Staff Vaccinations and Immunisations in Care Homes (England) Policy

Policy Statement

{{org_field_name}} strives to comply with all aspects of health and safety legislation including taking all the measures required and recommended to prevent and control the risks of the people who use the service from contracting infectious illnesses and diseases from staff. It also recognises its duty of care to its staff to prevent as far as possible their contracting infectious illnesses and diseases as part of their work.

This policy reflects the steps the home has taken to exercise its responsibilities to its staff to protect them as far as possible from catching common or uncommon infections as a result of their working at the home. In doing so, it also recognises that such a policy should operate in the interests of all concerned by reducing the potentially high rates of staff sickness that could occur as a result of failing to take preventive measures to reduce the risks of infection among its staff.

People who use the service in a care home have an expectation that they will not be unnecessarily exposed to individuals who are capable of transmitting conditions that are likely to pose a risk to their health. Equally the responsibility for bringing care home staff into proximity with conditions which might pose a risk to their health lies with {{org_field_name}}. Therefore care home managers must be able to demonstrate that they have taken adequate steps to protect these individuals from suffering avoidable adverse consequences.

This policy applies to all employees with direct contact with individuals who might contract an infectious illness through the course of their work that is preventable through immunisation.

The aims of the policy are to:

protect staff and their families and friends from infections contracted at work
protect people who use the service from contracting infections from staff
protect other employees who are in contact with infected employees
help the home to deliver its services without disruption.

Legal Considerations

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

the Health and Safety at Work, etc Act 1974
the Public Health Infectious Diseases Regulations 1988
the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

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

Regulation

{{org_field_name}} recognises that it must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in order to meet its legal requirement for registration with the Care Quality Commission (CQC).

With respect to infection control, the home understands that a range of regulations may apply, including Regulation 12: Safe Care and Treatment — this requires providers to assess the risk of, and prevent, detect and control the spread of, infections, including those that are healthcare associated.

Guidance for Providers on Meeting the Regulations, published by the CQC in March 2015, provides guidance on how this service should comply with the regulations.

Guidance

{{org_field_name}} seeks at all times to comply with evidence-based best practice in infection control, particularly with the Health and Social Care Act 2008 Code of Practice on the Prevention and Control of Infection and Related Guidance published by the Department of Health and Social Care (the Hygiene Code).

Compliance with this guidance is an effective way to help it to meet its regulatory requirements with the Care Quality Commission under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

In addition, the home will comply with all other relevant best practice infection control guidance.

Applicable guidance from the National Institute for Health and Care Excellence (NICE) includes:

CG139: Healthcare-associated Infections: Prevention and Control in Primary and Community Care (updated February 2017)
PH36: Healthcare-associated Infections: Prevention and Control (November 2011).

Guidance is also available from the Department of Health and Social Care (DHSC), the Health and Safety Executive (HSE) and the Medicines and Healthcare Products Regulatory Authority (MHRA) in the form of:

Infection Prevention and Control (IPC): Resource for Adult Social Care, DHSC
Prevention and Control of Infection in Care Homes: An Information Resource (2013), DHSC
HSG220 Health and Safety in Care Homes (2nd edition) (2014), HSE.

Specialist advice and support will be obtained from the local public health protection team and from relevant primary healthcare teams.

Procedures

The home accepts that it has a responsibility under the Control of Substances Hazardous to Health Regulations 2002 (COSHH) to take all possible steps to protect its employees from any infectious illness or hazardous substances to which they are at risk from contracting during the course of their work.

It exercises its responsibilities by ensuring that risk assessments have been or are carried out wherever there is a possibility of an employee contracting any infectious illness from their work. The home does not consider vaccinations to be a ready substitute for adequate risk assessments and good infection control procedures, as described in its infection control policy. Depending on the outcome of the risk assessment it will then take all necessary steps to protect its staff from contracting the identifiable illness or illnesses.

The first step will be to agree a risk management plan with all concerned and which employees will be expected to implement.

In the case of new people who use the service, the risk assessment and any management plan will be part of the initial assessment and agreed with the person who uses the service and their commissioners or care managers.

Where risks are identified at a later stage, the home will discuss how to control any risk by reviewing the situation with people who use the service, commissioners and care managers.

