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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Isolating People During Infections Policy

1. Purpose

The purpose of this policy is to ensure that the isolation of individuals during infections at {{org_field_name}} is undertaken in a manner that is clinically appropriate, legally compliant, proportionate, person-centred, and respectful of human rights. This policy outlines how our care home manages infection-related isolation efficiently, preventing the spread of infectious agents while safeguarding the dignity, mental wellbeing, and freedoms of the individuals affected. It is fully aligned with the Regulation and Inspection of Social Care (Wales) Act 2016, The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, and relevant guidance from Public Health Wales and Care Inspectorate Wales (CIW).

2. Scope

This policy applies to all staff employed at {{org_field_name}}, including management, care, housekeeping, catering, and maintenance staff. It is relevant to all individuals using our service who may require isolation due to a confirmed or suspected infectious illness. It also informs visiting professionals and CIW inspectors of our approach.

3. Related Policies

This policy should be read in conjunction with the following:

• CHW07 – Person-Centred Care Policy
• CHW08 – Dignity and Respect Policy
• CHW11 – Safe Care and Treatment Policy
• CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
• CHW16 – Health and Safety at Work Policy
• CHW17 – Infection Prevention and Control Policy
• CHW18 – Risk Management and Assessment Policy
• CHW24 – Management of Accidents, Incidents, and Near Misses Policy
• CHW38 – End of Life and Palliative Care Policy

4. Policy Statement and Procedures

4.1 Principles of Isolation

The decision to isolate an individual will always be based on clinical need and undertaken to prevent the transmission of infection. The approach at {{org_field_name}} is guided by:

• Clinical risk assessment.
• The least restrictive option principle.
• Respect for the person’s rights, choices, and mental wellbeing.
• Transparent communication and involvement of the individual (and their family where appropriate).

The decision to isolate is never used as punishment, coercion, or for staff convenience. It is a time-limited, reviewed measure intended to support the individual’s health and protect others.

4.2 When Isolation is Required

Isolation or other transmission-based precautions will only be implemented where they are necessary and proportionate having regard to the individual circumstances, the infection or suspected infection concerned, the route and risk of transmission, the individual’s clinical presentation and current national infection prevention and control guidance.

Isolation may be required where an individual:

• has a confirmed or suspected transmissible infection for which current infection prevention and control guidance recommends isolation or separation from others;
• has symptoms consistent with an infectious illness and isolation is required while clinical assessment, testing or public-health advice is obtained; or
• has been identified through a clinical or public-health risk assessment as requiring isolation or other transmission-based precautions following exposure to an infectious disease.

Exposure to an infectious disease or outbreak will not, by itself, automatically result in isolation. Asymptomatic contacts will only be isolated where this is indicated by current national guidance, an outbreak-control arrangement or advice from the relevant health protection or clinical professional.

The Registered Manager or their deputy will obtain prompt advice, where required, from the relevant Health Protection Team, the individual’s GP or other appropriate healthcare professional. Any advice received will be recorded and incorporated into the individual’s risk assessment and personal plan as appropriate.

The decision to isolate, continue isolation or apply alternative transmission-based precautions will be based on an individual risk assessment and will be kept under review. Appropriate signage may be used where required for infection prevention and control purposes, but it must preserve the individual’s privacy, dignity and confidentiality.

4.3 Planning and Implementing Isolation

Before isolation is commenced, or as soon as practicable where immediate action is required to manage an urgent infection risk, the Registered Manager or their deputy will ensure that the need for isolation has been assessed and documented.

The following arrangements will apply:

