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Survey of health and social care setting food businesses on implementation of the FSA Listeriosis Guidance

Implementation of the FSA Listeriosis Guidance: Annex: IFF Survey questionnaire

Full IFF Survey questionnaire used for the survey of health and social care setting food businesses on implementation of the FSA Listeriosis Guidance.

S Screener

Ask Telephonist

S1    Good morning / afternoon. My name is NAME and I'm calling from IFF Research. Please can I speak to NAME? [IF NO CONTACT INFO: Please can I speak to the owner or manager or the most senior person responsible for food safety at this site?]

ADD IF NECESSARY: We’re conducting a survey on behalf of the Food Standards Agency (FSA). This is exploring awareness of the FSA guidance on ‘Reducing the Risk of Vulnerable Groups Contracting Listeriosis’ within health and social care settings and understanding any challenges associated with implementing the guidance. 

IF WANT TO TRANSFER TO HEAD OFFICE OR ANOTHER BRANCH / SITE: We need to speak to someone based at this site, not at head office or another branch of your organisation. We are interested in activities at this location. Could I speak to the person at this site who would have the best overview of food safety issues?

Response Number Action
Transferred 1 Continue
Hard appointment 2 Make appointment
Soft appointment  3 Make appointment
Engaged 4 Call back
Refusal 5 Close
Refusal - company policy 6 Close
Refusal - taken part in recent survey 7 Close
Nobody at site able to answer questions 8 Close
Not available in deadline 9 Close
Fax line 10 Close
No reply/answer phone 11 Close
Residential number 12 Close
Dead line 13 Close
Company closed 14 Close
Request reassurance email - Collect email address then continue or make appointment (see appendix for email text)


Ask All

S2    NEW    Good morning / afternoon, my name is NAME, calling from IFF Research, an independent market research company, conducting a survey on behalf of the Food Standards Agency (FSA).

Can I first just check if chilled ready-to-eat food is available at your site?

IF NECESSARY: Examples of chilled ready-to-eat foods are sandwiches and fresh salads.
ADD IF HOMECARE: If you or your staff work in people’s own homes, please answer assuming that the home is the ‘site’ we are interested in.

IF NECESSARY: We’re conducting a survey on behalf of the Food Standards Agency (FSA).  This is exploring awareness of the FSA guidance on ‘Reducing the Risk of Vulnerable Groups Contracting Listeriosis’ within health and social care settings and understanding any challenges associated with implementing the guidance.
 

Response Number Action
Yes 1 Continue
No 2 Thank and close, if online. Unfortunately you are not eligible for this survey. Thank you for your time. 
Don't know 3 Thank and close.

This survey on behalf of the FSA is about exploring awareness of the FSA guidance on ‘Reducing the Risk of Vulnerable Groups Contracting Listeriosis’ within health and social care settings and understanding any challenges associated with implementing the guidance.

Please be assured that the responses you give will not be used to assess the food safety of your establishment. Your answers will only be used for the purpose of this research and all responses will be anonymised when reporting back to the FSA. 
The survey should take around 15 minutes. 

Would it be ok to run through this with you now? 

IF NECESSARY: We can provide a link for you to do the survey online in your own time if you prefer?

Response Number Action
Continue 1 Continue
Referred to someone else at establishment Name... Job title... 2 Transfer and re-introduce
Hard appointment 3 Make appointment
Soft appointment 4 Make appointment
Refusal 5 Thanks and close
Refusal - company policy 6 Thanks and close
Refusal - taken part in recent survey 7 Thanks and close
Not available in deadline 8 Thanks and close
Prefer to do online 9 Send email containing online survey link to respondent

ASK ALL

Throughout this survey, we will be asking about food safety practice at your ‘site’. By this, we mean the specific site where you work, rather than your organisation as a whole.

ADD IF HOMECARE: As a reminder, if you or your staff work in people’s own homes, please answer assuming that the home is the ‘site’ we are interested in.

S4    Which of these health and social care settings best describes your site? 

IF NECESSARY: If your site straddles more than one category, please choose the category your site most belongs to.

Read out. Single code. 

