Minimising infection risks: Safe laundry practices in UK care homes through research and guidance development

Those living in care homes are often the most vulnerable in our society, either due to their age, frailty or ongoing physical and mental health needs. Care homes are more susceptible to infectious diseases due to their communal living environments, resulting in transmission of infections through day-to-day interactions. Infection prevention and control (IPC) is therefore a priority for all care homes, including safe practices for laundry management. Despite the clear risk posed by contaminated textiles, the implementation and understanding of effective laundry IPC measures in care homes remains underexplored. This study aimed to assess current laundry management practices, awareness of IPC guidance, and the barriers care homes face in adopting standardised laundering protocols. Using a mixed-methods approach, data were gathered from 1,062 online survey responses, follow-up interviews, and focus groups with care home managers, staff, and industry experts. Key findings revealed a significant lack of awareness and inconsistent application of the national Health Technical Memorandum (HTM-01-04). Over 50% of care homes lacked formal management of laundry training programs, and only 46% of care home staff reported having clear IPC procedures for linen management. Additional challenges included spatial constraints, costs, equipment maintenance, and the difficulty of laundering mixed textiles, such as residents' personal clothing, at appropriate disinfection temperatures without damage. The survey also showed that nearly half of the managers expressed a preference for the outsourcing of laundry to commercial laundries. The findings highlight an urgent need for accessible, practical, and sector-specific linen IPC guidance, tailored to the unique care home environments. In response, adapted guidance and educational resources were co-created with sector stakeholders to support implementation. This study is the first of its kind in the UK and emphasises that safe linen management is fundamental to infection control in care homes, protecting both vulnerable residents and staff from healthcare-associated infections.