With the NRC Show coming up in a few weeks’ time and infection control being one of the key discussion items in the clinical stream, we thought it was the perfect time to share our tips for infection prevention and control in care homes.

Our Clinical Operations Manager (and former Care Home Manager) Claire Bailey shares her advice below.

Infection Prevention and Control

Infections have the capacity to spread rapidly within environments where many people are living and eating in close quarters. Infection prevention, and prompt control of outbreaks where they do occur, are critical to demonstrating quality care in care homes.

“An outbreak can be defined as two or more cases of infection occurring around the same time, in residents and/or their carers or an increase in the number of cases normally observed. The commonest outbreaks are due to viral respiratory infections and gastroenteritis”. 

Department of Health, 2013.

The spread of infection within care homes is particularly dangerous due to the vulnerability of elderly people in care homes. Care home residents are often frail and may have numerous health conditions that complicate recovery from infection.

Care homes must maintain rigorous standards of infection prevention and control to provide residents with a clean and safe environment. These standards should include risk assessments as well as processes for managing and communicating infection outbreaks.

Based on the information gleaned from risk assessments carers ought to be able to make an informed decision on the necessary precautions to take, and implement these with the rest of staff.

Common Precautionary Measures During an Outbreak

  • Reinforcing hygiene and cleaning measures, including extra measures such as deep cleaning as well as a regime for cleaning all common touch points frequently
  • Isolation of residents with infection
  • Review of care provided to residents with infection
  • Heightened observation of residents to identify suspected new cases of infection
  • Postponing of visitors, outside trips, new admissions and readmission’s from hospital

Documentation and Communication to Staff

  • Resident notes
  • Central record (a Dashboard) – all information on the outbreak including resident details, onset date, symptoms and action taken
  • Advice available for staff via messages and bulletin board

It is good practice to have staff involved in ongoing training and professional development on the latest best practice infection prevention and control. 

“Adherence to good practice in relation to infection prevention and control has been shown to reduce the risk of infection to residents and care workers. Staff training is important and will improve compliance with policies, which should be regularly audited, updated and clearly marked with a review date”.

Department of Health, 2013.

Instances That Increase Risk of Infection

Use of invasive devices increases the risk of infection. Policies should be in place at the care home for the proper care and storage of such devices.
This should be documented in the associated residents care plan and all carers made aware of the signs and symptoms that could indicate a resulting infection in the resident.

Invasive devices common to care homes include:

  • Catheters
  • Tracheostomy’s
  • Intravenous tubes for enteral feeding
  • Sharps for glucose monitoring
  • Sub cutaneous lines for fluids and/or medication

Aspects of Managing Infection

  • General cleaning of environment, including deep cleaning schedules where infection is present
  • Using an aseptic technique with clinical procedures
  • The rigorous use of Personal Protective Equipment such as gloves and aprons
  • Colour coding to prevent cross contamination in cleaning procedures
  • Cleaning of reusable equipment
  • Food safety measures
  • Clean linen
  • Pest control
  • Waste management and disposal

Infection Control and the CQC

Infection control falls under Section 8 of the CQC Fundamental Standards, as well as the Health and Social Care Act 2008 (the section commonly referred to as the Hygiene code).

NHS, 2013.

Compliance with this code involves the reporting of infection outbreaks by care homes to Public Health England. It also involves the appointment of an authority within the care home to set and monitor all standards for prevention and control.

Chain of Infection

More Nursing Notes by Claire Bailey.