Food safety for all. A guide for shared homes for people with a disability

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1 Food safety for all A guide for shared homes for people with a disability

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3 Food safety for all A guide for staff of shared homes for people with a disability

4 ii Food safety for all Acknowlegements Food safety for all was developed by the Disability Services Division of the Department of Human Services. Main contributors to the project are: Naomi Roberts Dietitian and Project Officer Sue Milner Statewide Adviser, Nutrition and Dietetics Thank you to the Food Safety Unit, Public Health Branch, Department of Human Services for contribution to the content development of this book. Published by the Victorian Government Department of Human Services 2003 Copyright State of Victoria, 2003 Authorised by the State Government of Victoria, 555 Collins Street, Melbourne, Printed by Big Print, 520 Collins Street, Melbourne.

5 Food safety for all 1 Table of contents Introduction 2 Unit assessment 3 Recommended references 4 What is food poisoning? 5 Why is food poisoning serious? 6 The food poisoning chain 7 Personal hygiene 10 Safe food shopping 13 Safe food storage 15 Storing food in the pantry 15 Storing food in the refrigerator 15 Storing food in the freezer section of a free standing freezer or in the freezer section of the refrigerator 16 Safe food preparation 18 Thawing food 18 Cooking and preparing food 20 Cooking in advance, leftovers and reheating 23 Minced, mashed and blended meals 25 Nourishing drinks 26 Enteral (tube) feeds 28 Packed lunches 31 Barbeques 32 Picnics 33 Keeping the kitchen clean 35 Pest control and waste disposal 37 Answers to questions 38 Assignment for units HLTFS7A and HLTGM7A 44

6 2 Food safety for all Introduction When residents in a household suffer from a bout of diarrhoea, or claim to be feeling unwell, it is often assumed that there is a cold or bug going around. Food poisoning is often over-looked as a cause of these symptoms. Food poisoning is not only picked up from food prepared in commercial outlets, as about twenty percent of food poisoning occurs from food prepared in the home. With a little knowledge about how to prevent food poisoning, the amount of illness that occurs in shared homes can be significantly reduced.

7 Food safety for all 3 Unit assessment Food safety for all covers information needed to meet the elements of the following two units from the Disability Services Individual Learning Plan: Unit HLTFS7A, Follow basic food safety practices Unit HLTGM7A, Carry out work in a food handling area. The elements for each of these units are as follows: Learning objectives for unit HLTFS7A and HLTGM7A. Unit HLTFS7A Follow basic food safety practices On completion of this unit, you should be able to demonstrate that you can: 1. maintain food safety while carrying out food handling activities and 2. comply with personal hygiene standards. Unit HLTGM7A Carry out work in a food handling area On completion of this unit, you should be able to demonstrate that you can: 1. maintain food safety while working in a food handling area and 2. maintain food handling area in a clean and orderly state. Food safety for all is a reference book for shared homes for people with a disability. Throughout Food safety for all are some self-paced learning questions to assist those using the book for learning. These questions do not form part of the assessment for learners and answers for all questions are provided on page 38. A staff member being assessed for Certificate IV in Disability Work will be required to submit the assessment task on page 44. This assessment task contributes to the overall assessment for HLTFS7A and HLTGM7A.

8 4 Food safety for all Recommended references Internet site for the Food Safety Unit, Department of Human Services Internet site for Safe Food Hygienic Food Preparation and Handling. Food Safety Victoria and Department of Human Services, Personal Hygiene. Food Safety Victoria and Department of Human Services, Sure Protection Against Infection. Department of Human Services, May Best Practice Guidelines for Tube Feeding: A Nurse s Pocket Manual, Abbott Australia, June, 2001.

9 Food safety for all 5 What is food poisoning? Food poisoning is caused by bacteria, viruses or chemicals in food. These are usually present in the food as a result of mishandling such as keeping food at the wrong temperature, cross contamination or inadequate reheating. It is often not possible to tell if a food contains bacteria, viruses or chemicals by the food s appearance, smell or taste. Food poisoning results in illness, which may occur anytime between one and seventy-two hours after eating unsafe food. Food poisoning illnesses most commonly include nausea, vomiting, stomach cramps or diarrhoea.

10 6 Food safety for all Why is food poisoning serious? In general, people with a disability are at greater risk of food-borne infection. This is because of medical and physical problems and because some people with a disability have a poorer nutritional status than the general population. It is therefore critical that food is purchased, prepared and stored safely in all shared homes for people with a disability. If it is suspected that a resident has food poisoning, seek medical assistance immediately.

