INFECTION PREVENTION AND CONTROL POLICY

INFECTION PREVENTION AND CONTROL POLICY

(ENGLAND)

POLICY STATEMENT

Home Instead is devoted to providing the highest-quality care to older people in the
comfort of their own homes. Infection prevention and control is an essential element of
high-quality care. Having effective infection prevention and control measures in place
contributes to the safety of the environment for clients, CAREGivers, employees, and
visitors to Home Instead. Infections are those caused by exposure to harmful micro-
organisms such as bacteria, fungi, viruses, internal parasites, and other infectious agents.
Exposure to a micro-organism can occur outside or inside your work environment, in
order to protect yourself and those in your care and your colleagues you must be vigilant
at all times and adhere to the measures in this policy.

CONTEXT
This policy relates to and should be read in conjunction with the following policies: Privacy
and Dignity, Health, Safety and Welfare, Mental Capacity, Food Safety and Nutrition,
Confidentiality, Staff Immunisation Policy and General Data Protection Policy.

LEGISLATION & GUIDANCE

The primary legislation & guidance related to this Policy is the Health and Safety at Work
Act (1974), Control of Substances Hazardous to Health Regulations (as amended), Health
and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) applies. Of
particular relevance is Regulation 12: Safe care and treatment and Regulation 15:
Premises and equipment. The regulations can be accessed here
http://www.legislation.gov.uk/uksi/2014/2936/contents/made.TheRegulation references
the Code of Practice on the prevention and control of infections and related guidance
(2015), this can be accessed here
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/449049
/Code_of_practice_280715_acc.pdf.

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The Care Quality Commission (CQC) is responsible for the registration, inspection and
regulation of Adult Social Care providers. They set out Fundamental Standards below
which the standard of care must never fall http://www.cqc.org.uk/content/fundamental-
standards.

The CQC uses five key questions as a framework for its inspections and rating of services.
Each of the questions is supported by statements of Characteristics that inspectors would
expect to find in services that are good or outstanding. The following one is particularly
relevant:

Are they safe? Safe means how well are people protected by the prevention and control
of infection?.

The Providers Handbook Appendix B contains the Characteristics of each rating level and
can be found here http://www.cqc.org.uk/content/provider-handbooks.

COVID-19 is also a reportable disease under the Reporting of Injuries, Diseases and
Dangerous Occurrences Regulations (known as RIDDOR) which strengthens employers’
encouragement that employees should agree to vaccination.

Data Protection Act 2018 sets out the framework for processing personal data including
special categories of data which includes health data. This Act sets out the framework
for when and how special categories of data can be processed. The full Act can be
found here: https://www.legislation.gov.uk/ukpga/2018/12/contents/enacted

DEFINITIONS

Standard infection control precautions (SICPs) - SICPs are the basic infection prevention
and control measures necessary to reduce the risk of transmitting infectious agents
from both recognised and unrecognised sources of infection.

Communicable Disease - also known as infectious diseases or transmissible diseases,

are illnesses that result from the infection, presence and growth of pathogenic (capable
of causing disease) biologic agents in an individual human or other animal host

Transmissible – disease able to be transmitted usually from person to person or animal

to human (rarely)

Personal Protective Equipment (PPE) - PPE is equipment that will protect the user
against health or safety risks at work. It can include items such as masks, gloves, apron
and eye protection.

