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CH150-Isolating People During Infections Policy

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Isolating People During Infections Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} will assess and manage situations in which a person may need to stay away from other people because of a suspected or confirmed infectious illness, while protecting their safety, dignity, autonomy, rights, relationships and wellbeing.

{{org_field_name}} will assess the risk of infection and take appropriate measures to prevent, detect and control the spread of infection in accordance with Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including Regulation 12(2)(h), and will have regard to the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance and current national infection prevention and control guidance applicable to adult social care in England.

Any measure requiring a person to remain in their room or stay away from other people must be necessary, proportionate to the identified infection risk, based on an individual assessment and reviewed regularly. The least restrictive effective measures must be used.

Where infection prevention and control measures affect visiting or visits outside the care home, {{org_field_name}} will comply with Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and will facilitate visiting unless exceptional circumstances apply. Appropriate and proportionate precautions will be used wherever reasonably practicable to allow visits to continue safely.

Isolation or other infection-control measures will not result in a person being deprived of necessary care, treatment, nutrition, hydration, medicines, communication, meaningful activity, emotional support or contact with people important to them.

2. Scope

This policy applies to all individuals within the care home setting, including staff, service users, visitors, and external healthcare providers. It ensures that anyone potentially exposed to or diagnosed with an infectious disease receives appropriate care and support while preventing transmission within the home.

Staff must understand their roles and responsibilities in implementing this policy, ensuring consistency and adherence to infection control standards. Visitors and external providers will be informed about relevant procedures when accessing the care home during an outbreak.

3. Related Policies

This policy is closely linked to several other policies that guide infection control, care provision, and service user rights, including:

4. Policy Statement

{{org_field_name}} is committed to protecting people who use the service, staff and visitors from avoidable risk associated with infection while ensuring that infection prevention and control measures respect each person’s dignity, autonomy, human rights, individual preferences and wellbeing.

A person will only be asked or supported to remain in their room or stay away from other people where this is indicated by the nature of the suspected or confirmed infection, an individual risk assessment and current national or UK Health Security Agency advice.

Any restriction will:

Blanket or unnecessarily prolonged isolation arrangements will not be used.

Throughout any period in which a person is being supported to stay away from others, they will continue to receive safe, person-centred care and treatment and appropriate support for their physical, psychological, emotional, cultural, spiritual and social needs.

Visiting will continue in accordance with Regulation 9A unless exceptional circumstances make a particular restriction necessary. Where there is an infection risk, the service will first consider whether visits can continue safely through appropriate and proportionate infection prevention and control precautions.

5. Procedures for Isolation

5.1 Identification and Risk Assessment

Where a person develops signs or symptoms of a potentially infectious illness, or a suspected or confirmed infection is otherwise identified, staff must promptly assess the situation and take appropriate infection prevention and control precautions.

The assessment must consider, where relevant:

Where symptoms require clinical assessment, appropriate medical advice must be obtained without delay.

The decision to ask or support a person to remain in their room or stay away from others must be based on the individual risk assessment and current guidance for the suspected or confirmed infection. Such a measure must not be imposed automatically solely because an infection or colonisation has been identified.

The assessment, decision, reasons for the decision, precautions required and planned review arrangements must be documented in the person’s care records and care plan.

Where an outbreak is suspected, the Registered Manager or delegated competent person must follow current UK Health Security Agency reporting arrangements and seek advice from the local Health Protection Team or other locally designated infection prevention and control service.

5.2 Communication, Consent, Capacity and Restrictive Measures

Staff must explain proposed infection prevention and control measures to the person in a clear, respectful and accessible way. Information must be adapted to the person’s communication needs and must include, as appropriate:

Valid consent must be sought where care or treatment requiring consent is provided.

A person who has capacity to make the relevant decision must be supported to make their own decision. Staff must not treat a person as lacking capacity merely because the person makes a decision that staff consider unwise.

Where there is reason to doubt the person’s capacity to make a particular decision, capacity must be assessed in accordance with the Mental Capacity Act 2005. Capacity is decision-specific and time-specific.

Where the person lacks capacity to make the relevant decision, any decision made on their behalf must comply with the Mental Capacity Act 2005, including the best-interests requirements and the requirement to consider whether the purpose can be achieved in a way that is less restrictive of the person’s rights and freedom of action.

Family members must not be treated as having authority to consent on behalf of an adult who lacks capacity unless they have relevant legal authority, for example as an attorney under a valid Lasting Power of Attorney or as a court-appointed deputy with authority covering the decision concerned. Family members and others interested in the person’s welfare must nevertheless be consulted where required by the Mental Capacity Act 2005.

Where infection prevention and control arrangements may amount to a deprivation of liberty, the Registered Manager must ensure that the circumstances are reviewed promptly and that any necessary lawful authorisation is sought in accordance with the Mental Capacity Act 2005 and the legal framework applicable at the time.

