Put in place a system* for infection prevention and control*.

Make sure this system* reduces the spread of diseases and infections. This system* should be used together with processes* to prepare for, prevent and control infections in clinical care* services (Outcome 5.2).

Make sure your infection prevention and control* system* includes processes* to:

• appoint an Infection Prevention and Control Lead* for residential care homes. This role acts as the main point of contact for all infection issues. This role also oversees the infection prevention and control* system* and processes* to prepare for outbreaks. The Infection Prevention and Control Lead* needs to be a nurse who has completed, or is in the process of completing, the required specialist infection prevention and control* training. Consider how to best assign an Infection Prevention and Control Lead* during workforce* planning (Outcome 2.8). For home service providers, look for ways to appoint a worker* or team to oversee your infection prevention and control* system*.
  • for regional and remote providers, limited resources and increased workforce* challenges may affect access to appropriately qualified and trained Infection Prevention and Control Leads*. These providers should consider strategies to make sure their infection and prevention control* system* is overseen.
• put in place infection control strategies that are appropriate for the older person’s home or service environment* (Outcomes 4.1a and 4.1b). This includes standard and transmission-based controls. For example:
  • cleaning practices
  • hand hygiene practices
  • respiratory hygiene
  • cough etiquette
  • waste management and disposal.
• check infection* prevention controls and processes* to prepare for outbreaks are in line with contemporary, evidence-based practice* (Outcome 5.2)
• put in place policies* and procedures* to prepare for, prevent and control infections. This includes developing and maintaining outbreak management plans.
• manage infections and infectious disease outbreaks (Outcome 2.10). This includes both suspected and confirmed infectious diseases such as COVID-19, influenza, gastroenteritis or novel viruses. This means you need to act promptly when people are sick, even if you’re not sure if it’s an infectious disease.
• collect and analyse data on immunisation and infection* rates. This is to inform risk assessment and the ways you can improve your infection prevention and control* system* (Outcome 2.4).
• share information about infection* risks with older people, their supporters, families, carers*, visitors and workers* by using the communication system* (Outcome 3.3)
• prioritise the rights, safety, health and wellbeing of older people (Outcome 3.2). You need to include older people in deciding how to manage the risk of infection* (Outcome 1.3).
• meet public health notification needs, where relevant.

For residential care homes, undertake risk-based vaccine-preventable diseases screening and immunisation for older people and workers*. This includes disease screening and immunisation requirements for visitors. This makes sure visitors or workers* don’t expose older people to infectious diseases.

Make sure you give older people current, accurate and timely* information about vaccines from relevant health professionals*. Make sure you provide this information in a way older people can understand by considering their language and communication needs and preferences (Outcome 1.1). This information can include benefits, risks and costs (where applicable) of vaccinations. The older person can then make an informed decision and provide informed consent* if they have agreed to be vaccinated (Outcome 1.3).

Home care settings have unique infection risks. Older people are likely to have multiple workers* and providers delivering care and services in their home. Workers* may also be moving between multiple home settings. This can increase the risk of infection* between workers* and older people. Put in place strategies to make sure workers* are minimising or preventing the spread of infection*. For example, support older people to maintain a clean and safe environment (Outcome 4.1a), perform hand hygiene and use personal protective equipment (PPE) appropriately.

The guidance for Outcome 5.2 has more information on infection prevention and control* in clinical care* services.
 

Put in place a system* to manage the supply and use of personal protective equipment (PPE).

Put in place a system* to make sure PPE is suitable, available and has instructions on how to use it safely. In particular, where you are using PPE as a mitigative control to reduce disease and infection, as part of the risk assessment system* (Outcome 2.4). Make sure PPE is available for workers*, older people, visitors and other care partners in your service, and you put in place strategies to make sure PPE is used correctly.

You need to develop, maintain and manage a PPE inventory to make sure there’s enough PPE stock. The inventory manages:

• what PPE you need. For example, gloves, gowns, face shields/glasses and masks.
• where to store PPE. Make sure you store PPE correctly, in a dedicated and accessible area.
• when you need to replace PPE.

This inventory can be integrated with your processes* for managing equipment (Outcomes 4.1a and 4.2b).
 

Make sure workers* have the time, support and resources to manage infections and use PPE.

Provide workers* with guidance and training on correct infection prevention and control* practices, including use of PPE (Outcome 2.9). This needs to be in line with:

• the organisation’s policies* and procedures*
• contemporary, evidence-based practice*
• workers’* roles and responsibilities*.

Make sure workers* and other care partners in your service understand how to:

• use and apply the infection prevention and control* system*
• identify when to use standard and transmission-based precautions and apply this to the appropriate setting
• use and maintain PPE correctly. This applies to all people who need PPE, as well as to visitors and other care partners in your service.

The guidance for Outcomes 2.8 and 2.9 has more information on workforce* planning and worker* training. 
 

Monitor that workers* follow the system* for infection prevention and control*.

To check if your system* for managing risks of infection* is working, you can review:

• older people’s care and service documents. For example, care and services plans* and progress notes (Outcome 3.1).
• complaints* and feedback* (Outcome 2.6)
• infection rates and trends
• incident* information (Outcome 2.5).

Look for situations where:

• infections have been transmitted between workers*, carers*, older people or their families
• your organisation hasn’t responded to outbreaks of infectious diseases or viruses in a timely* manner
• you haven’t shared information on infection* risks well with older people, their supporters, family, carers* or workers*
• suitable PPE wasn’t available, used when needed or it wasn’t used correctly.

Also, talk with older people, their supporters and others they may want to involve, such as families and carers*, about the infection prevention and control* processes (Outcome 2.1). For example, ask them if they feel their provider and workers* follow appropriate infection prevention and control precautions when delivering care and services. These conversations can then inform continuous improvement* actions and planning (Outcome 2.1).

Assess if workers* are following your quality system* (Outcome 2.9). You can do this through quality assurance and system* reviews. This can be done as part of the monitoring process* in Outcome 5.2.

If you find any issues or ways you can improve through your reviews and assessments, you need to address them. If things go wrong, you need to:

• practise open disclosure* (Outcome 2.3). This means being open about what has gone wrong. Share what went wrong with older people, their supporters and others they may want to involve, such as family and carers*.
• put in place strategies to mitigate the risk of things going wrong again.

The guidance material for Outcome 2.3 has more information on monitoring the quality system*.