A care home infection control audit should test what staff, residents and visitors experience—not simply whether a policy exists. It is a structured check of leadership, cleaning, equipment, laundry, spills, waste, personal protective equipment (PPE), competence, outbreak readiness and records. The aim is to find weak controls early, assign corrective action and retain evidence that the home is managing infection risks sensibly.
Direct answer: A robust care home infection control audit reviews the everyday controls that prevent transmission and the evidence that those controls work. Audit routines at the point of care, speak with staff, inspect records and close every gap with an owner and review date. This helps demonstrate a proportionate response to CQC expectations; it does not guarantee an inspection outcome.
Table of Contents
What CQC expects from infection control in care homes
In England, Regulation 12 requires registered providers to assess risks to people’s health and safety, take all reasonably practicable steps to mitigate them, and assess, prevent, detect and control the spread of infections, including healthcare-associated infections.1 CQC’s current infection prevention and control quality statement also looks for clean, hygienic premises and equipment, clear responsibilities, and appropriate sharing of infection-risk information.2
An audit is therefore a governance exercise as well as a cleaning check. Compare written arrangements, observations, staff knowledge and records. Investigate a signature gap; do not assume either that cleaning happened or that it did not.
The Department of Health and Social Care (DHSC) sets out standard infection control precautions (SICPs) for workers and people regardless of whether infection is known to be present. Its core controls include hand and respiratory hygiene, PPE, care equipment, the environment, laundry, spills, waste and exposure management.3 The National infection prevention and control manual (NIPCM) for England presents the same controls as measures to use by all staff, at all times, in all care settings.4
How to run a care home infection control audit
Set a defined scope: the whole home, a unit, a shift, a recent outbreak or a concern such as laundry. Include the registered manager or delegated IPC lead, and sample different areas and times without disrupting residents’ dignity: communal spaces, bedrooms where appropriate, utility rooms, staff areas, laundry and waste storage.
Score each check as assured, partly assured or not assured. CQC’s detailed care-home IPC information-gathering tool, published under its previous approach and currently marked as under review, used a similar assurance scale supported by notes and observations.5 Add the evidence seen, not just the score. An effective audit trail answers: what was found, why it matters, what will change, who owns it and when will it be checked again?
| Evidence type | What to test | Useful evidence |
|---|---|---|
| Documents | Is the control defined and current? | Risk assessment, policy, schedule, procedure |
| Observation | Does practice match the document? | Walk-round notes, task observation, product availability |
| Conversation | Do people understand their role? | Staff and agency-worker responses, handover prompts |
| Records | Can the home show oversight and learning? | Audit results, incidents, actions, review dates |
The 10 checks in an IPC audit checklist
1. Leadership, roles and local risk assessment
Confirm who leads infection prevention and control (IPC), who covers absence, how concerns reach the registered manager and how oversight is recorded. Responsibilities should be clear across care, domestic, catering, maintenance and agency teams. CQC identifies clear IPC roles and responsibilities as part of its quality statement.2
Review the home-wide infection-risk assessment and task-specific assessments. They should reflect the people being supported, the premises, shared equipment, known risks and local escalation routes. Check that changes in infection risk, new guidance, incidents or outbreak learning prompt review. A policy copied from elsewhere without a local risk assessment is not a workable control.
2. Cleaning schedules and high-touch points
A care home cleaning audit should follow the route of contact, not only the room list. Check that the schedule states the area or item, frequency, method, product, responsible role and completion record. Observe whether staff can find the current schedule and whether supervisors sample completion and standards rather than merely collect signatures.
Give specific attention to high-touch points: door and cupboard handles, handrails, call bells, light switches, dining furniture, taps, toilet flushes, mobility aids and shared devices. These are not automatically “deep-clean only” items; their frequency should follow local risk assessment, occupancy and use. The DHSC advises that cleaning arrangements, product efficacy and frequency should be reviewed and amended when risks change, including during outbreaks.3
3. Clean, safe care equipment
List reusable and shared equipment, from hoists and wheelchairs to clinical devices and commodes. For each item, establish who cleans it, when, with what product, where it is stored and how staff identify it as ready for use. Equipment intended for one person should not drift into shared use without controls.
