipment M3.5 Services M4 Office: clerk (delivery area) M4.2 Function M4.3 Requirements M4.4 Fixtures, fittings and equipment M4.5 Services PART 6 BUILDING AND SERVICES MATERIALS and FINISHES Floors Walls Ceilings Windows Doors Hatches Ducts FIXTURES, FITTINGS and EQUIPMENT Sterile storage shelving Worktop furniture Wash-hand basins ELECTRICAL POWER SUPPLY General Standby power Power points Power supply to office areas Power supply to cooking equipment LIGHTING Natural lighting Artificial lighting: general Artificial lighting: extraction hoods Artificial lighting: refrigerated stores VENTILATION Ventilation: general

12 6.5.2 Natural ventilation Hot air extraction HVAC WET SERVICES Drainage Water supply Water heating and water treatment system SPECIALIST SERVICES High-pressure cleaning system Cooking equipment Food distribution systems Pot- and dish- washing Communications Fire detection and prevention PART 7 GLOSSARY REFERENCES ANNEXURE A ERGONOMIC REQUIREMENTS

13 LIST OF FIGURES Figure 1: Departmental relationships Figure 2: Conventional food system Figure 3: Cook-freeze food system Figure 4: Cook-chill food system Figure 5: General workflow Figure 6: Workflow from delivery to storage Figure 7: Workflow from storage to dishing up

14 LAYOUTS Figure 1: Departmental relationships Figure 2: Conventional food system Figure 3: Cook-freeze food system Figure 4: Cook-chill food system Figure 5: General workflow Figure 6: Workflow from delivery to storage Figure 7: Workflow from storage to dishing up

15 Table 1: IUSS:GNS Reference Documents CLINICAL SERVICES Adult Inpatient Services Clinical Diagnostic Laboratory Guidelines Mental Health Adult Critical care Emergency Centres Maternity Care Facilities Adult Oncology Facilities Outpatient Facilities Paediatrics and Neonatal Facilities Essential Recommended SUPPORT SERVICES Administration and Related Services General Hospital Support Services Catering Services for Hospitals Laundry and Linen Department Hospital Mortuary Services Nursing Education Institutions Health Facility Residential Central Sterile Service Department Training and Resource Centre Essential x x Recommended HEALTHCARE ENVIRONMENT/ CROSSCUTTING ISSUES Generic Room Requirements Hospital Design Principles Building Engineering Services Environment and Sustainability Essential Recommended x PROCUREMENTand OPERATION Integrated infrastructure planning Briefing Manual Essential x Recommended x Space Guidelines x x x Cost Guidelines x Materials and Finishes Procurement x Future Healthcare Environments Healthcare Technology Inclusive Environments Infection Prevention and Control Pharmacy Waste Disposal x Information Technology and Infrastructure Primary Health Regulations Care Facilities Diagnostic Radiology Adult Physical Rehabilitation Adult Post-acute Services Facilities for Surgical Procedures TB Services x x Commissioning Health Facilities x Maintenance x x x Decommissioning Capacity Development x x Colours Legend Consultants Administrators Related documents 11

16 PART 1 - GENERAL PLANNING CONSIDERATIONS 1.1 CATERING SERVICES DEPARTMENT IN A HOSPITAL A catering service department is concerned solely with the large-scale storage and production of food. 1.2 LOCATION and RELATIONSHIP TO OTHER DEPARTMENTS The catering service unit should be on one level to facilitate an effective workflow. It should be located centrally to supply patients needs within the shortest time and have direct connection to most hospital corridors. Ideally it should also be on the same level as the wards in order to reduce the transport distance for food and the movement of people. See Figure 1. If a multi-floor relationship with the service departments is unavoidable, the service elevators by which food must be transported to wards/divisions, must be close to the food service unit. The service elevators must be reliable and supported by emergency power. The transport corridors must be covered with an even surface, and ramps should be within the design tolerance required by the food trolleys. Alternative routes should be available in emergency situations. Due to the nature of the activities taking place in the catering department, it is a high fire-risk area. Fire-fighting vehicles should therefore need to have immediate and easy access to the unit. The unit should not be located where it may be exposed to airborne and waterborne contamination. 12

17 FIGURE 1: DEPARTMENTAL RELATIONSHIPS 1.3 VEHICULAR ACCESS FOR DELIVERIES AND COLLECTIONS The ground-floor level provides the most economic and convenient location, with easy access for delivery vehicles to the delivery bay. There should be sufficient space for parking and manoeuvring service and other vehicles. The unit should have easy access to a good road system to ensure safe and easy vehicular access for deliveries of supplies and refuse removal. The route through which the refuse is removed must be the shortest possible route to the refuseremoval area. The removal of refuse from the refuse-storage area to the central refuse-removal areas must take place through an exit door with a ramp. 13

