Guidance

Background, context and responsibilities for infection prevention and control (IPC) in adult social care (ASC) settings 

Published 28 October 2026

This section provides an overview of the adult social care landscape, explains what infection prevention and control is, and outlines the roles and responsibilities of those working in ASC settings, and partners who support ASC settings in preventing and managing infections.

Key summary

• this guidance brings all IPC guidance for adult social care into one place
• this guidance helps staff understand and apply IPC to protect people and themselves
• IPC reduces infections, prevents outbreaks, and improves care quality
• IPC should be flexible to suit different care settings
• IPC should balance safety with dignity and wellbeing
• good IPC supports staff, services, and public health
• everyone has a role in preventing infection

Call for action

• follow IPC guidance and promote safe practice
• keep skills up to date and keep up to date with IPC training
• report risks
• stay off work if unwell with an infection that may pose a risk of spreading to others
• ensure IPC practice is person-centred

Who this guidance is for

This guidance is for all people working in Adult Social Care (ASC) settings across England to help them apply correct IPC standards to protect themselves and people accessing care and support.   

This IPC guidance for ASC updates existing IPC guidance ‘Infection Prevention and Control in adult social care settings’ (2022) and ‘Care Homes: infection prevention and control 2013’, so it is all in one place, using a new structure which is clear, practical and easy to use.  

This guidance will ensure that:  

• the care and support workforce have easy access to evidence-based IPC advice and information tailored to ASC settings
• all care and support workers understand the importance of IPC and their role in preventing infections
• all the necessary guidance is available to prevent infections from spreading in ASC settings
• the wellbeing of staff and people accessing care is considered
• all ASC settings are represented as best as possible
• unpaid carers have access to key IPC messages about the importance and key IPC measures to prevent infections where applicable to them

This guidance will also support people working in the following related organisations and teams:

• community Infection Prevention and Control Teams (IPCTs)
• local authority public health teams and officers
• Integrated Care Boards (ICBs)
• quality assurance teams within commissioning or provider organisations
• UKHSA local and regional health protection teams (HPT)
• Care Quality Commission (CQC)

While this guidance cannot account for every possible variation in ASC settings, it is designed to be flexible and adaptable to different ASC settings. Providers may need to develop local processes and practical tools to support implementation of this guidance within their own settings. 

IPC measures should therefore be applied proportionately, considering the setting, the needs of people accessing care, and the level of environmental control available. Support from local IPC teams, UKHSA health protection teams, NHS partners, Integrated Care Boards and local authorities may be required to support implementation.

The adult social care (ASC) sector

Adult social care (ASC) supports people over the age of 18, who need help with daily living activities due to age, illness, disability, or other circumstances. ASC aims to help people live as independently, safely, and with as much dignity as possible. 

In England, ASC is delivered across a wide range of settings, including care homes, supported living, day services, and people’s own homes (domiciliary care). It is a large and diverse sector, made up of both public and independent providers. 

Adult social care settings differ from environments that primarily provide healthcare such as hospitals. Many ASC settings are designed to be ‘homely’ and comfortable for people, which may include features such as soft furnishings, carpets, and shared living spaces. While these environments support wellbeing and quality of life, they can present practical challenges for infection prevention and control. IPC measures in ASC therefore need to be applied in a proportionate and balanced way, recognising the importance of maintaining a homely environment while reducing the risk of infection.

Care provided in a person’s own home (domiciliary care) is included within the scope of this guidance. While the core principles of IPC apply across all settings, care delivered in a person’s home differs from care in communal or regulated environments. In homecare settings, care and support workers operate in environments they do not control, and people retain the right to make decisions about their own space and daily life. IPC measures must therefore be applied in a way that is person-centred, proportionate, and respectful of consent, dignity and autonomy, while still managing risks effectively. 

This guidance supports staff to apply IPC principles in a practical and realistic way within people’s homes, recognising both the importance and the limits of infection prevention in this context.

What infection prevention and control is

IPC means using safe practices to stop pathogens from spreading and causing illness. Robust IPC practices protect both people accessing care and the staff providing it. IPC reduces infections, protects public health, and helps prevent antimicrobial resistance, which in turn improves health outcomes, helps prevent outbreaks, reduce staff absences, and thereby improve quality of care. 

Care and support workers already play an important role in public health by preventing illness, promoting wellbeing, and supporting healthy ageing. Effective IPC also builds trust, ensures compliance with regulations, and supports the long-term sustainability of the ASC sector. 

