1. Introduction
Good infection prevention and control (IPC) measures are essential to ensure that adults who use the service receive safe and effective care. It must be embedded into everyday practice, with the same high standards applied by all staff.
In order to ensure such working practices, effective management is vital to ensure those standards are maintained by the service.
This chapter outlines the different areas in which action must be taken to keep adults and staff safe.
2. Service Processes
2.1 Designated lead
The service manager (or the designed responsible person – see Designated Responsible Person) should be the designated lead for IPC.
The IPC lead should report in to the health and safety arrangements in the service. Their role also includes ensuring that this policy and procedures is adhered to by staff, and is monitored accordingly. Any issues with compliance should be addressed through the service’s health and safety arrangements.
2.2 Training and information
All relevant staff should complete IPC training as part of their induction (see Staff Training). Periodic update training should also be provided. Additional training for the service may be required in response to an incident.
2.3 Audit
The service should ensure there is a robust audit process to ensure that all necessary IPC processes are adhered to. This should include a review of care and support practices to ensure that principles and guidance covered in training are being fully implemented.
It will be the responsibility of the IPC lead to ensure that any corrective actions identified as a result of an audit are implemented within the agreed timescales. See Quality Assurance and Learning Lessons.
2.4 IPC Risk assessments
The IPC lead should ensure that risk assessments in relation to IPC risks to adults who use the service are carried out:
- during the first contact with the adult; and
- reviewed at agreed intervals or sooner if changes occur.
The risk assessment should be recorded and retained in the service and should identify any steps required to eliminate, reduce or control risks from infection.
Where required, in conjunction with health practitioners, the IPC lead should monitor the risks of infection to determine whether further steps are needed to reduce or control infection.
3. Cleaning
See also Premises and Equipment.
3.1 Cleaning
The service manager is accountable for ensuring that wherever possible staff work in a safe and clean environment. When working with adults in their own homes levels of tidiness and cleanliness will vary, but staff should always adhere to the same principles of IPC whatever the circumstances in which they are working.
Where there is equipment in the adult’s home for use during the provision of care and support, for example hoists, beds and commodes staff should ensure it is cleaned and disinfected as required.
The IPC lead should ensure there is adequate and suitable hand washing facilities and anti-microbial hand washes where required. This may include issuing staff with pocket sized bottles to use should there not be adequate facilities in the adult’s home.
4. Information
4.1 Information to adults and their visitors
Information on the general principles of infection prevention and control should be available to all adults, their relatives, friends and any other visitors. This should include:
- general principles on the prevention and control of infection;
- supporting adults’ awareness and involvement in relation to IPC;
- the role of adults (where appropriate), carers, relatives and advocates in IPC;
- the importance of hand hygiene measures;
- reporting any concerns about hygiene or cleanliness;
- providing explanations of incidents / outbreaks.
Where care staff have more complex concerns, they should report them to the service manager. They may need to consult a specialist IPC advisor, information about which should be shared with the adult’s and their family as appropriate.
5. Responding to Infections
5.1 Medical intervention
At the first sign of any transmissible illness, the adult’s relatives should be informed. With the adult’s permission (or their carer should the adult not have the mental capacity to consent – see Mental Capacity), their GP should be contacted and a visit requested.
Where the illness is more urgent the ambulance service should be contacted and visit the adult to conduct an assessment. If it is suspected that hospital or Accident and Emergency admission will be necessary, the hospital should first be contacted for advice, as it may be inadvisable to take an adult with an infectious illness to an area where there are other people.
The adult’s GP should arrange any relevant testing required for diagnosis, treatment and management of the illness. Staff should ensure that the adult receives any treatment as prescribed by the doctor.
5.2 Obtaining advice
The service manager should obtain advice from relevant practitioners whenever required.
5.3 Reducing the risk of spreading infection
Staff who are suspected or have contracted an infectious disease should be placed on sick leave and contact / visit their GP or other medical services as necessary.
Specialist health and safety advice may also be required to provide further guidance. Care staff should work with health professionals, the adult and their family in order to provide continuing care and support to the adult, and reduce the risk of further spread of infection.
Care workers should wear any additional Personal Protection Equipment as required.