18 1.4 TYPES OF CATERING SERVICES The choice of a specific type of food system for a healthcare facility can currently be made from the following systems: Conventional food system (the topic of this document) Cook-freeze food system Cook-chill food system. This document only covers the conventional food system. The other two systems will be discussed briefly for clarity only Conventional food system Cook-serve is the conventional system of catering currently in use in many hospitals. complies with the following criteria: The system Food is freshly prepared and cooked for each meal and served whilst hot to the patients and staff. The conventional food system is a system with a continuous preparation period and a serving period. Food is prepared according to standardised recipes and according to conventional or automated preparation methods. Food is freshly prepared for each meal and is directly portioned, dished up, garnished and served after the cooking process/preparation process which can also take place in batches. The dishing-up and garnishing of complete meals in suitable crockery can take place individually and be transported on trays in suitable trolleys to the different service points for serving to the patient/client. An alternative method is that food is portioned and garnished in mass portions in stainless steel food containers with lids, and transported to the service points in suitable food trolleys where it is dished up for serving to the patient/client. With the pre-dished tray-food service system the trays with used crockery are placed back in the food trolley and transported back to the food-service unit where it is centrally washed up. Cups, saucers, bread plates and cutlery are washed and stored at the service points. When food is served from food trolley containers at the service points, the washing-up procedure can be decentralised or partially decentralised: (i) Decentralised procedure The cleaning and washing up of the food trolley and food trolley containers and all crockery takes place at the service points. The clean crockery is stored at the service points. The clean trolley with containers is taken back to the food-service unit. (ii) Partially decentralised procedure Some crockery - such as cups, saucers, bread plates and cutlery - is washed and stored at the service points. The other used crockery is transported in the food-service unit, where it is cleaned and washed up, as well as the food trolley with food trolley containers. 14

19 FIGURE 2: CONVENTIONAL FOOD SYSTEM Cook-freeze food system Cook-freeze means a catering system based on full cooking followed by fast freezing, and complies with the following criteria: The cook-freeze food system is a system in which the preparation period is separated from the serving period by a freezing process and frozen storage. Food preparation takes place according to standardised recipes with adaptations where necessary to prevent the detrimental effect of freezing on some foods such as the stabilisation of starch products. Food preparation takes place according to conventional or automated preparation methods. The food preparation and freezing can be geographically separated from the service point or client. Portioning can be effected in single portions, as complete meals or in mass portions of a suitable size in different packaging materials. Laminated carton, aluminium or plastic containers can be used. Reconstitution of frozen food takes place at the service points in convection ovens. 15

20 FIGURE 3: COOK-FREEZE FOOD SYSTEM Cook-chill food system Cook-chill means a catering system based on the full cooking of food followed by fast chilling and storage in controlled low-temperature conditions above freezing point (0 C to 3 C) and subsequent thorough reheating close to the consumer before consumption. Cook-chill systems comply with the following criteria: With a cook-chill food system the preparation period is separated from the serving period by a temporary cooling process and cooled storage. Food is prepared by conventional or automated preparation methods, using standardised recipes. Food is cooked to a temperature of 80% after which it is cooled in a cooling tunnel or cooling room. Complete meals can be portioned or cooled in suitable crockery in which it is served. Complete meals cooled in suitable crockery, can be heated in the food service unit and transported on trays in trolleys to the service points for serving to patients. Food cooled in mass portions can be dished up in the food service unit in suitable crockery, assembled on trays and transported in trolleys to the service points, where it is heated and served to patients/clients. The cleaning and washing up takes place partially decentralised, as described in the conventional food system. Food can alternatively be heated in mass portions at the service points (such as in a cafeteria system), dished up and served. The cleaning and washing up takes place decentralised or partially decentralised, as described in the conventional food system. 16

21 FIGURE 4: COOK-CHILL FOOD SYSTEM 17

22 PART 2 FUNCTIONAL REQUIREMENTS 2.1 ACTIVITY SPACES IN THE CATERING SERVICE UNIT The activities in a catering department are distinct and sequential. See Figure 5. FIGURE 5: GENERAL WORKFLOW Delivery Packaging to refuse Stores Preparation Cooking Dishing-up To service department Central wash-up Returns Refuse store / waste holding The above workflow diagram can be detailed, as in Figure 6 and Figure 7. FIGURE 6: WORKFLOW FROM DELIVERY TO STORAGE 18

23 FIGURE 7: WORKFLOW FROM STORAGE TO DISHING UP The activities taking place in the catering department are categorised under the following zones: Deliveries and receiving Storage areas Preparation areas Cooking area Dishing up Washing up Trolley parking Offices Staff facilities Support spaces. In order to align this design guide with the DoH (2001), the numbering code guide in the DoH document will be used in this document. See Table 2 for the codes. The colour selected for each zone is arbitrary and only used to visualise relative positions of zones and activities and their relationship to their adjacent activities. 19

