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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Cleaning, Disinfection, and Sterilisation Procedures Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} maintains satisfactory standards of hygiene and infection prevention and control when providing domiciliary support services in individuals’ own homes. Appropriate cleaning, disinfection and decontamination practices are essential to minimise the risk of infection to individuals receiving care and support, staff and other persons who may be affected by the service.

{{org_field_name}} will ensure that care and support is delivered in a manner which promotes hygienic practice, minimises the risk and spread of infection and provides for the appropriate management and disposal of general, clinical and hazardous waste.

This policy ensures that:

• appropriate infection prevention and control precautions are applied according to the care or support activity being undertaken and the identified risk;
• cleaning and decontamination of equipment used by staff is undertaken safely and in accordance with current national guidance and the equipment manufacturer’s instructions;
• cleaning and disinfectant products are selected, used, stored and disposed of safely and in accordance with the Control of Substances Hazardous to Health Regulations 2002, as amended;
• staff have access to appropriate personal protective equipment and understand when and how it must be used;
• clinical and general waste generated during the provision of care is identified, segregated, handled and disposed of appropriately;
• staff receive infection prevention and control training relevant to their duties and are competent to undertake the activities expected of them; and
• infection prevention and control arrangements are monitored and reviewed and any identified shortfalls are acted upon.

This policy must be read and implemented in accordance with:

• the Regulation and Inspection of Social Care (Wales) Act 2016;
• the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, including Regulation 12 concerning policies and procedures, Regulation 56 concerning hygiene and infection control and Regulation 57 concerning health and safety;
• the Health and Safety at Work etc. Act 1974;
• the Control of Substances Hazardous to Health Regulations 2002, as amended;
• applicable waste-management legislation and statutory requirements in Wales;
• current Welsh Government and Care Inspectorate Wales statutory guidance applicable to domiciliary support services;
• current Public Health Wales infection prevention and control guidance and, where applicable to the activity being undertaken, current national infection prevention and control guidance adopted for use in Wales;
• the Food Safety Act 1990 and applicable food-hygiene requirements where staff provide support involving food preparation or handling; and
• manufacturers’ instructions for the safe use, cleaning, disinfection and decontamination of equipment and products.

Where any guidance referred to within this policy is updated, staff must follow the current version and this policy must be reviewed without unnecessary delay where the change affects the way the service is provided.

2. Scope

This policy applies to:

• all employees and workers of {{org_field_name}}, including care workers, supervisors and managers;
• agency workers, contractors and other persons carrying out relevant activities on behalf of {{org_field_name}}, where applicable;
• all individuals receiving regulated domiciliary support services from {{org_field_name}};
• care equipment and medical devices used by staff as part of the regulated service;
• cleaning, disinfection and decontamination activities which staff are required to undertake as part of an individual’s agreed care and support; and
• waste generated as a direct consequence of care and support activities undertaken by {{org_field_name}}.

This policy covers:

• cleaning undertaken as part of the agreed domiciliary care and support service;
• hand hygiene and the use of personal protective equipment in connection with cleaning and decontamination activities;
• cleaning and disinfection of reusable care equipment;
• appropriate decontamination of reusable medical devices and equipment;
• management of blood and body-fluid contamination;
• segregation, handling and disposal of general, clinical, hazardous and sharps waste;
• safe selection, use, storage and disposal of cleaning and disinfectant products;
• staff training and competency; and
• monitoring, incident management and statutory notification requirements relating to infection outbreaks.

Staff must recognise that an individual’s home is their private home. {{org_field_name}} does not impose institutional or care-home cleaning regimes on individuals receiving domiciliary support. Cleaning or environmental support undertaken by staff must be consistent with the individual’s assessed needs, personal plan, agreed service, wishes and consent, except where immediate action is necessary to manage a significant health and safety or infection risk.

Where specialist sterilisation of a medical device is required, it must only be undertaken through an appropriate validated process by a competent person or service. Domiciliary care staff must not improvise sterilisation processes within an individual’s home.

3. Policy Statement

{{org_field_name}} is committed to ensuring that all service users receive care in a clean, safe, and hygienic environment. Our procedures aim to:

• Prevent healthcare-associated infections (HCAIs) through rigorous hygiene standards.
• Ensure consistency in cleaning and disinfection across all care settings.
• Minimise cross-contamination risks through correct handling of cleaning materials.
• Educate staff on best practices, ensuring compliance with infection control regulations.

4. Managing Cleaning, Disinfection, and Sterilisation Efficiently

4.1. General Cleaning Protocols

Cleaning undertaken by staff within an individual’s home must be proportionate to the care or support being provided and to the infection risk identified.

