Infection Prevention & Control Policy

1. Introduction

Clear accountability, procedures, lines of communication and clear delegation of authority are essential for the management of infection hazards.

It is recognised that effective healthcare associated infection prevention requires commitment and active involvement of all staff. This includes both employed staff and self-employed clinicians contracted by HiCare to deliver care. This policy covers the management arrangements for Infection Prevention and Control at HiCare.

This policy applies to all clinicians delivering care in service user's homes, temporary accommodation, or other non-clinical environments.

2. Policy Statement / Purpose

HiCare is committed to reducing and controlling the risk of infections and has produced this Infection Prevention and Control Policy to comply with the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections.

HiCare will also comply with all the mandatory requirements as well as Best Practice Infection Prevention and Control Guidelines for the safe delivery of care in the work environment.

The purpose of this policy is to:

• Ensure that systems are in place to manage and monitor the prevention and control of infection
• Assess infection control risks to service users
• Assess the susceptibility of service users and clinicians/staff
• Ensure prompt identification of service users and others who have, or are at risk of developing, an infection
• Work closely with other healthcare professionals as appropriate

This policy underpins HiCare's compliance with Regulation 12 (Safe Care and Treatment) and the Health and Social Care Act 2008.

3. Scope

This policy applies to all staff and clinicians within the organisation who are involved in direct service user care.

### Workforce Structure

HiCare engages two categories of personnel:

1. **Employed Staff** - administrative, operational and management personnel

2. **Self-Employed Clinicians** - independent practitioners (doctors, nurses, carers) contracted to deliver clinical and personal care services

The Infection Prevention and Control Lead for HiCare is **Dr Lizaveta Collins**.

4. Standard Infection Control Precautions (SICPs)

Standard Infection Control Precautions are the foundation of infection prevention and control. These are fundamental practices that all staff and clinicians must follow to minimise the risk of transmission of infectious agents:

I. Patient Placement/Assessment for Risk

II. Hand Hygiene

III. Respiratory and Cough Hygiene

IV. Personal Protective Equipment

V. Safe Management of Medical Equipment

VI. Safe Management of the Environment

VII. Management of Linen and Laundry

VIII. Management of Bodily Fluid and Blood Spills

IX. Waste Management including Sharps Management

X. Occupational Safety: Prevention of Exposure

5. Infection Control in the Home Environment

HiCare recognises that delivering care within a service user's home presents unique infection prevention and control (IPC) challenges compared to a clinical setting. Each home is a different environment, and staff must adapt their infection control measures to ensure safe, hygienic, and compliant care at all times.

### Dynamic Risk Assessment

Before entering a service user's home, all clinicians must carry out a dynamic risk assessment to identify any potential infection risks. This includes considering:

• The cleanliness and condition of the environment
• The availability of handwashing facilities and safe waste disposal
• The presence of pets, pests, or other environmental hazards
• Any known or suspected infectious illness in the household

If the environment poses an immediate health risk, staff must not proceed with care and must report immediately to the Registered Manager or Infection Prevention and Control Lead.

6. Infection Susceptibility

HiCare recognises that the overall health and personal circumstances of some service users may make them more susceptible to infections than others.

Older adults may be more susceptible due to:

• Chronic illnesses such as diabetes or arthritis
• Natural weakening of the immune system with age
• Multiple comorbidities
• Frailty and reduced Body Mass Index (BMI)

People with weakened immune systems due to underlying medical conditions (cancer, diabetes, HIV/AIDS) or treatments (steroids, chemotherapy) are more likely to get an infection.

HiCare will ensure that individual risk assessments are carried out for all service users and reviewed regularly.

7. Personal Hygiene

Working closely with service users and colleagues demands attention to personal hygiene:

• Adequate oral/dental hygiene
• Control of offensive body odours
• Regular bathing

8. Hand Hygiene

Most healthcare-associated infections are preventable through good hand hygiene. All clinicians must wash their hands:

• Before starting work
• Before eating, preparing or handling food
• Before and after administering treatment or interventions
• Before and after physical contact with service users
• After any activity that contaminates the hands
• After using the toilet
• After sneezing/blowing the nose
• After cleaning activities
• Before going home
• After handling animals
• After handling clinical waste
• After smoking