Roles and responsibilities

Care and support workers

The responsibilities of care and support workers are to:

• provide effective IPC practice in their day-to-day care
• keep IPC skills and knowledge up to date
• report any breaches in IPC precautions or measures, or any perceived risks that may lead to the spread of infection, to their registered manager (or nominated deputy) or office team leader
• avoid providing care or having close contact with people accessing care and other staff if they feel unwell or have an infection that may pose a risk of spreading to others
• ASC workers should always seek advice from their line manager and, where appropriate, medical advice before returning to or continuing with duties

Registered managers, office team leaders and supervisors

The responsibilities of ASC setting managers and supervisors are to:

• ensure all staff deliver effective IPC practice in their day-to-day care delivery, protecting themselves and reducing the risk of infection to people, colleagues, and others they come into contact with
• ensure Health and Social Care Act 2008 is followed
• ensure all staff have completed IPC training and that the training is kept up to date
• ensure sufficient support and resources are available for staff to implement, monitor and take corrective action in line with this guidance
• ensure risk assessments are carried out on any staff who may be at high risk of complications from infection (for example, pregnant staff)
• support and encourage staff to have recommended health checks and immunisations,  documenting any risks and adjusting duties as needed
• conduct regular IPC audits of infection prevention practices to provide assurance of compliance with this guidance
• assess risks and coordinate contact with General Practitioner (GP), UKHSA local HPT, or IPC services as required

Useful tools for ASC managers and supervisors include:

• CQC Adult social care inspection information gathering tool: on infection prevention and control
• HSE resource on how to identify hazards and assess risks at work
• Scottish national monitoring framework to support safe and clean care audit programmes: An organisational approach to prevention of infection auditing

NHS Integrated Care Boards (ICBs) and public health teams supporting ASC

ICBs hold overall responsibility for infection prevention across health and social care in their local area (as per Health and Social Care Act 2008: code of practice on the prevention and control of infections). Their legal responsibilities are to:

• commission services for ‘prevention of illness’ and ‘care of persons suffering from illness’ (noting that the ICB remit is much broader than IPC)
• ensure providers comply with statutory infection control law, including the Health and Social Care Act 2008 Code of Practice
• hold system‑wide accountability for quality performance (effectiveness, safety, experience) across the integrated care systems (ICS)

Healthcare services supporting the ASC sector

Healthcare services play an important role in supporting the ASC sector by working collaboratively with care providers to ensure safe, coordinated and person-centred care. This includes timely access to clinical assessment, treatment and specialist support, including end of life, effective hospital discharge and prevention of avoidable admissions. Clear communication and information sharing between health and ASC services is essential to ensure continuity of care and improve outcomes for people who access care and support.

Community IPC teams

Community IPC teams are specialist teams that provide expert advice and support on preventing and managing infections in ASC settings. They may be employed or commissioned by the NHS or local authorities.

The responsibilities of community IPC Teams where commissioned are to:

• provide hands-on IPC expertise and support for front-line ASC providers to help them implement best IPC practice
• provide direct support to ASC settings for outbreaks and/or infection incidents
• communicate with UKHSA HPTs where necessary

UK Health Security Agency (UKHSA)

The responsibilities of UKHSA at a national level are to:

• prevent and reduce the harm caused by infectious diseases
• provide leadership and clear IPC guidance that helps keep people safe, well and supported
• monitor infection and outbreak data to track the spread of disease

UKHSA Health Protection Teams (HPTs) (regional level)

UKHSA HPTs provide specialist public health advice and operational support to NHS, local authorities and other agencies.

UKHSA HPTs lead the UKHSA response to local outbreaks and incidents at a regional level and may provide advice and support for single cases of notifiable diseases. They track infections, learn how they spread, and give clear, practical advice to help stop people getting ill.

The extent of UKSHA HPT involvement in outbreak and incident management may vary slightly between HPT regions depending on local public health infrastructure, local risk profiles, ASC system capacity, and regional operational arrangements.

UKHSA HPTs do not have a performance management or assurance role within the regional or local health system. Their role is advisory and supportive, working in partnership with ASC providers to help manage public health risks effectively and in line with national guidance.

Local authority

Local authorities have a legal duty to protect and improve the health of people in their area. They help prevent and manage infections by working with local partners and supporting IPC.