11 Food safety for all 7 The Food Poisoning Chain Forfood poisoning to occur there must be a chain of events: there must be bacteria in the food, the bacteria must have time to grow and multiply, and the bacteria must have moisture and the right temperature. By preventing each of these, you can break the Food Poisoning Chain and prevent food poisoning. Bacteria in food Bacteria are the most common cause of food poisoning. Food poisoning bacteria are often present in food, but in numbers so small that they do not do any harm. Bacteria multiply on most foods if given the chance. Certain types of foods are called High Risk Food because bacteria are more likely to grow on them. High Risk Food includes: chicken, seafood, eggs, meat, dairy products, small goods, cooked rice and prepared salads (such as coleslaw or pasta salad). Time Number of bacteria 0 1 After 20 mins 2 After 40 mins 4 After 3 hours 512 After 5 hours 32, 768 After 7 hours 2,097,152 Bacteria and time Bacteria can multiply very quickly. In the right conditions, a single bacteria can multiply into more than two million bacteria in only seven hours. It is when bacteria are in large numbers that they cause food poisoning. Moisture Bacteria need moisture to grow. If there is no moisture present, the growth of bacteria may slow down or stop. For example, dry biscuits have a longer shelf life than bread, and milk powder has a longer shelf life than fresh milk. The Temperature Danger Zone Bacteria grow best when the temperature is between 5 C and 60 C. This is called the Temperature Danger Zone. Food must be kept in the Temperature Danger Zone for as little time as possible to prevent food poisoning.

12 8 Food safety for all Questions Scenario Betty made a quiche for dinner. When it was cooked, Betty pulled the quiche out of the oven and let it cool for two hours on the bench. She then covered the quiche with plastic wrap and put it in the fridge ready for dinner. At dinner-time, the quiche was reheated to 50 C and served. During the meal, the quiche sat on the dinner table for one hour. The leftovers then sat on the bench for two hours before being returned to the fridge. Jack discovered the leftover quiche in the fridge two days later and ate a slice. The next day he complained of feeling unwell. 1a) Is it possible that Jack had food poisoning? Give a reason for your answer. 1b) What signs and symptoms would you expect Jack to suffer from if he had food poisoning? c) If you suspect a resident has food poisoning, what should you do?

13 Food safety for all 9 2. Name three common types of food that bacteria grow well in What does the term Temperature Danger Zone mean? What temperatures does it refer to? 4. Bacteria have certain requirements for life. Name four things that they require to grow and multiply

14 10 Food safety for all Personal hygiene People handling food must maintain a high standard of personal hygiene and cleanliness. Even healthy people carry food poisoning bacteria on their bodies. These bacteria can be spread to the hands by touching certain parts of the body, such as the nose, mouth, hair or bottom, and then from the hands to the food. Bacteria can also be spread to the hands by contacting money, clothing and other general or household items. Washing your hands Thorough hand washing is a good way to reduce the chance of passing on bacteria. When washing hands, make sure to clean the backs of hands, wrists, between fingers and under fingernails with soap and warm water. Wash hands for about thirty seconds and then dry immediately on a disposable paper towel. Disposable paper towels are more hygienic then regular towels because they are only used once. In terms of food safety, these are the preferred option for shared homes for people with a disability. When to wash your hands Hands must be washed before handling food and frequently during food preparation. Hands must be washed after the following: visiting the toilet, handling raw food, blowing your nose, coughing, sneezing, handling garbage and other waste, touching your ears, nose, mouth, hair or other parts of your body, eating or smoking, every break or interruption to food preparation, touching pets or other animals, and changing dirty clothing, including changing nappies.

15 Food safety for all 11 Other ways to keep food safe While preparing food never smoke, chew gum, spit or eat. Hair, jewellery and clothing can contain and spread bacteria. Keep long hair tied back or covered. Wear only plain-banded rings and plain sleeper or stud earrings. Wear protective clothing (for example an apron) over regular clothing. Keep nails short so they are easy to clean and avoid nail polish as it can flake into food. Keep clothes not being worn at the time (coats for example), car keys and other personal items away from the kitchen. Staff or residents who feel unwell should not handle food. This includes staff or residents with any of the following signs and symptoms (unless it has been established that there is a non-contagious reason for these): diarrhoea, vomiting, upset stomach, nausea, excessive coughing or sneezing, fever, sore throat, or discharge from the ears, eyes or nose that is due to an infection (for example a cold, flu, stye, allergy). Cuts and wounds on the hands or arms should be completely covered by a waterproof wound strip (such as a Band-Aid TM ) or a bandage. If the wound is on hands, disposable gloves should be worn over the top of the wound strip. Both the wound strip and the gloves should be changed regularly. Use wound strips that are brightly coloured so that they can be seen if they fall off. Visitors that enter the kitchen or who are involved in food handling, must follow the same personal hygiene principles as residents and staff.

16 12 Food safety for all Questions 5. Describe how you should wash your hands before you cook a meal. 6. If you are preparing food, name five activities after which you should wash your hands What should you do with each of the following before you prepare food a) jewellery b) long hair c) a wound on the finger