Response Number Details
Nursing home 1 -
Residential care home 2 -
Day centre for the elderly or vulnerable 3 -
Community meal provision (for example, meals on wheels) 4 -
Home care service provider 12 -
Assisted living development for the elderly 5 -
Hospice 6 -
Private hospital 7 -
Day procedure unit 8 -
Antenatal clinic or centre 9 -
Commercial meal provider to health and social care settings 10 -
None of these (specify site type) 11 THANK AND CLOSE BUT EXPLAIN WILL CHECK ELIGIBILITY AND MAY CALL BACK. IF ONLINE: Thank you. We will check to see if you are eligible for this survey. We will email you back if this is the case.

ASK RESIDENTIAL CARE ESTABLISHMENTS, PRIVATE HOSPITALS OR DAY PROCEDURE UNITS (S4=2, 7 OR 8)

S5A.    Do you ever have elderly residents or any whose immune systems may be weakened in some way, for example (but not limited to) pregnant women, people with diabetes, cancer patients or people struggling with addiction? 

SINGLE CODE. DO NOT READ OUT.
 

Response Number Action
Yes 1 Continue
No 2 Thank and close.
Don't know 3 Thank and close.

ASK ALL BASED IN WALES (COUNTRY=4)

S6    Would you prefer the [IF CATI: interview] [IF ONLINE: survey] to be carried out in Welsh or English?

SINGLE CODE. DO  NOT READ OUT.

Language Number Action
Welsh 1 “One of our Welsh speaking interviewers will call back in the next few days to make an appointment with you.”
THANK AND CLOSE
English 2 Continue

ASK ALL
S7    [IF CATI: Before we begin the main survey, I need to read out a quick statement regarding GDPR legislation:] 

All information collected will be treated in the strictest confidence. You have the right to a copy of your data, to change your data or to withdraw from the research at any point until the final report has been written, If you’d like to do this, or find out more, you can consult our website at iffresearch.com/gdpr. 

[IF CATI: In order to guarantee this, and as part of our quality control procedures, all interviews are recorded. Is that OK?] 

DO NOT READ OUT. SINGLE CODE. 

Response Number Action
Yes - agree to continue 1 -
Refuse to continue 2 Thank and close.

Reassurances to use if necessary:

  • IFF Research is an independent market research company, operating under the strict guidelines of the Market Research Society’s Code of Conduct. This means that anything you tell us will be treated in the strictest confidence, and none of your answers will be attributed to you unless you give explicit permission for us to do so. 
  • the interview will take around 15 minutes to complete.
  • please note that all data will be reported in aggregate form and your answers will not be reported to the Food Standards Agency in any way that would allow you to be identified. 
  • if respondent wishes to confirm validity of survey or get more information about aims and objectives, they can contact:

A Awareness and usage of guidance

ASK ALL
A1    First, we’re going to ask about your general awareness of the FSA guidance on Reducing the Risk of Vulnerable Groups Contracting Listeriosis. 

Overall, how would you rate your knowledge of this FSA guidance?

IF NECESSARY: We are after your awareness of this specific guidance provided by the FSA on Listeriosis, rather than any other guidance you may have seen from the FSA.

SINGLE CODE. READ OUT SCALE

Response Number Details
I know a lot about it 1 -
I know a little about it 2 -
I am aware it exists but don't know anything about it 3 -
I have never heard of it 4 -
(FOR CATI: DO NOT READ OUT) Don't know 5 -

ASK ALL

A2    Across your [IF NOT HOMECARE: site / IF HOMECARE: organisation], who receives training about how to control the risk of Listeria monocytogenes? 
MULTICODE. PROMPT AS NECESSARY.

Response Number Details
Kitchen staff 1 -
Staff who sell or serve foo as their main role 2 -
Nurses, midwives or carers 3 -
Management personnel 4 -
Non-catering staff for example, maintenance or reception staff 5 -
Volunteers 6 -
Other (please specify) 7 -
None of these 8 Single code only
For CATI DO NOT READ OUT: Don't know 9 Single code only

B Barriers

ASK ALL

We will now ask about how easily different areas of the guidance can be implemented at your setting.  

