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Clostridium Difficile (C. diff) Infection Prevention and Control Policy

1. Purpose

At {{org_field_name}}, we are committed to preventing and controlling the spread of Clostridium Difficile (C. diff) infections to protect individuals receiving support, staff, and visitors. This policy ensures compliance with CQC regulations, The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, The Infection Prevention and Control Code of Practice, NICE Guidelines (NG199: Clostridioides difficile infection: antimicrobial prescribing), and UK Health Security Agency (UKHSA) infection control guidance.

This policy outlines best practices for early detection, prevention, management, and control of C. diff infections within our Supported Living service to ensure a safe, hygienic, and person-centred approach to care.

2. Scope

This policy applies to all staff, individuals receiving support, visitors, and external professionals entering our premises. It provides guidance on infection control procedures for preventing the spread of C. diff, a bacterium that causes severe diarrhoea, colitis, and complications in vulnerable individuals.

3. Related Policies

• SL16 – Infection Prevention and Control Policy
• SL12 – Safe Care and Treatment Policy
• SL07 – Person-Centred Care Policy
• SL08 – Dignity and Respect Policy
• SL34 – Confidentiality and Data Protection (GDPR) Policy
• SL21 – Medication Management and Administration Policy
• SL13 – Safeguarding Adults from Abuse and Improper Treatment Policy

4. Understanding Clostridium Difficile (C. diff)

C. diff is a bacterium that produces toxins affecting the intestines, causing:

• Watery diarrhoea (persistent or severe)
• Abdominal pain and cramping
• Fever and nausea
• Loss of appetite and dehydration

Individuals at higher risk include those who:

• Are receiving antibiotic treatment, particularly broad-spectrum antibiotics.
• Have a weakened immune system (e.g., due to age, chronic illness, or medications such as steroids).
• Have had previous hospital stays or recent healthcare contact.
• Use proton pump inhibitors (PPIs), which reduce stomach acid.

5. Infection Prevention Measures

5.1 Standard Infection Control Precautions

• Strict hand hygiene using soap and water (not alcohol-based sanitiser, as it does not kill C. diff spores).
• Personal Protective Equipment (PPE), including gloves and aprons, must be worn during personal care tasks for infected individuals.
• Enhanced cleaning and disinfection using chlorine-based solutions (1000 ppm) to eliminate C. diff spores.
• Isolation precautions for symptomatic individuals to prevent cross-infection.

5.2 Early Identification and Reporting

• Staff must immediately report suspected cases of C. diff to senior management.
• Diarrhoea of unknown cause lasting more than 24 hours must trigger a C. diff test request via a healthcare professional.
• If C. diff is confirmed, the infection must be recorded, and an individualised care plan must be developed.

5.3 Environmental Cleaning and Disinfection

• Daily deep cleaning of affected areas using chlorine-based disinfectants.
• Dedicated cleaning equipment must be used in areas where C. diff cases are present.
• Regular decontamination of high-touch surfaces, including door handles, toilets, and medical equipment.
• Terminal cleaning (full disinfection of a room) must be performed after an individual with C. diff no longer requires isolation.

5.4 Isolation and Cohorting

• Individuals with confirmed or suspected C. diff infection should be isolated in a separate room with an ensuite bathroom where possible.
• If individual rooms are not available, cohorting infected individuals together may be considered in consultation with infection control specialists.
• Minimise staff movement between infected and non-infected individuals to reduce cross-contamination.

5.5 Hand Hygiene Compliance

• Staff must wash hands with soap and water for at least 20 seconds before and after providing care.
• Alcohol hand gels must not be relied upon, as they are ineffective against C. diff spores.
• Posters and training should reinforce correct handwashing techniques.

5.6 Safe Handling of Waste and Laundry

• All waste from infected individuals, including gloves, aprons, and contaminated wipes, must be disposed of in clinical waste bags.
• Soiled laundry (bedding, clothing) must be placed directly into alginate bags and washed at high temperatures (minimum 60°C).
• No shaking or sorting of soiled linens should occur to minimise airborne contamination.

5.7 Appropriate Use of Antibiotics

• Antibiotic prescribing should follow NICE antimicrobial stewardship guidelines.
• If an individual is prescribed antibiotics, staff should monitor for C. diff symptoms and report concerns immediately.
• Unnecessary antibiotics should be avoided to prevent antibiotic-associated C. diff infections.

5.8 Supporting Individuals with C. diff

• Ensure the individual stays hydrated and follows a nutritionally balanced diet.
• Support with skin care and continence management to prevent discomfort and secondary infections.
• Educate individuals and families on infection prevention measures and hygiene practices.
• Maintain dignity and respect while assisting with personal care, ensuring individuals feel comfortable and informed.

6. Staff Training and Competency

• All staff must complete infection prevention and control training, including C. diff awareness, on induction and annually thereafter.
• Training must cover:
  • Recognising C. diff symptoms
  • Hand hygiene and PPE use
  • Decontamination procedures
  • Isolation and waste management protocols
  • Correct handling of contaminated laundry
• Senior staff must conduct spot checks to ensure compliance with infection control measures.

7. Incident Reporting and Outbreak Management

• Any suspected outbreaks (two or more linked cases) must be reported to Public Health Authorities.
• An Incident Management Plan should be activated, including enhanced cleaning, contact tracing, and communication with healthcare professionals.
• CQC must be notified if an outbreak affects service provision or results in serious harm.
• A post-incident review should be conducted to assess response effectiveness and implement necessary improvements.

8. Confidentiality and Data Protection

• All infection control records must be stored securely, ensuring compliance with GDPR and confidentiality policies (SL34).
• Information regarding an individual’s infection status should only be shared on a need-to-know basis with healthcare professionals and authorised staff.

9. Monitoring and Quality Assurance

• Regular infection control audits must be conducted to ensure compliance with CQC and NICE guidelines.
• Feedback from individuals receiving support and families should be considered to improve infection control measures.
• Any identified breaches in hygiene protocols must result in immediate corrective action.

10. Policy Review

This policy will be reviewed annually or sooner if required due to:

• Changes in CQC regulations or NICE guidelines.
• Lessons learned from outbreaks or reported incidents.
• Updates in best practice infection prevention measures.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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