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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Infection Prevention and Control (IPC) Policy

1. Purpose and Scope

This policy sets out {{org_field_name}}’s commitment to preventing and controlling infections in the delivery of domiciliary care services. It has been developed to meet the requirements of Care Inspectorate Wales (CIW) and relevant legislation, ensuring we provide safe, high-quality care in clients’ homes. In accordance with Regulation 56 (Hygiene and Infection Control) of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, we maintain satisfactory standards of hygiene, proper disposal of waste, and have procedures “for the control of infection and to minimise the spread of infection”. This policy applies to all employees of {{org_field_name}}, including care workers, managers, and any others involved in direct care or support services.

Key Objectives:

• Protect the health and wellbeing of individuals using our service and our staff by minimizing the risk of healthcare-associated infections (HCAIs). (HCAIs can occur in any care setting – from care provided in the home to care in hospitals.)
• Ensure compliance with national standards and CIW requirements for infection prevention and control, including providing appropriate resources (protective equipment, hand washing facilities, etc.) and staff training.
• Provide clear guidance that staff can easily follow to maintain high standards of hygiene during care delivery in clients’ homes.

2. Roles and Responsibilities

• Responsible Individual (RI) / Registered Manager (RM): The RI and RM ({{org_field_nominated_individual_first_name}} {{org_field_nominated_individual_last_name}} and {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}, respectively) have overall accountability for infection prevention and control in the service. They must ensure that this policy is implemented, kept up to date, and that resources (such as personal protective equipment and cleaning supplies) are available. They will promote a culture of safety and high hygiene standards, and ensure compliance with relevant laws and guidance. The RM will also ensure that all notifiable incidents (e.g. outbreaks) are reported to relevant authorities including CIW, Public Health Wales, and the Local Authority as required.
• Infection Control Lead: {{org_field_infection_control_lead_name}}, {{org_field_infection_control_lead_role}}, is designated as the Infection Control Lead for {{org_field_name}}. This person is responsible for overseeing day-to-day infection control practices, monitoring compliance, and acting as a resource for staff. Duties include conducting risk assessments, arranging infection control training, keeping updated on current guidance (e.g. Public Health Wales directives, the National Infection Prevention and Control Manual), and advising on actions to take in the event of infectious incidents or outbreaks.
• All Care Staff: Every staff member has a duty to follow the procedures in this policy and maintain high standards of personal hygiene and infection control at all times. Staff must:
  • Adhere to Standard Infection Control Precautions (SICPs) in every client interaction (explained in Section 4). These precautions must be applied with all individuals at all times, as it is often impossible to know who may be carrying an infection.
  • Use Personal Protective Equipment (PPE) as directed (gloves, aprons, masks, etc.) and safely dispose of it after use.
  • Maintain personal health and hygiene, including wearing clean uniform or attire for each shift, and report any personal illness or exposure to infection (see Section 7 on Staff Health).
  • Report immediately to their line manager any concerns about infection risks (e.g. if a client has symptoms of an infectious illness, or if there is a potential outbreak situation).
  • Cooperate with infection control monitoring and training – attend required training sessions, complete workbooks or e-learning, and participate in audits or spot checks (such as hand hygiene audits).
• Domestic/Ancillary Staff or Others (if any): Any staff or contractors involved in cleaning client environments or handling waste on behalf of {{org_field_name}} must also follow this policy and the cleaning protocols herein. They must wear appropriate PPE and use approved cleaning products and methods as described.

3. Legal and Regulatory Framework

This policy is written in line with current legislation, regulations, and guidance to ensure compliance and best practice in infection prevention and control:

• Regulation 56: Hygiene and Infection Control (RISCA 2017): Requires service providers to maintain satisfactory standards of hygiene in the delivery of care, ensure proper disposal of general and clinical waste, and have effective infection control policies and procedures. We meet this by providing necessary facilities and protective equipment to staff, and by having this policy and related procedures in place. We also ensure staff receive training in hygiene and in preventing the spread of infections.
• Health and Safety at Work etc. Act 1974: We acknowledge our duty to protect the health, safety, and welfare of employees and others. Staff must also take reasonable care of their own and others’ safety. This includes following infection control procedures as a key safety measure. Failure to do so could put clients, colleagues, or themselves at risk.
• Control of Substances Hazardous to Health (COSHH) Regulations: Cleaning products and disinfectants are used safely and as directed by manufacturers. Data sheets are available for all hazardous substances used, and staff are trained on safe handling (e.g. dilutions for cleaning agents as per Section 5.4).
• Public Health Wales Guidance: {{org_field_name}} adheres to national best practice guidance, including the National Infection Prevention and Control Manual (NIPCM) for Wales. We follow the standardised policies and practices outlined in the NIPCM to ensure consistency with NHS and social care guidance. This includes all standard infection control precautions and transmission-based precautions recommended in Wales.
• Other Relevant Guidance: We also consider guidance from the Welsh Government, Social Care Wales, and Public Health Wales (PHW) on infection prevention. For example, we utilize the NHS Wales Preventing Infection Workbook for Domiciliary Care as a staff training resource to reinforce best practices in community settings. Current COVID-19 guidelines and any specific disease outbreak guidelines (e.g. for influenza, norovirus) are followed in conjunction with this general policy (see Section 8 for COVID-19 measures).