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RESPONSIBILITY

The Registered Manager as Infection Prevention and Control Lead must ensure that:

• All clients are assessed for Infection Risk as part of the Care Consultation
Process. This risk assessment will vary depending on the specific infection risk,
there can be multiple risk assessments for different exposure risks.
• All CAREGivers are familiar with this policy and the Health and Social Care Act
2008 (Revised July 2015) Code of Practice on the prevention and control of
infections and related guidance in so far as they relate to domiciliary care.
• All CAREGivers have had instruction and training in infection control and any
related training that would assist in the prevention and control of any infection
such as hand hygiene and ensure that such training is included and noted in
personal development plans.
• All CAREGivers have adequate resources and support to put into practice
infection control procedures, this includes providing all forms of personal
protective equipment (PPE) that may be necessary or advised by guidance
issued by the government or Public Health England (PHE)
• Appropriate Risk Assessments are carried out for any CAREGivers which may
put them at increased risk of disease and illness associated with any infection
that may be circulating within a general population or that may have been
identified as either present or possibly present with a CAREGivers client.
• Recognise that what may put a CAREGiver at increased risk may be different
for each infection depending on any health concern, pregnany or any other
relevant risk factors and appropriate control measures must be put in place.
• Any CAREGiver who receives an occupational exposure to infective materials
should receive a timely referral to GP, Accident and Emergency Department
or other appropriate screening and support services.
• Information and guidance is provided to family and carers of clients when and
where appropriate to do so.

All CAREGivers must ensure that they:

• Understand and apply the principles of infection control as outlined in this

policy and the Code of Practice on the prevention and control of infections
and related guidance (2015).
• Maintain their knowledge, skills and competence by reading any material
provided by the Registered Manager and attending Home Instead training
sessions either in person, digital or remotely.

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• Use any personal protective clothing provided as instructed and where

appropriate, understanding that the required level of PPE may fluctuate
throughout the year depending on varying situations, it is important to follow
all guidance that is relevant to the specific situation that you are dealing with.
• Communicate relevant infection control practices in place for specific clients
to clients, their family/visitors, any colleagues involved in care giving and other
health professionals where appropriate and within bounds of confidentiality.
• Report any concerns or risks to Registered Manager and work with them to
conduct specific risk assessments and implement control measures if
necessary.
• Inform the Registered Manager if they are currently infective with a
communicable or transmissible infection or have been in close contact with
someone else who is. They must refrain from work where there is a risk of
transmission of infection to other CAREGivers, Key Players or vulnerable
clients if they are suffering from an infectious or contagious condition.

OPERATIONAL

Standard Infection Control Procedures

The following Standard Infection Control Procedures map to the Code of Practice
on the prevention and control of infections and related guidance (2015) and are
adapted for the setting within which Home Instead provides care and support – in
the client’s own home or in the community. (Only the criteria applicable to or
relevant to Home Instead activities are included).

1. Systems to manage and monitor the prevention and control of infection.

These systems use risk assessments and consider the susceptibility of
service users and any risks that their environment and other users may
pose to them.
The Registered Manager (Infection Prevention Lead) will ensure that systems
and processes are in place to manage and monitor the prevention and control
of infection. All clients should be assessed for Infection Risk as part of the
initial Care Consultation process. Any specific infection risks should be
documented within the care plan, along with how any identified needs will be
planned for and met.

2. Provide and maintain a clean and appropriate environment in managed

premises that facilitates the prevention and control of infections.

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Home Instead provides care and support in clients’ own homes and provides
support to access community and social activities. As such the care
environment is outside of the control of the service and its staff. CAREGivers
should endeavour to ensure good practices of hygiene where possible,
supporting the client with cleaning, appropriate management of risks (e.g.
ensuring pets do not contaminate food or soil the home) and ensuring as safe
management of care environment as is practicable without interfering with
client choice of lifestyle. With respect to community activities, CAREGivers
should discuss choice of activity with the client if there is any presenting issue
related to infection control which indicates that the usual activity might be
unwise and support them in whatever they choose to do. Any concerns
regarding hygiene in the home, infestations or risky activities should be
reported to the Registered Manager.

3. Provide suitable accurate information on infections to service users,

their visitors and any person concerned with providing further support
or nursing/ medical care in a timely fashion.
Generic information on infection control will be made available to clients,
family and the public via the Home Instead website and leaflets. Refer to
Family information / Guidance section.

