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Infection Control in Care Homes

Jan 29 2018, 09:55 AM

Residents in care homes regularly share the same space and equipment - meaning it is very easy for infections, viruses and bacteria to spread. Elderly residents are also vulnerable to contracting infections, which can have serious consequences.

Care home members of staff need to be trained to prevent infections, as well as understanding how to detect and manage the outbreak of one. All care homes should have an outbreak plan already in place, to minimise the number of people it could affect.

Section 8 of the Care Quality Commission (CQC) monitor care homes, holding them to account based the Health and Social Care Act 2008: Code of practice on the prevention and control of infection and related guidance. This is usually referred to as the hygiene code. Care homes have a responsibility to report any outbreak of infection to Public Health England (PHE).

Many infections spread quickly in care homes due to shared accommodation and because the residents there have an increased chance of catching infection. This is mainly due to:

Infection control has become increasingly important in care homes due to the number of organisms that are now resistant to treatment, such as Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, E.coli o157 and the possible spread of blood-borne viruses.

Managing infection control in care homes however isn’t just about the best practice - maintaining high standards of hygiene and preventing cross contamination to protect elderly residents is also the law. Regulation 15 of the Health and Social Care Act states that it is a legal requirement for all care homes to be clean and suitable for the purpose and properly maintained.

As well as following this, care homes must also maintain an overall high standard of good hygiene in order to manage infection control. Preventing infection and the spread of infection comes down to hygiene practices and a commitment to people putting those practices into action. 

Infection control checklist
There are nine core elements that at all times should be taken into account, in all care homes. These are based on the assumption that each individual in a care home could be carrying some harmful microorganism, meaning there is a possibility for transmission.

These elements include:
Hand hygiene
The majority of us are aware of that hand hygiene is the number one way to stop the spread of infection. In a care setting this is one of the most important hygiene procedures to have in place. But are we all demonstrating the best practice when it comes to one of the most basic hygiene habits?

You should be washing your hands on average for 40-60 seconds, removing all rings watches and bracelets as part of the process, for a thorough clean.

Using a teaspoon worth of soap, rub this into the palm for your hands and work it between your fingers before washing it off with a scrub brush and water.

For more details on the correct way to wash your hands we have an in depth guide available, click here to read more.

The World Health Organisation advises that care staff should be washing their hands in these ten specific circumstances:
Hand sanitiser can be useful in some situations but it is not recommended for routine use within care homes. It must never be used when hands are visibly dirty as this can deactivate the alcohol.

Personal protective clothing
Wearing protective clothing is an essential part of infection control and health and safety, as it offers protection for both residents and carers. It is to be worn as well as your usual work clothing, whether that be your own clothes or a set uniform.

It's inevitable that clothes will become contaminated with microorganisms throughout the day, however, wearing protective clothing when needed can help towards reducing the likelihood of infection.

Personal protective clothing includes:
Gloves are a must have, when working in a care home. They must be worn when there is a possibility that your hands will come into contact with any sort of bodily fluid or blood etc.

Gloves should never be washed or reused because liquids could, in fact, penetrate through the gloves or they could also become damaged, so you should be using a fresh pair every time. Vinyl gloves are suitable for personal care only.

Bear in mind that between attending to each patient, gloves need to be changed to prevent cross-contamination and also when gloves are worn for a specific task they must be removed before touching uncontaminated areas; for example writing up notes on a resident.

When removing gloves you should take them off wrist end first, pulling them down gently over the hand which turns the glove inside out. Dispose of the gloves correctly and immediately into a pedal operated disposal bin and then wash hands.

Take a look at our guide on how to remove disposable gloves for more information.

Cleaning protocols
As microorganisms are always present in a care home environment it is the responsibility of the staff to ensure that everything in the care home environment clean e.g. furniture, wheelchairs, bathrooms, medical devices, kitchens and so on. This is to properly minimise the risk of infection to residents, staff and visitors.

Cleaning methods include:
Disinfection - this reduces the number of microorganisms.
Sterilisation - this process renders an object free from all microorganisms.

Cleaning is one of the single most effective ways of reducing the risk of infection within care homes and it begins with disinfection and sterilisation. In order for the cleaning to actually make a difference, there are a number of products required:
Having these to hand at all times, ensures you are able to minimise cross infection and provide a safe environment for residents to enjoy.

Linen and laundry management

Clean linen is a significant requirement for every care home and the incorrect handling of contaminated linen can pose a risk of infection. There should be a designated laundry area used for laundry only. The design of this particular section must allow space for both clean and dirty clothing, for example when the dirty linen is brought in it needs to be moved to one area without coming into contact with the clean linen.

All laundry bins need to be fully washable and well maintained at all times. Plastic aprons and disposable gloves should be worn when handling dirty linen. Each care home should also introduce their own colour coding system for the safe handling of soiled linen and should also have instructions on how to wash different items of clothing available to refer to on the walls.

Linen that has been soiled, contaminated with blood or used by someone who has an infection, must be kept separate from other laundry. It is worth considering dissolvable laundry bags that reduce the risk of cross contamination. They split open to release the soiled clothing into hot water.

Raise concerns quickly
Concerns of infection needs to be raised in care homes as the elderly are very susceptible to infections and with their weaker immune systems it can be a lot harder for them to fight it. Following all these simple steps can make for a clean and infection free care home.

BSI Quality Management

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