Staff must:

• undertake only those routine cleaning activities which form part of the individual’s agreed care and support, except where an immediate cleaning response is necessary to manage contamination arising during the delivery of care;
• respect the individual’s home, belongings, preferences, dignity and independence when undertaking cleaning activities;
• perform hand hygiene at the appropriate points before and after cleaning or care activities;
• use appropriate personal protective equipment where indicated by the task and risk assessment;
• clean visibly soiled surfaces and equipment promptly;
• clean reusable care equipment after use and between individuals where equipment is used for more than one person, in accordance with the equipment manufacturer’s instructions and applicable infection prevention and control guidance;
• use cleaning equipment and products which are suitable for the intended purpose;
• avoid using the same contaminated cleaning materials for different areas or tasks where this could cause cross-contamination;
• follow the manufacturer’s instructions concerning the concentration, application, contact time, rinsing, drying and safe use of cleaning products; and
• report to the manager any hygiene or environmental concern which presents a significant risk to the individual’s or staff member’s health and safety and which cannot be safely resolved during the visit.

There is no requirement under this policy for staff to clean every individual’s floors, carpets, soft furnishings, windows, bathrooms or other household areas on a daily basis unless such activity forms part of the individual’s assessed and agreed care and support.

A separate institutional cleaning checklist must not be imposed routinely on an individual’s private home. Where cleaning activities form part of the individual’s personal plan, completion of the agreed task must be recorded through the normal care-recording arrangements.

4.2. Disinfection Procedures for High-Risk Areas

Disinfection must be used where it is required by the nature of the contamination, the care activity, an identified infection risk, current infection prevention and control guidance or the manufacturer’s instructions for the equipment or surface concerned.

Cleaning must normally precede disinfection where visible dirt, organic material, blood or body fluids are present, unless the product being used is specifically designed and authorised for a combined cleaning and disinfection process.

Staff must:

• select a product which is suitable for the surface, equipment, organism or contamination concerned;
• use the product only for its intended purpose;
• follow the manufacturer’s instructions, including any required dilution, concentration, application method and contact time;
• observe all applicable COSHH control measures;
• wear the personal protective equipment identified for the product and task;
• ensure that products used on food-contact surfaces are used and, where required, rinsed in accordance with the manufacturer’s instructions;
• never mix cleaning or disinfectant chemicals;
• ensure adequate ventilation where this is required for the safe use of the product;
• keep products secure and prevent inappropriate access by children or vulnerable individuals where this presents a risk; and
• report any exposure, spillage, adverse reaction or other incident in accordance with {{org_field_name}}’s health and safety procedures.

Disinfectant products are not selected on the basis of being “CIW approved”. Care Inspectorate Wales does not approve individual disinfectant products. {{org_field_name}} must ensure that products are legally supplied for their intended use, suitable and effective for the purpose for which they are selected, and used in accordance with the manufacturer’s instructions and applicable health and safety requirements.

Routine disinfection of every surface in an individual’s home is not required unless indicated by the circumstances, risk assessment, care activity or relevant current infection prevention and control guidance.

4.3 Decontamination of Reusable Care Equipment and Medical Devices

Reusable care equipment and medical devices must be managed in a manner which minimises the risk of cross-infection and ensures that they remain safe for use.

Staff must comply with the following requirements:

• equipment and devices identified by the manufacturer as single-use must not be reused;
• reusable equipment must be cleaned and, where required, disinfected or otherwise decontaminated in accordance with the manufacturer’s instructions and the level of infection risk associated with its use;
• reusable equipment must be decontaminated following contamination with blood or body fluids and between different individuals where the equipment is intended for multi-person use;
• staff must not use a cleaning agent, disinfectant or decontamination method which is incompatible with the device or contrary to the manufacturer’s instructions;
• equipment must be visually checked following cleaning or decontamination and must not be used if it remains contaminated, is damaged or cannot be adequately decontaminated;
• personal items intended solely for one individual’s use must not be shared with another individual unless they are specifically designed for shared use and can be appropriately decontaminated;
• equipment which cannot be safely or effectively decontaminated must be removed from use and reported to the manager;
• where a reusable medical device requires specialist reprocessing or sterilisation, the manufacturer’s validated process must be followed and the activity must only be undertaken by an appropriately competent and authorised person or specialist service; and
• domiciliary care staff must not attempt improvised heat sterilisation, autoclaving, chemical sterilisation or another specialist sterilisation process within an individual’s home unless {{org_field_name}} has specifically authorised the procedure, provided validated equipment and arrangements, and verified that staff carrying it out are trained and competent.

Items that penetrate sterile tissue or otherwise require sterility must be single-use sterile items or must have been processed through an appropriate validated sterilisation system before use. Staff must not attempt to make an item sterile by wiping, soaking or applying a household disinfectant.

