Infection Control and Cleanliness in Domiciliary Care Policy

Aim

The aim of this home care organisation is to ensure that staff and people who use the service are as safe as possible from acquiring infections because home care staff are aware of and put into practice effective systems of infection prevention and control.

Policy Statement

This care at home service understands that adherence to strict guidelines on infection prevention and control is of paramount importance in ensuring the safety of both people who use the service and staff.

The organisation understands the term “infection prevention and control (IPC)” to refer to a wide range of policies, procedures and techniques intended to prevent the spread of infectious diseases among staff, people who use the service and communities. All of the staff working in a care setting are at risk of infection or of spreading infection, especially if their role brings them into contact with blood or bodily fluids like urine, faeces, vomit or sputum. Such substances may well contain pathogens which can be spread if staff do not take adequate precautions. Infection prevention and control systems and procedures are also vital in minimising risk during outbreaks of communicable disease, or during pandemics.

The agency is aware that health-related infections can be passed on by people who use the service to staff, and by staff to people who use the service in the course of care delivery. The aim is always to prevent any cycle of infection transmission occurring by making sure that care staff, when visiting homes and when in contact with one another, follow basic infection control measures as described in this policy.

The service will therefore always makes sure that:

people who use the service, their families and staff are as safe as possible from acquiring infections from any source
all health and care staff are aware of and put into practice the basic principles of infection control when carrying out their work in a person who use the service’s home.

Adherence to strict guidelines on infection control is of paramount importance in ensuring the safety of people who use the service and staff. All staff are required to make infection control a key priority and to act at all times in a way that is compatible with safe, modern and effective IPC practice.

Legal Considerations

{{org_field_name}} will adhere to all relevant legislation, including:

the Health and Safety at Work, etc Act 1974
the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Under the above legislation, and associated Codes of Practice, {{org_field_name}} understands its legal and moral duty to ensure the health and safety of both staff and people who use the service, and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

In addition to the above, the service must also comply with the Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). These place a duty on the service to report outbreaks of certain diseases as well as accidents such as needle-stick accidents.

Guidance

The policy has been written to ensure compliance with the requirements of applicable guidance and best practice, including:

The NHS Scotland National Infection Prevention and Control Manual (NIPCM)
Covid-19: Guidance for Domiciliary Care, Health Protection Scotland.

{{org_field_name}} understands that the NIPCM manual should be adopted for infection prevention and control practices and procedures by all those involved in care provision. The manual is mandatory for NHS Scotland and best practice in all other care settings.

The NIPCM contains guidance on:

Standard Infection Control Precautions (SICPs)
Transmission Based Precautions (TBPs)
Healthcare Infection incidents, outbreaks and data exceedance.

Infection Control Responsibilities

All staff have responsibilities for “playing their part” in the maintenance of high standards of hygiene and in implementing effective systems of infection prevention and control.

Specific responsibilities are as follows.

_______________ is the infection control lead for the organisation.
_______________ is responsible for infection control risk assessment and staff training.
_______________ is responsible for ordering resources such as personal protective equipment, cleaning materials and hand sanitiser.

Managers will work closely with staff safety representatives in ensuring a co-ordinated approach by the entire workforce. Staff are required to make infection control a key priority and to act at all times in a way that is compatible with safe, modern and effective infection control practice.

Managers and supervisors are responsible for ensuring that staff have access to sufficient facilities and supplies of appropriate equipment to ensure that they can implement effective infection control procedures and techniques.

Any staff who do not feel they have access to sufficient resources have a duty to inform their line manager or supervisor.

Covid-19 and Other Airborne Illnesses

Covid-19 (and similar illnesses) are passed from person to person:

directly by droplet infection from respiratory secretions
indirectly by touching a surface, object or the hand of an infected person that has been contaminated with respiratory secretions.

This service will comply fully with all Scottish Government guidance, including Covid-19 — Information and Guidance for Social, Community and Residential Care Settings, by Public Health Scotland, last updated May 2023.

Managers and staff should read the guidance carefully and be aware of its requirements. Supervisory staff should ensure that the guidelines are being followed at all times. Key elements include:

an enhanced cleaning and decontamination regime
enhanced hand hygiene requirements and practices
special requirements for the wearing of infection control personal protective equipment (PPE) including the wearing of masks at all times during periods of sustained virus transmission
arrangements for testing
requirements to self-quarantine and stay away from work for staff who have symptoms of Covid-19 infection or who test positive with Covid-19 or who have been in contact with someone who has tested positive
outbreak management
the isolation of new or symptomatic people who use the service
social distancing
good respiratory hygiene (ie using tissues for sneezes)
special arrangements for visiting based on risk assessments and Scottish Government guidance
workplace adaptations to support social distancing and reduce virus transmission, eg one-way systems in corridors, increased ventilation, etc.

See associated policies and procedures for Covid-19 for further details of specific infection prevention and control measures in the delivery of care.

Effective Hand Hygiene

This service accepts that a significant cause of cross-infection in a care environment is from unwashed or poorly washed hands which provide an effective transfer route for microorganisms. The service believes that regular, effective hand hygiene, when done correctly, is a key element in preventing the spread of communicable diseases. Staff who fail to adequately carry out effective hand hygiene before and after contact with people who use the service may transfer microorganisms from one person to another and expose themselves and others to infection.

All staff should, at all times, observe high standards of hand hygiene. NIPCM Standard Infection Control Precautions (SICPs) regarding hand hygiene apply.