24 TABLE 2 CODE GUIDE (DOH, 2001, P20) DoH (2001) CODE GUIDE A B B1 B2 C C1 C2 C3 C4 C5 C6 C7 C8 C9 C10 C11 C12 D D1 D2 D3 D4 D5 D6 D7 E F K K2 K3 K4 L L1 L2 M M1 M2 M3 M4 N N1 ZONES AND ACTIVITIES DELIVERY & RECEPTION AREA PRE-PREPARATION AREA VEG & FRUIT PREP REMOVAL OF PACKAGING MATERIAL STORAGE AREAS ST ORE : GROCERIES WEIGHING AREA & DAILY SUPPLIES ST ORE : BREAD COLD ROOM : GENERAL COLD ROOM : DAIRY PRODUCTS COLD ROOM : MEAT COLD ROOM : FRESH VEG & FRUIT FREEZER : FISH & CHICKEN ST ORE : FRESH VEG & FRUIT ST ORE : CLEANING MAT ERIAL / EQUIPM ST ORE : CROCKERY, EQUIPM & LINEN ST ORE : REFUSE PREPARATION AREAS PREP : VEGET ABLE & FRUIT PREP : FISH & POULT RY PREP : MEAT PREP : GENERAL PREP : BREAD & SANDWICH PREP : T HERAPEUT IC PREP : T UBE FEED COOKING AREA DISHING-UP & GARNISHING WASH-UP AREAS WASH-UP : CROCKERY WASH-UP : POT S & PANS WASH-UP : T ROLLEYS PARKING PARKING : CROCKERY & TRAY RACK PARKING : FOOD TROLLEYS OFFICES OFFICE : DIET ICIAN(S) OFFICE : FOOD SERVICE MANAGER OFFICE : FOOD SERVICE SUPERVISOR(S) OFFICE : CLERK STAFF FACILITIES STAFF FACILITIES 20

25 2.2 WORKFLOW THROUGH A CATERING SERVICE UNIT The workflow illustrated in Figures 5-7, if applied to the zones and activities in Table 2, could be illustrated as follows: LAYOUT 1: WORKFLOW THROUGH A CATERING DEPARTMENT The above workflow and spatial relationship could be translated into the following designs: Layout 2, a theoretical design; Layout 3, an as-built illustration. 21

26 LAYOUT 2: WORKFLOW THROUGH A TYPICAL CATERING SERVICE UNIT (DOH, 2001, P21) Not to scale 22

27 LAYOUT 3: WORKFLOW THROUGH CHRIS HANI BARAGWANATH CATERING SERVICES UNIT Not to scale 23

28 PART 3 GENERAL DESIGN CONSIDERATIONS 3.1 IMPROVED HYGIENIC CONDITIONS The operating procedure for hygiene control falls outside the scope of this guideline. Planning and design features to support hygiene control should include the following: Containment of steam and moisture Building and layout details that would facilitate easy cleaning Selection of suitable building materials and finishes Selection of fixtures, fittings and equipment with suitable detail, materials and finishes for easy cleaning, and prevention of build-up of harmful organisms Hand washing remains one of the most significant ways in which cross-infection through contact can be avoided. To enhance this, hand-wash facilities should be placed appropriately The selected system for soap and towel dispensers is a hospital policy and dictates the type of dispenser to be specified. 3.2 OCCUPATIONAL HEALTH AND SAFETY Planning and design features to support occupational health and safety include the following: Selection of floor finishes with a non-slip finish Selection of fixtures, fittings and equipment with suitable detail, materials and finishes to prevent personal injury through accidents or misuse Provision of suitable and adequate facilities to support and encourage a high level of personal hygiene, with special reference to hand hygiene Provision of adequate dispensing points for the appropriate personal protection (PPE) items Ill-considered dimensions and layouts of fixtures and fittings could have a significant effect on occupational health and the safety of staff. 3.3 CHANGE AND TECHNOLOGY Although it is difficult to predict future trends in catering department technology, it is advisable to allow some flexibility and adaptability in space requirements, electrical consumption and layout, and also in airhandling capacity. Current trends that need to be considered are the following: The facility should be able to reasonably accommodate access and positioning of possible outsize equipment. Consideration for this possibility should be given from (and including) point of delivery to point of positioning Possible future extensions and/or enlargement of the facility should be considered during the design stage An element of adaptability should be incorporated in the layout, particularly with regard to equipment, where improved models are continuously being developed Engineering services and catering equipment will normally have a much shorter life than the building fabric, and access for plant removal and replacement should therefore form part of the design concept. 24

