Infection Prevention & Control Policy

1. Purpose

This policy sets out how ExcelCare Agency prevents and controls infection in the homes of the people we support and in our office. It reflects the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance, and the NICE guidance on healthcare-associated infections.

The risk in domiciliary care is real: staff move between several homes each day, sometimes supporting people who are unwell or immunosuppressed. Hand hygiene, personal protective equipment and careful sequencing of visits are our principal defences.

2. Responsibilities

• Registered Manager — owns this policy, acts as Infection Control Lead, investigates outbreaks and reports notifiable diseases to UKHSA as required.
• Senior carers — observe practice, audit hand hygiene and PPE use, and act on gaps immediately.
• All staff — apply standard precautions at every visit, report illness and follow exclusion guidance.

3. Standard precautions

Standard precautions apply to every person we support regardless of diagnosis:

• hand hygiene before and after every episode of care, and after contact with surfaces
• assessment of infection risk at each visit
• appropriate personal protective equipment for the task
• safe handling and disposal of sharps and clinical waste
• cleaning of equipment and shared surfaces between people
• safe management of linen and laundry
• safe handling of body fluids and spillages

4. Hand hygiene

Hands are washed with liquid soap and warm running water, or cleaned with alcohol-based hand rub where hands are visibly clean. The correct technique is applied for at least 20 seconds. Hands are cleaned:

1. on arrival and before leaving a person's home
2. before and after preparing food, medicines or a drink
3. before and after applying or removing PPE
4. after using the toilet or helping someone to use it
5. after contact with body fluids, laundry or waste
6. after touching pets, bins or shared equipment

Staff with skin conditions that make hand washing difficult are referred to the Registered Manager for advice and, where needed, occupational health support.

5. Personal protective equipment

PPE is provided free of charge to all staff, including bank and agency workers.

• Gloves — for contact with body fluids, non-intact skin, invasive procedures, medicines and waste. Gloves are not a substitute for hand hygiene and are never worn from one person to another.
• Aprons — for tasks where clothing may be contaminated.
• Fluid-resistant masks and eye protection — where splashing or aerosol generation is possible, in line with the care plan.
• Aprons and gloves are put on immediately before a task and removed afterwards by the correct doffing sequence, then disposed of as clinical waste.

Where a person's care plan requires respiratory protection, staff are fit-tested and trained.

6. Cleaning and equipment

• Shared equipment such as blood pressure monitors, hoists and commodes is cleaned and decontaminated between people.
• Staff never carry linen or reusable equipment between two homes without decontamination.
• Cleaning agents are used at the correct dilution according to the manufacturer's instructions, following COSHH principles and with appropriate gloves.
• Single-use items are never reused.

7. Spillages and sharps

• Body fluid spillages in the home are cleared using the correct spill kit and solution after removing obvious matter with disposable paper rolls.
• Sharps boxes are never overfilled, are closed by the lid mechanism only, and are placed in the person's home or returned to a pharmacy as agreed.
• Needlestick or sharps injuries are attended to immediately, reported as an incident and reported to the Registered Manager, who arranges appropriate clinical follow-up.

8. Waste and laundry

• Clinical waste such as dressings, gloves and incontinence pads is handled as per the local authority's collection arrangements for the person's home.
• Non-clinical waste is placed in household waste and is never left in communal areas without permission.
• Soiled linen is handled with gloved hands and never shaken or placed on the floor. Where the family has agreed to it, staff may launder in a dedicated load at 60°C or above.

9. Incontinence and catheter care

Pads and disposable continence products are changed promptly, skin is cleaned in a front-to-back motion and dried thoroughly. Staff supporting catheters follow the district nurse's documented plan, maintain a closed system and report any change in urine, temperature or pain immediately.

10. Staff health and exclusion

Staff must not work if they have vomiting or diarrhoea; they must be clear of symptoms for at least 48 hours before returning to work. Staff must report certain infections, including norovirus, influenza, chickenpox, shingles, measles and mumps, before attending work. The Registered Manager provides specific return-to-work advice in each case.

11. Outbreaks and notifiable diseases

1. On suspicion of an outbreak (for example, two or more linked cases of vomiting or diarrhoea), the Registered Manager is informed immediately.
2. The person's GP and community infection team are contacted, and care plans are reviewed.
3. The Registered Manager notifies UKHSA of any notifiable disease, and CQC where the outbreak affects the safe delivery of care.
4. Staff movement between affected and unaffected homes is restricted where necessary, and dedicated staff are allocated where possible.
5. The outbreak is reviewed at closure, with learning shared across the team.

12. Audit and training

• Hand hygiene audits at observation and PPE spot checks are completed quarterly by senior staff.
• All staff complete infection prevention and control training at induction and annually.
• The office maintains a hand washing facility and a cleaning schedule with signed records.
• Audit results are reported to the Board quarterly.