Infection prevention and control
In this section
Information, guidance and resources on infection prevention control
Symptoms of COVID-19
Most commonly reported symptoms are:
– A new continuous cough
– A high temperature (>37.8°C)
– A loss of, or a change to smell or taste
Other symptoms may include:
– Sore throat
– Muscle aches
– Reduced mobility
Care home residents (both older residents and younger residents living with a learning disability) may not present with the typical symptoms.
- It is estimated that 1 in 5 people may not display any symptoms (asymptomatic) and may inadvertently be spreading the virus
- 20% of people may go on to develop more serious illness and require hospitalisation.
- The infectious period is anytime from 2 days before symptoms started or the date of the positive test up to 10 days after the onset of symptoms.
- Symptoms can start 1-14 days after exposure.
Transmission of COVID-19
Respiratory Droplets: The virus is transmitted from person to person via infectious respiratory droplets. These are produced when people sneeze, cough or speak. They travel directly from the respiratory tract of an infected individual to susceptible mucosal surfaces (eyes, nose, mouth) of another person and they can also be inhaled into the lungs.
Contact with Contaminated Surfaces: The virus can also be transmitted after an infected person sneezes, coughs or touches surfaces, or objects, such as tables, doorknobs, keyboards etc. Other people may become infected by touching these contaminated objects or surfaces, then touching their eyes, noses or mouths without having cleaned their hands first.
Steps you can take to prevent to the spread of COVID-19
To protect yourself, other staff, residents and service users and your families, remember:
- Wash your hands frequently – (refer to Hand Hygiene section)
- Follow government guidance about wearing a face covering in public places and ensure that you are following the latest government guidance for your workplace (refer to PPE section)
- Keep to a minimum of 2m whenever possible
- Follow good respiratory hygiene at all times (refer to Respiratory hygiene section)
- Clean high touch surfaces frequently (refer to Decontamination section)
Improve VENTILATION in all indoor areas, particularly communal areas, to reduce the concentration of the virus in the air and therefore reduce the risks of airborne transmission. Good ventilation is a balance between making sure workplaces are warm and keeping a flow of air going through an area.
Respiratory & Hand Hygiene
- Use disposable, single-use tissues to cover the nose and mouth when sneezing, coughing, blowing the nose
- Put used tissues into the nearest bin as soon as possible
- Clean hands (preferably with soap and water, or use alcohol hand sanitiser) after coughing, sneezing, using tissues and after any contact with respiratory secretions and contaminated surfaces or objects
- Provide tissues, waste bins and hand hygiene facilities for residents, service users, staff and visitors
- Encourage residents/service users to keep their hands away from their eyes, nose and mouth
Washing your hands frequently is essential to reduce the spread of all bacteria and viruses, including COVID-19.
All care workers should wash their hands:
- Direct contact with a resident/service user
- Preparing food
- Taking a break
- Eating and drinking
- Leaving the workplace
- Putting on PPE (donning)
- Arriving at the workplace
- Direct contact with a resident/service user
- Touching residents/service users immediate surroundings
- Handling waste and linen
- Using the toilet
- Each piece of PPE is removed (doffing) – including gloves
Before starting work ensure that you
- Wear short sleeves or roll up long sleeves up to the elbows so that the mid forearm is exposed.
- Remove stoned rings, watches and wrist jewellery. (a plain wedding band is acceptable)
- Keep your nails short and clean. Do not wear nail varnish or false nails to work
- Whenever possible use warm water, soap and paper hand towels. If not available or more convenient then use alcohol hand sanitiser (>70% alcohol) and allow to dry – see poster
- Dry hands thoroughly by patting them dry. This helps to reduce skin damage.
Wash/sanitise hands and the forearms after you have had close contact with a resident/ service user
Please remind and support residents and service users to wash their hands
- After coughing/sneezing
- Before eating
- After using the toilet
- After removing a face mask
Hand wipes or alcohol hand sanitiser can be a convenient way to support them to wash their hands more easily
Please utilise the NHS ‘How to wash your hands’ guidance and the following poster.
Cleaning and Decontaminating the Care Environment
FOGGING MACHINES and other Cleaning Devices are NOT recommended
- There is currently no national guidance as to how effective these machines are in regard to COVID-19
- Spraying of any disinfectants can result in risks to the eyes, skin and respiratory system and have adverse health effects on staff disinfecting premises during the coronavirus pandemic HSE news
- WHO Guidance can be found – Coronavirus disease (COVID-19)
- HSE Guidance can be found – Disinfecting premises during the coronavirus pandemic
COVID-19 can easily be removed from the care environment by cleaning following National guidance using:
- A general purpose detergent in a solution of warm water followed by a disinfectant (containing 1,000ppm available chlorine)*
- A combined detergent/disinfectant solution (containing 1,000ppm available chlorine) e.g. Actichlor-plus, Chlor-Clean, SoChlor DST
- All cleaning solutions must be prepared and used according to the manufacturer’s instructions and the recommended product ‘contact times’ must be followed.
- Always dilute chlorine solutions/tablets with cold or tepid water (not hot) to reduce production of fumes.
- All disinfectants used must have been tested and conform to the EN standard 14476 for virucidal activity (this ensure that it will be effective for COVID-19)
- All cleaning equipment should be colour coded
- Ideally all mop heads and cloths should be disposed of after a single use (refer to Waste Management section). Reusable equipment e.g. mop handles, buckets etc. must be decontaminated after every use and dried thoroughly
- Declutter all communal areas and care environments and remove non-essential items and items which are difficult to clean – This will make cleaning easier and reduce the number of surfaces that are exposed to infectious particles
- Increase the frequency of cleaning in all areas, paying particular attention to all high touch surfaces e.g. door handles, light switches, toilet flush, keyboards etc.