Please remember that the survey is anonymous and do not hesitate to let us know about any challenges you may face – this is really useful for providing insight for the FSA’s review into where extra clarification or support may be needed.

B1    How easy or difficult is it for sites like yours to implement best practice in…?

READ OUT SCALE, REPEAT IF NECESSARY
 

Response Very difficult Fairly difficult Fairly easy Very easy (FOR CATI DO NOT READ OUT: Don't know) (FOR CATI: DO NOT READ OUT: Not applicable)
1 Personal Hygiene 1 2 3 4 5 6
2 Cleaning and disinfection of food preparation areas 1 2 3 4 5 6
3 Washing fruit before serving 1 2 3 4 5 6
4 Controlling access to kitchens/pantries 1 2 3 4 5 6

IF THEY FOUND ANY ASPECT OF CONTROL OF CONTAMINATION TO BE DIFFICULT [IF ANY B1_1 - 4=1 OR 2]. 

A1    You said you thought it would be difficult to implement best practice in:
 [INSERT AREAS FROM B1 WHERE CODES 1 OR 2 ARE SELECTED]

Why is this?

ONLINE ONLY: Please describe your difficulties in each area of best practice listed above.
PROBE FOR EACH BEST PRACTICE THAT THEY FIND DIFFICULT

Write in:

B3    How easy or difficult is it for sites like yours to implement best practice in…?
READ OUT SCALE, REPEAT IF NECESSARY

Response Very difficult Fairly difficult Fairly easy Very easy (FOR CATI DO NOT READ OUT: Don't know) (FOR CATI: DO NOT READ OUT: Not applicable)
1 Ensuring chilled Ready to Eat food is kept at 5c or below from delivery to service 1 2 3 4 5 6
2 Time and temperature control during food service, including ensuring ready-to-eat foods are eaten as soon as possible 1 2 3 4 5 6
3 Shelf life controls for example, checking use-by dates and rotating stock 1 2 3 4 5 6
4 Temperature monitoring of fridges in residents' rooms, kitchenettes, or pantries 1 2 3 4 5 6
5 Ensuring packed lunches for patients going home or off site including advice on how quickly any ready-to-eat food should be eaten 1 2 3 4 5 6

IF THEY FOUND ANY ASPECT OF CONTROL OF GROWTH TO BE DIFFICULT [IF ANY B3_1 - _5=1 OR 2]

B4    You said you thought it would be difficult to implement best practice in: [INSERT AREAS FROM B3 WHERE CODES 1 OR 2 ARE SELECTED]

Why is this?

ONLINE ONLY: Please describe your difficulties in each area of best practice listed above.
PROBE FOR EACH BEST PRACTICE THAT THEY FIND DIFFICULT

Write in:

B5    How easy or difficult is it for sites like yours to implement best practice in…?
READ OUT SCALE, REPEAT IF NECESSARY
 

Response Very difficult Fairly difficult Fairly easy Very easy (FOR CATI DO NOT READ OUT: Don't know) (FOR CATI: DO NOT READ OUT: Not applicable)
1 Having clear documented guidance on roles and responsibilities for all staff.  1 2 3 4 5 6
2 Training staff in listeria control procedures 1 2 3 4 5 6
3 Collecting feedback from patients, residents or customers including incident and complaint monitoring  1 2 3 4 5 6
4 Specifications describing food safety standards expected of suppliers 1 2 3 4 5 6
5 Using assessed suppliers, covering each stage of the supply chain. 1 2 3 4 5 6
6 Checking food safety at suppliers by carrying out unannounced visits to them every 6-12 months. 1 2 3 4 5 6
7 Including food safety requirements in contracts for on-site retailers or contract caterers
 
1 2 3 4 5 6
8 Labelling and refrigeration of food brought in by visitors or patients/residents/customers themselves 1 2 3 4 5 6

IF THEY FOUND ANY ASPECT OF MANAGEMENT CONTROLS TO BE DIFFICULT [B5_1-_8=1 OR 2]

B6    You said you thought it would be difficult to implement best practice in:
[INSERT AREAS FROM B5 WHERE CODES 1 OR 2 ARE SELECTED]
Why is this?

