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Northern Territory Department of Health Library Services Historical Collection
DL HIST
725.51 MIN
1982
N.T. DEPARTMENT OF HEAL'rH
MINIMUM BASIC REQUIREMENTS FOR NURSING HOME BUILDINGS NURSING STAFF REQUIREMENTS
REGULATIONS (36)
DATE OF ISSUE: OCTOBER 1982
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HISTORICAL COLLECT.l~N
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WP: 3.8-C
NURSING HOME FACILITIES Nursing Home Definition
A Nursing Home for this purpose means premises that are fitted, furnished or staffed for the purposes of providing accommodation and nursing care for patients who, by reason of infirmity or illness, disease, incapacity or disability, have a continuing need for nursing care and in which patients of that kind are received and lodged exclusively for the purpose of providing them with accommodation and nursing care.
Nursing Home Operation
Any person or body corporate may establish and maintain or enter into an agreement to establish and maintain a nursing home (as defined), subject to the approval of the Secretary for Health.
The Secretary for Health being satisfied of the bona fides of the operation of a proposed nursing home shall cause a licence to be issued.
The licencee of a nursing home shall request approval of the Secretary for Health for a person to be the Chief Nurse or Assistant Chief Nurse of the nursing home. A Chief Nurse or Assistant Chief Nurse shall be a registered nurse as registered by the Northern Territory Nursing Registration Board.
Minimum Basic Requirements for Nursing Home Buildings Preamble '
In addition to specific requirements for special purpose buildings, all construction of buildings in the Northern Territory must overall conform to the requirements of the Northern Territory Building Board. Buildings in cyclone prone areas must conform to the appropriate building code.
1.
2.
SITE
The site must be in an appropriate environment for constructjon of a nursing home.
The site must be approved by the appropriate local authority.
The total ground floor of all buildings on Lhe site shall not exceed 50% of the total site area.
Public transport should be available and general noise exposure (eg traffic) should be considered.
A suitable sitting-out area should be provided with handrails on the approaches.
BUILDING
The building should be of solid brick or masonry construction and insulated.
Main entrances should be sign posted.
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FIRE PRECAUTIONS
The nursing home must conform to the requirements of the local Fire Authority.
As part of continual licensing, the proprietor shall be required to contact the fire brigade to advise on fire detection systems and to ensure that fire drill is carried out on a regular basis.
4. WARD ACCOMMODATION 4.1 Floor Area Per Bed
Single Bed Ward Multiple Bed Ward
9.5 square metres 7.5 square metres
One single bed ward for each 20 beds or part thereof shall be provided.
4.2 Walls
Walls and partitions shall be smooth, even, impervious to moisture and capable of being washed and disinfected in situ without drimage Lo Lhc surfJcc.
Walls should be finished ' in attractive, cheerful colours.
Flammable wall linings an"' prohihitC'd.
4. 3 Ceilings
: Minimum height 3000mm.
Construction premises to condition.
and finish shall be be maintained in a
such as will enable the clean, hygienic and safe
Ceilings should be finished in white or light pastel colours.
4.4 Floors
Floor coverings shall have a non-slip surface.
Loose floor coverings shall not be used.
Linoleum shall not be used.
Joins in vinyl floor sheeting shall be vulcanised at the seams.
Carpeted areas to be of a standard similar to Hycraft 80% wool 20% nylon commercial grade.
4.5 Windows
An area equivalent to at least 1/10 of the floor area shall be glazed windows. Windows to be safety glass as per Australian Standards.
50% of the window area shall be capable of being opened.
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4.6
Patients should be able to have a scenic outlook from a sitting position wherever possible.
Where a window sill is less than 770mm from a floor a safety rail must be provided.
Doors, Width of Doors or Doorways
Minimum 1370mm where the corridor is narrower than 2130mm.
Minimum 1060mm where the width of the corridor is 2130mm or more.
Where the width of a door, if installed, is 1370mm or more, it shall be bi-parting, or 2 leaved.
No ward door shall have a locking device or barrel bolt except where otherwise approved.
4.7 Ventilation
Each ward shall be independently and efficiently ventilated.
