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DC159-Cleaning, Disinfection, and Sterilisation Procedures Policy

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Cleaning, Disinfection, and Sterilisation Procedures Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} prevents, identifies, assesses, manages, and monitors risks relating to infection prevention and control in the delivery of domiciliary care services in England. The policy is designed to protect service users, staff, families, visitors, and others from avoidable harm and to support compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including Regulation 12 (Safe care and treatment), Regulation 15 (Premises and equipment), Regulation 17 (Good governance), Regulation 18 (Staffing), and Regulation 19 (Fit and proper persons employed).

This policy reflects the Department of Health and Social Care’s Health and Social Care Act 2008: code of practice on the prevention and control of infections, current Care Quality Commission expectations, and relevant national guidance issued by organisations such as UKHSA, NICE and the NHS, as applicable to adult social care in England. It applies specifically to the challenges of providing care in people’s own homes, where staff do not control the full environment and must use a dynamic, risk-based approach.

This policy provides the framework for safe cleaning, decontamination, equipment hygiene, waste handling, laundry precautions, staff training, incident reporting, escalation, and governance arrangements so that infection risks are reduced so far as is reasonably practicable.

2. Scope

This policy applies to all employees, bank staff, agency workers, managers, volunteers, and contractors engaged by {{org_field_name}} in connection with domiciliary care services. It applies whenever staff are delivering care or support in a service user’s own home, handling equipment used for care delivery, transporting equipment between visits, recording or escalating infection-related concerns, or undertaking cleaning and decontamination duties linked to the regulated activity.

This policy covers:

This policy does not override the rights of service users in relation to their own home. Staff must work respectfully, proportionately, and in partnership with service users, while taking all reasonably practicable steps to reduce infection risks and escalating concerns where a home environment or practice presents a serious risk to health, safety, or welfare.

3. Legal and Regulatory Framework

This policy is informed by, and should be read alongside, the following legislation and regulatory guidance, as amended from time to time:

4. Definitions and Key Concepts

Cleaning – the physical removal of dust, dirt, organic matter, and contamination from surfaces or equipment, usually using detergent and water. Cleaning is an essential first step before disinfection where disinfection is required.

Disinfection – the use of a chemical or thermal process to reduce microorganisms to a level that is not harmful. Disinfection must only be carried out where indicated by risk assessment, national guidance, manufacturer instructions, or the nature of the task or contamination.

Decontamination – the overall process of making an item or environment safer to handle and use. This may include cleaning alone, or cleaning followed by disinfection, depending on the item, contamination, and intended use.

Sterilisation – a validated process that removes or destroys all viable microorganisms. Sterilisation is not part of routine domiciliary personal care activity unless the service is carrying out a clinical task, regulated activity, or equipment reprocessing arrangement that specifically requires it.

Single-use item – an item intended to be used once only and then safely discarded in accordance with local procedure and manufacturer guidance.

High-touch surface – a surface or item frequently touched during care delivery, for example door handles, light switches, call devices, walking aids, or equipment used during personal care.

Domestic environment – a service user’s own home, where infection prevention and control measures must be adapted proportionately to the layout, facilities, wishes, and risks present in that household.

5. General Cleaning Protocols

{{org_field_name}} recognises that, in domiciliary care, staff usually provide care in service users’ own homes and do not have full control over the environment. Cleaning responsibilities must therefore be clearly identified and based on risk assessment, the care tasks undertaken, the equipment used, the condition of the home environment, and whether there is any known or suspected infection.

Staff must:

Where the service user, family, or another party is responsible for the general household environment, staff must still assess whether it is safe to deliver care and whether additional precautions are required. Staff must work respectfully with the service user to reduce risks where possible and must escalate to their line manager where environmental conditions present an ongoing or significant infection risk.

Routine household cleaning of fixtures, furnishings, curtains, ventilation systems, and general domestic rooms is not the responsibility of {{org_field_name}} unless this has been specifically agreed as part of the commissioned care package or support plan. Any such responsibility must be clearly documented in the care plan and risk assessment.

6. Disinfection and Disinfection of Equipment and Surfaces

Disinfection must not be used routinely where thorough cleaning is sufficient. The level of decontamination required must be determined by risk assessment, the nature of the task, the level of contamination, the type of equipment or surface, relevant national guidance, and the manufacturer’s instructions for use.

{{org_field_name}} will ensure that:

In people’s homes, staff must focus on the items, equipment, and surfaces relevant to the care being delivered. Examples may include mobility aids, commodes, blood pressure monitors, thermometers, care caddies, and any reusable item handled during personal care. Cleaning or disinfection frequency must be based on use, contamination, and infection risk, rather than fixed blanket time intervals.