4. Standard Infection Control Precautions (SICPs)

All staff must apply Standard Infection Control Precautions at all times with every client, as these are the core practices that prevent the spread of infections in any care setting. SICPs include the following key elements, each of which is detailed below:

• Hand Hygiene
• Respiratory Hygiene (Cough Etiquette)
• Personal Protective Equipment (PPE)
• Safe Management of Care Equipment
• Safe Management of the Care Environment & Cleaning
• Safe Management of Linen and Laundry
• Safe Management of Waste (Including sharps)
• Management of Blood and Body Fluid Spillages

Staff should be familiar with all these precautions and implement them routinely. By using these safe working practices for every client, we take the guesswork out of infection prevention – assuming that any person could be infectious and therefore consistently following precautions helps break the chain of infection. The following subsections provide guidance on each precaution:

4.1 Hand Hygiene

Proper hand washing is the single most important measure to prevent the spread of infections. All staff must practice diligent hand hygiene:

• When to Wash Hands: Wash your hands (or use approved alcohol hand gel if appropriate) before and after every direct contact with a client, before clean/aseptic tasks, after exposure to bodily fluids, after touching a client’s surroundings, and after removing gloves or other PPE. In practice, hands should be cleaned on entering and leaving the client’s home, before putting on gloves, after removing gloves, after personal care or toileting tasks, before preparing or serving food or medication, and any time hands may have become contaminated.
• How to Wash Hands: Use liquid soap and warm running water. Rub all parts of hands vigorously for at least 20 seconds, covering palms, backs, between fingers, fingertips and thumbs. Rinse and dry with a disposable paper towel. If running water or soap is not immediately available (e.g. during an outdoor activity), use an alcohol-based hand sanitiser (minimum 60% alcohol) until you can wash properly. However, note that if hands are visibly soiled or contaminated (e.g. with dirt, blood), soap and water washing is required.
• No Touch Technique: Where possible, turn off taps using a paper towel to avoid re-contaminating clean hands. Avoid touching the faucet or other surfaces after washing.
• Hand Sanitiser Use: Alcohol hand gel can be used in addition to hand washing or when soap and water are not practical, but it is not effective against some organisms (like norovirus or Clostridioides difficile spores). Always wash with soap and water if in doubt, especially after known or suspected contact with such infections.
• Nails and Jewelry: Keep nails short and clean. No artificial nails or nail polish (these can harbor germs). Remove hand and wrist jewelry when at work – a plain wedding band is usually permitted, but rings with stones, bracelets, or wristwatches should not be worn during care activities as they hinder proper hand hygiene. Sleeves should be rolled up (bare below the elbows) to enable thorough hand and wrist washing.

By following strict hand hygiene at all required moments, staff protect both themselves and the clients from cross-infection. Management will conduct periodic hand hygiene observations or audits to ensure compliance.

4.2 Respiratory Hygiene and Cough Etiquette

To prevent respiratory infections (such as colds, flu, etc.) from spreading:

• “Catch it, Bin it, Kill it”: Encourage and model good respiratory etiquette. Cover your mouth and nose with a tissue when coughing or sneezing. If tissues are not available, cough/sneeze into the crook of your elbow, not your hands. Dispose of used tissues immediately in a waste bin.
• Hand Hygiene After Coughing: Always clean your hands after coughing, sneezing or blowing your nose, and after disposing of tissues.
• Client Education: If appropriate, encourage or assist clients to practice good respiratory hygiene as well. Provide tissues and a bin, and remind them to wash hands. This is especially important during cold/flu season or if the client has a respiratory infection.
• Distancing and Ventilation: If you or the client has symptoms of a respiratory infection (cough, runny nose, etc.), try to maintain a reasonable distance when possible and ensure good ventilation in the room (open a window if weather permits) to dilute airborne germs. Staff should consider wearing a mask (see PPE section) if they have a mild cold but are not excluded from work, or if the client has a respiratory infection, to prevent virus spread via droplets.

4.3 Personal Protective Equipment (PPE)

{{org_field_name}} provides all necessary Personal Protective Equipment (PPE) to employees at no cost. Staff must wear the appropriate PPE for the task at hand, based on risk assessment and current guidance. The Infection Control Lead or Manager will ensure PPE supplies (gloves, aprons, masks, visors, etc.) are available. General principles for PPE use:

• Gloves: Wear disposable single-use gloves whenever there is a risk of contact with blood, body fluids, mucous membranes, broken skin, or contaminated items (e.g. when providing personal care, handling soiled bedding, cleaning up spillages, or handling waste). Use gloves once and dispose of them appropriately – do not wash or reuse disposable gloves. Remember that gloves are not a substitute for hand hygiene; perform hand hygiene before donning gloves and immediately after removing them.
• Aprons: Wear a disposable plastic apron for tasks that may involve splashing or contamination of your clothing/uniform (such as bathing a client, helping with toileting, or cleaning tasks). The apron protects against transfer of germs to/from your clothes. Like gloves, aprons are single-use for one client or one task; remove and dispose after use and do not reuse.
• Face Masks: Use a fluid-resistant surgical mask when there is a risk of respiratory droplets or secretions, or if required by infection control guidance (for example, if a client has a known respiratory infection like COVID-19 or flu, or during an outbreak situation). Also, if mandated by public health guidance during periods of high community transmission of an illness, staff may be required to wear masks for all visits – {{org_field_name}} will advise when this is the case. Masks may also be worn by staff who have mild respiratory symptoms (and have been risk-assessed to work) to protect clients. The need for masks at routine visits will be determined by risk assessment and current public health advice.
• Eye Protection: Wear goggles or a face shield if there is a risk of splashing of blood or body fluids to the face, or aerosol generation (for instance, if assisting with a nebuliser or suctioning, or cleaning a heavy duty spill). Eye protection should be reusable (cleaned after use) or single-use – follow manufacturer instructions. Typically, eye protection is used in higher-risk scenarios or outbreaks, as indicated in risk assessments.
• Overshoes or Footwear: Generally, staff should have dedicated footwear for work that can be easily cleaned. In certain situations (e.g. caring for a client with a Clostridioides difficile infection where floors may be contaminated), disposable shoe covers might be used based on risk assessment. If used, remove and dispose of them at the end of the visit along with other PPE.