ONLINE ONLY: Please describe your difficulties in each area of best practice listed above.
PROBE FOR EACH BEST PRACTICE THAT THEY FIND DIFFICULT

Write in:

ASK ALL
A1  [IF NOTHING DIFFICULT: What difficulties, if any, do / IF ANYTHING DIFFICULT (IF B1_1 - 4=1 OR 2 OR B3_1 - _5=1 OR 2 OR B5_1-8=1 OR 2): Are there any other difficulties] you face in meeting the good practice guidance?  Please give as much detail as possible.

Write in:

C Implementation

ASK ALL
C1    How aware are you of the risks associated with chilled ready-to-eat foods and listeria?

SINGLE CODE. READ OUT SCALE

Responses Number Details
I am fully aware of the risks 1 -
I am aware of some of the risks 2 -
 I know little about the risks 3 -
I know nothing about the risks 4 -
(FOR CATI: DO NOT READ OUT) Don't know 5 -

ASK ALL
C2    To what extent do you agree or disagree with the following statements in relation to your own site:
SINGLE CODE. READ OUT SCALE.
 

Response Strongly agree Agree Disagree Strongly disagree (FOR CATI DO NOT READ OUT: Don't know)
1 Cleaning of all food contact surfaces on site controls the risk of Listeria monocytogenes 1 2 3 4 5
2 Food safety controls on site are effective in stopping cross-contamination of food with Listeria monocytogenes 1 2 3 4 5

ASK ALL

C3    What is the maximum temperature that chilled ready-to-eat foods reach from supply of chilled ingredients until the point of sale or service? 
SINGLE CODE. READ OUT.

Response Number Details
11 1 -
8°C 2 -
Over 8°C for up to 4 hours 3 -

Over 8°C for more than 4 hours 

4 -
(FOR CATI DO NOT READ OUT) Don't know 5 -
(FOR CATO DO NOT READ OUT) Not applicable  6 -

ASK ALL

C4    What is the maximum temperature that chilled ready-to-eat foods reach during storage in areas for patients or residents, such as their rooms?
SINGLE CODE. READ OUT.

Response Number Details
5°C 1 -
8°C 2 -
Over 8°C for up to 4 hours 3 -

Over 8°C for more than 4 hours 

4 -
(FOR CATI DO NOT READ OUT) Don't know 5 -
(FOR CATO DO NOT READ OUT) Not applicable  6 -

ASK ALL

C5    To what extent do you agree or disagree with the following statements in relation to your own site:
SINGLE CODE. READ OUT SCALE.

Response Strongly agree Agree Disagree Strongly disagree (FOR CATI DO NOT READ OUT: Don't know)
1 The maximum shelf-life for ready-to-eat sandwiches sold or distributed on site is day of production plus 2 days unless shelf-life studies are provided 1 2 3 4 5
2 Across the site, we monitor and record temperatures throughout the cold chain, consistently and accurately 1 2 3 4 5
3 Across the site, we carry out regular sampling for Listeria monocytogenes to verify compliance with microbiological criteria regulations 1 2 3 4 5

ASK ALL

C6    Does your business have a food safety management system based on hazard analysis critical control point (HACCP) principles? 
SINGLE CODE. DO NOT READ OUT

Response Number Details
Yes 1 -
No 2 -
Don't know 3 -

ASK ALL

C7    Please rate to what extent you agree or disagree with the following statements in relation to your own site:
SINGLE CODE. READ OUT SCALE.

Response Strongly agree Agree Disagree Strongly disagree (FOR CATI DO NOT READ OUT: Don't know)
1 The site’s food safety management system covers all food pathways e.g. on-site catering, retail, food prepared off-site, visitor supplied food 1 2 3 4 5
2 Across the site, we monitor and record the performance of all our controls for Listeria monocytogenes effectively and take effective action when required as a result 1 2 3 4 5

3 Across the site, we ensure that the risk of Listeria monocytogenes is controlled effectively in the whole supply chain, for example, we ensure that there are effective safety controls in place at our suppliers and their suppliers

1 2 3 4 5

D Perceptions of the guidance

ASK ALL

D1    How effective do you feel the FSA guidance is in reducing the risk of vulnerable groups contracting listeriosis?
SINGLE CODE. READ OUT SCALE.