29 3.4 SHARED SERVICES The planning and design of the facility should take cognisance of the policies regarding the following services, which could have an influence on the layout: Waste management Staff ablution facilities Staff catering facilities Administration (IT, tel, data, fax, etc.) Communications HVAC systems Hot water, steam, compressed air systems Power supply and standby power facilities Fire detection and prevention Security. 3.5 ERGONOMIC AND USER-COMFORT CONSIDERATIONS Workspaces should be sufficiently flexible and adaptable to accommodate adequate working spaces for individual comfort. See ANNEXURE A for ergonomic requirements. 3.6 MAINTENANCE AND CLEANING The catering department requires conditions of cleanliness and safety with means for maintenance and routine inspection that minimise disruption and risk of contamination Materials and finishes should be selected to minimise maintenance and be compatible with their intended function Building elements that require frequent redecoration or are difficult to service or clean should be avoided Special design consideration should be given to corners, partitions, counters and other elements which may be subjected to heavy use Engineering services and catering equipment will normally have a much shorter life than the building fabric, and access for plant removal and replacement should therefore form part of the design concept Pipe and cable runs must not be routed over cooking or preparation equipment; and pipe insulation must be easily cleaned, impervious to water, and sealed to prevent the harbouring of pests and insects as far as is reasonably practicable The finishes of all equipment and service connections must be able to withstand frequent cleaning. Electrical socket outlets, light fittings and switches should be splash-proof Switch rooms should be accessible only from the circulation area, outside food production areas. 25

30 3.7 PEST CONTROL Catering departments are very prone to infestation, and service ducts, trunking, channels, casings, pipework and insulation should be designed and installed to prevent the ingress of rodents and insects Overhanging roofs, light fittings, girders and beams should be protected to prevent the entry of birds. All outer doors should be pest-proof, particularly sliding doors and roller shutters Where electric fly-killing units are used they should be carefully sited to ensure maximum effect and to prevent contamination of food, utensils, work surfaces and production lines Ceiling voids and ducting must be accessible from outside the high-risk areas for inspection or treatment purposes The space surrounding equipment must allow access for engineering/ maintenance staff and for regular cleaning. The provision of flexible service connections to each unit and the use of lockable castors or integral rollers will allow equipment to be moved to enable cleaning machines to pass over the whole floor area. 3.8 STRUCTURE AND LAYOUT (EXISTING VS FUTURE EXTENSIONS) Possible future extensions and/or enlargement of the facility should be considered during the design stage An element of adaptability should be incorporated in the layout, particularly with regard to equipment, for which improved models are continuously being developed Engineering services and catering equipment will normally have a much shorter life than the building fabric, and access for plant removal and replacement should therefore form part of the design concept. 3.9 PLANT AND SERVICES The various areas within the catering services unit should accommodate the equipment manufacturer's recommendations, as space requirements may vary from one manufacturer to another. All items of equipment will need to be itemised and the dimensions of all equipment obtained from manufacturers to ensure they can be suitably housed. The following requirements are relevant: doors are to be sized to allow passage of equipment electricity loads need to be estimated and catered for weight loads need to be estimated and checked structurally equipment requiring services such as water and special power need to be accommodated at an early stage all cooking equipment should be located to have service/maintenance access space allowed for and around equipment should be sufficient to allow for the physical equipment as well as circulation/working space around the equipment the spaces should be able to reasonably accommodate access and positioning of possible outsize equipment, including point of delivery to point of positioning the area should be designed to allow for periodic ease of routine cleaning or, particularly in dirty areas, for handling of accidental spillages. 26

31 PART 4 CATERING SERVICES AREA DETERMINATION 4.1 DETERMINANTS OF SIZE AND LAYOUT The size of a catering services unit in a hospital is unique to that hospital, as the size, layout and function of the catering department is defined in the Operational Policy Statement that guides the operational management of the hospital. The operational policies specific to the catering department precede the sketch-design stage. These policies are developed by the project team in consultation with health service stakeholders, who should have the knowledge and experience to analyse the various processes in and related to the catering services unit. These operational policies define the What, How, When, Where, Who and With What of any activity and/or process and are major space determinants which could significantly affect the planning and design of the catering services unit, as they can have an impact on the size, configuration and the nature of accommodation. Operational policies will vary from unit to unit, depending on a wide range of factors, both external and internal to the catering services unit Determining factors external to the catering department Examples of these space determinants could include the following: Number of patients and staff to receive meals Type of patient (religion/age/culture) Type of menu Type of food preparation system Space availability Access to the site Amount of space needed for waste management Staff facilities to be shared with adjacent departments Determining factors internal to the catering department Examples of these space determinants could include the following: Types of food preparation equipment to be used Number of and type of cooking system Type of food delivery system to be used Type of washing-up system or procedure Anticipated inventory storage Anticipated volume of consumable supplies Instrument inventory Equipment inventory Projected workload Staffing structure Staffing policy - number of staff to be accommodated. 27