17 Food safety for all 13 Safe food shopping Good food safety practice begins when food is purchased from the supermarket or another food outlet. The following are recommendations for safe food shopping: Buy food from food outlets with a good reputation. Look for clean shops where the food looks fresh. Always check use-by or best before dates and only purchase items that will be used well before the date indicated. Only buy unwrapped food from people who appear to be following safe food handling techniques (for example hair tied back or in a hair net, minimal jewellery, clean clothes or apron, not handling money and then food without washing their hands or changing gloves in between). Where possible, avoid purchasing self-serve foods, for example nuts or ready-made salads. These foods are open to people sneezing, coughing or touching with unclean hands. Ensure packaged foods are in good condition. Avoid boxes with tears or tins with dints. Avoid leaking cartons, cans or bottles, cracked eggs, broken or imperfect seals, and products in loose vacuum packs. Avoid products with moulds, discolouration or infestation by insects. Avoid dairy products and other chilled and frozen foods left out of the refrigerator or freezer. Getting food back to the shared home Ifnon-food shopping tasks are to be done during a food-shopping outing, do these before any fresh or frozen food is bought. Fresh or frozen food shopping should always be left as the last task so that food is not left in the vehicle for longer than necessary. Always take these foods back to the shared home immediately after buying. Ifbuying foods from different locations, visit the locations that sell meat, poultry, fish or dairy products as the last task and drive immediately back to the shared home. In hot weather, try to shop in the coolest times of the day, for example early in the morning or in the evening. In hot weather, an insulated food transport container (such as an Esky TM or a cooler bag) is recommended for transporting fresh or frozen foods. If an insulated food transport container is not available, and an air-conditioned vehicle is being used, do not put food in the boot of the car because the boot will be warmer than the inside of a vehicle. Any food bought to the house by visitors, must reflect the above food safety principles. If staff have any doubt about food safety issues of any food bought in by visitors, they must discard the food.

18 14 Food safety for all Questions 8. Why are self-serve foods, for example salads and nuts a potential food safety hazard? 9. List five things that would make you think a food product in a supermarket may be unsafe from a food safety point of view Why is it a food safety hazard for shop assistants to serve unpackaged foods and handle money without washing their hands or changing gloves in-between?

19 Food safety for all 15 Safe food storage Careful storage of food will reduce the chance of foods becoming contaminated with harmful bacteria. It will also help to retain the food s nutritional value. As a general rule, store all food products as directed on the label. The following are some general recommendations for safe food storage: store food wrap, food bags and containers in a clean area (for example in a clean closed drawer) so they do not get contaminated, store unused food containers upside down so dust and dirt do not get into them, wash containers carefully before using them, and, do not re-use containers that are designed for a single use. Storing food in the pantry Place packaged products, for example flours and sugars, into food grade lidded containers after opening. Avoid storing any foods on the floor because this can make cleaning at floor level difficult. It can also hide pests, such as cockroaches or rats. Avoid over crowding the pantry because this makes cleaning and keeping track of the pantry contents difficult. Store chemicals, cleaning equipment and personal belongings separately from food. Rotate stock on the shelves so that food that has just been purchased goes to the back of the shelves. Storing food in the refrigerator Check the temperature of the refrigerator regularly using a thermometer. A thermometer can be purchased at a hardware store or borrowed from some local councils. Refrigerators should be run at temperatures between 0 C and 5 C to prevent food-borne bacteria from multiplying and causing illness. After food shopping, place foods that need to be kept cold into the refrigerator without delay. Cover all unwrapped food with lids, plastic wrap or foil before placing in the refrigerator. Do not leave food in unopened cans, jars or containers. Store raw meats, fish and poultry on the bottom shelves of the refrigerator, so that they cannot drip onto other foods. If raw meats need to be stored higher in the fridge, store them in a container so that they cannot drip. Store raw food separately to cooked food. Raw foods may contain bacteria that could contaminate cooked food. Rotate food on the shelves so that newly purchased food is moved to the back of the shelf and older food is moved to the front, where it will be seen and used first. Ensure the refrigerator is always clean.

20 16 Food safety for all Storing food in a free standing freezer, or in the freezer section of the refrigerator Regularly check that the temperature of the freezer is appropriately cold. The easiest way to do this is by checking that all foods removed from the freezer are frozen hard. Any concern about the functioning of the freezer should be reported to the house supervisor. Freezing greatly extends safe storage life. Bacteria cannot grow at the low temperatures of freezing and thus food is safe as long as it remains frozen at a safe temperature. It is sometimes recommended that foods be frozen for limited time periods, for example frozen foods may have a best before date. This does not relate to food safety but to food quality. Freezing food for longer than the time period recommended by a food manufacturer may affect the taste, texture or colour of a food. Although bacteria cannot grow in safe freezing temperatures, they can survive. Freezing does not make unsafe food safe (that is, it does not kill bacteria). Once food is out of the freezer and warms up, the bacteria present in the food will begin to multiply. When returning to the shared home, place foods that need to be kept frozen into the freezer without delay. Freeze raw meat, fish and chicken that you don t intend to use within a few days of purchase. Freeze food in small batches to allow it to freeze quickly. Domestic freezers are designed to hold frozen food. They are not designed to freeze large amounts of food at once. Avoid putting large amounts of unfrozen foods into the freezer at one time. Follow the manufacturer s instructions on how to freeze food in the freezer. When freezing food, keep it in the store wrap or place it in a freezer-safe container or in a freezer bag. Tie the bag after removing as much air as possible, label and date.