Ask staff to demonstrate the process rather than relying on a verbal “yes”. Check that product instructions are available, that cleaning materials are compatible with the item and that damaged or difficult-to-clean surfaces are reported. CQC considers cleanliness and hygiene of both the environment and equipment within IPC assessment.2
4. Laundry from collection to return
Audit the laundry route: used-linen handling and segregation, bag or container movement, laundry environment, machine use, hand hygiene and clean-linen storage. Prevent cross-contamination while respecting residents’ clothing and preferences.
The audit should distinguish normal used linen from linen that requires additional precautions under the home’s risk assessment and current guidance. Staff need a clear response for contaminated linen, including safe handling and the route into the designated process. NIPCM identifies safe management of healthcare linen as one of the ten SICP elements.4
5. Blood and body-fluid spill response
A spill procedure works only if materials are available where a spill can occur and staff understand the immediate steps. Check spill-kit contents and replenishment, PPE, product instructions, waste route, any required signage and reusable-equipment cleaning.
Test competence with a short scenario, such as a resident becoming unwell in a communal area. Staff should explain how they protect people, use risk-based PPE, contain and clean the area, dispose of waste and report or escalate. Spill management is an explicit SICP component.3
6. Waste, sharps and clinical specimens
Walk the waste journey from production to collection. Inspect labels, containers, closure, placement, segregation, storage, access and records. Sharps containers should suit the risk assessment and be available where used; colour alone does not prove a waste classification.
Clinical or infectious waste, offensive hygiene waste, pharmaceuticals and sharps may need different handling. The route depends on classification, local risk assessment, medicines or chemicals present and contractor acceptance criteria. HSE advises providers to consider infection-control, health and safety, environmental and transport legislation.6
Retain paperwork for each confirmed stream. Hazardous-waste movements generally require consignment notes; non-hazardous transfers need the relevant written description and transfer information.7 HTM 07-01 is best-practice guidance, not a word-for-word rule for every care home.8
Where a gap concerns containers, classification, storage or records, link the corrective action to a clinical waste management review or a waste compliance audit. A provider remains responsible for safe arrangements even where it uses an external contractor.1
7. PPE availability and correct use
Audit PPE by task and risk, rather than treating gloves and aprons as universal. PPE is used when risk assessment shows it is necessary; inappropriate use can spread infection.3 Check stock, point-of-use storage, size, accessibility and that it is clean, dry, covered and off the floor.
Observe donning and doffing where appropriate. Staff should perform hand hygiene before putting on and after removing PPE, change damaged or contaminated PPE and dispose of used items through local procedures.3 National adult social-care guidance requires PPE use to follow risk assessment, correct donning and doffing, hand hygiene and appropriate disposal; staff must be trained for the controls relevant to their role.3
8. Staff competence, agency induction and hand hygiene
Training attendance alone does not establish competence. Sample staff across roles and shifts, including bank and agency colleagues. Check induction, refresher arrangements, supervised practice and competency records. Staff should know where to find guidance, what to do if unwell and how to escalate a suspected infection or control failure.
Observe hand-hygiene facilities, soap, towels, alcohol-based hand rub and instructions. NIPCM directs staff to use soap and water when hands are visibly soiled and for vomiting, diarrhoea, gastrointestinal or spore-forming infections; hand rub is used for routine direct care otherwise.4 Ask staff why the method changes.
9. Outbreak recognition, response and recovery
Read the outbreak plan alongside a local scenario. It should cover symptom reporting, clinical or health-protection advice, individual and service-wide risk, communication, staffing, proportionate activity and visiting decisions, and how additional controls end. Identify who can authorise decisions if the manager is unavailable.
During increased risk, review cleaning frequency and product efficacy, staffing contingencies, PPE and paper-product stocks, shared spaces and the point at which additional measures end.3 Decisions must remain risk-based and consider residents’ wellbeing, rights and clinical advice.
Routine cleaning continues during an outbreak but may need more frequency or focus. Disinfection is an additional control only where risk assessment and product instructions support it. Significant contamination may need a planned specialist response, not an unplanned extension of routine tasks.
| Response level | Purpose | Audit question |
|---|---|---|
| Routine cleaning | Remove dirt and reduce contamination in normal operation | Are scheduled tasks, high-touch points and supervision working? |
| Risk-based disinfection | Address a specific identified infection risk using a suitable product | Is the product, contact time and target surface defined locally? |
| Specialist outbreak response | Manage significant contamination or an enhanced decontamination requirement | Has the home assessed scope, access, waste, verification and documentation? |
For a site-specific specialist scope, Eighty Eight can assess infection-control cleaning requirements. This supports, rather than replaces, the home’s own clinical advice, risk assessment and day-to-day IPC responsibilities.