Donning and Doffing: Put on PPE in the correct order before contact with the client, and remove it carefully in the correct order to avoid self-contamination. A suggested sequence for putting on PPE is: hand hygiene → apron → mask (if needed) → eye protection (if needed) → gloves. For removal, generally gloves off first → apron off (rolling it inside out) → eye protection off → mask off last, performing hand hygiene at each stage (especially before touching your face to remove mask). Dispose of used PPE immediately in a waste bag (see waste section). Do not wear used PPE between different clients’ homes – always use fresh PPE for each client contact.

Staff will be trained on correct PPE use (donning and doffing) to prevent contamination. Always perform hand hygiene after removing PPE.

4.4 Safe Management of Care Equipment

Care equipment includes any reusable items used during care delivery (e.g. blood pressure monitors, hoists, slings, thermometers, commodes, shower chairs, etc.). To prevent cross-infection via equipment, staff should:

• Use Single-Use Items where possible: Many care items (like syringes, needles, incontinence pads, etc.) are single-use disposable. Never reuse items labeled for single use. Dispose of them after one use on one client.
• Client-Specific Equipment: Where feasible, dedicate certain equipment to a single client to avoid cross-contamination. For example, if a client has their own hoist sling or blood pressure cuff, use only on that client. If equipment must be shared or reused for multiple clients (e.g. a portable hoist or a repair toolkit), it must be cleaned and disinfected between clients.
• Cleaning of Equipment: All reusable care equipment must be cleaned regularly and whenever visibly soiled. As a minimum, clean frequently-touched care equipment at least weekly in a domiciliary setting (for example, a hoist or wheelchair that a care worker assists with should be wiped down at least weekly). In practice, equipment should be cleaned after each use or each visit if it becomes contaminated. Use an appropriate disinfectant or detergent wipe according to the item:
  • Non-invasive items (like BP cuff, stethoscope): wipe with a detergent wipe or as per manufacturer guidance.
  • Bathing aids, commodes: clean with detergent, then disinfect (two-stage cleaning) especially if contaminated with body fluids.
  • Follow manufacturer’s instructions for cleaning and maintenance. Ensure electronic equipment is not submerged and use alcohol wipes if appropriate for those surfaces.
• Approved Cleaning Products: Use only the cleaning products provided or approved by {{org_field_name}} for care equipment. These are usually chlorine-releasing disinfectants (e.g. sodium hypochlorite solution or tablets), alcohol wipes, or detergent wipes depending on the situation. Staff must follow the correct dilution and contact time for any disinfectants (for instance, allowing a disinfectant spray to sit wet on the surface for the recommended number of minutes) to ensure effective germ kill. A “two-stage” cleaning process is advised: first clean (remove dirt) with detergent, then apply a disinfectant to kill microbes.
• Maintenance: Keep equipment in good repair. Report any faults or damage to equipment (which could make cleaning ineffective or harbor germs). Equipment like commodes or hoists should be serviced and maintained as required. Clean equipment is to be stored dry and in a clean area (for example, do not store a commode pan on the floor; keep care items in a clean box or designated shelf in the client’s home if possible).
• Care Worker’s Bag and Supplies: When carrying supplies or a care kit into clients’ homes, staff should practice a “bag technique”: keep your care bag off the floor (hang it on a chair or hook if possible), carry minimal necessary equipment, use clean plastic liners or compartments to separate clean and dirty items. Clean and disinfect your bag or box regularly (e.g. wipe it daily) and avoid placing it on unclean surfaces. This minimises the bag becoming a source of infection transfer between homes.

4.5 Safe Management of the Care Environment (Cleaning and Housekeeping)

Although care is provided in individuals’ own homes (which are not under our full control), staff must still promote and maintain a clean environment in the areas where they are providing care:

• Clean as You Go: After performing care tasks, staff should clean any surfaces or equipment that were used. For example, if you assist with a wound dressing on the kitchen table, ensure the table is wiped clean afterwards. If you bathe a client, rinse and where necessary disinfect the bath or shower surfaces you touched. This routine cleaning prevents accumulation of infectious agents.
• High-Touch Surfaces: If part of the care role includes light housework or if a client is known to have an infection, pay extra attention to disinfecting high-touch surfaces (door handles, grab rails, toilet flush, etc.) during or after your visit. Use appropriate disinfectant wipes or solutions provided.
• Spillages: Any spillage of blood or body fluids (e.g. vomiting, urine or feces accidents) must be dealt with immediately and safely. Wear appropriate PPE (at minimum gloves and apron, plus eye protection if splash risk) when cleaning spills. Use disposable paper towels to mop up, then clean the area with a suitable disinfectant cleaner. For blood spills, a chlorine-based disinfectant (e.g. a bleach solution at 10,000ppm available chlorine) is recommended after initial clean-up. Dispose of all waste materials (paper towels, gloves, etc.) in a sealed plastic bag (see Waste section). After cleaning, remove PPE and perform hand hygiene.
• Cleaning Schedules: If our staff are assigned to also do routine cleaning tasks in a care plan, they should follow any cleaning schedule agreed (for example, regular bathroom cleaning, kitchen cleaning for infection control). Use the client’s cleaning products unless we have provided special products (do not mix chemicals, and use color-coded cloths if provided to avoid cross-contamination between kitchen, bathroom, etc.).
• Pets and Pests: Be mindful of hygiene if pets are in the home. Avoid letting pets lick your hands or wounds. Wash hands after touching pets. If pests (e.g. rodents, insects) or heavy infestations are noted that pose infection risk, report this to the manager so the issue can be addressed with the client (as it may require environmental health intervention).

Overall, while we respect that a client’s home is their own, we will advise and assist with maintaining cleanliness in areas related to care, for the safety of the client and staff.

4.6 Safe Management of Linen and Laundry

Staff may at times handle soiled laundry or assist with washing a client’s clothes or bedding. Dirty and soiled linens can harbor microorganisms, so safe handling is important:

• Handling Soiled Linen: Wear gloves and an apron when handling any used linen or clothing that is soiled with bodily fluids (e.g. bed sheets with urine, clothing soiled with feces). Try to avoid contact with your clothing. Do not shake or flap linens, as this can disperse microbes into the air. Instead, carefully fold or roll up used linens inward into a bundle to contain any contamination.
• Bagging: Place used linen straight into an appropriate laundry bag. If the linen is wet or soiled, use a water-soluble (alginate) bag inside a plastic bag if available, or a double-bag method, to contain the waste and protect those handling it. For infection cases, a red “infected linen” bag may be used if a service is in place for laundering infected laundry. In most home settings, laundry will be washed in the domestic washing machine, so ensure it is transported without dripping or contaminating surfaces (use a designated laundry basket or bag which is then cleaned).
• Washing: Do not rinse soiled clothes or bedding by hand – rinsing or pre-soaking by hand can cause splashes of contaminated water onto yourself or surfaces. Instead, put the items directly into the washing machine. Use a pre-wash or soak cycle if available, then a main wash at the highest temperature safe for the fabric. Typically, washing at 60°C or above with a bleach-based laundry detergent will kill most germs. Follow care labels – if items cannot withstand hot washing, consider using an anti-bacterial laundry additive for lower temperatures. Ensure that the machine is not overloaded so it washes properly.
• After Handling Laundry: Remove your gloves and apron (if worn) after loading the machine or handling dirty laundry, and wash your hands thoroughly. Clean any surfaces that might have been contaminated (e.g. if a soiled sheet touched the floor, clean that area).
• Drying: Dry laundry thoroughly, preferably using a dryer on a hot setting if fabric permits, or line dry in sunlight (sunlight also has a mild disinfectant effect). Ensure laundry is fully dried before re-use.
• Client and Staff Clothing: Clients’ clothing should be washed regularly. Encourage good hygiene with clean clothes. Staff uniforms or work clothes should be kept clean – a clean uniform must be worn for each shift. Ideally, staff should launder their uniforms/work attire separately from other household laundry, at as high a temperature as suitable (60°C if fabric allows), to avoid cross-contamination. Uniforms or work clothes should be transported home in a disposable or washable bag and washed after each day’s use. Staff should have spare uniforms available in case one becomes contaminated during the day.

4.7 Safe Management of Waste and Sharps

Managing waste safely in clients’ homes is crucial to prevent injury or spread of infection. Waste includes used PPE, dressings, incontinence products, or any contaminated materials.

• Clinical Waste vs. Household Waste: In a domiciliary care setting, small amounts of waste like used gloves, aprons, or wound dressings can often be disposed of in the household refuse if properly sealed (unless there is a known highly infectious case, or local policy provides clinical waste pick-up). We will assess each client’s situation – if a client produces large amounts of healthcare risk waste (e.g. many soiled dressings or incontinence pads), {{org_field_name}} may arrange for a clinical waste service via the local council or healthcare provider. Otherwise, double-bagging and disposing via domestic trash is the usual procedure, with precautions as below.
• Waste Disposal Procedure: Place all used PPE (gloves, aprons, masks) and any contaminated disposable items (like tissues, gauze, pads) into a plastic rubbish bag. Do not overfill bags – they should be able to be securely tied. For infectious or potentially infectious material, take the following extra steps:
  • Put the waste bag into a second bag (double bagging) to provide an extra barrier.
  • Mark the bag with the date and keep it in a safe place, out of reach of others (e.g. in a bin with a lid).
  • If the waste is from a known infection case (for example, a client with COVID-19 or norovirus), leave the double-bagged waste for 72 hours before putting it out for collection with the normal rubbish. This 72-hour holding period ensures any virus in the waste has time to die off and reduces risk to refuse collectors. If 72 hours storage is not feasible, or waste collection is more frequent, we will arrange it as clinical waste pickup.
  • After sealing the bag, remove gloves and perform hand hygiene.