- Soft furnishings should be cleaned with a detergent and ideally steam cleaned.
- Ensure that all Cleaning staff are following the latest PPE guidance COVID-19: how to work safely in care homes
*(e.g. 10ml of household bleach in 1L of water, 50 mls of Milton in 1L of water or follow the manufacturer’s instructions)
Cleaning COVID-19 Positive Isolation Rooms
A Deep Clean of the isolation room is required when:
- the isolation period is over
- following the death of the resident/service user,
- if the resident is moved to another room or admitted to hospital
- Doors should be kept closed and a window opened during cleaning
Cleaning reusable care equipment
- Whenever possible, all care equipment should be single use. Reusable non-invasive equipment e.g. hoists, commodes etc. should, whenever possible, be allocated to an individual resident/service user
- Any equipment which needs to be shared (communal) must be decontaminated after every use and if it has become contaminated with blood or body fluids
- Small items of equipment can be cleaned first with a detergent wipe followed by a 70% alcohol wipe or by using a combined detergent/disinfectant wipe e.g. Clinell wipes
- All reusable care equipment must be cleaned according to the manufacturer’s instructions
Please refer to the poster for further guidance: Routine_decontamination of_reusable_noninvasive_equipment
- All linen from confirmed/suspected COVID-19 residents/service users should be managed as ‘infectious’ linen and placed inside a water soluble alginate bag within the room.
- Linen must be handled, transported and processed safely to reduce the risk of exposure to the eyes, nose and mouth of the staff and their clothing and the environment – DO NOT shake linen or place into onto the floor or other surfaces
- All staff handling linen must be wearing appropriate PPE – Gloves, apron and surgical mask (Type 11 or Type 11R)
- Linen should be placed into the appropriate outer bag outside the resident’s room (do not bring linen trolleys inside a resident’s room)
- Linen must be washed and prepared in an appropriate manner and in accordance with the manufacturer’s instructions.
- Linen should be handled in accordance with Health Technical Memorandum 01-04 (2016).
Within Care Home Settings –
All waste generated within care settings must be handled, segregated and stored safely to ensure that it does not pose a potential risk of infection. It is the LEGAL responsibility of the care setting to ensure that they are complying with the Environmental Waste Regulations
- All staff who handle waste must be wearing the appropriate PPE
- Lidded, foot operated and lined waste bins should be provided in all care facilities and resident rooms
- Interim waste management guidance for care homes can be found in Annex J Admission and care of residents in a care home during COVID-19 – GOV.UK (www.gov.uk)
- A care environment that does not have access to health care waste must ensure that all waste from any confirmed/suspected cases of COVID-19 must be double bagged (black bin bags), dated and stored safely for 72 hours before placing into the normal disposal route. This includes all personal waste e.g. tissues, soiled items, PPE and disposable cleaning cloths etc.You should maintain written records to demonstrate the waste has been held for 72 hours.
Within Domiciliary Care Settings –
If the client does not have COVID-19 symptoms or has not been tested positive
- Waste should be placed into a plastic rubbish bag and disposed of as normal domestic waste.
If the client has COVID-19 symptoms or has tested positive
All waste generated including cleaning materials, PPE, used tissues etc. should be :–
- Placed into a plastic rubbish bag
- Tied when full – do not overfill
- Placed inside a second plastic rubbish bag, tied and dated
- Stored in a suitable and secure place (away from children) and left to be stored for 72 hours
- Placed into the domestic waste stream after the 72 hours has passed (to reduce the risk to waste operatives)
Do NOT ever put any PPE into a recycling bin
Refer to the COVID-19: how to work safely in domiciliary care in England guidance – section 2, page 16
Management of staff uniforms/work clothing
Whenever possible staff are advised to wear a uniform if providing direct contact to residents/service users.
Care home staff
- Ideally staff should change into their uniforms or work clothing when they arrive at work
- Ideally staff should change out of their uniform or work clothing before leaving the workplace and not wear these home
- Clothing should be washed at the workplace (if possible) or transported home in a plastic bag.
- Domiciliary Care staff should change out of their uniforms/work clothes immediately on arriving home
- Work clothing/uniforms should be washed separately from other household items at the maximum temperature that the material can withstand in a load not more than half the machine capacity.
- Iron and/or tumble dry all uniforms/work clothing
- Ideally footwear worn at work should not be taken home
Care Homes: Best Practice Self Audit Tool
The Best Practice Tool is a very simple self audit tool which you can utilise to ensure COVID-19 standards are in place
- Use often with an active walk through the home (it is very much an active, not passive process)
- Record, date and document
- Raise and complete action points
- Document and restart
Infection Preventionand Control and PPE (Donning and Doffing) Training
Training is available for anyone delivering care in the London Borough of Sutton. For more information and how to book on to a session please visit our Infection Prevention Training Page.
- ADASS Care Homes Infection Control: Top Tips Guide
- ADASS Cohorting, Zoning and Isolation Practice report
- COVID-19: Infection prevention and control recommendations
- NICE guidance
- How to wash your hands video
- Health Technical Memorandum: Decontamination of linen
- Admission, isolation and testing of residents
Page last updated on August 10th, 2021 at 2:44pm