21 Food safety for all 17 Questions 11. List two reasons why it is recommended that food is not stored on the floor of the pantry a) What does it mean if you remove a frozen chicken from the freezer and it feels slightly soft when you touch it firmly? b) What should you do if food removed from the freezer is slightly soft when touched firmly? Scenario It is 2 pm and Gary has just returned from the supermarket. He is putting the shopping away: he puts a bag of apples at the floor of the pantry because there is no room left on the shelves. He then places the raw bacon and sliced lunch ham together on the bottom shelf of the fridge and the rump steaks on the top shelf of the fridge. 13. List the things that Gary has done that put his food at risk of being unsafe and causing food poisoning. Give reasons for your answers.

22 18 Food safety for all Safe food preparation Thawing Food The following are recommendations for the safe thawing of food. Do not re-freeze food that has already been thawed without cooking it first. When a frozen food is thawing, any bacteria present will start to multiply. If the food is refrozen these bacteria will not die and will still be present when the food is thawed for the second time. This means that when you thaw the food for the second time it is likely to have higher levels of bacteria. Thaw food on the bottom shelves of the refrigerator. Do not thaw food at room temperature (for example on the bench top) because this can increase the rate at which bacteria will multiply. Ensure food is properly thawed prior to cooking so that it cooks all the way through. If it is necessary to cook food while still frozen, make sure that the food reaches an internal temperature of 75 C. This can be tested using a thermometer with a probe which can be inserted into the food. These thermometers (called probe thermometers) are available at hardware stores and large department stores. Freeze food in small batches to allow it to thaw quickly. Defrost the freezer as recommended by the manufacturer. Plan to defrost when the freezer stocks are low. Food that has been thawed should be cooked immediately. Thawing food in a microwave Microwaves are a convenient and fast way to thaw foods. The following are some recommendations for safe thawing using a microwave. Remove food from the store wrap, place it in a microwave-safe dish and cover with a lid or with plastic wrap for thawing. Rotate and rearrange food during defrosting because microwaves do not heat foods evenly. Where possible separate the food items and remove those that have already thawed. This enables the remaining items to thaw faster and stops the thawed parts from starting to cook.

23 Food safety for all 19 Questions Jan took five chicken breasts out of the freezer and placed them onto the bench so they would defrost in time to be cooked for the evening meal. Two hours later she received a phone call to say that one of the residents would not be home for dinner. This meant that she only needed to cook four chicken breasts. 14 a) What should Jan do with the fifth chicken breast? b) Has Jan thawed the chicken in an appropriate way? Explain your answer. 15. Why should food be thawed in the bottom of the fridge? 16. What are three things you should do when thawing food in the microwave? 1. 2.

24 20 Food safety for all Cooking and preparing food The following are recommendations for food safety while cooking and preparing food. Wash hands with hot soapy water between handling raw food and cooked food. Raw foods can contaminate cooked foods so care must be taken to keep these foods separate. Use different sections of the kitchen bench and different cooking utensils (or wash these with hot soapy water) between use with raw and cooked foods. Take care when using chopping boards to prevent the spread of bacteria from one food to another. It is important to use a separate chopping board (or wash the chopping board with hot water and detergent) between chopping foods that may carry bacteria. For example, cooked food must not be chopped on a board that has just been used to chop raw meat, poultry or seafood. Wash all raw fruit and vegetables as these may be contaminated with harmful bacteria or chemicals. Utensils used for tasting food must not be placed back into food. Wash all garnishes, such as raw parsley. Minimise handling of food after cooking. Use clean tongs and utensils. Avoid touching the surfaces of plates, bowls, cups and cutlery that come into contact with food or drink (for example the inside of cups and bowls). Where possible, complete the cooking process close to the time of serving food. Aim to serve food immediately after cooking. Cooking food in the microwave Microwaves are an effective method of cooking and reheating. To ensure that microwave cooking and reheating is safe from a food safety point of view, the recommendations below must be followed. Microwaves cook foods unevenly, leaving cold spots. When cooking in the microwave, rotate and stir food to promote more even cooking. Turn over large food items that cannot be stirred. Where possible, cut food into pieces of a similar size so they will cook evenly. If this is not appropriate, put larger pieces toward the outside of the dish. Cover food with a microwave-safe lid or microwave-safe plastic wrap. This will help trap steam and give more even cooking. During cooking, rotate the dish once or twice even if you have a rotating turntable. Do not cook or reheat food in plastic takeaway food trays because they are not intended for this purpose and may not be safe.

25 Food safety for all 21 Before testing to see if food cooked in the microwave is ready, let it stand for three to five minutes or until any recommended standing time is over. This is because food continues to cook once food is removed from the microwave. Another reason for doing this is that it reduces the risk of people burning themselves with hot steam or hot dishes. Itis important to keep the microwave clean to ensure that it operates efficiently. Check the microwave manual for recommended cleaning products and methods, or call the manufacturer. Is it cooked yet? Meat Processed raw meats such as mince, sausages, hamburger patties and rolled or stuffed roasts are likely to contain large numbers of bacteria because the food processing involved in making these exposes them to aspects of the environment such as the air, machinery and human contact. To ensure these foods are safe, they must be cooked right through (until the juices run clear when you place a skewer into the centre of the meat). Steaks, chops and whole roasts (not rolled or stuffed) can be cooked to preference because they are not likely to contain bacteria internally, provided that they have been handled in a safe manner before cooking. Chicken Chicken is highly susceptible to bacterial contamination. Chicken must always be cooked until the juices run clear. Chicken meat should be cooked until the flesh is white. Any chicken meat that remains pink in colour is uncooked. Fish Cook fish until it flakes easily with a fork. Eggs Cook all eggs and foods made with eggs until they are not runny.

