Infection prevention and control (IPC) compliance
The COVID-19 Care Home Addendum and the National Infection Prevention and Control Manual for older people and adult care homes
During the pandemic, advice in the Scottish COVID-19 Care Home Infection Prevention and Control Addendum continues to be mandated and therefore should be followed by all adult care homes. The COVID-19 IPC Addendum is disease-specific so it stipulates control measures over and above the standard IPC to specifically respond to COVID-19. Therefore, the COVID-19 IPC Addendum has the most appropriate guidance to manage the transmission risk while within the pandemic.
The National Infection Prevention and Control Manual for older people and adult care homes and the Cleaning Specification were published on 24th May 2021. The Manual and Cleaning Specification are mandated for all adult care homes and provide guidance for IPC practices to be used as business as usual (non COVID-19 pandemic).
To support care homes to implement the Manual and Cleaning Specification workshops have been created. The Manual workshops finished on 29 June 2021, however a video will be uploaded to TURAS in due course.
Toilet access for visitors
Care homes are asked, wherever possible, to enable visitors access to dedicated toilet facilities (for visitor use only), and ensure frequent enhanced cleaning is in place (at least hourly) for all surfaces and using a chlorine releasing agent 1000 ppm (bleach). This should include the toilet, sink and frequently touched surfaces like door handles and light switches, but not including floors.
However of course if there is an urgent need, visitors should use the staff toilet. It should be cleaned as above.
Supporting visitors to comply with infection prevention and control
Visits generally do not need to be supervised. Each situation should be taken on a case by case basis - care homes may use their discretion where they feel it is necessary, while ensuring that the visit is as close to normal as possible.
Care home staff should take time with visitors to explain what is needed in terms of infection prevention and control and why it is important. The intention is that by doing this, care homes will be assured that supervision is not necessary.
Refreshments for visitors (food and drink)
It is recommended that visitors can remove their masks to enjoy refreshments with the person they are visiting. Advice on removing masks is as follows: when removing your mask always remember to observe hand hygiene prior to removing your mask, and after putting it back on- either through alcohol based rub or hand washing.
Further information on how to correctly remove and replace your facemask can be found on the Health Protection Scotland website.
Visitors with long sleeves should be asked to roll their sleeves up to help support hand hygiene. If their sleeves are too tight to be rolled up, they should still be allowed to visit but advised that, for next time, they should ideally be wearing short sleeves.
Visitors do not need to change clothes upon entry to the home.
Touch, including hand holding and hugging for parts of people’s time together, can and should be supported, with the recommended IPC and hand hygiene, as outlined in the Open with Care guidance.
Bringing items into the home
Visitors should be allowed to bring in gifts and residents’ belongings. If the item(s) can be wiped clean, such as books, then do so. However items such as flowers do not need to be cleaned before being given to the residents. Gifts to residents do not need to be quarantined.
Additional disinfection for COVID-19 infection prevention and control
The cleaning that is required to be undertaken by care homes is specified in the COVID-19 Care Home IPC Addendum. There is no need for care homes to go beyond this.
We are aware that commercial companies are offering ‘fogging’ and UV technology as additional methods of ‘cleaning’ but this is not required for COVID 19 control. ‘Fogging’ and UV technology are methods of disinfecting an area. This is only effective if the required cleaning has been undertaken prior to this enhanced level of disinfection.
If a care home does decide to undertake fogging, it is important that the required cleaning is undertaken prior to this.
Any further questions on cleaning procedure or products used should be directed to your local health protection team.
Visitors with difficulties in understanding infection prevention and control advice
Some visitors to the care home may not be able follow infection prevention and control advice for various reasons. For example, it may be difficult to explain the need to socially distance to a visitor with learning disabilities or dementia. In such instances it may be appropriate for the visitor to be accompanied by a loved one or carer, or to provide support during the visit.
Care homes should do everything they can to support equality of access for residents’ family and friends, taking into account their specific needs.
It is important that care homes are a homely environment, so soft furnishings, such as sofas and arm chairs are recommended to be supported. The care home may wish to remove items that could be passed around, such as cushions. However this must be done with consideration of the effect on the comfort of the residents.
Visitors and residents can use soft furnishings during the visit, unless otherwise advised by local oversight teams. Any hard surfaces that the visitor is likely to have touched should be wiped down after each visit. There is no need to clean floors after a visit.
Care homes should continue to follow standard procedures for any soft furnishings that are soiled with bodily fluids.