Spillages of blood or body fluids must be dealt with promptly, using appropriate PPE, approved cleaning products, and the service procedure for spill management. All waste arising from the cleanup must be disposed of safely and staff must perform hand hygiene immediately afterwards.

7. Protocols Reusable Equipment, Single-Use Items, and Sterilisation

For domiciliary care services providing personal care only, {{org_field_name}} will not routinely sterilise reusable medical devices. Equipment hygiene will normally be managed through cleaning and, where indicated, disinfection or other decontamination arrangements appropriate to the item and the task. Where a device is designated single-use, it must never be reused.

Reusable equipment supplied by the service must be:

Single-use items, including gloves, aprons, dressings, lancets, syringes, and any device labelled for single use only, must be used once and discarded safely after use in accordance with the service waste disposal procedure and manufacturer guidance.

Where {{org_field_name}} delivers a task under another regulated activity, or uses equipment for which validated sterilisation is specifically required, the service must have a separate written procedure covering device tracking, validation, transport, storage, staff competency, and compliance with manufacturer instructions and any specialist decontamination requirements.

8. Waste, Laundry, and Body Fluid Management in People’s Homes

Waste arising from care must be segregated and disposed of according to the nature of the waste, the care task undertaken, contractual arrangements, and local procedure. Staff must not assume that all waste generated in a service user’s home is clinical waste; however, any waste that is infectious, contaminated with blood or body fluids, or otherwise falls within the service’s hazardous or clinical waste arrangements must be handled and disposed of in line with the service procedure and waste contractor requirements.

Soiled laundry must be handled with minimum agitation, appropriate PPE where indicated, and good hand hygiene. Laundry should be washed according to the item manufacturer’s instructions and the level of contamination. Where items are contaminated or infection risk is increased, staff must follow the service procedure for enhanced precautions and advise the service user or household accordingly. Staff uniforms or work clothing contaminated during care must be changed promptly and laundered in accordance with the uniform and laundry procedure.

Spillages of blood and body fluids must be managed immediately using the approved spill response procedure, with appropriate PPE, safe containment, cleaning, disposal of waste, and hand hygiene.

9. Staff Responsibilities, Health, Training and Competency

All staff are responsible for following this policy, completing infection prevention and control training, maintaining good personal hygiene, carrying out effective hand hygiene, using PPE appropriately, reporting concerns promptly, and working in accordance with risk assessments, care plans, service procedures, and current national guidance.

Care workers must:

Managers and supervisors must:

Staff must inform the service promptly if they have symptoms of infectious illness, a diagnosis that may affect fitness to work, or an occupational exposure incident. The service will assess fitness to work, the need for restriction from duties, medical advice, post-exposure action, and any reporting requirement. The service will also assess and communicate staff vaccination requirements appropriate to the role.

Training must be completed at induction, refreshed at least annually or sooner where guidance changes or incidents indicate the need, and supported by competency checks relevant to the staff member’s role and the tasks they undertake in people’s homes.

10. Monitoring, Auditing, and Compliance

{{org_field_name}} will maintain effective governance systems to assess, monitor, and improve infection prevention and control arrangements. These systems will include, as appropriate:

Findings from audit, incidents, complaints, and feedback from service users, relatives, staff, and professionals will be used to improve practice. Where required, action plans will be put in place, monitored by managers, and escalated through the provider’s governance arrangements.

Records required by this policy must be accurate, contemporaneous, securely retained, and made available for internal review, commissioning review, and regulatory inspection where appropriate.

11. Domiciliary Care Specific Infection Risk Assessment and Escalation

Before and during care delivery in a service user’s home, staff must consider environmental and household factors that may affect infection prevention and control, including cleanliness, availability of handwashing facilities, presence of pets, waste arrangements, laundry arrangements, household illness, ventilation, availability of PPE, the condition and storage of equipment, and whether the service user or others in the home have symptoms of infectious disease.

Where an infection risk is identified, staff must apply proportionate control measures, which may include enhanced PPE, additional cleaning or decontamination, safe separation of clean and used equipment, changes to visit sequencing, advice to the service user, and prompt escalation to the line manager or on-call manager.

Where risks cannot be adequately controlled, the service must review whether care can continue safely, what alternative arrangements are required, whether external advice is needed, and whether any safeguarding, clinical, commissioner, or public health escalation is necessary. All decisions and actions must be recorded.

12. Policy Review and Updates

This policy will be reviewed at least annually and sooner if there is a change in legislation, CQC requirements, national guidance, service delivery model, regulated activities, learning from incidents, audit findings, outbreaks, or identified best practice. Updated versions will be communicated to staff and supported by additional training or competency assessment where needed.

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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