4. Ensure prompt identification of people who have or are at risk of

developing an infection so that they receive timely and appropriate
treatment to reduce the risk of transmitting infection to other people.
If a CAREGiver arrives to discover a client is unwell, after having carried out
the usual procedures such as encouraging self-care or calling a GP, they must
observe additional precautions on leaving the property to ensure they do not
spread the infection. They should contact the Registered Manager for advice
prior to visiting their next client.

5. Systems to ensure that all care workers (including contractors and

volunteers) are aware of and discharge their responsibilities in the
process of preventing and controlling infection.
Refer to Staff Training section.

6. Have and adhere to policies, designed for the individual’s care and
provider organisations that will help to prevent and control infections.
Hand Hygiene: Hand washing is considered an important practice in the
control of infection. All CAREGivers should follow the recommended
procedure which is to avoid wearing any watches or jewellery (except for

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wedding rings) and to ensure any cuts or wounds are covered with waterproof
dressings. Nails should be kept short and free of cosmetic products. Hands
should be washed with hot water and soap using an appropriate technique
for the recommended duration. The use of single-use disposable paper
towels for drying is recommended, do not share the client’s personal towels.
If out in the community, the use of antibacterial hand gel is acceptable unless
hands are visibly dirty, in which case they should be washed.

Hands should be washed:

• When arriving at a client’s home.

• Prior to the preparation of food.
• Prior to assisting with personal care.
• After assisting with personal care.
• After completing domestic tasks, handling pets or supporting clients
outdoors with gardening. This is not an exhaustive list and common
sense should be applied.
• After attending to own personal hygiene matters (including visiting
the toilet).
• Before leaving the client’s home.

Attention should be given to skin care, conditions can be avoided by ensuring

hands are dried properly after washing, ensuring appropriate soaps and
antibacterial products are used and applying an emollient hand cream where
necessary. Should an adverse reaction be observed this must be reported to
the Registered Manager.

Respiratory and Cough Hygiene: The following procedures are designed to

minimise the spread of infections. Wherever appropriate the CAREGiver
should encourage the client and client’s family to practice the same
procedures.
• Cover the nose and mouth with a disposable tissue when sneezing,
coughing or blowing the nose.
• Dispose of the tissue immediately in a bin.
• Keep contaminated hands away from mouth, nose and eyes.
• Wash hands after sneezing, coughing or having any contact with
respiratory secretions.

Personal Protective Equipment: Gloves and aprons will be provided for use by
the franchise owner. Before undertaking any tasks associated with personal

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care CAREGivers must put on Personal Protective Equipment (PPE), the use of
gloves and aprons protects the client from any contamination which might be
present on the CAREGiver’s hands or clothing and protects the CAREGiver
from exposure to bodily fluids. Masks are worn there is a risk of respiratory
infections being transferred and spread from one person to another.
Normally a fluid resistant mask id required, Registered managers must ensure
they are aware of the correct PPE to be worn in the correct circumstances to
ensure that staff, clienst and te wider team are protected for person to person
transmission of communicable diseases. Before undertaking any domestic
duties, the CAREGiver should assess if PPE is required and use if appropriate.
Gloves and aprons must be worn if there is a likelihood of coming into contact
with any bodily fluids (e.g. through soiled laundry). CAREGivers should report
to the Registered Manager any instances where additional PPE might be
required (e.g. facemasks might be indicated for domestic duties in particularly
dusty environments). All PPE provided is disposable and should be disposed
of in accordance with the relevant local authority guidance, under no
circumstances should any item be used on more than one occasion unless this
is allowed within government guidance as a response to PPE supply levels
within the community.

Safe Management of Care Equipment: Home Instead provides care in client’s

own homes so any equipment in use is likely to be unique to that individual
and not used for anyone else, this lowers the risk of infection transmission.
Nevertheless, where equipment is used it should be kept in a clean and
hygienic condition according to manufacturers’ instructions. Any equipment
or devices marked as single-use must be disposed of after use in line with the
relevant local authority guidance. Any concerns should be reported to the
Registered Manager.