• The reason for isolation, the infection risk being managed, the proposed restrictions, the anticipated duration and the criteria for ending isolation will be recorded.
• The individual will be given information about the proposed isolation in a manner and format they can understand and will be supported to participate fully in the decision.
• Where the individual has capacity to make the relevant decision, their consent will be sought and recorded. A person who has capacity must not be treated as lacking capacity merely because they make a decision that staff consider unwise.
• Where there is reason to doubt the individual’s capacity to make the specific decision about the proposed arrangements, a decision-specific mental capacity assessment will be undertaken and recorded in accordance with the Mental Capacity Act 2005.
• Where the individual lacks capacity to make the relevant decision, any decision made on their behalf must be made in accordance with the Mental Capacity Act 2005, including its best-interests and least-restrictive principles, and appropriate consultation must take place with any person who has lawful authority to represent the individual and with others who should be consulted under the Act.
• A best-interests decision will not be treated as authority, by itself, for arrangements which amount to a deprivation of liberty. Where the proposed isolation arrangements amount, or may amount, to a deprivation of liberty, the Registered Manager must ensure that the necessary lawful authority is sought and obtained in accordance with the Mental Capacity Act 2005, the Deprivation of Liberty Safeguards and Regulation 31 of The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as applicable.
• Where isolation restricts the individual’s liberty of movement and constitutes control or restraint, the requirements of Regulation 29 and the service’s control, restraint and restrictive practice policy must be followed. The restriction must be necessary to prevent a risk of harm and must be a proportionate response to that risk.
• If an individual who has capacity refuses or withdraws consent to isolation, staff must not prevent the person from leaving their room solely on the basis of this policy. The Registered Manager or senior person in charge must immediately review the risks, seek appropriate clinical or Health Protection Team advice and consider the least restrictive lawful measures available.
• The individual’s personal plan and relevant risk assessments will be reviewed and updated to describe the isolation arrangements, how their care and support needs will be met, the measures necessary to minimise infection transmission and the steps being taken to reduce the impact of isolation upon their well-being.
• Appropriate PPE, cleaning, decontamination, waste-management, laundry and equipment arrangements will be implemented in accordance with current infection prevention and control guidance.
• Isolation arrangements will be reviewed regularly and whenever the individual’s condition, infection risk, capacity, wishes or relevant professional guidance changes.

4.4 Infection Control Measures During Isolation

While isolated, individuals are cared for using strict infection prevention and control procedures, including:

• Dedicated staff where possible or staff cohorting to minimise movement between zones.
• Use of appropriate PPE (gloves, aprons, face masks, goggles) in line with the organism involved.
• Enhanced cleaning using virucidal/disinfectant solutions, especially high-touch surfaces.
• Dedicated clinical equipment, with appropriate decontamination.

Staff follow guidance from CHW17 – Infection Prevention and Control Policy and are trained in donning and doffing PPE.

4.5 Dignity, Wellbeing and Mental Health During Isolation

While physical isolation may be required, social and emotional isolation is actively prevented. Staff are trained to provide emotional support and maintain the dignity and psychological wellbeing of individuals during isolation. This includes:

• Regular compassionate interaction and reassurance.
• Access to communication aids (e.g. phone, video calls) to remain in contact with loved ones.
• In-room activities and entertainment.
• Consistent monitoring of mood, sleep, nutrition, and hydration.
• Immediate escalation to the GP or mental health professionals if there are signs of distress, anxiety, depression, or cognitive deterioration.

Isolation plans include a record of how these needs are being met. For individuals with dementia or cognitive impairment, tailored reassurance techniques and visual prompts are used.

4.6 Supporting Staff

Staff are fully supported to implement isolation procedures safely and confidently. This includes:

• Ongoing training in infection prevention and control.
• Clear written guidance and access to senior leadership.
• Mental health and debriefing support, particularly in prolonged outbreaks.
• Access to necessary PPE and prompt replacement when needed.

The {{org_field_infection_control_lead_name}}, acting as the {{org_field_infection_control_lead_role}}, ensures daily oversight of infection control and safe implementation of isolation protocols.

4.7 Ending Isolation

Isolation is lifted only when the risk of transmission has passed, guided by the current public health advice (e.g. 48 hours symptom-free for gastrointestinal infections). The individual and their family are informed, and the isolation record is concluded with an outcome review.

A post-isolation review is carried out by the senior care team to assess the effectiveness of the isolation, any lessons learned, and updates needed to infection control or care planning protocols.

4.8 Safeguarding, Restrictive Practice and Rights Protection

{{org_field_name}} will ensure that infection prevention and control measures are implemented in a manner which protects individuals from abuse, neglect, improper treatment and unlawful restriction of their liberty.

Isolation must never be used as punishment, coercion, a means of managing staffing difficulties or for the convenience of staff. Restrictions must be necessary, proportionate to the identified risk and no more restrictive than is required to manage that risk safely.