• Sharps (Needle) Disposal: If care staff use or encounter any sharps (needles, lancets, syringes, etc.), a proper yellow sharps container must be used. Never dispose of sharp objects in regular bins. For example, if assisting a client with insulin injections using pen needles, each needle should be immediately placed in a sharps bin. Do not re-sheath used needles; use the safety device or a one-handed technique to drop it in the sharps box. {{org_field_name}} will provide portable sharps containers to staff when needed, or coordinate with district nursing services to ensure one is available in the home. Sharps containers must be kept out of reach of children or vulnerable adults in the home, and must not be overfilled above the line. When 3/4 full, arrange for disposal via the local health services or pharmacy sharps disposal scheme as per local protocols. Accidental needle-stick injuries must be reported immediately to the manager and prompt medical advice sought.
• Other Hazardous Waste: Any waste contaminated with significant blood (e.g. blood-soaked dressings) should ideally be treated as clinical waste. In practice, double-bagging and 72-hour hold as described is used if a clinical waste pickup isn’t in place. Waste such as empty urine catheter bags can be emptied (drained into toilet) then disposed in trash, but if not empty, treat as clinical waste. Sanitary waste (pads, diapers) from an individual without infection can go in domestic waste if wrapped; with known infection, handle as above.
• Recycling: Do not put contaminated waste into recycling bins. When in doubt, dispose of it as general refuse following the precautions.

Staff should also follow any additional local authority guidelines for waste disposal in the area. Always perform hand hygiene after handling and disposing of waste bags.

4.8 Food Hygiene in the Home

When staff assist with food preparation in a client’s home, they must apply safe food-handling practices to prevent food-borne infection. Always begin by washing hands thoroughly before and after handling any food. Keep raw foods separate from ready-to-eat foods to avoid cross-contamination, using different chopping boards, utensils, and cloths where possible. Ensure cooked food is heated and served at the correct temperature (above 63 °C) and cold food is stored below 5 °C. Check use-by dates, and never reheat food more than once. Clean and disinfect kitchen surfaces before and after use, and dry equipment with disposable paper towels or a clean cloth reserved for kitchen use. Encourage clients and family members to maintain these standards to support overall infection prevention and control in the home.

5. Additional Precautions for Specific Infectious Risks

While Standard Precautions must be used with all clients, sometimes additional measures (called Transmission-Based Precautions) are needed for certain known or suspected infections (e.g. a gastroenteritis outbreak, COVID-19, influenza, MRSA, etc.). In a domiciliary setting, isolation in the usual sense (keeping someone completely separate) is often not fully possible, as individuals live in their own homes and may not have separate en-suite facilities or may live with family. However, we will take appropriate steps on a case-by-case basis to minimise the spread of infection while respecting the client’s rights and home environment.

If a client is known or suspected to have an infectious disease that could spread to others (or to staff), the following measures will be implemented:

• Risk Assessment and Care Planning: The Manager or Infection Control Lead will conduct a risk assessment. This includes identifying how the infection spreads (contact, droplet, airborne?), who is at risk (family members, other clients, staff), and what interventions are needed (additional PPE, limiting visits, etc.). A care plan adjustment will outline any special arrangements.
• Cohorting Staff/Visits: Where feasible, we will assign a small, consistent team of care workers to the affected client so as to limit the number of different staff exposed and to reduce the risk of onward transmission to other clients. We may also schedule the client’s visits either at the end of staff rounds or in a way that infected and non-infected individuals are not seen by the same staff member back-to-back without precautions.
• Enhanced PPE and Hygiene: Staff will use enhanced PPE as appropriate. For example, if the client has a confirmed or suspected COVID-19 or flu, staff will wear a face mask (and possibly eye protection) in addition to gloves and apron. If the client has Clostridioides difficile or norovirus (causing diarrhea), staff will use gloves and aprons and ensure soap-and-water handwashing (as alcohol gel is less effective against these). In some cases, disposable gowns or an FFP2/FFP3 respirator may be advised (e.g. tuberculosis or during aerosol-generating procedures) – these will be provided with proper training if needed.
• Client Cooperation: We will encourage the client, if they are able, to also follow infection control advice – e.g., ask them to cover coughs, wear a mask if appropriate when a care worker is present (for airborne infections), stay in a specific room if possible during the infectious period, or avoid seeing other vulnerable individuals until they are better. We do this with sensitivity and seek consent, explaining it is for their safety and others’.
• Environmental Controls: Increase cleaning frequency in the client’s environment, especially of high-touch surfaces and bathroom facilities. If the client shares a household with others, advise on cleaning and disinfection practices for them as well (for instance, family should regularly clean toilet and bathroom if one member has norovirus). Ensure good ventilation if it’s a respiratory infection.
• Restrictions and Notifications: There may be cases where temporarily pausing certain services or visits is prudent (for example, if a client is in hospital with an infection, staff won’t visit until they return; or if a client has highly infectious illness, non-essential visits or outings might be postponed during the contagious period). Always document and communicate clearly any changes. Also, with consent and on a need-to-know basis, inform other professionals involved (GP, district nurse) so that they use precautions when visiting the client.
• Duration: Follow public health guidance on how long precautions should last (e.g., at least 48 hours after a person’s last episode of vomiting/diarrhoea for norovirus; or after 5 days of appropriate antibiotics for certain infections; or after the official isolation period for diseases like COVID-19, etc.). The Infection Control Lead will communicate when it’s considered safe to resume normal routines.