The service must not rely upon infection prevention and control considerations as a general authority to compel a person to remain in their room. Where a person with capacity does not agree to recommended infection control measures, staff must undertake an individual risk assessment, seek appropriate clinical or UK Health Security Agency advice where necessary and consider the least restrictive lawful measures available.

All significant discussions, capacity assessments, best-interests decisions, decisions concerning restrictions and review outcomes must be recorded.

5.3 Implementing Infection Control Precautions

Where an individual assessment and current guidance indicate that a person should stay away from others, they should normally be supported in their own room or another appropriate single-occupancy room where this can be achieved safely.

Where possible and appropriate, the person should have access to a dedicated toilet or en-suite facility. Where a dedicated facility is not available, arrangements for safe use and appropriate cleaning and disinfection must be established according to the infection risk and current national guidance.

The person’s accommodation must remain safe, clean, comfortable and suitable for their assessed needs. Necessary care and treatment must continue throughout the period in which the person is staying away from others.

Staff must use standard infection control precautions and any additional transmission-based precautions required for the suspected or confirmed infection.

Personal protective equipment must be selected following an assessment of:

PPE must be put on, removed and disposed of safely, and staff must perform hand hygiene at the required points before and after care.

Care equipment should be dedicated to the individual where indicated. Where equipment must be shared, it must be appropriately cleaned and, where required, disinfected or decontaminated between uses.

Environmental cleaning and disinfection must be undertaken using products and processes appropriate to the organism and transmission risk and in accordance with the service’s infection prevention and control procedures and current national guidance.

Waste and laundry must be segregated, handled, stored and disposed of according to their actual infection risk, applicable waste requirements and current infection prevention and control guidance. Waste must not automatically be classified as clinical or infectious waste solely because it has come from the room of a person who is staying away from others.

5.4 Supporting the Individual

A person who is being supported to remain in their room or stay away from others must continue to receive safe, person-centred care and must not experience avoidable neglect, loss of care or unnecessary social isolation.

The person’s care plan must address their individual physical, psychological, emotional, communication, cultural, spiritual and social needs during this period.

Staff must continue to provide all necessary care and treatment, including support with:

The frequency and nature of observations must be determined by the person’s clinical condition, assessed needs and relevant healthcare advice rather than by a fixed observation schedule for every infection.

Staff must maintain meaningful contact with the person and monitor for any deterioration in physical health, mental health or emotional wellbeing.

The person must be supported to maintain contact with relatives, friends, advocates and other people important to them.

In-person visiting must be facilitated in accordance with Regulation 9A unless exceptional circumstances apply. Where infection transmission is a concern, appropriate and proportionate precautions must first be considered to enable visiting to continue safely. These may include changes to the location of the visit, ventilation, hand hygiene, use of appropriate PPE or other precautions advised for the particular infection.

Any restriction on visiting must:

Blanket visiting restrictions must not be imposed unless the exceptional circumstances and risk assessment justify the particular restriction and no less restrictive means can adequately manage the risk.

In-person visits to a person receiving end-of-life care must continue to be supported.

Telephone calls, video calls and other forms of remote communication may supplement in-person contact but must not routinely be used as a substitute for in-person visiting where a safe visit can reasonably be facilitated.

5.5 Infection Prevention and Control Measures

Standard infection control precautions must be applied consistently and additional transmission-based precautions must be used where indicated by the infection risk.

Measures must include, as applicable:

Staff must follow current national infection prevention and control guidance and any organism-specific advice provided by the UK Health Security Agency, Health Protection Team, infection prevention and control service or other relevant healthcare professional.

Hand hygiene must be performed using the method appropriate to the task and organism. Alcohol-based hand rub must not be treated as a universal substitute for handwashing where soap and water are specifically required.

PPE must be selected according to the assessed transmission and exposure risk. Gloves, aprons, gowns, masks and eye or face protection must not be used routinely unless indicated by the task, exposure risk or infection-specific guidance.

Reusable care equipment must be appropriately cleaned and, where necessary, disinfected or decontaminated between people. Dedicated equipment should be used where required by the risk assessment.

Laundry and linen must be handled in a way that minimises dispersal and contamination and must be processed in accordance with current infection prevention and control requirements.

Waste must be classified and disposed of according to applicable waste requirements and the nature of the waste. Items originating from a person’s room must not automatically be classified as clinical or infectious waste unless that classification is appropriate.

The Registered Manager or delegated competent person must ensure that infection prevention and control measures remain appropriate and effective and are adjusted when the assessed risk or relevant professional guidance changes.

5.6 Monitoring, Review and Ending Restrictions

The person’s health, wellbeing and infection status must be monitored throughout any period in which additional infection prevention and control precautions are in place.

Monitoring must be appropriate to the person’s condition and may include observations such as:

The Registered Manager or responsible staff member must ensure that signs of deterioration are recognised and escalated promptly in accordance with the person’s care plan and clinical escalation arrangements. NHS 111, the person’s GP, relevant healthcare professionals or emergency services must be contacted as appropriate to the person’s condition.