32 4.2 CATERING SERVICES AREA DETERMINATION The Bertha Gxoba Hospital in Germiston has 300 beds, and is included in this study for its detailed areas. See Layout 4. LAYOUT 4: BERTHA GXOBA CATERING SERVICES UNIT The IUSS spatial measurement assignment, initiated by the NDoH, and executed by CSIR Building Science and Technology, yielded the information as per Table 3. Chris Hani Baragwanath s kitchen and Bertha Gxoba s kitchen (Layouts 4 and 5) are also included in this table. 28

33 Although the data is not sufficient to provide scientifically sound results, it is an indication of estimated average sizes of kitchens. The data also gives no indication of the efficiency of the layouts. TABLE 3: COMPARATIVE AREAS OF CATERING SERVICES IN CASE STUDIES MOSES KOTANE HOLY CROSS WORCESTER KHAYELITSHA BERTHA GXOBA PAARL NATALSPRUIT CHRIS HANI BARAGWANATH NR OF BEDS IN THE FACILITY DoH (2001) CODE GUIDE ZONES AND ACTIVITIES AREA AREA AREA AREA AREA AREA AREA AREA A DELIVERY & RECEPTION AREA B PRE-PREPARATION AREA B1 VEG & FRUIT PREP B2 REMOVAL OF PACKAGING MATERIAL C STORAGE AREAS C1 ST ORE : GROCERIES C2 WEIGHING AREA & DAILY SUPPLIES C3 ST ORE : BREAD 23.6 C4 COLD ROOM : GENERAL C5 COLD ROOM : DAIRY PRODUCTS C6 COLD ROOM : MEAT C7 COLD ROOM : FRESH VEG & FRUIT C8 FREEZER (FISH & CHICKEN) C9 ST ORE : FRESH VEG & FRUIT C10 STORE : CLEANING MAT & EQUIPM C11 ST ORE : CROCKERY, EQUIPM & LINEN C12 ST ORE : REFUSE D PREPARATION AREAS D1 PREP : VEGET ABLE & FRUIT D2 PREP : FISH & POULT RY D3 PREP : MEAT 24.5 D4 PREP : GENERAL D5 PREP : BREAD & SANDWICH D6 PREP : T HERAPEUT IC D7 PREP : T UBE FEED E COOKING AREA F DISHING-UP & GARNISHING K WASH-UP AREAS K2 WASH-UP : CROCKERY K3 WASH-UP : POT S & PANS K4 WASH-UP : T ROLLEYS L PARKING L1 PARKING : CROCKERY & T RAY RACK L2 PARKING : FOOD TROLLEYS M OFFICES M1 OFFICE : DIET ICIAN(S) M2 OFFICE : FOOD SERVICE MANAGER M3 OFFICE : FOOD SERVICE SUPERVISOR(S) M4 OFFICE : CLERK N STAFF FACILITIES N1 STAFF FACILITIES : STAFF NETT AREA OF KITCHEN (SQ M) AREA PER BED (SQ M)

34 Based on the information in Table 3, the CSIR IUSS measurement team calculated the net kitchen area per bed as per the produced a linear graph. See Table 4. TABLE 4: NET KITCHEN AREA PER BED FACILITY NR OF BEDS KITCHEN NETT AREA m² KITCHEN AREA/ BED m² Moses Kotane Holy Cross George Worcester Khayelitsha Bertha Gxoba Paarl Natalspruit If this data is captured on a linear graph with a deviation of 10% in both directions, a range of area estimates can be obtained which serves as a guide to calculate kitchen area per bed. 30

35 TABLE 5: AREA GUIDE : KITCHEN AREA/ NO. OF BEDS NR OF BEDS NETT AREA* PER BED CATERING SERVICE NETT AREA GUIDE* NETT AREA LESS 10% DEVIATION* NETT AREA PLUS 10% DEVIATION*

36 PART 5 INDIVIDUAL SPACE REQUIREMENTS The discussion on individual space requirements is based on a layout of the Chris Hani Baragwanath hospital. See Layout 5. The following shortcomings in the original design are highlighted: A separate fish freezer is required (not included in this layout) The activity flow of food and refuse should not cross. For the purpose of this design guide, the refuse collection point and trolley wash areas have been moved to the returns entrance. Although a variety of loose items are listed under Fixtures, Fittings and Equipment, these items generally do not form part of the building contract. Their inclusion in this document is merely to provide an overview of space requirements. 32

37 A1 Delivery and reception area LAYOUT 5: LAYOUT OF BARAGWANATH HOSPITAL main kitchen with changes to illustrate recommended location and relationships 33

38 A1.1 Location and relationship A1.2 Function Receipt of provisions. There are three main groups of goods delivered to the kitchen: Vegetables (fresh and frozen) Raw meat and fish (fresh and frozen items) Packaged and dry goods, including dairy. A1.3 Requirements An under-cover delivery platform to be the height of a standard delivery vehicle (height approx 1 500mm). The ramps for mobile trolleys and platforms must slope conveniently and must be calculated in accordance with the platform height. Platform to have a rubber protection-strip and a set of stairs next to the ramp. The receiving area and the storage area must be on the same level to facilitate the transport of supplies, for example, and the storage of trolleys. Lockable roll-up steel door to B1 (pre-preparation area / veg cleaning area). 34