4.8 Access
Each ward sl1all ' hJvc s p<.1ralc access Lo a corrLdor.
4.9 Lighting/Power Outlets
Adequate overhead light with a night light or dimmer switch shall be provided.
A permanent inbuilt bed-lamp and a power point additional to that used for the bed lamp shall be provided for each bed.
4.10 Heating/Cooling
A safe and satisfactory means of heating/cooling which meets the requirements of the appropriate local authority shall be provided in each ward.
Portable heaters and naked heating elements shall not be used. Ceiling fans shall be mounted so that the blades are not less than 2440mm from the floor.
Electric wall fans shall be mounted at least 2130mm from the floor and adequately protected by stiff metal guards.
All controls for heating and cooling shall be at least 1980mm from the floor.
4.11 Ward Numbering
On the outer face of the entrance of every room there shall be painted or otherwise marked in prominent and permanent characters numbers or letters indicating the assignment to that room according to the approved plan and licence.
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4.12 Hand Washing Facilities
Hand washing facilities with elbow taps shall be provided in or adjacent to all wards.
WARD FURNITURE AND FITTINGS 5.1 Beds Number
5.2
One approved hospital type bed with firm base for each patient with a minimum width of 914mm. A proportion shall be of adjust- able height.
Beds Minimum Spacing
Beds shall be accessible from both sides.
5.3 Mattresses
One mattress shall be provided for each bed and one extra for each 10 (or fraction of 10) beds.
Mattresses shall be of good quality ie inner spring, foam rubber or similar type.
Each mattre;s shall be fitted with a walcrproof mattress cover. 5.4 Pillows and Linen
5.5
Four pillows per bed .
. .' Bed linen shall be in sufficient supply to allow for changes twice weekly or more frequently if necessary.
Bed linen must be in good condition.
Blankets
Blankets shall be of adequate numbers and condition.
good shall
quality cotton be maintained
and in
provided in a hygienic
Electric blankets shall be of low voltage transformer type and comply to Northern Territory Electricity Commission require- ments.
5.6 Bedside Locker
One bedside locker (with rounded corners) shall be provided for each bed and situated so that they are within easy reach of the patient.
Bedside lockers shall have impervious surfaces.
5.7 Overbed Table
One overbed table (with rounded corners) of adjustable height shall be provided for each bed. Overbed tables shall have impervious surfaces.
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5.8 Chairs
One comfortable armchair shall be provided for each bed. Arm- chairs shall be of var:i ous heights. i\] so one bedside chair to be provided.
Chairs shall be made of such materials which facilitate them
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6.
7.
5.9 Wardrobes
One wardrobe or other suitable receptacle, provided for storage of patients' clothes.
space must be included.
5.10 Bed Screens
per bed sha 11 be Clothes hanging
Multiple wards shall be fitted with individual draw screens to ensure privacy for each patient.
The screens shall be made from washable, woven fabrics .
The bed screens shall be suspended from strong overhead tracking which shall be a minimum distance or 460mm from Lhc c-eiJ ing.
5. 11 Call Bells
An approved electrically operated audio-visual call system for communications from each patient's b d to a nurses station or other approved location shall be provided.
.' The call buttons shall be easily accessible for the patients.
Calls shall be able to be cancelled only from the bedside or ward door.
EQUIPMENT
Sufficient medical and/ or surgical equipment, appliances and materials necessary for Lhe proper care of patients shall be provided. In addition the following apparatus and appliances shall be provided; resuscitators, approved suction apparatus, oxygen equipment with flowmeter, airway tubes where necessary.
FACILITIES 7.1 Toilets
There shall not be less than one toilet (WC) for each 10 patients (or fraction of 10 patients).
On each floor, not -lf'ss Lhc1n one Loi-let LlinL 1s cap,11Jlc or accommodating a wheel chair and is 1500mm wide by 1800mm deep with the pedestal positioned at least 460mm from the side wall to the bowl centre.
All toilets shall be fitted with "grab bars". Handrails shall be fitted in airlock approaches to toilets. Toilets for male patients to include wall-hung urinals.
