Infection Prevention and Control

Resource Order Form for

Care Home and Domiciliary Care

Name
Job Title
Organisation Name / No of beds
Delivery Address
(inc postcode) / No of staff
Telephone No
Email address
Where did you hear about this resource?
Do you grant permission for us to identify
your organisation as a user of the resources? / Yes No

Please complete the order form transferring each total to the ‘Totals’ box on page 4 and forward the completed form to or the address below.
Alternatively, telephone 01423 557340.

Community Infection Prevention and Control, Harrogate and District NHS Foundation Trust,

Gibraltar House, Thurston Road, Northallerton, North Yorkshire. DL6 2NA

www.infectionpreventioncontrol.co.uk

1. Preventing Infection Workbook for Care Homes / Unit Price / Quantity / Total Price
Qty / 10* / 11-19 / 20-50 / 51-100 / 100+
Price per book / £4.99 / £3.49 / £2.99 / £2.99 / £2.99 / £ / £
P&P price / £4.80 / £8.50 / £17.75 / £25.25 / Telephone 01423 557340 for a P&P price / £
*Minimum order quantity TOTAL / £
1 copy Sample Workbook (stamped ‘SAMPLE COPY’ on each page) / 1 copy = £4.99 including P&P / £
2. Preventing Infection Workbook for staff providing
Care at Home (domiciliary) / Unit Price / Quantity / Total Price
Qty / 10* / 11-19 / 20-50 / 51-100 / 100+
Price per book / £4.99 / £3.49 / £2.99 / £2.99 / £2.99 / £ / £
P&P price / £4.80 / £8.50 / £17.75 / £25.25 / Telephone 01423 557340 for a P&P price / £
*Minimum order quantity TOTAL / £
1 copy Sample Workbook (stamped ‘SAMPLE COPY’ on each page) / 1 copy = £4.99 including P&P / £
3. IPC Guidance for Health & Social Care (IPC Policy folder) / Unit Price / Quantity / Total Price
Qty / 1 / 2 / 3+
Price per pack / £95.00 / £90.25 / £85.50 / £ / £
P&P price / £5.80 / £12.60 / Telephone 01423 557340 for a P&P price / £
TOTAL / £
4. IPC CQC Inspection Preparation Pack for Care Homes / Unit Price / Quantity / Total Price
Qty / 1 / 2 / 3+
Price per pack / £95.00 / £90.25 / £85.50 / £ / £
P&P price / £16.00 / £22.50 / Telephone 01423 557340 for a P&P price / £
TOTAL / £
5. Viral Gastroenteritis Outbreak Management Pack for Health and Social Care / Unit Price / Quantity / Total Price
Qty / 1 / 2 / 3+ / Special offer if purchased with IPC CQC Inspection Pack
Price per pack / £49.99 / £47.49 / £44.99 / £24.99 / £ / £
P&P price / £4.80 / £7.80 / *Telephone / £0.00 / £
* 01423 557340 for a P&P price TOTAL / £
6. Urinary Catheter Passport / Unit Price / Quantity / Total Price
Qty / 10 / 20 / 30 / 40
Price per pack / £14.99 / £28.99 / £42.99 / £54.99 / £ / £
P&P price / £3.80 / £3.80 / £4.80 / £4.80 / £
TOTAL / £
7. Other Resources / Size / Unit / Unit
Price / Qty / Total
Price
Environ-mental Cleanliness / Cleaning Notice Poster (laminated) / A5 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
National Colour Coding Scheme poster for cleaning materials for Care Homes Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Hand Hygiene / Bare Below the Elbows Poster / A5 / 1 copy or / £0.75 / £
Pack of 5 / £3.38 / £
Hand Hygiene Technique for staff Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Handwashing Guide for Service Users/Visitors Poster / A5 / 1 copy or / £0.75 / £
Pack of 5 / £3.38 / £
Handwashing Information leaflet for community service users Leaflet / A4 / 1 copy or / £0.50 / £
Pack of 10 / £4.50 / £
Thumbs up to help prevent infections spreading handout for service users and visitors Poster / A5 / 1 copy or / £0.75 / £
Pack of 5 / £3.38 / £
Your 5 moments for hand hygiene at the point of care Card / Credit Card Size / 1 copy or / £0.40 / £
Pack of 20 / £7.20 / £
Isolation / Stop. Please see the person in charge before entering this room Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
PPE / Correct order for putting on and removing Personal Protective Equipment Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Sharps / Actions to be taken following a sharps injury, blood splash or body fluid incident Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Correct Sharps Disposal Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Sharps: Sharps injury (Bleed it, Wash it, Cover it, Report it) Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Viral Gastro-enteritis / Are you or have you been suffering from diarrhoea and/or vomiting ... Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Bristol Stool Form Scale Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Local contact numbers for reporting outbreaks of infection poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Do you have an outbreak of Viral Gastroenteritis Flow Chart / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
During an outbreak of viral gastroenteritis ... Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
This facility is closed Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Viral Gastroenteritis factsheet—for service users and visitors / A4 / 1 copy or / £0.50 / £
Pack of 10 / £4.50 / £
Viral Gastroenteritis Outbreak Guidance for Care Homes Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Waste / Waste stream guide Poster / A4 / 1 copy or / £0.99 / £
Pack of 5 / £4.45 / £
Sub‐Total / £
P&P Charge: 1‐25 posters = £2.90
26‐50 posters = £3.30
51‐150 posters = £4.80
150+ Telephone for a price
(Please add total quantity of each poster ordered, e.g., 1 copy + 1 pack of 5 + 1 pack of 10 = 16 posters ordered. Therefore, the P&P charge would be £2.90) / P&P for posters only / £
TOTAL / £
TOTAL FOR ALL RESOURCES INCLUDING P&P / £

*For a combined post and packing charges when ordering more than one type of resource, please telephone 01423 557340.

Please note change of bank account for BACS payments.

Payment method
(please indicate payment choice with an ‘x’)
Cheque / Payee: Harrogate and District NHS Foundation Trust
BACS / Sort Code: 60 70 80
Acc No: 10004890
Acc Name: GBS RE Harrogate Dist NHSF
Ref: 255070 IPC
Credit/debit card / Telephone 01423 557340

Signed………………………………………………………………………………………………….

(Print name if returning form electronically)

Date……………………………………………………………………………………………………..

Community Infection Prevention and Control,

Harrogate and District NHS Foundation Trust,

Gibraltar House, Thurston Road, Northallerton. DL6 2NA

Tel: 01423 557340 | Email:

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