The home expects to be fully informed of any risks from infectious illnesses that have already been identified from the original needs assessment. It will discuss with the service commissioners or case managers in the contractual process how any continuing risks are to be assessed and managed. It will ensure that the risks continue to be monitored through the care plan and are kept under review.

As a general rule, the home accepts that the risks of transmission of infection to care staff is very low but it considers it prudent to take sensible precautions. The organisation therefore recommends to all of its employees that they are vaccinated against any infections or infectious illnesses that they are at risk from within the general population, including tetanus. It then expects its employees to have the following additional vaccinations.

Covid-19

{{org_field_name}} understands that it remains strongly recommended that all health and adult social care staff are fully vaccinated against Covid-19. This recommendation, which is supported by all professional bodies, is not only vital for their own protection but also for the protection of other staff and vulnerable people. The home will continue to ensure that staff are supported to access the Covid-19 vaccination and advice.

Hepatitis B

In line with Department of Health and Social Care (DHSC) guidelines, the organisation recommends vaccination against hepatitis B for any of its care workers who may have a risk of direct contact with people’s blood or blood-stained body fluids. This includes anyone at risk of injury from blood-contaminated sharp instruments or of being deliberately injured or bitten.

Varicella

The home recommends care workers who are proven through screening or testing not to have had chicken pox or herpes zoster to be given the varicella vaccination.

Influenza

The organisation also follows DHSC guidance in recommending to its employees that they have annual vaccinations against influenza. The guidance states that influenza immunisation for health and social care staff is likely to reduce the transmission of influenza to vulnerable people, some of whom may have impaired immunity and reduced protection from any influenza vaccine they have received themselves.

Employment procedures

On appointment, each new employee completes a pre-employment health questionnaire, which should give information about previous illnesses and immunisation against relevant infections (or refusal to give consent to immunisation). This enables the home to review with the employee any new immunisation needs that can be identified from the home’s general health and safety risk assessments.

To protect people who use the service and other employees, staff are also asked to report episodes of possible infectious illness to the home, particularly if contracted after travel abroad. When necessary, the home might need to exclude employees who have been infected from work until they have recovered or the results of specimens are available.

Where the risk assessment indicates this, the home will support affected employees to have any vaccinations that are recommended and pay for these or reimburse any costs to the employee. Where appropriate and reasonable to do so, the home will then negotiate any costs it incurs with the service purchasers or commissioners.

Consent

The organisation asks that employees give their consent to vaccination voluntarily and freely. All employees who are being considered are informed about the process, benefits and risks of immunisation and their decision is recorded.

It also respects the rights of employees to take their own decisions on whether to be vaccinated and recognises that some employees will not wish to be vaccinated for their own reasons. It will then fully discuss the implications with those individuals and the further risks that will need to be managed.

Vaccination Procedures

Where vaccination is the most effective way to protect against an infectious illness, the home will follow these procedures.

The home will make clear to all employees affected the reasons for supporting and recommending vaccination, including the extent of the risks involved.
The home will outline any measures to be taken to protect employees who agree to vaccination during the period before vaccination and between vaccination and the onset of immunity.
The home will outline any measures to be taken to protect employees who do not give their consent to being vaccinated and who will be exposed to any risks of contracting the illness in consequence.
The home will need to consider the position of any employee who refuses not only to be vaccinated but also to work in the at-risk situation(s), as this might create problems of equity and fairness in relation to other staff members. If the staff member has good reasons for withholding consent, eg they are allergic to the vaccination, all measures will be taken to reduce the risks to that person or they might be transferred to other care situations.
The home will keep a record on the employees’ files of any vaccinations carried out in relation to the work situation including monitoring the need for follow ups, boosters, etc.

Staff Training and Information

The organisation encourages all of its employees to have access to occupational health advice. It seeks information and advice as needed from its local occupational health service and infection control units. The organisation provides employees with up-to-date information it receives on vaccination guidance.

Staff receive information on the policy on appointment and during their induction programme. They receive further training on selective vaccination issues as required and are encouraged to raise specific concerns in supervision.

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}}

CH323. Staff Vaccinations and Immunisations in Care Homes