Where responsibility for decontamination rests with another healthcare provider, equipment supplier or other organisation, staff must follow the agreed arrangements and must not undertake decontamination outside their training, competence or authority.

4.4 Handling and Disposal of Waste

Waste generated during care and support must be handled, segregated, stored and disposed of safely and in accordance with its classification, the associated infection or injury risk, applicable waste-management requirements and local collection arrangements.

Staff must:

• distinguish between ordinary household waste, recyclable waste, clinical waste, hazardous or infectious waste, medicinal waste and sharps waste as appropriate to the activity being undertaken;
• not assume that every used glove, apron, dressing or other item used during personal care automatically requires disposal as infectious clinical waste;
• place waste into the correct waste stream and container according to its classification and applicable local arrangements;
• use the appropriate clinical-waste stream where waste is assessed as infectious or otherwise requires clinical-waste disposal;
• never place loose needles, lancets or other sharps into household or general clinical-waste bags;
• dispose of sharps immediately after use into an appropriate compliant sharps container intended for the type of sharps waste being generated;
• never overfill a sharps container and must close or lock it at the manufacturer’s marked fill line;
• handle waste in a way which minimises contact with the body, prevents leakage and contamination and reduces the risk of needlestick or other injury;
• use appropriate personal protective equipment when handling potentially contaminated waste;
• perform hand hygiene after handling waste and after removing gloves;
• follow agreed arrangements for the storage and collection of clinical or hazardous waste generated through the service;
• ensure that waste for which {{org_field_name}} has responsibility is transferred only through lawful and authorised waste-management arrangements; and
• report any waste spillage, sharps injury, inappropriate disposal or other waste-management incident without delay.

Clinical waste must not automatically be placed in a yellow waste bag. The correct container, bag colour and waste stream must be determined by the classification and contents of the waste and the applicable waste-management arrangements.

Blood or body-fluid spillages arising during care must be managed promptly using appropriate personal protective equipment and the cleaning and disinfection method required for the nature of the contamination. Staff must follow the relevant infection prevention and control and COSHH procedures and must never create hazardous chemical mixtures when treating spillages.

Waste generated as ordinary household waste within the individual’s home remains subject to the individual’s/local authority’s household-waste arrangements unless the nature or origin of the waste requires a different legally compliant disposal route.

Where {{org_field_name}} produces or controls waste at its own workplace premises, the organisation must comply with applicable Welsh workplace waste-separation and recycling requirements in force at the time.

4.5 Safe Use of Cleaning Chemicals

{{org_field_name}} must assess and control risks arising from hazardous cleaning products, disinfectants and other substances used by staff in accordance with the Control of Substances Hazardous to Health Regulations 2002, as amended.

Before staff are required to use a hazardous cleaning or disinfectant product, {{org_field_name}} must ensure that a suitable assessment has identified:

• the hazards associated with the substance;
• who may be exposed and how exposure may occur;
• the circumstances and frequency of its use;
• appropriate measures to prevent exposure or adequately control the risk;
• any personal protective equipment required;
• safe storage and handling requirements;
• action to be taken in the event of accidental exposure, spillage or another emergency; and
• appropriate disposal arrangements.

Staff must:

• follow the applicable COSHH assessment, product label, safety information and manufacturer’s instructions;
• use only the quantity and concentration necessary for the task;
• dilute concentrated products only in accordance with the manufacturer’s instructions;
• never mix cleaning or disinfectant products;
• use the personal protective equipment identified for the product and activity;
• ensure adequate ventilation where required;
• keep products in their original or correctly identified container unless a safe documented system requires otherwise;
• never transfer a hazardous product into a food, drink or other misleading container;
• ensure products are stored securely and in a manner which prevents inappropriate access or accidental exposure;
• report damaged containers, missing labels, accidental exposure, adverse reactions and spillages; and
• perform hand hygiene after removing protective gloves.

Where staff are expected to use a cleaning product belonging to an individual receiving care, they must not use the product where the instructions are unavailable, the container is unlabelled, the product is being stored unsafely, its use would expose the individual or worker to an unacceptable risk, or the product is unsuitable for the intended task. The concern must be reported and an appropriate alternative arrangement agreed.

An up-to-date record of cleaning and disinfectant products supplied by {{org_field_name}}, together with the applicable safety information and COSHH assessments, must be maintained and accessible to staff who need the information.

4.6 Staff Training and Competency in Infection Control

All staff must receive infection prevention and control training appropriate to their role and to the care and support activities they undertake.

