Infection Prevention and Control in Adult Social Care: The Essentials Every Registered Manager Needs

Infection prevention and control in adult social care is not a side issue for CQC inspectors: it sits at the centre of how they judge whether a service is safe. Norovirus, flu, and drug-resistant organisms remain a routine feature of care delivery, and how consistently a service applies basic precautions shapes both resident wellbeing and the rating on the front of the inspection report. This guide sets out the essentials every registered manager needs in place.

Why infection prevention and control in adult social care matters under CQC Regulation 12

The legal foundation sits in Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12(2)(h) requires providers to assess the risk of, and prevent, detect and control the spread of, infections, including those that are healthcare associated. Alongside Regulation 12 sits the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections, often called the Hygiene Code, which CQC must take into account when making regulatory decisions.

In practice, this means providers need to show not just that infections are being managed reactively, but that risk is being assessed, prevented and monitored as a matter of routine governance.

Understanding how infection spreads: the chain of infection

Every infection depends on six linked factors: pathogen, reservoir, portal of exit, means of transmission, portal of entry, and susceptible host. Break any one link and transmission stops.

This is the underlying logic behind almost every IPC measure a service applies:

• Pathogen: completing prescribed antibiotic courses reduces the chance of resistance developing

• Reservoir: regular cleaning and decontamination reduce pathogens on surfaces and equipment

• Portal of exit: covering coughs and sneezes limits the spread of respiratory secretions

• Means of transmission: hand hygiene is the single most effective break in this chain

• Portal of entry: covering wounds and minimising unnecessary use of invasive devices closes entry routes

• Susceptible host: vaccination reduces the risk of severe illness in vulnerable residents

Standard infection control precautions: the essentials

Standard infection control precautions (SICPs) are the basic IPC measures that apply to every worker, for every person, whether infection is known to be present or not. They are the foundation everything else in this guide builds on.

Hand hygiene : Hand hygiene should happen before touching a person, before any clean or aseptic procedure, after exposure to blood or body fluid, and after touching a person or their surroundings. Alcohol-based handrub is appropriate for most situations, but liquid soap and water must be used when hands are visibly soiled or when caring for someone with diarrhoea or vomiting, since pathogens such as norovirus are not reliably destroyed by alcohol.

Respiratory and cough hygiene : Tissues should be within reach, disposed of promptly, and hands cleaned afterwards. Where a tissue is not available, the crook of the arm should be used rather than the hands.

PPE : PPE is the last line of defence in the hierarchy of controls, used only when other measures cannot sufficiently reduce risk. Gloves and aprons should be worn for any task involving contact with blood, body fluids, or non-intact skin, changed between care activities for the same person, and disposed of correctly. PPE should never be stored on the floor.

Safe management of care equipment and the environment : Reusable equipment must be decontaminated after each use, with clear responsibility for who does this, how often, and by what method. Cleaning schedules should specify responsibility, frequency, and method for every area of the environment.

Laundry, waste, and sharps : Infectious laundry should be bagged at the point of use and never sorted on the floor. Waste should be segregated by category and disposed of in line with local colour coding. Sharps must go directly into a sharps container, never passed hand to hand, and containers should never be filled above the fill line.

Assessing infection risk: the hierarchy of controls

Before reaching for PPE, providers should work through the hierarchy of controls: reducing the hazard (vaccination, isolation, prompt reporting), changing what staff do, changing where care is delivered, changing how work is organised, and only then using PPE. This ordering matters for inspection evidence: CQC wants to see risk being designed out, not just covered up with equipment.

Every person using the service should have an individual infection risk assessment covering symptoms, recent contact history, and personal risk factors such as wounds, invasive devices, or a weakened immune system. This should be completed on admission and kept under review.

CQC Readiness Assessment: if infection prevention evidence is one of the gaps in your inspection preparation, this assessment maps where your current documentation and practice stand against what inspectors expect to see.

Recognising and responding to outbreaks

An outbreak is defined as two or more linked cases of the same suspected or confirmed infection occurring around the same time and associated with the service. Staff should be alert to symptoms even before someone reports feeling unwell, and curious if more than one person shows similar signs, even without an obvious link between them.

Once an outbreak is identified, providers should notify the local UKHSA health protection team, review their outbreak management plan, increase monitoring of infection control practice, and review cleaning and waste arrangements. Isolation should be used proportionately, and contact with relatives and friends should be maintained wherever it can be done safely: visiting restrictions must be risk-based, proportionate, and time-limited under CQC's Regulation 9A.

Leadership, governance, and training: what CQC expects to see

CQC looks for an identified IPC lead within the service, a policy setting out training requirements and frequency, and an annual statement covering outbreaks, audits, training delivered, and risk assessments undertaken. Core IPC training should cover how infection spreads, when and how to perform hand hygiene, how to risk-assess PPE use, how to respond to a suspected infection, and how to manage waste and laundry safely.

Frequently asked questions

What is the difference between infection prevention and infection control?

Infection prevention refers to the measures that stop infection occurring in the first place, such as hand hygiene and vaccination. Infection control refers to the additional measures used once an infection is suspected or confirmed, such as isolation and enhanced PPE.

What are standard infection control precautions (SICPs)?

SICPs are the basic IPC measures, including hand hygiene, respiratory hygiene, PPE, and safe management of equipment, environment, laundry, and waste, that apply to every worker and every person, regardless of known infection status.

What counts as an infection outbreak in a care home?

Two or more linked cases of the same confirmed or suspected infection occurring around the same time and associated with the service.

Is IPC training mandatory for care staff?

Yes. Under Regulation 12, providers must ensure staff have the competence and skills to deliver care safely, and CQC expects a documented training policy covering IPC alongside evidence of ongoing competency.

Verified sources

• Care Quality Commission, Regulation 12: Safe care and treatment

• Department of Health and Social Care, Infection prevention and control: resource for adult social care (updated 1 March 2024)

• UK Health Security Agency, Understanding and managing infection in adult social care (published 26 August 2026)

• Health and Social Care Act 2008: Code of Practice on the prevention and control of infections

• Skills for Care, Infection prevention and control