They are responsible for coordinating local outbreak responses, ensuring the provision of environmental health services, and maintaining emergency preparedness through local resilience forums.

Local authorities also develop and implement health protection strategies, commission relevant public health services, and work in partnership with agencies such as the UKHSA and the NHS to ensure a coordinated and effective approach to managing infectious disease threats.

Environmental Health Officers (EHOs)

EHOs are employed by local authorities, and they advise on the management of food safety, including hygiene, kitchen design, pest control and waste disposal.

Their duties include the inspection of food premises, as well as enforcing the provisions of the UK laws.

Director of Public Health

The Director of Public Health (DPH) is a statutory chief officer within the local authority, accountable for the delivery of its public health duties. The DPH provides expert advice on a wide range of health issues, including infectious disease outbreaks, emergency preparedness, and population health improvement.

In the context of IPC, the DPH leads the development and implementation of outbreak management plans, ensures health protection is embedded in local strategies, and coordinates multi-agency responses with partners such as UKHSA and the NHS.

During outbreaks, public health teams under the DPH may provide specialist support to ASC settings, either directly or through Community IPC Teams where these are in place. This support helps manage risks and maintain safe care environments.

Department of Health and Social Care

The Health and Social Care Act (2008) provides for the Secretary of State to issue a Code of Practice concerning compliance with requirements relating to the prevention and control of healthcare-associated infections and requires any such Code to be kept under review. Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, registered health and adult social care providers are required to provide safe care and treatment, including by assessing the risk of, and preventing, detecting and controlling the spread of infections. The Care Quality Commission takes the Code into account when making relevant decisions about registration.

All CQC-registered providers (employers), including domiciliary care providers

The code of practice on the prevention and control of infections and related guidance helps providers registered with the CQC develop and maintain good infection prevention practices. It supports the legal requirements set out in the Health and Social Care Act 2008 (Regulated Activities), including Regulation 14 Meeting nutritional and hydration needs, Regulation 12 Safe Care and Treatment, Regulation 15: Premises and equipment and Regulation 17: Good Governance.

Health and care service providers that provide regulated activities and are registered with the CQC are required to comply with regulations for preventing and controlling the spread of infection and ensuring the cleanliness of premises and equipment where care is delivered.

Registered providers are the organisations or individuals legally responsible for delivering regulated activities, whereas registered persons refer to the specific individuals within the organisation, usually the Registered Manager and/or the Nominated Individual, who hold personal legal accountability for ensuring the provider meets regulatory requirements.

Registered persons also have legal considerations relating to the Health and safety at work Act 1974 which place duties on companies and individuals (duty holders) to ensure that adequate provision is made for health and safety at work. Employers have a primary duty of care to ensure the health, safety, and welfare of employees and others affected by their business so far as is reasonably practicable.

Risk assessments of work activities are to be carried out by ASC providers. ASC providers should put in place any reasonable measures to control the identified risks. The general requirements of Control of Substances Hazardous to Health (COSHH) will also apply. More information on COSHH and biological agents can be found here: what the law says about biosafety.  

How this guidance was updated

This guidance was commissioned by Department of Health and Social Care (DHSC) and developed by UKHSA. A multidisciplinary working group comprising of care providers, NHS partners, Integrated Care Boards, Care Quality Commission, IPC and academia led this update. An additional stakeholder group of care providers and expected end users of this guidance were also consulted at key stages of the update. Inclusion of technical expertise for individual pathogens has been assured throughout. Relevant expert advice has been taken throughout.

Definitions  

The term ‘people/person’ is used throughout this guidance to refer to people who access care and support from social care services or other forms of assistance to live their daily lives and are active participants with choice and control over their support. This group includes anyone needing extra help due to age, disability, illness, or other circumstances.

The term ‘pathogen’ is also used through this guidance to refer to a germ that causes infection.

The term ‘care and support workers’ is also used throughout to refer to all ASC workers/staff. 

Additional definitions can be found in the glossary 

Safeguarding statement

In keeping with the Mental Capacity Act 2005, care and support workers must presume capacity unless assessed otherwise, provide tailored support to enable understanding, and document any capacity assessments clearly. Where a person lacks capacity, decisions or protective measures must be made in their best interests and be proportionate, necessary, and least restrictive, with involvement from relevant professionals and those close to the person wherever appropriate.

Always ensure any information sharing about a person who is infectious is done in a compassionate and proportionate way.