Infection prevention and control sit at the heart of quality care. A single lapse — an unwashed hand, a reused glove — can set off a chain of infection that puts vulnerable people at risk. Whether you work in a care home, a hospital or community support, preventing infection is everyone’s responsibility.
The 2025 update to the Care Certificate introduces new guidance on infection prevention and control, focusing on the six links of infection and the latest PPE guidance 2025. It strengthens Care Certificate Standard 15, ensuring every worker understands how to protect themselves and others through safer, more consistent infection control practices.
In this article, you’ll learn:
- What each of the six links of infection means and how to break them
- The updated PPE rules and practical guidance for 2025
- How the infection prevention and control Care Certificate supports safer working
- Real-world examples and easy ways to apply the new standards in your daily role
What are the six links of infection control?
The six links of infection form the foundation of how infections spread — and how we can stop them. The 2025 update to the Care Certificate Standard 15: Infection Prevention and Control highlights these links as essential knowledge for all care workers. Understanding each one helps you recognise risks early, apply the right PPE guidance 2025, and break the chain of infection before it harms anyone.
The chain of infection explains how infectious diseases move from one host to another. According to the Care Certificate workbook, there are six links that must all be connected for an infection to spread :
- Causative agent (pathogen). This is the germ that causes disease, such as bacteria, viruses, fungi or parasites. Examples include MRSA, norovirus and influenza.
- Reservoir. The place where the pathogen lives and multiplies. It may be a person, an animal, soil, water or food.
- Portal of exit. How the pathogen leaves its reservoir, for instance, through saliva when someone coughs, or via broken skin and bodily fluids.
- Mode of transmission. How the pathogen travels from one host to another. Direct contact (hand‑to‑hand) and indirect contact via equipment or surfaces are common routes.
- Portal of entry. How the pathogen enters a new host. This might be through a wound, the mouth, eyes or medical equipment.
Susceptible host. The person who becomes infected. Vulnerability depends on factors like age, general health and immune status.
If just one link is broken, the chain collapses and infection cannot spread. That is why infection control practices – from handwashing to equipment cleaning – focus on interrupting one or more of these links.
Breaking the chain of infection
So how do we break those links in daily practice? Here are some practical measures for each stage:
- Eliminate or reduce the pathogen. Cleaning and disinfection remove germs from surfaces and equipment. Sterilisation for invasive procedures ensures no viable organisms remain. Vaccination protects workers and service users against specific diseases.
- Control the reservoir. Cover food, store waste safely and manage water systems to prevent bacterial growth. Isolate individuals when necessary to limit exposure.
- Block the portal of exit. Respiratory hygiene – covering coughs and sneezes – and appropriate dressings on wounds prevent droplets from reaching others. Safe handling of bodily fluids, including using disposable tissues and proper waste containers, also helps.
- Interrupt transmission. Hand hygiene is the cornerstone of infection prevention and must be performed at key moments: before touching a person, after exposure to body fluids, after removing gloves and before moving to the next task. Regular cleaning of shared surfaces and equipment, along with social distancing when respiratory symptoms are present, further reduces spread.
- Protect portals of entry. Protective clothing such as aprons, gloves and masks create a barrier so that pathogens cannot enter through skin or mucous membranes. Safe injection practices and aseptic techniques prevent contamination via medical devices.
- Strengthen hosts. Maintaining general health through proper nutrition, vaccinations and adequate rest supports immune defences. Recognising vulnerable people – such as older adults or those with chronic illness – allows for tailored precautions.
Updated PPE Guidance in the Care Certificate (2025): 7 Practical Steps
Personal protective equipment (PPE) is a vital standard infection control precaution, but its use must be risk‑based rather than automatic. The 2025 update to the Care Certificate expands on PPE requirements, emphasising when, how and why to use each item. Key points include:
- Assess the task and risk. Before reaching for gloves or masks, consider the likelihood of exposure to blood, body fluids, respiratory droplets or hazardous materials. Use PPE appropriate to the level of risk – not because it is routine.
- Choose the right PPE. Gloves protect hands from direct contact and reduce cross‑contamination. Aprons shield clothing and uniforms from spills. Masks and respirators prevent inhalation of droplets or aerosols. Eye protection is needed if splashes are likely.
