Isolation of People with Infectious Illnesses in Care Homes (Wales) Policy

Policy Statement

This policy shows how the home deals with situations that require a person to be treated in isolation to prevent the spread of infectious illness. The policy is in line with The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, particularly Regulations 56: Hygiene and Infection Control, 57 Health and Safety and Regulation 25: Respect and Sensitivity.

Despite all preventive measures, it is sometimes not possible to totally eliminate the risks of people developing a transmissible infection. When this does occur, it might be necessary to reduce the contact between anyone affected and others in order to prevent its spread and to reduce the risks to non-infected people.

People receiving care will be asked to reduce or minimise their contact with others only if the home has received medical advice that it is in their and others’ interests because of the nature of the infection to which they are exposed. This advice will come from communications with people’s GPs and local health protection units, and where there is evidence that a person has a transmissible and communicable infectious illness that needs to be contained.

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 receiving care and to protect them, wherever practicable, from dangerous substances in the workplace, including the risk of transmission of infections.

Guidance

{{org_field_name}} is guided by the Scottish electronic National Infection Control Manual (NICM). All healthcare organisations in Wales are encouraged to access the manual and apply its standards.

Scope of Policy

The home’s isolation policy applies to instances where one or more people receiving care have contracted a transmissible infection that requires a reduction of contact with other people to contain the spread and reduce the risks to others. It is assumed that the person, on medical advice or other grounds, will not be moved to hospital but that a conscious decision has been taken to continue to care for the person or persons within {{org_field_name}} for the duration of the illness.

The policy needs to be read in relation to other infection control policies, particularly Diarrhoea and Vomiting Outbreak Management, which addresses the more common forms of infectious illness to which people receiving care and staff are susceptible.

Definition

By “isolation” is meant a request to a person to stay and be looked after in their room with minimal or no contact with other people receiving care, visitors, staff or anyone whose health would be seriously jeopardised, if they contracted the illness. The home will wherever practical and where there is no increased risk, control the spread of infection effectively without moving the person receiving care from their room, which also preserves dignity and reduces the risk of his or her suffering the further emotional distress that an enforced move to a dedicated isolation facility would bring.

Practice and Procedures

The home might seek to change a person’s accommodation only where it is unable to provide all the facilities needed to look after the person for the duration of his or her isolation.
Many people using services accept the need to be in isolation because they are ill, and do not seek contact with others, effectively volunteering to be in isolation. However, the home considers that it is important to seek the written consent of any person who needs to or who has been recommended to remain in isolation until free from infection.
Where people are unable to give their consent because of lack of mental capacity, the home carries out a “best interests” assessment in line with its responsibilities under the Mental Capacity Act 2005. In some cases, the home might also need to seek a deprivation of liberty authorisation, eg if an infectious person fails to understand the reasons for needing to remain in isolation and risks spreading the infection by his or her movements outside the room.
The home will thus make sure that any restraints imposed on the person’s freedom of movement are fully authorised and proportionate to the need and will last only as long as is necessary to control the spread of infection.
The home guarantees that it will treat every person being cared for in isolation in the context of its infection control measures with dignity and respect, and will comprehensively meet their needs under those circumstances, eg by providing stimulation and activities in line with the person’s wishes and inclinations. It makes sure that once a decision has been made to keep the person or people in isolation and their consent has been obtained, it produces a specific care plan for each person affected and uses that plan to make sure that their assessed needs are fully met.
The home will continue to seek advice and guidance from relevant medical experts to make sure that the period of isolation lasts no longer than necessary to help the person get better and to contain the spread of the infection.
The home uses the individual care plan, which is developed in consultation with all involved, to determine the restrictions to be imposed on the individual. These are based on the assessed risks to the person and of cross-infection to others from any contacts.
Everyone, staff and visitors, who has contact with any person in isolation is informed of the risks and how to reduce the risks by following all infection control procedures applicable to those circumstances.
The home emphasises the importance of everyone following good infection control procedures in these particular circumstances, ie hand hygiene, the wearing of protective equipment, safe disposal of waste, etc. These measures are outlined in the home’s raft of infection control policies.

Staff Care

The home makes sure that staff in contact with people in isolation are aware of the risks and the need for safe practices.
The home will always seek expert advice on the issues to be addressed by a particular infection.
The home screens all care staff who are likely to be in contact with people receiving care in these circumstances for any risks to them and checks on their immunisation status (in line with its general policy on this matter). It might exclude staff who are assessed as being vulnerable to the infection or its effects, or who risk spreading it, from having contact with a person who is in isolation.

Training

All new and existing staff are trained to implement this policy when required.

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}}

WCH164. Isolation of People with Infectious Illnesses in Care Homes