### WHO 5 Moments for Hand Hygiene

1. Before touching a patient

2. Before clean/aseptic procedures

3. After body fluid exposure risk

4. After touching a patient

5. After touching patient surroundings

### Hand Care Guidelines

• Cover all cuts/abrasions with an occlusive dressing
• Keep nails short. Do not wear nail varnish or artificial nails
• Jewellery should be kept to a minimum (i.e., wedding ring only)
• Hand cream can be applied to protect skin from drying
• Staff with skin conditions should seek expert advice

### Bare Below the Elbows

Healthcare professionals should adopt a 'Bare Below the Elbows' policy whilst providing or undertaking care procedures:

• Nails should be short and clean with no nail polish or extensions
• Wrist watches should not be worn
• No jewellery around the wrist
• No rings with stones (one plain band is acceptable)

All HiCare clinicians must perform hand hygiene before entering and after leaving each home, and before and after any direct contact with the service user or their surroundings. Where access to running water is unavailable or unsuitable, clinicians must use alcohol-based hand rubs containing at least 60% alcohol.

9. Safe Handling and Disposal of Sharps

Sharps include needles, scalpels, stitch cutters, glass ampoules and sharp instruments. The safe handling and disposal of sharps is essential in reducing the risk of exposure to blood borne viruses.

The management of clinical sharps should include:

• Safe storage locked away once full
• Sharps that are single use only
• Not re-sheathing needles
• Disposing of syringes and needles as a single unit
• Discarding sharps immediately after use directly into a sharps container
• Sharps containers that conform to UN standard 3291 and British Standard 7320
• Never over-filling sharps containers (above manufacturers' fill line)
• Completing the label on the sharps container
• Closing the aperture when carrying or when left unsupervised
• Carrying sharps containers by the handle close to the body

All injuries from sharps must be reported immediately to the Infection Control Lead so that immediate treatment can be provided.

10. Blood-Borne Viruses (BBVs)

The main BBVs of concern are:

• Hepatitis B virus (HBV)
• Hepatitis C virus
• Hepatitis D virus
• Human Immunodeficiency Virus (HIV)

All clinicians at risk of exposure to a BBV should be vaccinated against Hepatitis B. When on assignment, all cuts and abrasions should be covered with a waterproof dressing before providing care.

### Management of Exposure to BBVs

Any suspected contamination should be treated with the utmost urgency. Any clinician who has significant occupational exposure to blood or bodily fluids must notify the Infection Control Lead as soon as practicably possible and immediately make their way to the nearest Emergency Department.

11. Personal Protective Equipment (PPE)

HiCare clinicians must carry appropriate PPE (gloves, aprons, masks, and eye protection) in sealed, clean packaging for each home visit.

PPE must be:

• Donned immediately before providing care
• Removed and disposed of safely within the home following completion of care
• Never reused or carried between homes

The application of appropriate PPE must be determined by assessing the risk to and from individuals, including the task, level of interaction and/or the anticipated level of exposure to blood and/or other body fluids.

### Gloves

Gloves must conform to current standards (ISO 11193-1:2020) and be:

• Worn when exposure to blood and/or other body fluids is anticipated
• Appropriate for use, fit for purpose and well-fitting
• Changed if a perforation or puncture is suspected
• Changed immediately after each service user

Gloves should not be worn as an alternative to hand washing. Hands should be washed before and after glove use.

### Aprons

Aprons must be:

• Worn to protect uniform or clothes when contamination is anticipated
• Changed between transports and/or after completing a procedure or task

12. Cleaning Blood and Body Fluid Spills

All spillages of blood, faeces, saliva, vomit, nasal and eye discharges should be cleaned up immediately, wearing PPE. Clean spillages using a product that combines a detergent and disinfectant, effective against both bacteria and viruses. A spillage kit should be available for bodily fluids.

13. Cleaning Equipment

Reusable medical or care equipment taken into the home (e.g. blood pressure monitors, thermometers, stethoscopes) must be decontaminated:

• Before and after each visit using approved disinfectant wipes or solutions
• Stored separately in clean containers away from contaminated equipment and waste
• Regularly audited for cleanliness and maintenance

14. Single Use Medical Devices

Single use medical devices must be used on one service user only. It is expressly forbidden to use single use devices on multiple service users. Single use medical devices must be disposed of safely according to manufacturer's guidelines.

