Policy Statement

AHP Healthcare provides a range of services and support for older people nationwide. In carrying out these services and providing this support, staff and volunteers working for AHP Healthcare may be at risk of contracting or spreading infection. This policy document outlines the step-by-step prevention and control processes which should be followed, to minimise and mitigate infection risks, enabling the organisation’s operations to be carried out safely at all times and in all circumstances.

Introduction

This policy is intended for all employees carrying our work for AHP Healthcare, their supervisors and managers. It includes both paid staff and volunteers.

Responsibilities and Accountability

Ultimate responsibility
The Chief Executive Officer will oversee the implementation of the policy, ensuring enough resources are in place to support the training of staff in infection control practice, the purchase of adequate protective equipment and managers are supported to fulfil their responsibilities.
Managers and Supervisors
Managers and supervisors will ensure that staff:

• Are aware of and have access to this policy
• Have had appropriate training in infection prevention and control
• Have adequate support and resources to implement, monitor and take corrective action to comply with this policy
• They regularly monitor the implementation of the infection control policy, monitoring any near miss incidents identified by employees and volunteers

Employees and Volunteers
All employees and volunteers should follow this policy and must:

• Show their understanding by applying the infection prevention and control principles in this policy
• Maintain competence, skills and knowledge in infection prevention
• Report to managers any concerns about the implementation of this policy or deficit in their knowledge and skills regarding infection control
• Report to managers any ‘near misses’ in terms of infection control, so these can be monitored, and policies and practices amended if necessary.

The policy is not contractual and may be changed subject to the approval by the Directors and consultation with employees.

Procedures and Implementation

All staff are to follow standard infection control precautions when interacting with older people using AHP Healthcare services. The precautions must always be followed, whether there is a known infection risk, or not.
Precautions will include:

• Assessment of infection risk in care plan
• Hand hygiene
• Respiratory and cough hygiene
• Personal Protective Equipment
• Safe Management of equipment and the care setting

Assessment of infection risk in care assessments
All care plans must consider the specific infection risk for each service user. If there are any specific infection risks identified in the care plan, specific precautions must be clearly identified and documented. These must be shared with all members of staff working with the service user and if required training must be undertaken in these specific precautions.
When reviewing care plans, consideration should be given to whether specific infection risk has changed.

Hand hygiene

All staff must have regard to the hand hygiene procedures. For those undertaking personal care tasks, hand hygiene must be performed:

• Upon entering the place where the personal care will take place (for example the person’s home)
• Immediately prior to leaving where the personal care took place
• Before touching medication boxes, medication sheets or the older person’s notes • Before preparing food
• After touching or emptying rubbish bins • Immediately before any episode of personal care given to an older person (for example bathing/showering, transporting an older person)
• Immediately after any episode of personal care given to an older person
• Immediately after any exposure to bodily fluids
• Immediately after any other activity or contact with an older person’s surroundings which could potentially result in hands becoming contaminated
• Immediately after the removal of gloves or when hands are visibly soiled or potentially contaminated with bodily fluids.

Hand hygiene must follow the steps below:

• Forearms must be bare below the elbow whenever delivering personal care to older people.
• All hand and wrist jewellery must be removed
• Fingernails must be kept clean and short, and artificial nails and nail products must not be worn at work
• All cuts and abrasions must be covered with a waterproof dressing.

All staff and volunteers must follow good hand washing techniques. Annex 1 has the full NHS guidance for effective hand washing.

Respiratory and cough hygiene

Respiratory and cough hygiene will minimise the transmission of respiratory illness.
All staff must follow good respiratory and cough hygiene, including:

• Covering the nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing the nose
• Dispose of all used tissues promptly into a waste bin
• Wash hands according to hand hygiene advice after coughing, sneezing and using tissues
• Where there is no running water use antibacterial hand wipes
• Keep contaminated hands away from eyes, nose and mouth.

Personal Protective Equipment

All PPE should be:

• Put on and taken off in line with training and guidance from Public Health England (Annex 2)
• Worn in line with latest government guidance, as communicated by your service manager
• Located close to the point of use
• Stored to prevent contamination in a clean, dry area until required for use
• Items should only be used once unless specified otherwise by the manufacturer
• Changed immediately after each patient and/or after completing a procedure or task
• Disposed of correctly, either placed in the relevant disposal bin or bagged up if no bin is accessible
• Reusable items such as face shields must be decontaminated after each use.

Gloves must be:

• Worn when performing care tasks
• Changed immediately after completing each care task
• Changed if a tear, or perforation is suspected

Well-fitting Aprons must be:

• Worn when performing care tasks
• Changed after completing a care task

Fluid-resistant surgical face masks must be:

• Well-fitting and fully cover the mouth and nose
• Removed or changed regularly and immediately when damp

Footwear must be:

• Visibly clean, non-slip and well-maintained and cover the entire foot

Safe Management of equipment and the setting

Infection may be transmitted on shared equipment or surfaces touched by different people.
Staff must manage equipment and the setting by:

• Ensuring that seat covers are used on vehicle seats whenever an older person is transported
• Seat covers must be changed for new passengers and the used cover disposed of with other PPE
• Wiping down with antibacterial wipes surfaces which are regularly touched in any care setting ahead of use, including door handles, table surfaces, equipment. Equipment should be wiped down between use by different older people.
• Ensure the cleanliness of all kitchen equipment, plates and cutlery. Wipe all surfaces where food will be prepared or served.
• Ensure all other food safety guidance and procedures are followed Related Policies, Guidance and Procedures.

HAND WASHING TECHNIQUE

• Wet hands with water.
• Use soap (liquid soap if available) to lather the hands.
• Wash the palms of the hands (this is an area often forgotten).
• Wash the backs of each hand, including in-between the fingers.
• Interlace the fingers and wash these.
• Link the fingers together and wash the ends of the fingers (this is the area most often forgotten about).
• Wash each thumb.
• Wash the middle of the palms more carefully.
• Wash the wrists.
• Dry the hands thoroughly with a paper towel (care home/domiciliary care) or clean hand towel (domiciliary care).

Hands should now be clean enough to prevent the spread of infection.

Effective Hand washing should take 15 – 30 seconds.

For health and social care settings