Training must include, where relevant to the staff member’s duties:

• principles of infection prevention and control and standard infection-control precautions;
• hand hygiene;
• appropriate selection, putting on, removal and disposal of personal protective equipment;
• cleaning, disinfection and decontamination of care equipment;
• prevention of cross-contamination;
• safe management of blood and body-fluid spillages;
• safe handling and disposal of general, clinical and sharps waste;
• management of needlestick and contamination incidents;
• safe use of cleaning and disinfectant products and relevant COSHH controls;
• actions to take where infection is suspected or confirmed; and
• responsibilities for reporting infection-control concerns, incidents and outbreaks.

Staff must not undertake a specialist cleaning, decontamination or sterilisation activity for which they have not received the necessary instruction, training and competency assessment.

Training must be provided during induction where relevant to the staff member’s role and refreshed at appropriate intervals, including when:

• legislation, national guidance or organisational procedures change;
• new equipment, products or procedures are introduced;
• an audit, incident or supervision identifies a knowledge or competency gap; or
• the manager otherwise identifies a need for refresher training.

Where {{org_field_name}} retains an annual infection prevention and control refresher requirement, the annual refresher must be completed in addition to any earlier training required because of a change, incident or identified competency concern.

{{org_field_name}} must maintain records of infection prevention and control training, competency assessments and any identified refresher or development requirements.

Managers must take appropriate action where a staff member does not demonstrate the knowledge, skill or competence required to undertake infection prevention and control activities safely.

4.7 Monitoring and Auditing Compliance

{{org_field_name}} must have effective arrangements for monitoring compliance with this policy and identifying and addressing infection prevention and control risks.

Monitoring must be proportionate to the nature of the domiciliary support service and may include:

• review of infection prevention and control incidents, accidents and near misses;
• review of staff practice during observations, spot checks or competency assessments;
• review of hand-hygiene and personal protective equipment practice;
• checks that equipment supplied or used by the service is being appropriately cleaned and decontaminated;
• review of clinical-waste and sharps-management arrangements;
• checks that COSHH assessments and product information remain current;
• review of infection prevention and control training and competency records;
• review of complaints, concerns and feedback relating to hygiene or infection control; and
• analysis of infection outbreaks or recurring infection-control concerns.

Monitoring of the service must not involve treating an individual’s private home as though it were a care-home environment or imposing a general institutional cleaning audit where cleaning is not part of the service being provided.

Where a cleaning or hygiene-related task forms part of the individual’s personal plan, managers must be able to establish whether that agreed care or support has been provided appropriately.

Any shortfall which may affect the safety or well-being of an individual must be acted upon according to the level of risk. Immediate action must be taken where necessary to prevent continuing exposure to a significant infection, contamination or health and safety risk.

The findings from monitoring, incidents and audits must be used to identify corrective action, staff learning and service improvement where required.

4.8 Infectious Disease Outbreaks and Statutory Notifications

Where an infectious disease outbreak is suspected or identified in connection with the service, the manager must ensure that immediate and proportionate action is taken to protect individuals receiving care and support and staff.

The service must:

• implement appropriate infection prevention and control precautions;
• obtain appropriate professional infection prevention, health-protection or clinical advice where required;
• ensure that affected individuals receive appropriate support and that their care continues safely;
• communicate relevant information to staff while maintaining confidentiality;
• review staffing and continuity arrangements where staff absence or infection affects safe service delivery;
• maintain an appropriate record of the outbreak and the action taken;
• review whether personal plans, risk assessments or staff instructions require temporary or permanent amendment;
• cooperate with Public Health Wales, the relevant health protection service, local authority or other statutory body where their involvement is required; and
• implement and record any corrective or preventive actions identified following the outbreak.

An outbreak of infectious disease occurring in the service must be notified to Care Inspectorate Wales in accordance with Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

The notification to Care Inspectorate Wales must:

• be made without delay unless a different statutory timescale applies;
• be made in writing;
• contain the details required by the Regulations and Care Inspectorate Wales; and
• be submitted in the manner and form required by Care Inspectorate Wales.

The manager must also consider whether the incident gives rise to any additional notification, reporting or referral requirement under health and safety, safeguarding, public-health or other applicable legislation.

A record must be retained of the notification, any advice received, actions taken and the outcome of the outbreak.

5. Related Policies

This policy aligns with:

• Infection Prevention and Control Policy (DCW17) – Covering infection prevention strategies.
• Safe Care and Treatment Policy (DCW11) – Ensuring service users receive safe and hygienic care.
• Health and Safety at Work Policy (DCW16) – Covering staff responsibilities for maintaining a safe environment.
• Waste Disposal and Environmental Policy (DCW35) – Addressing correct disposal of waste.
• Staff Supervision, Training, and Development Policy (DCW27) – Covering ongoing competency in infection control.

6. Policy Review

This policy will be reviewed annually or sooner if required due to:

• Changes in CIW regulations or Public Health Wales guidelines.
• New infection risks or disease outbreaks.
• Feedback from staff or service users.

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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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.