Where isolation involves preventing or restricting an individual from leaving their room or another area, staff must consider whether the arrangements constitute control or restraint for the purposes of Regulation 29 of The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017. Where Regulation 29 applies:

• the restriction must be necessary to prevent a risk of harm to the individual or another person;
• the restriction must be a proportionate response to that risk;
• any control or restraint must be undertaken only by staff who have the required training for the method used; and
• the required record of any incident involving control or restraint must be completed within 24 hours.

Where an individual has capacity to decide whether to comply with isolation arrangements, their decision must be respected unless another lawful authority permits the restriction concerned. Staff must not use a Mental Capacity Act best-interests decision to override the decision of an individual who has capacity.

Where an individual lacks capacity to make the relevant decision, staff will act in accordance with the Mental Capacity Act 2005, including its statutory principles, best-interests requirements and the requirement to adopt the least restrictive option.

Where the overall isolation arrangements amount, or may amount, to a deprivation of liberty, the individual must not be deprived of their liberty without lawful authority. The Registered Manager must ensure that the appropriate Deprivation of Liberty Safeguards process or other lawful route is followed, as applicable, and that the relevant assessments, applications, authorisations, conditions and reviews are recorded and acted upon.

Any request made to a supervisory body in relation to the application of the Deprivation of Liberty Safeguards will be notified to Care Inspectorate Wales in accordance with the applicable notification requirements.

Any concern that isolation or another infection-control restriction is unnecessary, disproportionate, harmful, unlawfully applied or being used improperly must be reported immediately to the Registered Manager and to the {{org_field_safeguarding_lead_name}} ({{org_field_safeguarding_lead_role}}). Where the concern meets the threshold for a safeguarding referral, it must be reported to {{org_field_local_authority_authority_name}} in accordance with the Wales Safeguarding Procedures and CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy.

Staff must at all times have regard to the individual’s rights, dignity, privacy, protected characteristics, communication needs and personal outcomes in accordance with applicable human rights, equality, mental capacity and social care legislation.

4.9 Communication, Outbreak Reporting and Statutory Notifications

The individual will be kept informed about the reason for isolation, the arrangements being made, any changes to those arrangements and the criteria for ending isolation. Information must be provided in a language, style, presentation and format appropriate to the individual’s communication needs and level of understanding.

Information may be shared with family members, representatives and other persons involved in the individual’s care where the individual has consented to this or where there is another lawful basis or lawful authority for the disclosure.

Relevant information will be communicated, where appropriate, to:

• the individual’s GP and other healthcare professionals involved in their care;
• the relevant Health Protection Team and Public Health Wales where advice, outbreak management or reporting is required;
• the service commissioner or placing authority, where applicable;
• the relevant local authority where required; and
• other statutory or professional bodies where notification or involvement is required by law.

An outbreak of any infectious disease at the service is a notifiable event under Regulation 60 and Schedule 3 of The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017. The service provider will therefore notify Care Inspectorate Wales of an infectious-disease outbreak without delay, normally within 24 hours of the event occurring, using CIW Online and in accordance with current CIW notification requirements.

The Registered Manager will ensure that the Responsible Individual is informed promptly of an outbreak and of any significant effect the outbreak has, or may have, on the safe operation of the service.

Where the service provides a care home service to children, the Registered Manager will also ensure that all additional statutory notifications required by Regulation 60 and Schedule 3 are made to the relevant placing authority, local authority, health board or other body, as applicable.

Where an outbreak or infection-related event prevents, or could prevent, {{org_field_name}} from continuing to provide the service safely, the service provider will also submit the appropriate notification to Care Inspectorate Wales in relation to that event.

All notifications, advice received, communications, decisions and actions taken in response to an outbreak will be accurately recorded and retained in accordance with the service’s record-keeping arrangements.

5. Monitoring, Audit and Continuous Improvement

The Registered Manager, {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}, is responsible for ensuring this policy is applied consistently and effectively. Routine infection control audits include reviews of isolation practice. Any themes, errors, or improvement areas are discussed in team meetings and reflected in our Quality of Care Review cycle.

Audits may include:

• Compliance with PPE use.
• Dignity and person-centred documentation.
• Staff knowledge assessments.
• Feedback from individuals and their families.

6. Policy Review

This policy will be reviewed at least annually or earlier in response to an outbreak, audit findings, CIW inspection, legislative change, or updated public health guidance. All staff are notified of revisions through supervision, team meetings, and internal communication channels.

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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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