Throughout such situations, we strive to balance infection control with compassion and respect for the individual’s rights. Any measure that could infringe on a person’s normal freedoms (such as asking them to stay at home or wear a mask) will be considered in line with their well-being and human rights. We aim to ensure the person doesn’t feel isolated or punished due to infection – maintaining dignity is paramount. We also ensure that liberty is only restricted as absolutely necessary and for the shortest duration, in line with current laws and guidance.

If staff have any doubts about how to manage care for an infectious client, they must contact the manager or Infection Control Lead for advice before proceeding.

6. Managing Outbreaks and Notifiable Diseases

An outbreak is defined as two or more linked cases of the same infection (or a sudden increase in cases) in the context of our service. In domiciliary care, an outbreak might not be immediately obvious since clients live separately; however, if two or more clients or staff develop similar symptoms (e.g., diarrhoea and vomiting) in a short time frame and a connection is suspected (like a common source or caregiver), this could constitute an outbreak. Certain diseases are legally notifiable to public health authorities under the Public Health (Control of Disease) Act 1984 and related regulations.

Our procedure for outbreaks or notifiable disease incidents:

• Immediate Actions: Staff who become aware of unusual clusters of illness (e.g., two clients on their rota with diarrhoea, or a client diagnosed with a serious infectious disease like legionella, COVID-19, measles, etc.) must inform the Registered Manager or Infection Control Lead immediately. Quick identification allows quick action.
• Notification of Authorities: The manager will inform the appropriate health authorities without delay:
  • Local Health Protection Team (Public Health Wales): Contact our local health protection team for expert guidance and to formally report the situation. Contact: Phone: {{org_field_outbreaks_support_local_health_protection_team_phone_number}}, Email: {{org_field_outbreaks_support_local_health_protection_team_email}}, Website: {{org_field_outbreaks_support_local_health_protection_team_website}}. They can advise on outbreak management steps and whether any laboratory testing or special measures are needed.
  • Local Public Health Authority: If advised or required, we will also notify the Local Authority’s Public Health department. Contact: Phone: {{org_field_reporting_outbreaks_local_public_health_phone_number}}, Email: {{org_field_reporting_outbreaks_local_public_health_email}}, Website: {{org_field_reporting_outbreaks_local_public_health_website}}. (In Wales, Public Health Wales usually coordinates the response, but we ensure all relevant bodies are informed as appropriate.)
  • Care Inspectorate Wales (CIW): CIW must be notified of any significant infectious disease outbreak or incident affecting the service. The Registered Manager will send notification to CIW as required, in line with regulatory notification guidelines.
  • Local Authority Commissioning or Social Services: If we provide care on behalf of the Local Authority or health board, we will inform the contract manager or appropriate contact about the situation as needed.
• Out-of-Hours: If an urgent infection outbreak or incident occurs outside of normal office hours, staff should contact the On-Call Manager at {{org_field_out_of_hours}} for immediate guidance. The on-call manager may also directly contact the Public Health Wales on-call service or the Local Authority’s out-of-hours line (if applicable) using the provided emergency numbers.
• Follow Public Health Guidance: We will act on the advice given by the Health Protection Team/Public Health Wales. This may include:
  • Collecting specimens (stool samples, etc.) from ill individuals for testing.
  • Implementing specific control measures (e.g., prophylactic treatments, vaccination campaigns if relevant, enhanced cleaning protocols).
  • Providing information to clients, families, and staff about the outbreak and precautions to take.
  • Temporarily halting admissions of new clients or staff rotations if advised.
• Communication: We maintain clear communication with all staff during an outbreak. Staff will be updated on what symptoms to watch for, any additional PPE or infection control steps, and any changes in their duties. Similarly, we will inform clients (and their families/representatives as appropriate) about the situation in a truthful but reassuring manner, maintaining confidentiality where needed. Only the minimum necessary information will be shared (for example, telling a client “there is a stomach bug affecting a couple of people we care for, so we are taking extra precautions” without naming others).
• Documentation: All outbreak-related actions, communications, and decisions will be documented. An incident report will be completed, and a log of affected individuals maintained to track the outbreak.
• Aftermath and Evaluation: Once the outbreak is over (no new cases after a certain period, as determined by PHW guidance, e.g., 48 hours after last case’s symptoms), management will declare the outbreak ended, stand down extra measures, and do an evaluation. We will review what happened, how effective our response was, and identify any lessons learned to improve future infection control. CIW and other authorities will be updated with a final report if required.

Remember that certain single cases of disease must be notified immediately (for example, one case of suspected meningococcal meningitis, or one case of TB, etc.). Even if it’s not an outbreak, the steps of notifying Public Health Wales and CIW apply for notifiable diseases. The Infection Control Lead maintains a list of notifiable diseases and will ensure compliance with reporting requirements.