26 22 Food safety for all Questions 17(a). Peter plans to cook a roast chicken. The chicken is frozen. What steps should he take to thaw the chicken? (b) Peter then cooks the chicken. What should he do to check that the chicken has been cooked adequately? 18. What should be done to all raw fruit and vegetables prior to serving? 19. Why would it be recommended to use separate chopping boards for chopping raw meat and chopping salad vegetables? 20. How would you judge if a hamburger patty is cooked?

27 Food safety for all 23 Cooking in advance, leftovers and reheating It is best, in terms of food safety, to prepare meals as close as possible to the time that they will be eaten. Sometimes, however, it is necessary to cook food ahead of time. When food is cooked for later use it should be cooled in the shortest amount of time possible. Cooling food quickly Food will cool most quickly if it is divided into small lots. Shallow containers are ideal for cooling because they allow the food to spread out. Food should not be cooled on the bench. Food should be cooled in the refrigerator. Ensure that there is space around the container in the refrigerator to enable quick cooling. The only time that food should not be placed immediately into the refrigerator for cooling is when food has just been cooked and is still extremely hot. In this situation, the food may be cooled on the bench for ten minutes before being placed in the refrigerator for further cooling. This reduces the warming of the refrigerator s internal temperature by the food. If food is not to be eaten within the next two hours, write the time and date that the food was prepared on a label and place the label on the covering of the food. If food is not to be eaten with the next two days,itshould be transferred to the freezer as soon as it is cool. Leftovers Leftovers must be treated with care because there is a greater chance of them becoming contaminated with bacteria than freshly prepared foods. In general, it is best to try to avoid having leftovers by carefully planning the amount of food made at each meal. If leftovers have been cooled correctly (refer to recommendations above) they may be stored in the refrigerator for up to two days. After two days, leftovers stored in the refrigerator must be thrown out. If it is anticipated that leftovers will not be used within two days, they must be stored in the freezer. The following guidelines must be followed to ensure that left over food is safe for residents to eat. As soon as food is served, package all leftovers and place in fridge. If people desire more food than the amount initially served to them, food may be removed from the fridge and reheated (refer to page 24 for information about reheating food). All food to be used as leftovers must be clearly labeled with the time and date of preparation. All cooked foods to be used as leftovers must be stored on the top shelf of the refrigerator so that uncooked foods cannot drip onto them. Keep the leftovers separate to raw food.

28 24 Food safety for all Reheating food When reheating food, ensure that it is reheated rapidly. Bring the food to the boil and simmer for at least five minutes before serving. Make sure that food is stirred or rearranged while being re-heated so that it is heated adequately throughout. If reheating food that has been frozen, it is recommended that the food be defrosted prior to heating. This is because it takes frozen food a long time to reach a hot, safe temperature in the centre, making it difficult to ensure that the food has been adequately heated. Food being reheated in the microwave should be covered to assist rapid reheating. While reheating, stir, rotate and rearrange food because microwaves do not heat foods evenly. Questions Susan and Jim cooked a chicken casserole for dinner. They timed the cooking so that it was ready just before the mealtime. The casserole was served up and a small amount was left over. The leftover casserole sat on the kitchen bench while the residents ate their meal. Mealtime lasted for two hours. Two hours after dinner, Maggie started to do the dishes. When she had washed all of the plates, she looked around to see what else needed to be washed and saw the casserole dish sitting on the bench. She emptied the leftover casserole into a container and put it into the fridge so that she could wash the casserole dish. 21. a) From a food safety point of view, was Maggie s behaviour safe? b) What should have been done with the casserole to ensure safe storage of leftovers? 22. You have just finished making a soup for tomorrow night s dinner. It is sitting, steaming on the stove, in a cooking pot. What steps will you take to store it in a way that will ensure the soup is safe for tomorrow night?

29 Food safety for all 25 Minced and mashed and blended meals Texture modified meals are meals that have been minced, mashed or blended so that they are suitable for residents with chewing and/or swallowing problems. Texture modified foods are at a higher risk of bacterial contamination than other foods. The following are reasons for this. The process of mashing, mincing or blending meals involves additional handling of cooked food. This increases the potential for cross contamination. The process of mashing, mincing or blending meals involves additional kitchen equipment. This increases the potential for cross contamination. The temperature of hot food drops while it is being minced, mashed or blended. This means it can enter the Temperature Danger Zone easily. Texture modified foods have lots of little surfaces and spaces where air is present. This means that there is a lot of area where bacteria can grow and make the food unsafe. The following are recommendations for preparing safe texture modified meals. Wash hands thoroughly before mincing, mashing or blending meals. Prepare these foods away from where raw foods have been handled. Ensure that equipment used for mincing, mashing or blending raw foods is washed thoroughly before being used with cooked foods. For cooked meals, make sure food is cooked thoroughly before texture modification. Iffood is not to be minced, mashed or blended immediately after cooking, it must be stored at a temperature of 5 C or below, or at 60 C or above. For food that is not cooked, or that is to be served cold, such as desserts or salads (for example pasta salad or potato salad), store at all times (before and after mincing, mashing or blending) at 5 C or below. Before hot texture modified food is served make sure it has boiled or has been reheated to a core temperature of at least 75 C. Use a thermometer to verify the temperature. Clean the probe thermometer thoroughly between uses. If a probe thermometer is unavailable (for example if food is being heated at a resident s place of work or at a day placement) ensure that plenty of steam comes from the centre of the food. After heating is complete, allow food to cool to an appropriate temperature before serving, so it is not too hot for eating.