- Don and doff safely. PPE should be put on in a clean area and removed without contaminating yourself or others. Follow the sequence recommended by your organisation and dispose of single‑use items immediately. Perform hand hygiene before and after removal.
- Store PPE correctly. The Community Infection Prevention policy advises keeping PPE near the point of use and in clean, dry conditions. Never store aprons or gloves in a bathroom or on the floor.
- Replace between tasks. Disposable gloves and aprons are single use. Reusing gloves can lead to tiny tears and risk cross‑contamination. Change PPE between residents or procedures to avoid spreading microorganisms.
- Dispose of PPE safely. Follow your waste policy for infectious waste and sharps. Sharps bins should be assembled and closed by named staff, not filled past the marked line and kept above floor level.
- Use protective clothing for linens. When handling contaminated bedding or towels, wear appropriate PPE and launder items separately on a hot wash to kill bacteria.
This focus on risk assessment, correct choice, and proper disposal helps ensure PPE truly protects rather than gives a false sense of security.
Standard infection control precautions and safe practices
Beyond PPE, there are nine other elements of standard infection control precautions (SICPs), set out by NHS England. These precautions apply to all staff, in all settings, at all times, regardless of whether infection is known to be present. They include:
- Patient placement and infection risk assessment. On admission or transfer, assess each person for infection risk (diarrhoea, rash, fever, previous infections) and make decisions on placement accordingly.
- Hand hygiene. Wash hands with liquid soap and water when visibly dirty or after caring for people with vomiting or diarrhoea. Use alcohol‑based hand rub for routine decontamination. Dry hands thoroughly and cover cuts with waterproof dressings.
- Respiratory and cough hygiene. Encourage covering mouth and nose when coughing or sneezing. Provide tissues, waste bags and handwashing facilities. Consider wearing masks during outbreaks.
- Safe management of the care environment. Keep surfaces clean and clutter‑free. Use appropriate cleaning products and follow cleaning schedules.
- Safe management of equipment. Decontaminate reusable equipment between uses. Use disposable equipment where possible.
- Safe management of linen. Handle soiled linen as little as possible and place it directly into colour‑coded bags. Wash at the recommended temperature to kill pathogens.
- Safe management of blood and body fluid spills. Follow your organisation’s spill kit procedures and wear PPE when dealing with spills.
- Safe disposal of waste, including sharps. Dispose of sharps at the point of use into approved containers, ensure bins are labelled and not overfilled, and never re‑sheathe needles.
- Occupational safety. Vaccinations, risk assessments and reporting of incidents protect staff from occupational infections. Staff with symptoms of diarrhoea or vomiting should stay away from work until symptom‑free for 48 hours.
Infection control training, reflection and continuous improvement
Training is essential for embedding these practices. All care workers should receive induction and refresher training on the six links, standard precautions and appropriate PPE use. Training should include practical demonstrations of handwashing, donning and doffing PPE, and safe disposal. It should also cover the rationale behind each measure so that staff understand why it matters.
Reflective practice turns experience into learning. After each shift or after an incident, take a moment to ask: What went well? What could we improve? Did we follow the data and infection policies? Were there any near misses? Debriefing as a team helps identify gaps and develop better strategies. Regular supervision sessions provide space to discuss challenges, review audit logs and identify further training needs.
Continuous improvement means keeping up to date with emerging risks. Technology and pathogens evolve; so do care settings. The national infection prevention and control manual emphasises that precautions must be applied consistently by all staff, and implementation monitoring should be ongoing. Encourage staff to read updates from regulators, attend webinars and participate in scenario‑based training.
Roles and responsibilities in infection control
Infection prevention is everyone’s business. Leaders must ensure there are adequate resources, safe systems of work, and a culture that encourages reporting without blame. Managers and employers must provide training, support and risk assessments so staff can follow guidance confidently. Every worker has a duty to apply infection control principles, maintain competence, report concerns and stay home if unwell. Infection prevention teams develop systems and offer expert advice to support improvement. Sharing responsibility across these roles ensures that infection control is not just a policy but a lived practice.
