Infection control for home carers: hand hygiene, PPE and when to stay away

The NHS says a proper hand wash takes around 20 seconds. Alcohol handrub is fine for most moments in between, but UKHSA says you must use liquid soap and water when your hands are dirty or may have touched body fluids, and whenever you are caring for somebody with diarrhoea or vomiting, because alcohol does not destroy norovirus or Clostridioides difficile. A handrub should be at least 60% alcohol. Carry your own, because a client's home may not have a basin near where you work.

When you are giving hands-on care, UKHSA asks workers to be bare below the elbows: short sleeves or sleeves rolled up, and no wrist or hand jewellery apart from one plain ring. Keep your nails short and free of nail products, including false nails, and cover any cut on your hands with a waterproof dressing.

Gloves and aprons are single use. Use them for one task with one person, then take them off and clean your hands, because gloves can have holes you cannot see. Do not wash gloves to use them again. The NHS England infection control manual gives the order: putting PPE on and taking it off is apron, then mask and eye protection if you need them, then gloves. You take off gloves first, then the apron, then any eye protection and mask, and clean your hands last.

The contract between you and each client says the carer provides any equipment they need to do the work, so gloves, aprons and handrub are yours to buy. A client may offer to supply them, and you can agree that between you, but it is not something to assume. The cost counts towards your tax bill: gov.uk lists protective clothing needed for your work as an allowable expense, while everyday clothes you wear to work are not. Allowable expenses for self-employed carers explains how to record it. UKHSA suggests keeping your stock in a sealed container in your car, or in the client's home if they agree, and never on the floor.

1. 1

   Keep people away from it

   Ask your client and anyone else in the room to keep clear until it has been cleaned up.
2. 2

   Put on gloves and an apron

   Clean your hands first. Add eye protection if anything could splash.
3. 3

   Clean it up straight away

   Use a product that suits the surface and follow its instructions. Never use a chlorine-releasing product, such as bleach, directly on urine.
4. 4

   Bag the waste and clean your hands

   Put the waste in a bag no more than three-quarters full and tie it. Take off your gloves and apron, and clean your hands.

For laundry, UKHSA says not to shake soiled items, not to put them on the floor or on surfaces, and to wash them apart from everything else. Do not wash infectious laundry by hand. Where you are washing the clothes of somebody with an infectious illness, use the highest temperature the care label allows, with a pre-wash for heavily soiled items. The NHS gives the same advice for bedding with poo or vomit on it: wash it separately on a hot wash. Wear an apron while you handle it, and clean your hands between dirty and clean laundry.

Your own work clothes count too. UKHSA asks workers to start each day in clean clothes, to change straight away if they are soiled, and to wash workwear at the hottest temperature the fabric will take. Tie long hair back, and do not wear a lanyard during personal care.

Needles belong in a sharps box, never a bin bag. If a needle or a bite breaks your skin, HSE advises encouraging the wound to bleed gently and washing it with soap and water, without scrubbing or sucking it. If blood or body fluid goes in your eyes or mouth, wash them with plenty of water. Then get medical advice straight away: UKHSA says medical attention should be sought without delay. With no occupational health team, that means A&E or NHS 111.

Staying away costs you money. Statutory Sick Pay is only for people who are classed as an employee, so the days you miss are unpaid. At a rate of £20 an hour with our fee included, each one-hour visit you miss is £16 that does not reach you, and two days of four visits a day is £128. Holiday pay, sick pay and pensions when self-employed covers putting money aside for this.

Tell your client or their family as soon as you know you cannot come. The carer terms ask you to agree time off for illness with the client, and the contract's notice rules make an exception for illness. You can send a suitable substitute carer in your place, but you arrange and pay them yourself.

When it is the client who is ill, the contract says they must tell you about communicable illnesses or infections, before you start and whenever things change. Ask at the first visit, and again if you hear of a bug going round the family. You can stop work if you reasonably believe it is unsafe, but a client who has an infection usually still needs care. Gloves, an apron and soap and water, as set out above, are usually what lets you carry on. A visit the client cancels because they are ill or have gone into hospital is not payable under the contract. When a client cancels or goes into hospital explains the rest.

The NHS flu vaccine page and the government's flu programme letter for 2026 to 2027 both describe care workers by who employs them. Neither mentions self-employed carers. So we cannot tell you that you qualify as a care worker. Ask your pharmacy or GP surgery, and tell them what work you do. If a client employs you as a personal assistant using direct payments, the letter does include you, and working as a personal assistant explains how that arrangement differs from being self-employed.

You may qualify on other grounds, such as your age, a health condition, or being the main unpaid carer for somebody in your own life. The NHS COVID-19 vaccine page does not list care workers this autumn.

When you are ready to take on clients and ask them these questions yourself, you can register as a carer on PrimeCarers, or see the carer jobs open near you first.