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Blood-borne Viruses in Care Homes (Wales) Policy

Policy Statement

Effective infection prevention and control policies and procedures in place are of paramount importance in ensuring the safety of both people who use the services and staff from infectious organisms such as blood-borne viruses.

This policy shows how {{org_field_name}} prevents the spread of blood-borne viruses among people who use the services, staff and visitors and deals with infections if they occur.

It is written to ensure that:

1. people who use the services, their families and staff working at the home are as safe as possible from blood-borne viruses
2. all staff at the home are aware of the causes of the spread of blood-borne viruses and are trained to avoid these
3. people who are infected with blood-borne viruses receive the highest quality of care
4. staff who are infected with blood-borne viruses are not discriminated against and receive adequate adjustments and support.

The policy is in line with the requirements of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, particularly Regulations 56: Hygiene and Infection Control and 57 Health and Safety and associated statutory guidance.

Background

The home understands its legal and moral duty to protect staff and people who use the services from the risk of the transmission of blood-borne viruses wherever possible.

Blood-borne viruses are micro-organisms that cause disease and can be spread via infected blood and other bodily fluids. The most common blood-borne viruses which present a hazard to staff and people who use the services are the Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.

HIV is the virus which can cause Acquired Immune Deficiency Syndrome (AIDS). It is transmitted through infection with bodily fluids, such as through unprotected vaginal or anal sex, through sharing injecting drug equipment, or from mother to baby.

Hepatitis is an inflammation of the liver which can be caused by infection with either the Hepatitis B or Hepatitis C viruses. Hepatitis B and C are easily transmitted through contaminated blood. Importantly, there is an effective vaccination against Hepatitis B but none against Hepatitis C, and current treatments for it are not effective in all cases.

Staff who come into contact with bodily fluids are potentially at risk from blood-borne viruses, particularly if their work also involves sharp or abrasive implements or substances that can break the skin, such as needles.

People undergoing aseptic techniques are also at risk if inadequate controls are in place to ensure that all equipment used is sterile and all procedures are effectively carried out with proper attention to infection control principles.

Legal Considerations

This care service will adhere to all relevant legislation, including:

• the Health and Safety at Work, etc Act 1974
• the Health Protection (Notification) (Wales) Regulations 2010
• 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 services and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

Guidance

{{org_field_name}}’s policy is guided by Infection Prevention and Control: A Quick Reference Guide for Care Homes in Wales, published by Public Health Wales in 2018, and the Infection Prevention and Control in Social Care (Social Care Transition Plan), published by the Welsh Government in March 2022.

For further guidance, the organisation understands that Public Health Wales have collaborated with NHS Scotland to host and utilise the Scottish electronic National Infection Control Manual (NICM). All healthcare organisations in Wales are encouraged to access the manual and apply its standards.

The NICM in Wales is supported by National Model Policies for Infection Prevention and Control. These were published by Public Health Wales in August 2014 as part of the Welsh Healthcare Associated Infection Programme (WHAIP).

The guidance states that a care home manager, or a suitably delegated person, is responsible for ensuring that appropriate infection prevention guidelines are readily available, understood by all members of their staff and are part of their everyday practice in a care home.

Policy on Preventing Blood-borne Viruses

{{org_field_name}} understands that in nursing or residential adult social care settings the implementation of sound infection control techniques, especially rigorous attention to handwashing, and a thorough cleaning of the environment and equipment are the most effective ways to control the spread of infection. Therefore, in {{org_field_name}} the following applies.