Response Number Details
Very effective 1 -
Fairly effective 2 -
Not very effective 3 -
Not at all effective 4 -
IF CATI DO NOT READ OUT: Don't know 5 -

ASK ALL

D2    How clearly do you feel the FSA guidance distinguishes between legal requirements and best practice?
SINGLE CODE. READ OUT SCALE

Response Number Details
Very clearly 1 -
Fairly clearly 2 -
Not very clearly 3 -
Not at all clearly 4 -
IF CATI DO NOT READ OUT: Don't know 5 -

ASK ALL

D3    What parts of the guidance, if any, do you find most useful in reducing the risk of listeriosis on your site?
SINGLE CODE

Write in:

Response Number Details
Not useful at all 1 -
Don't know 2 -

D4 How, if at all, could the guidance be improved?

SINGLE CODE

Write in:

Response Number Details
Don't know 1 -
Refused 2 -

E Classification questions

SHOW TO ALL

Finally, we’d like to end by asking you a couple of questions about yourself and your site, to help us in our analysis. 
ASK ALL 

E1    What is your job title? 
SINGLE CODE

Write in:

Response Number Details
Don't know 1 -
Refused 2 -

IF IN ENGLAND OR WALES [COUNTRY =1 OR 3]

E2    Is your site registered as a food business operator with your local authority and/or does your business have a primary authority? 

IF NECESSARY: We are specifically interested in understanding whether you are registered as a food business operator. You may already be registered as a care operator with your local authority.

IF NECESSARY: Primary Authority was launched across England and Wales in 2009. It offers businesses an opportunity to form a legally recognised partnership with a local authority (the primary authority).

SINGLE CODE. READ OUT.

Response Number Details
Registered with local authority and have a primary authority relationship 1 -
Registered with local authority only 2 -
Not registered with local authority 3 -
(FOR CATI: DO NOT READ OUT) Don't know 4 -

IF IN NORTHERN IRELAND [COUNTRY = 2]

E3    Is your site registered as a food business operator with your local authority?
IF NECESSARY: We are specifically interested in understanding whether you are registered as a food business operator. You may already be registered as a care operator with your local authority.
SINGLE CODE. DO NOT READ OUT

Response Number Details
Yes. registered with local authority 1 -
No, not registered with local authority  2 -
(FOR CATI: DO NOT READ OUT) Don't know 3 -

F Thank and close

ASK ALL

F1    Thank you very much for your time today. Would you be willing for IFF to call you back regarding this particular study, if we need to clarify any information you provided? This would be before the end of the project, which is expected to be in October 2022. 
SINGLE CODE. DO NOT READ OUT.

Response Number Details
Yes 1 -
No 2 -

ASK ALL EXCEPT FOR COMMERCIAL MEAL PROVIDERS (S4 =/= 10)

F2 Do you sub-contract any of your catering to an outside organisation?
SINGLE CODE. DO NOT READ OUT.

Response Number Details
Yes 1 -
No 2 -

IF HAVE OUTSIDE CATERERS (F2=1)

F3    We would really like to include some outside caterers in the research.  To allow us to get in touch with them, would you be happy to share with us the organisation name, contact name if you have one, telephone number and email address? 

Details Write in Prefer not to say
Organisation name - 1
Contact name - 1
Email address - 1
Telephone number - 1

ASK COMMERCIAL MEAL PROVIDERS (S4 = 10)
F4    Would you be able to provide us with names of other commercial meal providers for health and social care settings? We’re looking to speak to more businesses like yours to ensure we capture a wide range of views.

Write in:

Refused 1

SAY TO ALL
Just to confirm, we’ll be keeping your details on file for up to 6 months. If you’d like a copy of your data, to change your data or for your data to be deleted then please get in contact with 
You also have the right to lodge a complaint with the Information Commissioners Office (ICO) and you can do so by calling their helpline on 0303 123 1113.

Thanks respondent and close interview.