30 26 Food safety for all Nourishing drinks Nourishing drinks are drinks that are especially high in kilojoules (energy) or nutrients. They are usually used to assist undernourished people or people with a limited food intake to get adequate nutrition. Nourishing drinks can be commercially prepared or can be made at home. Commercially prepared drinks may be purchased as a ready-made drink, or may be bought as a powder, which is then mixed with milk, soy drink or water before use. Home made nourishing drinks are often made using ingredients such as milk, soy drink, milk powder, ice cream, egg, yoghurt or flavouring. Care must be taken with nourishing drinks that they are not kept in the Temperature Danger Zone for longer than four hours. If they have been kept at more than 5 C or less than 60 C for longer than four hours they must be thrown out. If residents take nourishing drinks to work or day placement, sealed long-life drinks (for example UHT) must be taken. Extra attention must be paid when nourishing drinks are made for residents who are likely to take a long time to finish their drinks. In these cases, it may be best to serve them only half a drink and keep the rest in the refrigerator until they are ready for it.

31 Food safety for all 27 Questions 23. List three reasons why texture modified foods are a greater food safety risk than regular foods To what temperature should hot texture modified food be heated to ensure it is safe from bacterial contamination? 25. List four steps that can be taken to ensure that texture modified foods are safe from bacterial contamination Extra care needs to be taken to ensure that nourishing drinks are kept safe. Why are nourishing drinks considered to be vulnerable to contamination by bacteria?

32 28 Food safety for all Enteral (tube) feeds Enteral or tube feeding is the delivery of a liquid nutritional formula directly into the gut (stomach or intestine) via a feeding tube. A feeding tube is required for people who are unable to eat enough food to meet their nutritional needs or for people with swallowing problems. The nutritional formula contains the nutrients (protein, fat, carbohydrate, vitamins and minerals) usually found in the diet. Safe formula storage Store unopened formula in a cool dry place. In hot weather, store in the refrigerator. Once a container of formula is opened, it must be treated as high risk food in terms of food safety. This is because it is rich in nutrients and provides a favourable environment for the growth of bacteria. Opened formula must be refrigerated in a covered or sealed plastic or glass container. If not used within twenty-four hours of opening or mixing, it must be thrown out, unless otherwise directed by the product label or by a dietitian or doctor. Note: formula needs to be administered at room temperature. Cold formula can cause discomfort and diarrhoea. Take formula from the refrigerator and store at room temperature half an hour prior to administering feed. Recommendations for safe formula preparation Wash hands before opening formula. Ifusing formula from a tin, use a clean tin opener and wipe the top of the tin with a clean cloth before opening, so that if the top of the tin comes in contact with the formula it will not cause contamination. Safe feeding methods Do not allow formula to hang in the feeding container for longer than twelve hours (unless otherwise directed by the product label or by a dietitian or doctor). After this time, there is a risk of the formula becoming unsafe and it must be thrown away. Formula that has been opened or mixed and stored in the refrigerator must be thrown out if unused within twenty-four hours (unless directed otherwise by the product label). To keep track of how old formula is, always put the date and time of opening or mixing on every container of formula. Ifadding water to formula, use sterile water only (available from the supermarket). Tap water can contain bacteria, which if left in contact with formula for more than four hours, can multiply to dangerous levels and cause food poisoning. When flushing the tube, tap water is safe to use. This is because the water will not be left in contact with the feed where it could multiply, but will pass directly into the gut.

33 Food safety for all 29 Itis recommended that feeding containers, giving sets and syringes are thrown away and replaced every twenty-four hours. Follow this advice, unless a health professional directs otherwise. Continuous feeding Continuous feeding is a method of administering feeds where the formula slowly drips through the feeding tube all day or night (or both). If continuous feedings are given, wash the feeding container and giving set with warm, soapy water and then rinse with clean water between each container of feed or every twelve hours, whichever is first. Once the feeding container and giving set has been washed, only add fresh formula. Intermittent feeding Intermittent feeding is a method of administering feeds where larger amounts of the formula are given three to eight times a day. If intermittent feedings are given, close the feeding tube until the next feeding. Wash the container and giving set with warm soapy water and then rinse with clean water. Store in a clean, covered container or wrap in a clean towel until the next use. In hot weather, store in the refrigerator.