39 A1.4 Fixtures, fittings and equipment Writing board Wall-mounted electric clock with battery back-up, as per electrical engineer s specification Stainless steel wash-up sink Goods-receiving platform scale Preparation table Tables with splash back and mild steel coated backing for sound deadening Insectocuter (double tube) Stainless steel wall-mounted hand-wash basins. A1.5 Services Hot and cold water Waste drainage Smoke detection Adequate lighting and ventilation (mechanical/natural). B1 Pre-preparation area: fruits and vegetables B1.1 Location and relationship 35

40 B1.2 Function Space for de-crating and pre-cleaning of vegetables A pre-cleaning wet area for washing, peeling, cutting, chopping, prior to storage. B1.3 Requirements Should have easy access to dry store and vegetable cold room The area generates a lot of waste or refuse and should be located close to the vegetable store and should have easy access to the refuse-disposal area. B12.4 Fixtures, fittings and equipment Paper-towel dispenser Soap dispenser Clinical hand-wash basin Stainless steel pot-wash sink Work surface, stainless steel with opening for refuse bin Vegetable washers Cutting machines Stainless steel basin with elbow-action mixer, soap and paper-towel dispenser Refuse bin on dolly. B1.5 Services Floor drain Adequate lighting and ventilation (mechanical/natural) Hot and cold water Waste drainage Smoke detection. 36

41 B2 Removal of packaging material C1.1 Location and relationship C1.2 Function Space for removing contents from packaging. C1.3 Requirements Should have easy access to dry store and dairy cold room The area generates a lot of waste or refuse and should be located close to the vegetable store and should have easy access to the refuse-disposal area. C1.4 Fixtures, fittings and equipment Refuse bin on dolly. C1.5 Services Adequate lighting and ventilation (natural or mechanical) Smoke detection. 37

42 C1 Store: groceries C1.1 Location and relationship C1.2 Function Bulk storage of all dry, bottled and canned goods. C1.3 Requirements Adjustable shelving. C1.4 Fixtures, fittings and equipment Shelf, adjustable, epoxy coated steel (total shelf lengths divided in different adjustable levels) Mobile bins for flour, sugar, cereals, etc. Work surfaces 5-tier high shelves with adjustable feet Dunnage racks, stainless steel slatted White food bins mounted on mobile bin dollies. 38

43 C1.5 Services Adequate lighting Mechanical exhaust ventilation Smoke detection. C2 Store: daily supplies C2.1 Location and relationship C2.2 Function A store where smaller amounts of the most usual ingredients are withdrawn from the main store to be used that day and measured for recipes Weighing and measuring of ingredients according to recipes Storage of ingredients according to recipes and batch sizes in basket(s) in trolley(s). C2.3 Requirements Adjustable shelving Mobile bins for flour, sugar, cereals, etc. Work surfaces. 39

44 C2.4 Fixtures, fittings and equipment Shelving with 5-tier shelves constructed from 1.2mm galvanised steel with adjustable feet Paper-towel dispenser Stainless steel basin with elbow-action mixer Soap dispenser Writing board Stainless steel catering sink Tabletop scale: 0 to 10kg range. C2.5 Services Adequate lighting Smoke detection Mechanical extract ventilation. C3 Store: bread C3.1 Location and relationship C3.2 Function Storage of bread on mobile epoxy-coated steel shelves or in steel bread cupboard. 40

45 C3.3 Requirements Good ventilation Space allowance for storage of bread for 3 days according to the ration scale. C3.4 Fixtures, fittings and equipment Shelving. C3.5 Services Adequate lighting Smoke detection Mechanical extract ventilation. C4 Cold room: general C4.1 Location and relationship C4.2 Function Storage of dessert, supplies for night duty, portioned menu items and leftover food. C4.3 Requirements Mobile platforms in baskets or plastic food containers Temperature controlled at +4 C. C4.4 Fixtures, fittings and equipment Shelving stainless steel 4-tier high, constructed from 1.2mm 304 stainless steel, and uprights constructed from 3mm 40x40mm stainless steel uprights with adjustable feet. 41

46 C4.5 Services Prefabricated cold room with 100mm-thick polystyrene insulation walls and roof Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate Modular refrigeration plant consisting of internal evaporator(s) and external condensing unit Refrigerant to be ozone friendly Facility for evaporator condensate drainage to be provided Low-temperature waterproof light fittings. 42

