Hygiene in care homes


Regulations at a glance

Hygiene plays an important role in all areas of personal and public life: It is essential to maintain or improve our health and prevent diseases. Prevention of infection is particularly vital in places where large numbers of people come together. 



As well as hospitals, care homes are also highly sensitive facilities: Movements of care staff and visitors create high footfall in these environments. Pathogens can potentially be brought in and quickly spread. Care home residents also need particularly high protection: Their immune systems are often weakened due to age or underlying health conditions. Their bodies are unable to effectively fight off infection. Specific guidelines on hygiene in care homes are therefore even more important to ensure effective protection for all residents and staff. Various regulations have been introduced to guarantee hygiene standards in care homes. 


Legislation and regulations governing hygiene in care facilities

Hygiene in care homes encompasses a wide range of issues – from prevention of infectious diseases to handling of food in kitchens and medical products used to care for residents. Separate guidelines and regulations apply to each critical area. Overview:

  • German Protection against Infection Act: The German Protection against Infection Act (IfSG) is one of the most important pieces of legislation in hospitals, care homes and child daycare centres such as schools and nurseries. It is intended to prevent the spread of infectious diseases.

  • RKI Guidelines: The Robert Koch Institute (RKI) and the Commission for Hospital Hygiene and Infectious Disease Prevention have issued various guidelines for the construction and operation of medical facilities to create strong foundations for hygiene. 

  • Federal state hygiene regulations: As well as national legislation such as the German Protection against Infection Act, federal states have also introduced various regulations governing hygiene in care homes. These can vary from one state to another. 

  • German Medical Devices Act: A wide range of medical devices are used in care homes. To guarantee the safety and hygiene of these products, their manufacture and storage are governed by the German Medical Devices Act. 

  • German Biological Agents Ordinance: The aim of the German Biological Agents Ordinance (BioStoffV) is to protect employees whose work brings them into contact with biological agents such as bodily fluids. These agents pose a high infection risk. 

  • German Occupational Safety and Health Act: This Act sets out a range of occupational safety and health measures for interactions with residents of care facilities to ensure the health and safety of staff. 

  • German Food and Commodities Act: This Act sets out regulations governing correct and hygienic handling of foods during transportation, preparation and issue. 

Inadequate hygiene in care homes poses a high risk for health. Transmission of an infection in a facility with elderly residents can cost many lives. Multi-resistant pathogens are a particular risk. These are transmitted mainly through invasive procedures such as urinary catheters or feeding tubes. Patients who have already received several courses of antibiotics are at particular risk. They often affect very elderly patients who can no longer care for themselves independently or who are bedridden. Multi-resistant germs are also frequently found in hospitals – hence the description ‘hospital bugs’ – which means frequent inpatient stays among residents are also a risk factor. 

Requirements for staff and organisation

To ensure appropriate hygiene in care homes, various requirements for employees and organisation of processes are governed by law. These are specified in the care home law. These include: 

  • Required specialist knowledge of staff 
  • Appointment of a hygiene officer 

  • Creation of a hygiene committee with representatives from all relevant professional groups that meets regularly 

  • Involving doctors to ensure early diagnosis of diseases and correct therapeutic treatment as well as controlled use of antibiotics 

  • Creation of an internal hygiene concept 


  • Hand hygiene: Hand hygiene plays a crucial role in preventing infection. Various guidelines, such as sanitising hands after nursing tasks, contact with bodily fluids or potentially contaminated objects, are designed to prevent infection. 

  • Protective clothing: In some situations, care staff must wear protective clothing such as a face mask, gloves and a gown. 

  • Care products and medical equipment: Strict hygiene requirements apply to the preparation of medical products such as cannulas or catheters; care products such as manicure sets; care vessels such as urine bottles as well as bedding and wash bowls. 

  • Cleaning and disinfecting of surfaces: To prevent the spread of germs, cleaning and disinfecting procedures are based on the guidelines of the Robert Koch Institute. 


Framework hygiene plan according to § 36 of the German Protection against Infection Act

Care homes have different structural and operational requirements, which means each establishment needs to draw up its own hygiene plan. The health authority for each federal state provides a framework hygiene plan which can be amended as required. The hygiene plan should consider the following factors: 

  • Individual risk analysis 

  • Assessing risks and defining measures to reduce them 

  • Actions for monitoring hygiene measures 

  • Intervals for reviewing the efficiency of the hygiene concept 

  • Information and training for all affected individuals 

  • Documentation of the hygiene plan and its implementation 

Hygiene in care homes is essential to guarantee the best possible quality of life for residents, and to protect staff and prevent the spread of infectious diseases. Various legal measures have been introduced with the aim of improving protection against infection.