7. Staff Health and Hygiene

Our staff are our most important resource in delivering care, and protecting their health is part of infection control. The following measures relate to staff health:

• Pre-employment: New staff should disclose any health conditions that might affect their role (including infectious conditions). A pre-employment health check may include up-to-date immunisation status for common diseases (like measles, rubella, chickenpox, Tuberculosis risk assessment, etc.), especially for staff who will be working with vulnerable clients. If someone is known to be a carrier of a transmissible disease, occupational health advice will be followed to ensure safety and no discrimination.
• Illness Reporting: Staff must not attend work if they are ill with a potentially infectious condition. Key rules:
  • If you have symptoms of gastrointestinal infection (diarrhoea or vomiting), inform your manager and stay off work until at least 48 hours after your last episode of vomiting or diarrhoea. This 48-hour exclusion is critical to prevent spreading norovirus or similar bugs to clients.
  • If you develop a respiratory infection with fever and cough (e.g. flu-like illness), or a confirmed contagious illness like COVID-19, do not come to work. Follow medical advice on self-isolation and only return when safe (for COVID-19, follow current public health guidance on isolation period or testing strategy; for flu, stay off until fever free for 24 hours and well enough).
  • For skin infections (like scabies, or a wound infection), seek treatment and advice. You may work if the area can be covered and you’re undergoing treatment, but discuss with your manager.
  • Any infectious disease diagnosis (chickenpox, measles, hepatitis, etc.) must be reported to management immediately so we can risk assess any exposure to clients or other staff, and follow public health guidance.
• Return to Work: After sickness, always check with your manager before returning to work to confirm it’s safe. In some cases, they may require clearance from a GP or a negative test (for example, for COVID-19 if still within a certain timeframe). For food handlers (staff preparing food for clients), the 48-hour rule after D&V is especially enforced.
• Injuries and Exposure: If a staff member experiences a sharps injury or blood exposure incident during work (needle stick, blood splashed in eye, etc.), they must follow the Sharps Injury Protocol: encourage bleeding of wound (if puncture), wash area, cover it, then immediately seek medical advice (A&E or occupational health) for possible post-exposure prophylaxis. Such incidents must be reported to management for further action (RIDDOR reporting if applicable, investigation to prevent reoccurrence, etc.).
• Vaccinations: We encourage all staff to be up-to-date with recommended vaccinations for health and social care workers. This includes the annual flu vaccine (free for health and care staff)phw.nhs.wales, COVID-19 vaccinations as recommended by Public Health Wales, and immunisations like Hepatitis B if you perform exposure-prone procedures or there is risk of blood exposure. While not mandatory (unless required by specific role or outbreak control), vaccination significantly helps protect you and clients. The company will provide information on access to vaccines and may facilitate vaccination programs as needed.
• Personal Hygiene and Uniform: Staff are expected to maintain high personal hygiene standards:
  • Bathe or shower daily and ensure good hand and nail hygiene (as detailed in Hand Hygiene section).
  • Wear a clean uniform or work clothes each day. If a uniform becomes visibly soiled or contaminated during a visit, change into a clean set as soon as possible (carry a spare if feasible).
  • Keep hair clean and tied back if long. Avoid excessive jewellery – apart from being a hand hygiene issue, jewelry and long nails can also cause injury to clients or tear gloves.
  • Cover any cuts or abrasions with waterproof dressings.
  • Follow the organisation’s dress code (refer to our Dress Code Policy if separate) which aligns with infection control needs (e.g., no false nails, minimal jewellery, closed-toe shoes, etc.).
• Occupational Health: We will support staff health through occupational health referrals if needed (for example, if frequent illness occurs, or if adjustments are needed for health conditions). All health information is kept confidential. However, in the context of infection risk, certain information may need to be disclosed on a need-to-know basis (e.g., if a staff member has a potentially transmissible disease, management may need to inform clients or other staff who were exposed, following public health guidance, but will do so in a sensitive and confidential manner).

By keeping our workforce healthy and ensuring they practice good hygiene, we protect the wider community of clients we serve.

8. COVID-19 and Other Emerging Infections

Note: {{org_field_name}} has a separate detailed COVID-19 Policy; however, basic infection control measures for COVID-19 or any similar emerging infectious disease are covered here in brief:

• We treat COVID-19 as a high priority infection risk. Although as of {{current_year}} the acute pandemic phase has subsided, the virus continues to circulate. All standard precautions in this policy (hand hygiene, PPE, cleaning, etc.) apply to preventing COVID-19 transmission. In addition, we follow current Welsh Government and Public Health Wales guidance on specific COVID-19 measures (e.g. testing, isolation periods, use of face masks when required).
• Screening: Staff should be vigilant for COVID-19 symptoms (new continuous cough, high temperature, loss of taste/smell, etc.) in themselves and clients. If symptoms arise, follow the illness reporting protocol (do not work while potentially infectious and get tested if advised).
• Basic Preventative Measures: Maintain good ventilation during home visits when possible (e.g., open a window slightly). Practice respiratory etiquette (mask-wearing when appropriate, as outlined in PPE section). Continue to use appropriate PPE – for example, face masks are recommended when providing close personal care to a client who has respiratory symptoms or a confirmed COVID-19 infection (and for the staff member if they themselves have mild symptoms and are working under exceptional guidance).
• Physical Distancing: Where practical, keep a safe distance from clients during times of high COVID-19 prevalence, except when close contact is required for care. Avoid unnecessary physical contact (like handshakes) during outbreaks.
• Additional Cleaning: Pay extra attention to cleaning high-touch surfaces if either the client or staff is suspected to have COVID-19. Use disinfectants that are effective against viruses.
• Vaccination: All staff are encouraged to receive COVID-19 vaccinations and boosters as recommended, as well as seasonal flu vaccines, to protect themselves and clients.
• Client Support: Help educate and support clients regarding COVID-19 (for example, encouraging them to get vaccinated, helping them access tests if needed, and reassuring them about infection control measures). If a client is known to have COVID-19, we will follow the enhanced precautions outlined in Section 5 (Transmission-Based Precautions), including minimizing staff changes, using full PPE (mask, eye protection, gloves, apron), and liaising with health professionals about the client’s care needs.