Management of Linen: PPE should be worn when sorting linen and handling
soiled linen. Linen which is contaminated with bodily fluids (vomit, blood,
faeces or urine) should be washed separately from other linen. Specific
infections may also require linens to be washed separately. All relevant
guidance issued by bodies such as the Public Health England must be followed
to prevent cross contamination. Safe Management of Body Fluids: There
maybe circumstances where cleaning up body fluids might be part of a
CAREGivers role, such as an episode of incontinence or vomiting, or failure of
catheter bags for example. In such circumstances PPE should be worn and
the contamination should be cleaned up and the area disinfected. Any

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contaminated articles or cleaning utensils should be disposed of in

accordance with the relevant local authority guidance.

Safe Disposal of Waste: Infective waste (such as sanitary pads, soiled

dressings, incontinence pads and used PPE) should be disposed of in
accordance with the manufacturer’s instructions and in accordance to any
infection that the client may have, this may involve waste segregation over a
specific number of days. Particular care should be taken with any sharps, and
they should only ever be disposed of in yellow sharps containers appropriatly.

Staff Presentation and Personal Hygiene: Staff should practice and maintain
good personal hygiene at all times. Clothing and footwear should be in line
with company requirements and should be clean and practical. Common
sense should be applied if clothing becomes soiled during duties and
arrangements made to change them if necessary to prevent spread of
contamination.

7. Providers have a system in place to manage the occupational health

needs and obligations of staff in relation to infection.
A “significant occupational exposure” is regarded as exposure to infection risk
from contaminated bodily fluids via contact through injury (e.g. a bite, a sharp
instrument), contact with existing broken skin or splashing of the mucous
membranes. , If full care and attention is given to wearing the correct PPE for
the specific task being carried out the risk is limited but not completely
removed. If an event should happen including a failure to wear the correct
PPE, it must be reported immediately to the Registered Manager who will
advise on appropriate self-care and referral for screening and treatment. Risk
assessments should be carried out by the Registered Manager if any
CAREGiver is pregnant or has adverse health conditions that indicate
additional precautions; and appropriate control measures put in place.
CAREGivers should be advised of any appropriate immunisations deemed
necessary for their role, and strongly encouraged and enabled to take part in
public health initiatives such as annual influenza vaccinations (see staff
immunisation policy).

SPECIFIC CIRCUMSTANCES

Where there is a risk of transmission of infection in the following circumstances, the

Registered Manager must carry out an immediate risk assessment and implement

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any identified additional precautions to prevent the spread of infection to or from

the client:

• A client is suffering from an infectious condition.

• There is a known outbreak of infectious disease.
• A client is immune-compromised (through for example chemotherapy or a
chronic condition) or is considered at high risk for becoming ill if they contract
a specific illness.

STAFF TRAINING

All staff should receive training on Infection Control as part of their induction and
continue to update their knowledge and practice throughout their employment.
Home Instead will provide appropriate and relevant training for all staff. Registered
Managers will ensure that Infection Control is part of CPD and is recorded on staff
personnel records. Registered Managers should ensure their own knowledge is up
to date and they maintain that knowledge in respect of any specific outbreak of an
infectious disease and seek the information from required from relevant sources
such as government websites, Public Health England and Department of Health and
Social Care.

STAFF PRESENTATION AND PERSONAL HYGIENE

Staff should practice good personal hygiene at all times. Clothing and footwear
should be in line with company requirements and should be clean and practical.
Common sense should be applied if clothing becomes soiled during duties and
arrangements made to change them if necessary to prevent spread of
contamination.

FAMILY INFORMATION/GUIDANCE

CAREGivers in consultation with clients and the Registered Manager should

determine how best to support family and carers in management of infection
control. Appropriate information should be provided within the bounds of client
confidentiality which should be balanced according to risk.

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