Are care homes compliant with the Code of Practice on prevention of infections? Kate Morrow Health Protection Nurse Beds & Herts HPU September 2010

Introduction From October 2010 care homes must comply with DH Code of Practice for infection prevention and control. Local pilot recruited 38 care homes (from over 500) and audited compliance with the new Code.

Method An audit tool was developed and revised during the first 10 audits. The tool assessed 26 standards: –Infection control policies –Facilities –Practice 38 audits were undertaken by 1 of 3 HPNs Compliance with standards assessed by 3 nurses.

Level of Compliance Three compliance categories: Compliant85 % or Above Partial Compliance76 % to 84 % Minimal Compliance75 % or Below Not Applicable

Compliance Score The mean compliance score of 30 (out of 38) care homes audited is 59% indicating minimal compliance RegistrationNursingResidentialTotal Mean62%56%59% Range33% - 93%31% – 92%31% - 93%

Number Compliant RegistrationNursingResidentialTotal Compliant3 (19%)2 (14%)5 (17%) Partial Compliance2 (12%)1 (7%)3 (10%) Minimal Compliance11 (69%)11 (79%)22 (73%) Total161430

Compliance by CQC Star Rating Star Rating CompliantPartial Compliance Minimal Compliance Total 3 Star3 (30%)1 (10%)6 (60%)10 2 Star2 (17%)1 (8%)9 (75%)12 1 Star006 (100%)6 0 Star001 (100%)1 Not Rated 01 (100%)01 Total out of 22

Additional findings Some auditor variation has been noted with overall compliance scores and pass rate There was no association between bed size and compliance score Worst ScoreBest Score Sluice (42%) Linen (70%) Policies (34%) Staff training (72%) Staffroom (27%) PPE (79%)

Variation by Registration Mean compliance score for each standard StandardNursingResidential Staff Room38%15% Sluice55%28% Sharps63%43%

Discussion Minimal compliance with the Code: 11 (37%) homes achieved < 50% of all required standards. A higher CQC star rating = higher audit score. Nursing homes achieved higher audit score and better pass rate (than residential homes). Basic infection control requirements were deficient including: Sluice facilities Infection control policies Basic cleaning Food hygiene

Acknowledgements Caroline Foley Lesley Morley Joe Kearney Douglas Harding The Care Homes