10. Infection prevention records and corrective action
The final check is whether the home can show a credible management cycle. Bring together cleaning and equipment checks, laundry records, waste paperwork, PPE stock monitoring, competence, incidents, outbreaks, feedback and earlier audits. Look for patterns, such as unusable forms, recurring stock shortages or spill incidents requiring a care-plan or environmental review.
Every action should be specific. “Improve cleaning” is not an action; a scheduled check of call bells and handrails, with a named reviewer, can be tested. CQC expects incidents and potential-harm events to be reported, investigated, monitored and used to prevent recurrence.1
Turn findings into an inspection-ready improvement plan
Close the audit with a short prioritised plan. Address immediate risks at once, then schedule wider changes. Retest an action where the gap was found; do not close it simply because a policy was revised. Keep the audit, evidence and review notes together.
| Priority | Typical finding | Immediate control | Evidence of closure |
|---|---|---|---|
| Immediate | No suitable spill materials where needed | Provide safe access and brief affected staff | Restock record and observed practice |
| High | Sharps or waste segregation unclear | Stop unsafe route and seek competent classification advice | Confirmed containers, procedure and records |
| Planned | Cleaning supervision inconsistent | Introduce manager sampling and feedback | Completed samples and trend review |
| Learning | Outbreak plan not tested | Run a tabletop exercise and revise gaps | Exercise notes and updated plan |
Review live controls, due actions and a scenario-based competence check regularly. Keep resident experience in view: IPC should protect people without becoming an unnecessary barrier to communication, dignity or ordinary life.
Frequently asked questions
What should a care home infection control audit include?
It should cover leadership and risk assessment, environmental cleaning, high-touch points, care equipment, laundry, spills, waste and sharps, PPE, staff competence, outbreak planning, infection prevention records and corrective action. The scope should reflect the home’s people, premises, services and local risks.2
How often should a care home carry out an IPC audit?
There is no single frequency that suits every control. Set a schedule based on risk, review it after incidents, outbreaks, changes in guidance or changes to the service, and use ongoing spot checks for high-risk routines. The important point is that monitoring leads to timely action and retesting.
Is a cleaning schedule enough for CQC infection control in care homes?
No. A schedule is one piece of evidence. CQC assesses whether infection risk is managed effectively, premises and equipment are clean and hygienic, responsibilities are clear and concerns are shared appropriately.2 Observed practice, staff understanding, supplies, records and action follow-through matter as well.
When does a home need specialist infection-control cleaning?
Consider a specialist assessment when there is significant contamination, an outbreak-related decontamination requirement, biohazard risk or a task beyond the competence, equipment or safe scope of the routine team. The home should first assess the risk and follow applicable clinical and public-health advice. Specialist work must have a defined method, waste route and documented handover.
What infection prevention records should be available?
Maintain records that show the controls used and the learning cycle: local risk assessments, cleaning and equipment checks, staff induction and competence, PPE and stock checks, waste documentation, incidents, outbreak decisions, audit findings and corrective-action reviews. Keep only records that are useful, accurate and handled appropriately under data-protection obligations.
Authoritative guidance
Use the following sources to maintain and test local arrangements. National guidance should be applied through the home’s own risk assessment and local clinical or public-health advice.
- CQC explains the legal requirements for safe care and treatment, including preventing and controlling infection.1
- CQC’s IPC quality statement identifies the assessment themes for cleanliness, PPE, outbreaks, waste and related controls.2
- DHSC’s adult social-care IPC resource sets out standard precautions and risk-based responses.3
- NHS England’s NIPCM provides detailed SICP practice guidance, including hand hygiene, equipment, linen, spillages and waste.4
- HSE and NHS England provide healthcare-waste guidance, including the role of HTM 07-01 as best practice.6
Need a practical review of cleaning or waste controls?
Eighty Eight Management supports care-sector sites with documented waste arrangements, compliance-focused reviews and specialist infection-control cleaning where a site-specific assessment identifies the need. For a practical conversation about the gaps found in your audit, call 01902 239088 or review our sharps and pharmaceutical waste support.