1. The infection control lead for the home will carry out a risk assessment of the risks of blood-borne infection and will keep this assessment under regular review. The findings of each review will be recorded and control measures indicated by the assessment will be fully implemented and communicated to all staff.
2. All staff who perform duties that might expose them to risk will be given adequate information about the risks and how to minimise them and ensure their own safety. The information will include the immediate steps to be followed upon contamination with blood or other body fluids.
3. All staff must comply with all infection control policies and procedures and adhere to best practice in infection control at all times.
4. All staff should comply with the home’s handwashing policy at all times. Scrupulous handwashing before and after any contact with individuals and before and after any procedure is considered by the home to be the single most important infection control measure to prevent the spread of infection.
5. Disposable gloves and aprons should always be worn when attending to dressings, performing aseptic techniques, dealing with blood and body fluids or assisting with bodily care. All gloves and aprons should be changed and disposed of after each procedure or contact and always between contacts with different people.
6. Cuts, sores and wounds on staff and people who use the services should be covered with suitable impermeable dressings.
7. Blood and body fluid spills should be dealt with immediately according to the home’s Cleaning of Spillages Policy.
8. Clinical waste containing blood or bodily fluids should be disposed of according to the home’s infection control policy.
9. Sharps waste should be managed in compliance with the home’s Disposal of Sharps Policy and disposed of into proper sharps containers. Where possible the use of sharps will be minimised and safer alternatives implemented.
10. All aseptic procedures will be conducted by appropriately trained, qualified and competent staff using sterile equipment according to the Aseptic Techniques Policy. Wherever possible disposable single-use equipment should be used. Any reusable medium- or high-risk equipment used in clinical procedures should be sterilised according to the infection control policy. Low-risk equipment should be cleaned thoroughly with detergent and hot water after use.
11. Clothes and bedding fouled with blood or body fluids should be machine-washed separately from standard laundry at a high temperature, in accordance with the home’s infection control and laundry policies.
12. If a person’s wound does not respond to treatment then their GP should be advised.
13. Blood-borne virus risks should be included in COSHH assessments and any appropriate control measures taken to reduce identified risks.
14. The home should always inform the receiving hospital if a person from the home who is due to go into hospital is knowingly infected with a blood-borne virus.
15. People with blood-borne viruses or diseases should be cared for appropriately in the home by:
    a. having all details of their condition entered in their individual plan of care; this should include, where appropriate, input from multi-agency teams and other healthcare professionals involved in their care as well as any specialist input
    b. being subject to regular review
    c. the hospital responsible for the discharge of the individual providing the home with all the necessary details of the infection and any treatment in advance of discharge in a formal discharge plan that the home is agreeable to.
16. Where necessary, the home should seek and follow expert infection control advice from its local health protection team and/or from the Health Protection (All Wales Acute Response) Team.
17. Any incidents involving exposure to blood and other body fluids, or near misses where exposure was narrowly averted, will be recorded using an incident form and reported. The infection control lead will investigate reports and complete an annual audit of incidents.
18. Where necessary, reports will be made to the Care Inspectorate Wales (CIW) and to the HSE under RIDDOR.
19. Relevant nursing and care staff should be immunised against Hepatitis B. The need for a worker to be immunised should be determined by risk assessment and based upon advice from the home’s occupational health service provider. Such immunisation should only be seen as a supplement to reinforce other control measures and where assessed as necessary the home will arrange for immunisation free of charge to employees.
20. Staff who are infected with a blood-borne virus, such as HIV or hepatitis, will be treated in accordance with the home’s AIDS/HIV Policy. This is designed to ensure that such staff are not discriminated against or treated less favourably than other staff and to ensure that “reasonable adjustments” are made to ensure that they can carry out their duties safely and effectively. The policy is also designed to ensure that such staff have access to sufficient occupational health support.
21. Any incident where a member of staff has been or is suspected to have been exposed to possible infection from blood or other bodily fluids should be reported immediately to the person in charge who should refer the person to a GP, occupational health or Accident and Emergency Department as necessary based upon an assessment of urgency or severity. All incidents should be followed up by the occupational health service.

Contact details for local health protection teams and for the Health Protection (All Wales Acute Response) Team are as follows:

_________________________________

_________________________________

_________________________________

_________________________________

_________________________________

_________________________________

Personnel

________________________________ is the infection control lead for the home

Training

All new staff are required to read the policies on infection control as part of their induction process in line with the Social Care Induction Framework for Wales: Outcome 3 Maintain Safety at Work.

In-house training sessions covering basic information about infection control are conducted at least annually and all relevant staff attend.

Clinical staff and those with special responsibilities for infection control and risk assessment are also be offered additional advanced training in infection control.

_________________________________ is responsible for organising and co-ordinating training.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

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