Empathy, dignity and person‑centred care
Effective infection control is not just about compliance; it upholds dignity. People receiving care trust that their personal space will be respected and their information will remain confidential. Safe practices protect individuals from avoidable harm and demonstrate that their wellbeing matters. For example, offering choices about PPE when possible, explaining why certain measures are needed and ensuring consent is obtained before using invasive procedures all reinforce autonomy. Taking time to perform hand hygiene in front of the person you support shows respect and gives them confidence in your care.
Person‑centred care also recognises that infection prevention measures may feel intrusive. Gloves, aprons and masks can create a barrier, both physical and emotional. Communicating openly about why they are necessary, using the minimum PPE required and involving individuals in decisions helps maintain connection. In home‑care settings, offering paper‑based options or alternatives when digital records are challenging ensures inclusivity. Ultimately, infection prevention and respect for dignity go hand in hand: one protects physical health while the other protects emotional wellbeing.
Common mistakes and how to avoid them
Even experienced staff can slip into habits that undermine infection control. Here are some pitfalls to watch for and how to correct them:
- Rushing hand hygiene. Washing or rubbing for less than the recommended 20 seconds reduces effectiveness. Hum the tune of a short song to time your handwash and remember to dry hands thoroughly.
- Touching face masks. Adjusting the front of your mask with dirty hands contaminates it. Handle masks by the straps and avoid touching your face while wearing them. Replace masks if they become moist or soiled.
- Reusing gloves. Disposable gloves are single use. Change them between tasks and wash or sanitise hands afterwards.
- Not cleaning equipment and surfaces. Shared devices and high‑touch areas harbour germs. Wipe equipment, door handles and switches between uses and keep workspaces uncluttered so they can be cleaned easily.
- Ignoring near misses. Spills and PPE failures that do not cause immediate harm still reveal risks. Reporting them helps improve systems and prevent future incidents.
- Wearing inappropriate PPE. Gloves without an apron offer little protection from splashes and aprons without gloves expose hands. Assess the risk and select PPE that matches the task.
By being aware of these common errors and intentionally addressing them, you strengthen your practice and contribute to a safer environment for all.
Why the 2025 update matters: safety, trust and quality
The Care Certificate has been the benchmark for care support workers since 2015. The 2025 update was the first major overhaul in a decade. Standard 15 (infection prevention and control) has been fully revised and expanded. New learning outcomes include describing the causes of infection, explaining the six links, identifying standard precautions and finding up‑to‑date guidance, demonstrating effective hand hygiene, understanding how personal health and vaccination status influence risk, recognising different types of PPE and using them properly, cleaning and decontaminating the environment, and handling spills and waste.
These changes reflect a world in which digital tools, telehealth and remote monitoring are commonplace. They recognise that infection prevention cannot rely on paper checklists alone. By raising the profile of infection control and emphasising practical skills, the updated standard aims to reduce healthcare‑associated infections, protect vulnerable individuals and strengthen public trust in care services.
Conclusion
The 2025 Care Certificate update makes infection prevention and control everyone’s priority. By understanding the six links of infection and following the new PPE guidance 2025, care workers can stop infections before they start.
Good care isn’t just about treatment — it’s about protection. When we follow safe practices and reflect on our actions, we build trust, protect dignity, and create safer, healthier care environments for everyone.
Care Certificate Course - Standards (1 to 16)
Table of Contents
Frequently Asked Questions
The six links are: causative agent (the germ), reservoir (where it lives), portal of exit (how it leaves), mode of transmission (how it travels), portal of entry (how it enters a new host) and susceptible host (the person who is exposed).
The Care Certificate is a set of standards that all health and social care support workers in England must complete. Standard 15 covers infection prevention and control. The 2025 update expands this standard to include the six links of infection, standard precautions, hand hygiene, PPE use, and safe handling of the environment and waste.
PPE includes gloves, aprons, masks, respirators, goggles and face shields. Its purpose is to create a barrier that protects skin, clothing and mucous membranes from contact with pathogens. PPE should be selected based on risk assessment, put on and taken off correctly, and changed between tasks.
Follow standard infection control precautions: assess infection risk on admission, perform hand hygiene at key moments, practice respiratory and cough etiquette, manage the care environment and equipment safely, handle linen, spills and waste correctly, and maintain occupational safety. Use PPE appropriately, ensure vaccinations are up to date and stay off work if you have diarrhoea or vomiting.