34 30 Food safety for all Questions 27. Before you open a can of formula, what are three things you must do to prevent contamination of the feed? Once a can of formula has been opened but is not in use, how should it be stored and for how long can it be stored safely? 29(a). Why should tap water NOT be added to formula that will hang in the feed container for more than four hours? (b) What water should be used instead? (c)where is this water obtained from? 30 (a). What should be used for washing feeding containers and feeding tubes? (b)how should they be stored if not in use between feeds?

35 Food safety for all 31 Packed lunches Food taken out of the refrigerator early in the morning for a packed lunch and left at room temperature until lunchtime can become a food safety risk. Provided, however, that food is properly prepared and is stored at the correct temperature until lunchtime, it will be safe to eat. The following information shows how to keep lunch foods safe. Prepare food as close as possible to the time that it will be eaten. For example, if food is to be taken to work, day placement or on a picnic, food should be prepared shortly before the resident leaves the house. Once lunch has been prepared, it should be kept cold until it is eaten. Some workplaces and day placement centres have refrigerators. Where these are available, lunches should be placed in the refrigerator as soon as a resident arrives. Where refrigerators are not available, a packed lunch may be kept cool by packing a frozen drink in the lunch box, using a lunch box/ice pack combination, or an insulated bag such as an Esky TM. Particular care should be taken to keep texture modified foods (minced and mashed or blended foods), salads, soft cheeses, milk, yoghurt, dips, egg, fish, meat or meat pastes cold. These foods are especially vulnerable to food poisoning and should be eaten within four hours of when they were taken out of the refrigerator. If left out of the fridge for more than four hours, these foods should be thrown out as they may have become unsafe. Avoid packing perishable foods which have just been cooked or warmed, for example meat loaf or boiled eggs. Such foods should always be cooled in the refrigerator, preferably overnight, before being packed for lunches to prevent bacteria growing on the food. At times when food will be kept at room temperature for longer than four hours, only certain foods should be packed. The following types of foods are considered to be safe: unpeeled fruit, unopened packs of tinned fruit or dried fruit, fruit juice in an unopened sealed container, nuts, unopened long-life (UHT) milk drinks or yoghurt or milk drinks that have been completely frozen, unopened tins (such as tinned baked beans, spaghetti, fish or soup) and dried biscuits.

36 32 Food safety for all Barbeques Barbeques are a fun way to cook and provide residents with some variety. The following guidelines will help to make barbeques safe. Keep meat in the refrigerator until you are ready to use it on the barbeque. Always cook chicken, stuffed meats, sausages and minced products such as hamburger patties so that juices run clear- there should be no hint of pink. To prevent sausages from burning and to ensure they are well cooked, precook them by boiling in water or cook in a microwave. Steaks, chops and whole pieces of meat can be cooked to preference. Use a clean plate for the cooked meat. Never re-use the same one that held the raw meat without washing it. Salads, pates, spreads, dips and other perishable products should only be bought outside or placed on the table when required. Leftover cooked meats and other perishables can be covered and put into the refrigerator as soon as that part of the meal is finished. Perishables may be left out on the table for up to four hours in cool weather. If they have been out for this long, however, they must then be thrown out and not kept as leftovers. In warm or hot weather, perishables should be left out for up to two hours only. Ensure all food left out on the table is covered by plastic wrap or by a clean cloth to keep food free from flies. Ifthe barbeque is held away from the shared home, care must be taken when transporting the food. High risk foods must be transported in an insulated container with plenty of ice blocks.

37 Food safety for all 33 Picnics The following are some recommendations for a safe picnic. The simple rule for picnics is to keep hot food hot and cold food cold. Any foods that are to be cooked for the picnic should be cooked, covered and cooled the night before. Foods that have not been adequately cooled should not be taken. Coolers cannot cool foods to prevent bacteria growing. Perishable foods and drinks such as deli products, cooked chicken and dairy products must also be cold when added to the cooler. Ensure meat is cut into serving size pieces before leaving for the picnic, and ensure all salads are ready to eat. This will reduce the need to handle foods, particularly when there is no hand washing facility. Always pack plenty of ice blocks, frozen bricks or gel packs around the food. Frozen drinks thaw quickly in warm weather and provide extra cool drinks. Wicker baskets are best used for non-perishables and your other picnic needs. Carry disposable wipes in case there is no water for hand washing.

38 34 Food safety for all Questions 31. Barry attends day placement at a centre where there is no refrigeration available for his lunch. He leaves the house at 8am and eats lunch at 1 pm (five hours later). a. What foods would be safest for Barry to take to placement? b. What could be done to make Barry s lunch as safe as possible until lunchtime? c. Barry loves egg sandwiches. Is there any way that he could take an egg sandwich to day placement? 32. When going on a picnic and using a cooler, why is it important that all foods are cold before being placed in the cooler? 33. Name three common barbeque foods that must be thoroughly cooked to ensure that they are safe Order these four foods from the least safe to the most safe to pack into a picnic basket and eat three hours later on a picnic. i. chicken cooked the previous night and cooled in the refrigerator ii. chicken cooked just before leaving for the picnic and packed while still warm iii. a prepared salad packed in a sealed container iv. a box of dry biscuits

