Guidance

Staff health and managing sickness related to infection in adult social care

Published 28 October 2026

This section explains why staff health and wellbeing are important for safe, high-quality care and effective infection prevention and control (IPC). It highlights how physical and mental wellbeing can support good IPC practice, reduce the risk of infection, and help staff provide consistent, compassionate care. It also emphasises the importance of supporting staff who are unwell and promoting a healthy, resilient workforce.

Key summary

• good staff health and wellbeing supports safe, good quality care
• healthy staff are less likely to spread infection
• supporting wellbeing helps reduce sickness and keep care consistent
• vaccination and good hygiene help prevent illness
• staff should not work when infectious
• registered managers should support staff and assess risks for vulnerable workers

Call for action

• look after your physical and mental health
• always follow IPC precautions
• get vaccinated if eligible
• report illness early
• stay off work when infectious and return when safe

Health and wellbeing refers to overall physical, mental, and social functioning, all of which are essential for delivering safe, high-quality care.

Staff health and wellbeing are closely linked to preventing and managing infections. Good physical health helps support a strong immune system and protects against infection. Positive mental wellbeing promotes resilience, clear decision-making, and the ability to cope with challenging situations, including outbreaks and periods of increased pressure.

Feeling stressed, tired, or overwhelmed can affect wellbeing and make it more difficult to follow IPC practices consistently. Registered managers should support staff wellbeing and encourage staff to stay at home when they are unwell with an infectious illness.

Supporting staff wellbeing also helps reduce sickness absence, improving continuity of care for people who access care and support. In homecare services, staff absence can lead to delayed or missed visits if cover is not available. A healthy, supported workforce is better equipped to provide consistent, compassionate care while maintaining high standards of IPC.

Promoting health and wellbeing should therefore be seen as a core part of safe care, effective leadership, and high-quality adult social care services.

Preventing and managing sickness

In addition to supporting staff wellbeing, registered managers must have arrangements in place to prevent infection transmission and to manage sickness related to infection to maintain safe, effective and continuous care.

Care and support workers can prevent sickness or reduce its severity by accessing vaccinations that they are eligible for. Vaccinations can protect people from preventable diseases and seasonal infections.  

Using SIPCs routinely at work, including hand hygiene, will help minimise opportunities for infections to spread to care and support workers.

Registered managers should ensure any care and support workers who are more susceptible or clinically vulnerable to infections have risk assessments in place. This may include staff who:

• are pregnant
• have a weakened immune system
• have a long-term respiratory condition
• are receiving treatment such as chemotherapy

Registered managers should support care and support workers to report symptoms when they are unwell and stay away from work when needed to help stop infections spreading.

Registered managers should have plans in place to make sure care can continue when staff are unable to work due to infection. This may include arranging cover when needed.

Employers are responsible for making sure care and support workers can access occupational health advice and support where this is available. Where this is not available, staff should be encouraged to seek advice from their GP, NHS 111 or local pharmacy.

Registered managers should help create working conditions that support good health and wellbeing. This includes:

• providing appropriate breaks
• supporting staff to stay hydrated
• managing workloads where possible
• making sure work areas are safe, clean and well ventilated

Good working conditions can help reduce stress, fatigue and the risk of illness, helping care and support workers stay well and continue to provide safe care.

When staff should not attend work due to infection

The following advice relates specifically to work exclusion due to infection and should be considered separately from wider staff wellbeing and sickness absence support arrangements.

Table 1 gives advice on the minimum period of time that staff should stay away from work when they have an infection.

Care and support workers should tell their manager if they have symptoms of an infection, have been diagnosed with an infection, or are unsure whether they should attend work because of an infection. Registered managers can seek advice from occupational health services where available, or workers should seek advice from their GP or another healthcare professional if needed.

Care and support workers should contact the care setting occupational health advisor, or their GP or NHS 111 if concerned about contact with a suspected or confirmed case of infectious disease.

Advice on work exclusions due to infection or public health reasons can be sought from the care setting occupational health advisor, or if this is not available the UKHSA local Health Protection Team (HPT), or local IPC provider.

Registered managers should report any suspected outbreaks or a higher than usual number of infections in staff or people accessing care and support, following local IPC procedures.

During outbreaks or other public health incidents, advice may be different from the exclusion periods shown in Table 1. Care and support workers should follow advice from their healthcare professional, and registered managers should follow advice from the UKHSA local HPT, local IPC service, or occupational health service where available.

Table 1: Recommended exclusion from work for common infections

Disease or condition	Period of exclusion
Acute respiratory infections	Care and support workers with a high temperature or who are not well enough to work should stay away from work until they no longer have a high temperature and have recovered enough to return to work. Care and support workers with only mild symptoms of a respiratory illness, such as a runny nose, sore throat or mild cough, who are otherwise well enough to work do not usually need to stay away from work. They should follow standard infection control precautions, including good hand hygiene, and monitor their symptoms. and follow local advice on the use of face masks where appropriate.
Chickenpox	Exclude until all vesicles or blisters are dry and no new vesicles are forming (usually about 5 days from onset of rash).   Staff with a weakened immune system may remain infectious for longer and should seek advice from their healthcare professional before returning to work.
Diarrhoea and/or vomiting	Exclude until clinically well and after 48 hours without diarrhoea or vomiting.
Group A Streptococcus (GAS) (Scarlet fever, impetigo, and strep throat)	Scarlet fever or IGAS: exclude until 24 hours after starting to take appropriate antibiotics. Impetigo: 48 hours after starting to take appropriate antibiotics.
Hepatitis A	Exclude until 7 days after the onset of jaundice or from the onset of symptoms if no jaundice is present.
Measles	Exclude until 4 days after appearance of rash (first day of rash appearing is day 0).
Meningitis (viral meningitis)	Exclude until the person has recovered.
Meningococcal meningitis (bacterial meningitis)	Exclude until the person has been treated with antibiotics and has recovered.
Mumps	Exclude until 5 days after onset of jaw or neck swelling.
Rubella	Exclude until 5 days after the appearance of the rash (1st day of rash onset is day 0).
Scabies	Where possible, registered managers should consider adjusting duties to reduce close skin-to-skin contact until 24 hours after the first treatment dose. Where treatment has been advised, household contacts should be treated at the same time as the affected care and support worker to help prevent scabies spreading and coming back.   Staff with crusted scabies may need to stay away from work until advised they can return by a healthcare professional.
Shingles	Exclude only if the rash is weeping and cannot be safely covered. Return to work when the rash can be safely covered or is no longer weeping. Staff with a weakened immune system should seek advice from their healthcare professional before returning to work.
Tuberculosis (TB)	Exclude care and support workers with infectious TB until they are no longer infectious and have been advised that they can return to work by their TB specialist team or UKHSA local HPT
Whooping cough	Exclude until the staff member has had at least 48 hours of the appropriate antibiotic or until 21 days from the onset of coughing if no antibiotics have been taken and they feel well enough to return.
Unexplained rash	Exclude until assessed by a healthcare professional and advice has been given about returning to work.