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Doors of toilets shall be capable of being opened or removed from the outside by some simple method.
In toilets, call bells shall be provided no higher than 650mm from the floor and easily accessible for patients while using the facility.
Extractor ventilation fans shall be installed.
7.2 Hand Basins
One hand basin for each toilet, or if the toilets are in a block, at least one hand basin for each toilet block shall be provided.
All hand basins shall be provided with hot and cold running water. Preferably with mixer valve. Taps should be able to be operated by handicapped persons.
7.3 ABLUTION FACILITIES 7.3.1
7.3.2
7.3.3.
Common to Both Baths and Showers
On each floor, there shall hP J bathroom, with minimum ffoor dimensions of 9 square metres. Doors to ablution area - as for toilets.
Facilities shall be individually screened for privacy.
A hand basin ac essible to a wheel chair patient shall be provided on each floor.
Grab bars shall be provided at each point.
Call buttons shall be installed at each point, not more than 650mm above the floor and easily accessible for patients while using the facility. Extractor ventilation fans shall be installed.
Each bathroom shall contain a pedestal pan and hand basin.
Hot water (thermostatically controlled) control shall be at least 1980nm1 above the floor.
Showers
One shower cubicle for each 10 or fraction of 10 beds shall be provided on each floor.
Showers shall have no kerbs so as to be accessible by wheelchairs.
Each shower cubicle shall be at least 2 square metres.
Baths
Each bathroom (one for every 20 patients) shall contain an island or peninsular bath with recessed plinth and sunken floor along one side of the bath.
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7.3.4
A hand held hose or bidet is Lo be supplied with each bath.
Heating/Cooling
A safe and satisfactory means of heating/cooling which meets the requirements of the appropriate authority shall be provided for each shower/bath area.
7.4 Pan Rooms
On each floor Lhere shall be a pan room of noL less than 5. 6 square metres in area containing:
1. A pan sluice and pan washer/sanitizer.
2. Metal racks for pans and urinals. 3.
4.
5.
A work bench constructed of impervious materials.
A stainless steel trough with drainer and storage space.
A bed pan washer.
The materials used for the floor sha] I be impervious.
Extractor ventilation fans shall be installed.
7.5 Day Room/Lounge/Dinjng Room
There shall be separate lounge and dining areas.
Where one room is used for both purposes the dining area is to be separated by dividing partition doors.
The total dayroom/lounge floor area shall be at least 12 square metres for 10 beds or less, plus 1 square metre for each bed in excess of 10.
A dayroom/lounge shall be appropriately furnished for the comfort of patients.
7.6 Kitchen
Unless alternative arrangements for food services are made, a kitchen shall contain adequate space and equipment for:
1. Food preparation.
2.
3.
4. 5.
Cooking.
Handling and serving of food.
Washing of dishes and utensils.
Hand washing.
6. Storage for dry foods, crockery, utensils and cutlery.
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7. Adequate refrigerated storage for perishables and frozen foods.
8. A separate storage area for cleaning materials (detergents etc).
9. The holding and disposal of refuse' i_n a vermin proofed or refrigerated area.
10. In homes with more than 20 beds, a cook's sink and bench.
11. Adequate toilet and washing facilities for kitchen staff.
The washing up area js Lo be located separately from the food preparation area.
Internal kitchen doors shall have a vision panel.
Kitchen walls and ceiling shall be of a smooth, durable and washable finish.
Tables and bench tops and all surfaces on which food is prepared shall be smooth and impervious.
The kitche~ shall be conveniently siLuatcd Lo areas where meals are to be served, with a doorway leading to the outside or access area.
A stainless steel double bowl sjnk and drainer and hand basin with hot and cold water services shall be provided.
; Fly screens shall be fitted to all external doors and opening windows.
Where canopies are not fitted, xlra tor ventilation fans shall be installed.
Adequate facilities shall be provided to keep food hot for delivery to patients.
Laundry
A laundry or laundry holding area shall be provided with direct access to a corridor or access to a corridor or access area, and to the outside.
A non touch method of laundering foul linen shall be provided.
Facilities shall be provided for holding soiled linen before laundering or despatch, and sufficient additional space allowed for personal and light laundry.