For other emerging infections (for instance, if there were a new virus outbreak or any public health alert), {{org_field_name}} will refer to guidance from Public Health Wales and Welsh Government and integrate any new recommended practices into our infection control procedures. Staff will be kept informed of any changes or additional precautions required.

9. Training and Awareness

Effective infection prevention and control relies on knowledgeable staff. To ensure everyone understands and can implement this policy:

• Training at Induction: All new care staff must receive infection prevention and control training during their induction period. This includes the basic theory (chain of infection, standard precautions, hand washing technique, use of PPE, etc.) and practical demonstration of skills like proper handwashing and putting on/removing PPE. Induction training will cover Section 7.6 (Infection Prevention and Control) of the All Wales Induction Framework for Health and Social Care, which this policy supports.
• Preventing Infection Workbook: Staff are required to complete the NHS Wales Preventing Infection Workbook for Domiciliary Care (or equivalent training module) as part of their training. This workbook is a comprehensive resource covering standard infection control precautions and key topics, helping to reinforce knowledge. Completion of the workbook will be checked by a manager, and a certificate of completion retained as evidence of competence. It also counts towards required qualifications and evidences compliance with our policies.
• Ongoing Training and Refreshers: Infection control training isn’t a one-time event. We provide regular refresher training sessions (at least annually, and sooner if there are changes in guidance or if an infection incident suggests a need for re-training). Refreshers may be through e-learning, toolbox talks, or formal training courses. Key topics include hand hygiene refresh, use of any new PPE or equipment, updates on policies like COVID-19 measures, and lessons learned from any recent infection incidents.
• Competency Assessment: The Infection Control Lead or supervisors will periodically assess staff competence in infection control – for example, observing a care worker’s hand hygiene technique or use of PPE during spot checks or supervision sessions. Any gaps or incorrect practices will be corrected with additional training or coaching.
• Records: The Registered Manager will maintain training records to show that all staff have received up-to-date infection control training. This is important for CIW compliance and for internal quality monitoring. Staff are also expected to keep their own knowledge up to date; if unsure about any aspect of infection prevention, they should seek guidance from a supervisor or the Infection Control Lead.
• Employee Acknowledgement: Staff must read and understand this Infection Control Policy. They will be asked to sign an acknowledgement (or via electronic confirmation) that they have read and will adhere to the policy. Copies of the policy are accessible in the policy manual at the office and via the staff online portal/handbook.

By investing in staff knowledge and skills, we aim to create a confident workforce that consistently applies excellent infection control practices. This, in turn, protects our clients, our staff, and the broader community.

10. Monitoring and Review

Maintaining high standards of infection prevention and control is an ongoing process. {{org_field_name}} will ensure this policy remains effective through:

• Monitoring Compliance: The Infection Control Lead and management will monitor day-to-day adherence to infection control practices. This may include spot-check visits to observe care practice, checks on cleanliness of equipment, asking clients for feedback on staff hygiene (e.g., “Does your carer wash their hands when they arrive?”), and internal audits using an infection control checklist.
• Incident Review: Any infection incident (such as an outbreak, a case of healthcare-associated infection in a client, or staff contracting a work-related infection) will be investigated. We will look at whether all protocols were followed and identify any areas for improvement. Findings will be used to update practices or retrain staff if necessary.
• Feedback: We welcome feedback from staff and clients regarding infection control – if you notice any hazards or have suggestions (for example, a better type of hand sanitiser, or a concern about a particular task), inform the Infection Control Lead. Staff meetings and supervision sessions will include infection control as a standing agenda item to discuss any issues or updates.
• Policy Review: This policy will be reviewed at least annually, and sooner if there are significant changes in legislation or guidance. The Last Updated and Next Review dates are indicated at the top of this document. Reviews will be conducted by the Registered Manager in consultation with the Infection Control Lead and will incorporate any new CIW requirements, Public Health Wales guidance, or learning from our own service. Updated versions of the policy will be communicated to all staff and the old version archived.

Through regular review and vigilant monitoring, we ensure that our Infection Prevention and Control Policy remains current, comprehensive, and correctly implemented – thereby safeguarding everyone involved in our service.

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References and Guidance:

• Public Health Wales & NHS Wales: National Infection Prevention and Control Manual (All Wales guidance) – followed for standard precautions and procedures.
• Care Inspectorate Wales Regulations (Regulated Services (Service Providers and RIs) (Wales) Regulations 2017): Reg.56 on Infection Control – requires policies, hygiene standards, waste disposal, PPE, training.
• PHW & Social Care Wales: Preventing Infection Workbook for Domiciliary Care (2nd Ed.) – training resource supporting this policy.
• Bridgend CBC (Example IPC Policy, 2022) – emphasizes cleaning of equipment, adherence to NIPCM, reporting and training expectations.
• Lifestyle Homecare Infection Control Policy (2024) – example of PPE usage, waste disposal in community (72-hour double-bag rule) and staff sickness (48-hour rule), aligned with national guidance.

(For detailed guidance on COVID-19 or other specific infections, see our supplemental policies or Public Health Wales updates. This Infection Prevention and Control Policy works in conjunction with policies on Food Hygiene, Health and Safety, and Personal Protective Equipment.)

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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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