47 C5 Cold room: dairy products C5.1 Location and relationship C5.2 Function Storage for eggs, milk, cheese, butter, margarine, cream, etc. C5.3 Requirements Temperature controlled at +4 C Stainless steel shelving and racks, non-corrosive food-grade containers. C5.4 Fixtures, fittings and equipment Shelving stainless steel 4-tier-high shelves constructed from 1.2mm 304 stainless steel and uprights constructed from 3mm 40x40mm stainless steel uprights with adjustable feet. C5.5 Services Prefabricated cold room with 100mm-thick polystyrene insulation walls and roof. Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate Modular refrigeration plant consisting of internal evaporator(s) and external condensing unit Refrigerant to be ozone-friendly Facility for evaporator condensate drainage to be provided Low-temperature waterproof light fittings. 43

48 C6 Cold room: meat C6.1 Location and relationship C6.2 Function Storage of meat delivered ready-portioned (in some cases may be in large cuts) and storage of fresh and processed meat in plastic food containers on stainless steel 3-tier shelves. C6.3 Requirements Temperature +4 C Stainless steel shelving and racks, non-corrosive food-grade containers. C6.4 Fixtures, fittings and equipment Shelving stainless steel 4-tier high. C6.5 Services Prefabricated cold room with 100mm-thick polystyrene insulation walls and roof. Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate Modular refrigeration plant consisting of internal evaporator(s) and external condensing unit Refrigerant to be ozone-friendly Facility for evaporator condensate drainage to be provided Low-temperature waterproof light fittings. 44

49 C.7 Cold room: fresh vegetables and fruit C7.1 Location and relationship C7.2 Function Storage of pre-prepared vegetables and fruit in baskets on mobile shelves for food. C7.3 Requirements 80% humidity Storage containers on shelves or racks Good ventilation Ambient temperature 15 to 20 C Minimum amount of daylight Minimum of three air changes per hour Racking with shelves or wire mesh containers. C7.4 Fixtures, fittings and equipment Shelving stainless steel 4-tier-high shelves. C7.5 Services Prefabricated cold room with 100mm thick polystyrene insulation walls and roof Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate Modular refrigeration plant consisting of internal evaporator (s) and external condensing unit. Refrigerant to be ozone-friendly Facility for evaporator condensate drainage to be provided Low-temperature waterproof light fittings. 45

50 C.8 Freezer room C8.1 Location and relationship C8.2 Function For storage of frozen food in packaging material on stainless steel, 5-tier shelves or on freezer shelves. This store can open off one of the cold stores for maximum efficiency. C8.3 Requirements Temperature -20 C Stainless steel shelving and racks, non-corrosive food-grade containers No floor drains in freezer rooms. C8.4 Fixtures, fittings and equipment Shelving stainless steel 4-tier-high shelves C8.5 Services Prefabricated cold room with 100mm thick polystyrene insulation walls and roof. Floor structure recessed, insulated with 100mm-thick polystyrene or polyurethane insulation, covered with concrete and screed - to be level with rest of floor Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate Modular refrigeration plant consisting of internal evaporator(s) and external condensing unit Refrigerant to be ozone-friendly Facility for evaporator condensate removal in heated pipework to be provided No floor drains in freezer rooms Low-temperature waterproof light fittings. 46

51 C.9 Store: fresh vegetables and fruit C9.1 Location and relationship C9.2 Function Storage of vegetables and fruit in packaging material on mobile platforms or in baskets on mobile shelves for food. C9.3 Requirements Minimum amount of daylight Minimum of three air changes per hour Racking with shelves or wire mesh containers. C9.4 Fixtures, fittings and equipment Shelving. C9.5 Services Adequate lighting Smoke detection Mechanical-extract ventilation. 47

52 C.10 Store: cleaning materials and equipment C10.1 Location and relationship C10.2 Function Reserves of cleaning materials and equipment such as soap powder, detergents, disinfectants, mops, squeegees and scrubbers must be stored. C10.3 Requirements Store needs to be away from food Good drainage. C10.4 Fixtures, fittings and equipment Stainless steel sink with slatted shelving below Stainless steel hospital drip sink with hinged grating Hook above drainage furrow on which mops, brooms and squeegees are hanged Shelving stainless steel 4-tier- high shelves Wash trough. C10.5 Services Floor drain / grease trap as per civil engineer s specifications Smoke detection Adequate lighting Mechanical-extract ventilation Hot and cold water Waste connection. 48

53 C11 Store: crockery, utensils and linen C11.1 Location and relationship C11.2 Function Storage of new/additional crockery. Storage of clean linen in use and additional linen supplies. C11.3 Requirements C11.4 Fixtures, fittings and equipment Adjustable epoxy-coated steel shelves. C11.5 Services Adequate lighting Smoke detection. 49