15. Safe Handling and Disposal of Waste

Good clinical waste management is essential to reduce the risk to clinicians, service users and visitors and to protect the environment.

Staff must ensure all clinical waste generated in the home (e.g. PPE, dressings, swabs) is:

• Placed in an orange clinical waste bag
• Sealed and returned to base for disposal via HiCare's licensed waste contractor, unless local arrangements with the household are in place

Sharps must be disposed of immediately after use into a portable, UN-approved sharps container carried by the clinician. Sharps bins must:

• Be clearly labelled with the user's name and date
• Be closed securely before transport
• Never be left in the home unless part of agreed care plan

16. Vehicle and Equipment Decontamination

As HiCare clinicians travel between multiple service users' homes, vehicles and portable equipment represent potential sources of cross-contamination.

### Vehicle Hygiene

• Vehicles must be kept clean, tidy, and free from clinical waste at all times
• Clinicians are responsible for cleaning the interior of their vehicle daily
• Clinical items, PPE, and disinfectants must be stored separately from personal belongings
• Clean and dirty equipment must be transported separately
• Each vehicle must carry hand sanitiser, disinfectant wipes, disposable gloves and aprons, spill kit, and clinical waste containers

### Equipment Decontamination

• Reusable equipment must be cleaned and disinfected before and after each home visit
• Equipment must be inspected for cleanliness and integrity
• Contaminated equipment must be transported in sealed containers labelled as "used"
• Single-use items must never be reused

17. Mandatory Training

All clinicians will be required to undergo infection prevention and control accredited training as part of their mandatory training. All clinicians will be required to evidence or undertake infection control level 2.

The Infection Control Lead will undertake a dedicated accredited Infection Control Lead course.

Completion of mandatory infection prevention and control training is a requirement under Regulation 18 (Staffing) of the Health and Social Care Act 2008.

18. Infectious Diseases

If a service user or household member is suspected or confirmed to have an infectious disease (e.g. COVID-19, norovirus, influenza), staff must:

• Follow current UKHSA guidance for home visiting
• Use appropriate PPE and hand hygiene
• Minimise contact and time spent in the environment
• Report to the Infection Control Lead immediately

19. Notifiable Infectious Diseases & RIDDOR

Some infectious diseases may spread easily in a community or may cause serious diseases. The requirement to notify is contained within the Public Health (Control of Disease) Act 1984, updated 2010.

It is the responsibility of Registered Medical Practitioners (RMPs) to notify any suspected or confirmed instance of notifiable disease to the local authority and/or local UKHSA Unit.

20. Responsibilities

### All HiCare Clinicians

All staff and clinicians must:

• Attend mandatory IPC training and follow HiCare's IPC policies
• Carry sufficient PPE, hand hygiene products, and decontamination supplies
• Ensure vehicle and equipment are clean and free from contamination
• Report any IPC concerns or breaches immediately

### Registered Manager (Oxana Gorbatenko)

The Registered Manager in conjunction with The Infection Control Lead will oversee the implementation of Infection Prevention and Control Policies and be responsible for the company's IPC programme implementation, management and structure.

### Infection Prevention and Control Lead (Dr Lizaveta Collins)

The IPC Lead is responsible for supporting staff and clinicians with their compliance with this policy and ensuring that the contents remain current and in line with best practice.

21. Monitoring

Compliance with this policy will be monitored by the Infection Control Lead, through the examination of adverse incident reports and regular auditing. Lessons learned will be discussed at individual supervisions, Management meetings and at staff meetings.

Findings from audits and incident reviews are used to inform continuous improvement, demonstrating compliance with Regulation 17 (Good Governance).

22. Key Legal Principles / Legislation

• Control of Substances Hazardous to Health Regulations 2002
• Health and Safety at Work Act 1974
• Management of Health and Safety at Work Regulations 1999
• Public Health (Control of Disease) Act 1984 (as amended)
• The Health and Safety (Sharp Instruments in Healthcare Regulations) 2013
• The Health and Social Care Act 2008
• Code of Practice: Prevention and Control of infections

23. Related Policies

• Health and Safety Policy
• Incident Management Policy
• Governance Policy

24. Contact Information

**Infection Prevention and Control Lead:** Dr Lizaveta Collins

**Registered Manager:** Oxana Gorbatenko

**Email:** hello@hicare.uk.com