The need for the person to remain away from others must be reviewed regularly and whenever:

There must not be a single generic isolation period applied to all infectious illnesses.

The duration of any restriction must follow current guidance applicable to the particular infection or organism, together with individual clinical and risk considerations and any advice received from the UK Health Security Agency Health Protection Team or relevant healthcare professional.

For acute respiratory infections, including COVID-19 and influenza, staff must follow the current UK Health Security Agency guidance for adult social care rather than applying a locally determined fixed isolation period.

Restrictions must be ended as soon as they are no longer necessary or proportionate. The date, reason and decision to end the restriction must be recorded, and the person’s care plan and relevant risk assessments must be updated.

5.7 Outbreak Recognition, Reporting and Management – NEW SECTION

The Registered Manager must ensure that staff can recognise circumstances that may indicate an outbreak of infectious illness.

Where an outbreak is suspected, the care home must promptly undertake an outbreak risk assessment and follow current reporting arrangements specified by the UK Health Security Agency and any applicable local arrangements.

For acute respiratory infections, the service must apply the current UK Health Security Agency definition and reporting arrangements. Where two or more epidemiologically linked residents develop symptoms of acute respiratory infection within the period specified in current national guidance, the Registered Manager or delegated competent person must report the suspected outbreak in accordance with current UK Health Security Agency arrangements.

A single confirmed case must also be reported where current UK Health Security Agency guidance requires this, including a confirmed influenza case where applicable under current reporting arrangements.

The service must not delay reporting a suspected outbreak solely because diagnostic testing has not yet been completed.

The care home must follow infection prevention and control measures advised by the UK Health Security Agency Health Protection Team, local infection prevention and control service or other authorised health protection professional and must review those measures as the outbreak develops.

Relevant information about an outbreak and the precautions required must be communicated promptly and appropriately to:

Any transfer or admission during an outbreak must be managed through individual risk assessment and appropriate information-sharing with the receiving or referring service.

5.8 Visiting During an Outbreak – NEW SECTION

Visiting must remain enabled during an outbreak wherever it can be facilitated safely.

An outbreak must not automatically result in a blanket suspension of visiting.

Where an infection outbreak creates additional risk, {{org_field_name}} must undertake proportionate risk assessment and use appropriate infection prevention and control precautions to support visits to continue safely wherever reasonably practicable.

Residents and visitors must be informed of the outbreak and given information about relevant risks and precautions.

Where restrictions on visiting are considered necessary because of exceptional circumstances, the service must:

Residents must not be discouraged from leaving the care home merely because an outbreak is occurring. Where a resident wishes to leave the home, an individual risk assessment must be undertaken and the resident or their representative must be supported to understand the relevant risks and precautions.

In-person visits to residents receiving end-of-life care must continue to be supported.

6. Staff Training and Responsibilities

All staff must receive infection prevention and control training appropriate to their role and responsibilities and must be supported to maintain the knowledge and competence necessary to apply this policy safely.

Training and competency arrangements must include, where relevant:

Staff must follow current national infection prevention and control guidance and any specific instructions provided by the UK Health Security Agency, relevant Health Protection Team, infection prevention and control service or healthcare professional.

The Registered Manager is responsible for ensuring that:

Staff must report infection prevention and control concerns, suspected outbreaks, shortages of necessary equipment or PPE, failures in infection control practice and concerns about disproportionate restrictions to the Registered Manager or person in charge without delay.

7. Confidentiality, Information Sharing and Respect

The dignity, privacy, confidentiality, autonomy and rights of people affected by infectious illness must be respected at all times.

Information about a person’s health, infection status or reason for additional infection prevention and control precautions must only be accessed, used or disclosed where there is a lawful basis and where this is necessary for the person’s care, treatment, protection of others, statutory reporting or another lawful purpose.

Confidentiality must not prevent staff from sharing relevant infection-risk information with healthcare professionals, the UK Health Security Agency, local infection prevention and control services, receiving care services or other relevant organisations where the sharing is lawful and necessary to protect health or provide safe and effective care.

Only the minimum necessary personal information must be shared for the relevant purpose.

When a person is transferred to another health or social care service, relevant information about known or suspected infection risks and necessary precautions must be communicated promptly to the receiving service where required for safe continuity of care.

The reason for asking a person to stay away from others must not be unnecessarily disclosed to other residents or visitors. Where general information about an outbreak is required, information must be communicated without unnecessarily identifying an individual.

Records concerning infection, capacity, restrictions, risk assessments, decisions, reviews and communications must be accurate, complete, contemporaneous and securely maintained in accordance with the service’s record-keeping and data-protection requirements.

8. Policy Review

This policy will be reviewed at least annually and sooner where required because of:

The Registered Manager will ensure that amendments arising from changes in mandatory requirements are incorporated without waiting for the next scheduled annual review.

Audits, outbreak reviews, incidents, complaints, feedback and infection prevention and control monitoring will be used to assess whether this policy is being implemented effectively.

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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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