Soiled linen shall not be routed through a kitchen area. Where laundry is not done
reception area for clean soiled linen despatch area.
on the premises there shall be a linen which is separated from the
The holding area for clean linen and clothes shall be separaLe from the washing area.
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9.
Where a laundry is provided, trough, washing machine, hot drying, ironing and airing.
it shall include a double wash and cold water and areas for
7.8 Clean Utility Room
On each floor there shall be a clean utility room of not less than 6 square metres in area preferably situated next to the nurses station, separated by a barrier eg swing doors.
A clean utility room shall contain approved sterilizing facilities; a hand basin with hot and cold running water; and adequate storage space for instruments, dressings, medicines and lotions. A clean utility room is not to be situated in any pan room, laundry, kitchen, bathroom or toilet area, or in any air lock servicing these areas.
NURSES' STATION
There shall be a nurses' station on each Ward or floor preferably adjacent to the clean utility room containing:-
(i) A desk and chair.
(ii) (iii) (iv)
Work b~nch and cupboards.
Record storage area.
Drug s cc u r i Ly ca I i rw L
CLEANER'S ROOM
A cleaner's room shall be located on each floor, containing:-
(i)
(ii)
A cleaner's sink.
Storage for cleaning appliances.
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It shall be well ventilated.J
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10. OCCUPATIONAL THERAPY/PHYSIOTHERAPY ROOMS
There shall be rooms or areas which are suitably equipped for occupational therapy and physiotherapy.
A large sink shall be fitted in the occupational therapy room as well as storage cupboa~ds for materials.
A physiotherapy room shall have treatment areas individually screened. A power point shall be provided at each treatment area. GENERAL STRUCTURAL REQUIREMENTS
11. FLOORS
All floor finishes shall be of approved non-slip materials;
kitchens, bathrooms, toilets, sterilizing rooms, pan rooms, laundries, and therapy rooms shall have impervious floor coverings.
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12. WALLS
All internal wall surfaces shall be smooth, even, washable and impervious.
13. CEILINGS
Ceilings in nursing homes shall have a minimum height of 3000mm. 14. DOORS OTHER THAN WARD DOORS
The minimum width of doors shall be 1200mm.
All external doors shall open outwards into the line of egress.
15. PASSAGEWAYS
Passageways shall have a minimum width of 1800mm.
Passageways shall have a continuous handrail on both sides.
16. STAIRS AND LANDINGS
Where any door opens into a flight of steps, a landing at least as long and as broad as the width of the doorway shall in all cases be provided between the doorway and the first step of such flight.
Every such landing shall, when in connection with a stairway or fire escape provided as means of escape for any patient, be of such dimensions as will allow a patient hring rnsily rarrirrl on a strel her in J horjzonL.11 p sLLio11 Lo Llic saLd stairway or Lire escape.
Safety gates are required at the top of stairways in nursing homes caring for geriatric patients.
Stairways used by patients shall have a handrail continuous on both sides.
17. RAMPS
Where provided, ramps shall have a gradient no greater than 1 in 12. Handrails and safety rails shall be fitted on both sides.
18. LIFTS
Where a nursing home has more than 2 storeys it shall have a fire isolated lift.
The lift car shall be 2430mm by 2130~n by 2130mm. The doorway of a ]ift. sli.1-ll he 1370mm widC'.
19. FLY SCREENS
All external opening windows, doors and vents etc. shall have fly screens fitted.
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20. WINDOWS (See also 4.5)
All windows in wards and recreation areas are to be curtained and made of glare reducing safety glass as per Australian Standards. 21. LIGHTING
Lights shall be arranged at all changes of direction and doorways giving access to stairways. Emergency lighting shall be provided in all egress areas including stairways, passageways and fire lifts. The source of emergency lighting shall be from batteries permanently connected to a trickle charger or other approved system of recharging.
22. HEATING/COOLING
A safe and satisfactory means of heating/ cooling which meets the requirements of the appropriate authority sha 11 be provided in a 11 areas used by patients.