Before performing hand hygiene staff should:

expose forearms (bare below the elbows)
remove all hand/wrist jewellery (a single plain metal finger ring is permitted)
ensure fingernails are clean, short and that artificial nails or nail products are not worn
cover all cuts or abrasions with a waterproof dressing.

NIPCM SICPs state that hand hygiene should be performed with soap and water or with an ABHR:

before and after touching a person who uses the service
between carrying out different care activities on a person who uses the service
before clean/aseptic procedures
after body fluid exposure risk
after touching a person who use the service’s immediate surroundings
before handling medication
before preparing food
after visiting the toilet or blowing the nose
after removing PPE.

To enable effective hand hygiene {{org_field_name}} will supply cleaning wipes and personal alcohol-based hand rub (ABHR) dispensers to all home care staff.

Staff should support any person with hand hygiene regularly where required.

Using Personal Protective Equipment (PPE) for Infection Control

In {{org_field_name}}:

adequate and suitable personal protective equipment (PPE) for use in infection control will be provided (eg disposable gloves, disposable aprons, face masks and eye/face protection, etc
infection control PPE will be worn and used by staff as required in applicable policies and procedures and according to national guidance, training and best practice
the responsibility for ordering and ensuring that supplies of infection control PPE are readily available and accessible lies with ___________________
any member of staff who suspects that they or a person who uses the service might be suffering from an allergic reaction to the use of latex gloves should stop using them immediately and inform their line manager.

Individuals receiving care are not required to wear a face mask/covering in their own home. However, they may choose to and this should be respected/supported. Other household members are also not required to wear a face mask or covering in their own home when a carer provides care to another member of their household. However, they may also choose to do so.

See associated policy on the use of infection control PPE.

Cleaning and Decontamination

All care staff have a responsibility to help keep the homes of people who use the service clean and tidy and to use suitable cleaning products to ensure suitable hygiene levels where appropriate. Any equipment used during a visit, such as mobile aids, should be cleaned using a detergent or disinfectant and stored safely in the home.

Coronaviruses can be passed on by touching contaminated surfaces but are easily deactivated by common home cleaning disinfectant products. Frequently touched surfaces (eg door handles, toilet flush handles and kitchen counter tops) should therefore be subject to regular daily cleaning.

Staff must treat every spillage of body fluids or body waste as quickly as possible and as potentially infectious. They should wear protective gloves and aprons and use disposable wipes wherever possible. Eye protection should also be used if there is risk of splashing.

The Handling and Disposal of Clinical Waste

NICPM guidance requires that infection prevention waste (eg soiled dressings, used PPE) must be disposed of safely, usually as clinical waste.

In {{org_field_name}} all such waste should be disposed of in such a way that is compliant with the law and with locally agreed arrangements and protocols. Waste that may be hazardous, such as sharps and clinical waste, should not be disposed of in standard waste.

Whilst in a person who uses the service’s home, any waste generated due to personal care (including PPE) should be bagged as normal. If the person has Covid-19 or is suspected to have Covid-19 this should be double bagged and held in the home for 72 hours before disposal into the normal household waste stream for collection. The bag should be marked for storage for 72 hours (add date and time to the bag). If the household/individual has special waste collection arrangements for personal care items, PPE should be bagged and placed in the receptacle.

Reporting

RIDDOR requires an organisation to report the outbreak of notifiable diseases to the HSE. Notifiable diseases include: cholera, food poisoning, smallpox, typhus, dysentery, measles, meningitis, mumps, rabies, rubella, tetanus, typhoid fever, viral haemorrhagic fever, hepatitis, whooping cough, leptospirosis, tuberculosis and yellow fever.

Records of any such outbreak must be kept, specifying dates and times and a completed disease report form must be sent to the HSE.

In the event of an incident, _________________________ is responsible for informing the HSE.
RIDDOR forms are kept here: _______________________________.

The HSE states that the reporting requirements relating to cases of illness or deaths from Covid-19 under RIDDOR apply only to occupational exposure, that is, as a result of a person’s work. There is no requirement under RIDDOR to report incidents of disease or deaths of members of the public, patients or people who use the service from Covid-19.

Support and Outbreaks

The organisation will work in collaboration with community partners and with the local Health Protection Team (HPT) to maintain the highest standards of infection control at all times and ensure that, as far as is reasonably practicable, people who use the service and staff are protected from the spread of infection.

Contact details: ____________________________

On identification of a new suspected or confirmed Covid-19 case, care staff should report the case to their line/duty manager. Providers will work with community partners and the person receiving care to review and assess the impact on their care needs.

Infection Control Training

All staff will be trained in basic infection prevention and control measures in line with the service’s policies and procedures. Records of training completion and performance will be kept, along with details of any required competency achievement. Training should be updated as required by changes of legislation, policy and guidance. It will take the form of a blended learning approach which will include face-to-face sessions and online web-based e-Learning.

Staff with specific infection control responsibilities or specialist roles will be supported in accessing the relevant training for their role, duties and levels of responsibility.

All new staff should be required to read this policy, and other infection control and health and safety policies, as part of their induction process. All new care staff will be trained in the effective use of PPE at the point of care as part of their induction infection control training.

Monitoring and Review

All safety incidents or accidents relating to infection control should be reported and a record made. This must include near misses. The infection control lead and the service manager will investigate any incidents and regularly review incident records.

This policy will be subject to regular ongoing monitoring and review as required.

Signed Declaration

This policy reflects current compliance with all applicable infection prevention and control legislation, regulations, guidance and best practice.

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}}

DS102. Infection Control and Cleanliness in Domiciliary Care