A smell complaints audit: the twelve questions to ask

Fourteen complaints in a quarter, and every one of them used the same three words: the bin smell. The manager’s first move was to double the dose, which cost 40% more powder and changed nothing. The second was to change supplier, which cost three weeks and changed nothing either.

The smell was not coming from the gel. It was coming from the rim of a liner that had been folded over the edge of the bin and left there for two days. Finding that took an afternoon with a clipboard, and it is why the twelve questions below exist.

Ask about volume before you ask about product

Smell is a function of how much liquid is sitting around, how warm it is and how long it has been there. The product is the fourth variable, not the first. Most audits that start with the product end with a purchase, and most audits that start with volume end with a change of routine that costs nothing.

So the first four questions are about quantity and time.

• How much urine is in the container when it is dosed, in millilitres?
• How long between the void and the dose?
• How long between the dose and the bin leaving the room?
• How many containers per room per day?

If the answer to question two is more than an hour, stop. Nothing else in the audit matters until that is fixed, because no powder compensates for two hours of open liquid in a warm room.

Then the container

Five more questions, all about the thing the gel sits in.

• Does the lid close fully, or does it rest on the liner?
• Is the container cracked at the handle, where liquid collects?
• Is the liner changed every time, or only when it looks full?
• Where is the container stored between uses: in the room, the bathroom, the corridor?
• What is the room temperature at 06:00 and at 18:00?

A cracked handle is a reservoir. So is a folded liner. So is a container that lives in a corridor at 26 degrees because the room is too small. None of these are visible from a policy document and all of them are visible in thirty seconds with the lid off.

The temperature question catches people out more often than expected. A south-facing bathroom in July will sit at 28 degrees by mid-afternoon, and a gelled container at that temperature will start to smell within a day even with a correct dose.

Then the dose and the dosing

Two questions, and they are the ones staff answer least accurately.

• Who doses, and what do they use to measure it?
• What is the actual dose for the most common volume in this building?

Ask for the scoop. Weigh one level scoop on a kitchen scale. If it comes to 19 g when the label says 25 g, you have found a systematic underdose that no refresher course will solve, because the scoop has worn, or the powder has settled, or the scoop was never the right one for the pack.

The twelfth question is who empties the bin, and when. Not the role. The name, on the rota, for the shift that actually does it. In three audits out of five the answer is everyone, which means nobody, and the bin that nobody empties is the one that generates the complaint.

A 60-bed home put names against bins for two weeks. Smell complaints dropped from eleven in a month to two, with no change to product, dose or supplier. The only change was that a specific person was responsible for a specific bin on a specific shift.

Running the audit properly

Walk the building at the worst time, which is usually 07:00 after a warm night, and again at 16:00. Open three bins at random and smell them, at arm’s length, and write down what you find. Then ask the twelve questions of the person on shift, not the manager.

Score each room rather than each ward, because the problem is almost always local: one bathroom, one corridor, one cracked lid. Aggregate data hides it.

If the audit points at the product, the SAP powder specifications will tell you what the grade is designed to hold, and you can compare that with the volumes you are actually dosing. If it points at the routine, you have saved yourself a tender.

Start with question two. It is free, and it is usually the answer.