23. GENERAL REQUIREMENTS 23.1 Dangerous Drugs
The handlip.g and storage of cir1ngcrous drugs shaJ l be in accordance with the relevanl legislalion.
23.2 Household Refuse
Receplacles for household refuse shall have close filling lids and be stored in a fly proof enclosure.
23.3 Sewerage and Sullage
Sewerage and sullage disposal shall be in accordance with appropriate local government regulations.
23.4 Patient Register
A register of patients shall be kept, recording - (a) Name, age, usual address, date of admission. (b) Name of attending medical practitioner.
(c) Date of discharge or d ath.
(d) Such other particulars as may be prescribed.
A report book shall be kept in which shall be entered, in respect of each patient, the condition on admission and, at least once each day, a subsequent record of nursing care, medical and drug treatment and progress.
23.5 Birds/Animals
Birds and animals shall not be permitted in any portion of a building in which patients are accommodated or in which food is prepared, handled or stored.
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23.6 Protection from Vermin
Measures necessary for exclusion of vermin shall be maintained.
23.7 Visiting Hours
Visiting of patients on an open hours basis shall be encouraged.
23.8 Foods and Meals
Constant attention shall be given to the proper storage, preservation, preparation and serving of food.
Food shall be supplied in such variety and quantities that the recommended dietary allowances as defined from time to time by the Nutrition Committee of the National Health and Medical Research Council shall be provided.
Meals shall be served at reasonable hours. The midday meal is not to be served before noon. The evening meal shall be served not before 4.30 p.m. If the evening meal is served before 5.30 p.m. supper shall be served between 7 and 9 p.m. Cups, saucers and plates shall not be chipped, cracked or stained.
23.9 Dying or Seriously Ill Patients/Deceased Persons
In all nursing homes a mortuary (holding room) shall be provided.
Dying or seriously ill patients shall be Lransferred Lo a single room or be adequately screened from other patients.
23.10 Staff Accommodation
For employees who live out, there shall be:-
(i) A suitable changeroom and adequate toilet and washing facilities.
(ii)
(iii) 23. 11 Telephone
A full length locker or other suitable place fitted with lock and key for the safe keeping of clothes and personal effects.
Suitable dining room.
A Telecom Australia telephone service shall be provided and shall be available to patients public and staff at all times.
23.12 Storage
Suitable storage facilities, shall be provided for linen, blankets and portable equipment, wheel chairs, bed cradles, etc.
Provision shall also be made for the suitable storage of suit- cases and baggage belonging to patients.
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23.13 Public Toilet
A public toilet facility shall be provided clearly distinguished by signs as being for use by the public.
24. COMPLETION FOR BUILDING AND REGISTRATION
The building shall be deemed acceptable for final inspection when it has been completed accordj ng to approved plans and specifications; is connected to all services; and is eligible for issue of a Certificate of Occupancy by the Building Board. Samples of nursing equipment, patient requirements and furnishings shall be provided for inspection at this time.
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NURSING HOME - NURSING STAFF REQUIREMENTS - REGULATION (36)
In addition to the registered nurse in charge of the nursing home, the minimum requirements are -
Registered Nurse - 3 hours per week for each ordinary care
patient abd 5 hours per week for each intensive care patient.
Enrolled Nurse 7 hours per week for each ordinary care
patient and 12 hours per week for each intensive care patient.
A registered nurse must be on duty at all times.
Definition of Terms
Registered Nurse - a nurse who holds an appropriate certificate in any branch of Nursing, is registered under the Nurses Act 1982 in the Northern Territory and holds an Annual Practising Certificate.
Enrolled Nurse a person employed in nursing who works under the supervision of a registered nurse and is enrolled under the Nurses Act 1982 in the Northern Territory and holds an Annual Practising Certificate.
Ordinary Care care of a person who occupies a bed in a
nursing home for the purpose of nursing home care but is not in need of or receiving intensive nursing home care.
Extensive Care care of person who occupies a bed in a
nursing home who through illnees or dis- ability is
bed-fast, near bed-fast or bed-centered largely dependent on others for personal needs
in need of and receiving special nursing procedures aimed at restoring a person to an independant existence.