54 C12 Store: refuse C12.1 Location and relationship C12.2 Function Storage of waste and refuse awaiting removal preferably refrigerated to inhibit odours and insects Storage of wet refuse in refuse bins with lids Storage of dry refuse in secured plastic bags Parking of trolley for refuse removal Storage of hosepipe with spout on hook Cleaning and disinfecting of refuse bins and lids on stand, and hook over drainage furrow Cleaning and disinfecting of the area. C12.3 Requirements Temperature 5 C, if refrigerated Water connection for hosing down Exit for daily refuse removal to central refuse removal area of the hospital/ institution Hook and drainage funnel for clean refuse bins and lids Must be resistant to animals, rodents, flies and other insects Good temperature control Good drainage Allowance calculated at 3 refuse bins per 600 meals and 1 bin for each additional 300 meals Must be physically separated from incoming raw materials, and/or food being processed. 50

55 C12.4 Fixtures, fittings and equipment Hosepipe with spout Container for hosepipe and spout, wall mounted C12.5 Services Prefabricated cold room with 100mm-thick polystyrene insulation walls and roof Lockable cold room door with emergency escape knob on inside Internal walls clad to 1200mm height with aluminium checker plate. Modular refrigeration plant consisting of internal evaporator(s) and external condensing unit Refrigerant to be ozone-friendly Facility for evaporator condensate drainage to be provided Low-temperature waterproof light fittings0 Floor channel with grid over / floor drain / grease trap, as per civil engineer s specifications Cold water supply (hose bibcock). 51

56 D1 Preparation: vegetables and fruit D1.1 Location and relationship D1.2 Function A wet area used for washing, peeling, cutting, chopping Raw vegetables are prepared for cooking, while salad vegetables and fruit are cleaned and prepared before being taken to other areas for final make-up The area generates a lot of waste or refuse and should be located close to the vegetable store and should have easy access to the refuse-disposal area Prepare (process) vegetables and fruit for cooking or serving. 52

57 D1.3 Requirements Good ventilation Good drainage Floor finish must be durable and slip-resistant. D1.4 Fixtures, fittings and equipment Stainless steel basin with elbow-action mixer, soap and paper-towel dispenser Soap dispenser Refuse bin on dolly Potato peeler with stainless steel vegetable-prep sink Vegetable peeler and stand Combination preparation sinks Preparation tables Vegetable preparation machine floor-standing model Double-bowl preparation sink Can opener. D1.5 Services Floor drain as per civil engineer s specifications Hot and cold water Waste connection to grease trap Mechanical ventilation Adequate lighting Smoke detection Splash-proof switched socket outlet Dedicated isolator for potato peeler. 53

58 D2 Preparation: fish and poultry D2.1 Location and relationship D2.2 Function Prepare fish and poultry for cooking according to recipe. D2.3 Requirements Sinks Good drainage Floor finish must be durable and slip-resistant. 54

59 D2.4 Fixtures, fittings and equipment Paper towel dispenser Soap dispenser Work surface, stainless steel Preparation sinks Stainless steel basin with elbow-action mixer, soap and paper-towel dispenser Refuse bin on dolly. D2.5 Services Floor drain / grease trap as per civil engineer s specifications Mechanical ventilation Adequate lighting Smoke detection Splash-proof switched socket outlets Hot and cold water Waste connection to grease trap. D3 Preparation: meat D3.1 Location and relationship D3.2 Function All meat should lead off meat cold room with easy access to the freezer Prepare meat for cooking according to recipe. 55

60 D3.3 Requirements Good drainage Floor finish must be durable and slip-resistant. D3.4 Fixtures, fittings and equipment Stainless steel basin with elbow-action mixer, soap and paper-towel dispenser Paper towel dispenser Soap dispenser Butcher block Refuse bin on dolly Meat saw Mincing machine Slicing machine Preparation tables Storage for: o Knives o Sharpening steels o Chopping boards o Machine attachments o Containers. D3.5 Services Floor drain / grease trap as per civil engineer s specifications Mechanical ventilation Adequate lighting Smoke detection Splash-proof switched socket outlets Hot and cold water Waste connection to grease trap. 56

61 D.4 Preparation: general D4.1 Location and relationship D4.2 Function All bakery items, desserts and savoury dishes are prepared here. Should have easy access to dry store and dairy cold room, as also the day store. D4.3 Requirements Good drainage Floor finish must be durable and slip-resistant. D4.4 Fixtures, fittings and equipment Mixers Slicers Pastry top and roller Scales Bins Pan racks Stainless steel wall-mounted Clinical hand-wash basins Can opener Preparation tables Double-bowl preparation sinks Worktop refrigerator 1.5 door Mixer 20-litre with hub Wrap master Microwave oven Sandwich toaster Work surface, stainless steel with drawer Stainless steel basin with elbow-action mixer, soap and paper-towel dispenser Soap dispenser Paper towel dispenser Elbow-operated disinfectant dispenser Writing board Stainless steel catering sink. 57