39 Food safety for all 35 Keeping the kitchen clean Keeping the kitchen clean is one of the best ways of avoiding food poisoning. Cleaning tips: Wash all work surfaces, including drawer and cupboard handles. Clean all equipment and benches after you use them and before you use them. Work from the top down so that you are not soiling surfaces that have just been cleaned, for example wipe the walls before the benches and wipe the benches before floors. Wash dishes as soon as possible after a meal. Wash dishes in hot soapy water or in a dishwasher and leave to air dry or dry with a clean tea towel. Change tea towels after each use. Bacteria will grow in wet sponges and dishcloths. Change these regularly, wash in hot water and detergent or place in dishwasher and wash them with a load of dishes. Do not use dishcloths and sponges for wiping things from the floor. Clean the fridge and cupboards regularly. Crumbs in cupboards can attract pests and dirty refrigerators can carry bacteria. Wash chopping boards before and after each use. When buying kitchen equipment, choose equipment that is capable of being easily dismantled and cleaned after use. Equipment with detachable blades is preferred.

40 36 Food safety for all Questions 35. Why is it recommended you clean the kitchen from the top down (for example benches before floors)? 36. Why must cupboard door handles be cleaned regularly if they do not come in contact with food? 37. Why should cupboards and fridges be cleaned out regularly? 38. List two ways of ensuring that chopping boards are not carrying bacteria. How often should this be done? Give one reason why dishes should be washed as soon as possible after each meal.

41 Food safety for all 37 Pest control and waste disposal Aim to keep all shared homes free of pests. Houses must be made as pest proof as possible by the following. Regularly take out the rubbish. Rubbish bins should be strong, have a well-fitting lid and be insect and rodent proof. Clean all cupboards and pantries regularly. Keep all food products off the floor. Use sealed containers for foods where possible. Regularly inspect the premises for signs of pest infestation, especially in food preparation areas. Questions 40. List four things that can be done to reduce the chances of pests entering food packages? Why is it important to keep pests out of the kitchen?

42 38 Food safety for all Answers to questions 1a. It is possible that Jack had food poisoning. The quiche that Jack had eaten had been left in the Temperature Danger Zone for five hours. b. If Jack had food poisoning, you would expect him to experience nausea, vomiting, stomach cramps or diarrhoea. c. If it is suspected that a resident has food poisoning, medical assistance should be sought immediately. 2. The answer should include three of the following foods: chicken, seafood, eggs, meat, dairy products or cooked rice. 3. Temperature Danger Zone refers to the temperature at which food-borne bacteria grow best. This temperature is from 5 C to 60 C. 4. Four requirements for bacteria to grow are: correct temperature, time, moisture, food. 5. How to wash hands before cooking: use warm soapy water wash the backs of hands, wrists, between fingers and under the fingernails wash hands for thirty seconds dry hands immediately with a disposable towel. 6. Hands must be washed after the following (any five answers correct): going to the toilet handling raw food blowing your nose handling garbage touching your ears, nose, mouth, hair or other parts of your body smoking every break or interruption and touching a pet. 7. Before preparing food: a. remove all jewellery, except plain banded rings and plain sleeper or stud earrings b. tie long hair back or cover it c. cover wounds on fingers with brightly-coloured waterproof wound-strip and wear disposable gloves. 8. Self-serve foods are a potential food safety hazard because they are exposed to people sneezing, coughing or touching with their hands.

43 Food safety for all Any five of the following (or similar) responses are correct: the food outlet has a poor reputation, looks unclean or does not looks fresh, use-by date expired, unwrapped food served by people who appear to be following unsafe food practice (for example excessive jewellery, unclean clothes or apron, handling money and then food without washing their hands or changing gloves in between), self-serve food, package not in good condition, for example box with tear or tin with dint, leaking carton, can or bottle, broken or imperfect seal, products in loose vacuum packs, mould, discolouration or infestation by insects, or chilled and frozen foods left out of the refrigerator or freezer. 10. It is a food safety hazard for shop assistants to serve unpackaged foods and handle money without washing hands or changing gloves between because of the potential transfer of harmful bacteria from money to food via hands or gloves. 11. Food should not be stored on the floor of the pantry because: stored food on the pantry floor may make it difficult for pests to be seen and stored food on the pantry floor may make cleaning the floor difficult. 12a. If a frozen chicken is slightly soft to touch when removed from the freezer, it may mean that the freezer is not cold enough. b. If the freezer is too warm, this must be reported to the house supervisor. 13. Gary s following actions put his food at risk of causing food poisoning as the following shows. Gary put a bag of apples on the floor of the pantry, which may make cleaning hard and may hide pests. Gary put the raw bacon away together with the ham, which may cause the ham (which does not need to be cooked) to be contaminated by bacteria from the raw bacon. Gary put ham on bottom of fridge, which may cause it to be dripped on and thus contaminated. Gary put raw steak in the top of the fridge. The steak may drip raw meat juice (which may contain harmful bacteria) onto foods lower in the fridge. 14a The fifth chicken breast has already started to defrost and thus should not be re-frozen. It should be cooked with the other four breasts and stored in the fridge for later.