Personal hygiene in care homes: standards families can expect

Care homes in England must treat residents with dignity and keep people, premises and equipment clean and safe. There is no set number of baths or showers a resident must have: each person’s care plan should reflect their needs and preferences, while CQC regulations and the national infection prevention and control code set the standard the home is judged against.

At a glance

• Regulation 10 requires dignity and respect, Regulation 12 requires infection risks to be assessed and controlled, and Regulation 15 requires clean, suitable premises and equipment.
• The government’s infection prevention and control code of practice was last updated on 13 December 2022 and is guidance that CQC takes into account.
• NICE says every new resident’s mouth care needs should be assessed on admission, with natural teeth brushed at least twice a day with fluoride toothpaste.
• Personal care should follow the individual care plan, not a fixed rota.
• Scotland, Wales and Northern Ireland have their own regulators and standards.

Which rules cover hygiene in a care home?

No single rule covers hygiene. In England, several parts of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 work together, and the Care Quality Commission inspects against them. See what the CQC is and what it does.

• Regulation 10, dignity and respect: residents must be treated with dignity and respect. That includes protecting their privacy, supporting their independence and giving due regard to protected characteristics under the Equality Act 2010.
• Regulation 12, safe care and treatment: providers must assess the risk of infections and prevent, detect and control their spread.
• Regulation 15, premises and equipment: premises and equipment must be clean, suitable, properly used and maintained, with hygiene standards that suit how they are used.
• Regulation 14, nutrition and hydration: covers meals and drinks. See our guide to food hygiene in care homes.

The Health and Social Care Act 2008 code of practice on the prevention and control of infections sits alongside these. It applies to adult social care providers in England and is described as guidance rather than mandatory. CQC must take it into account when making registration decisions, and a provider can meet the regulations another way if that is equivalent or better. The UK Health Security Agency also publishes infection prevention and control guidance for all adult social care settings, including care homes.

Different regulators apply elsewhere in the UK. See our guides to Care Inspectorate grades in Scotland, Care Inspectorate Wales ratings and RQIA inspections in Northern Ireland.

What does good personal hygiene care look like day to day?

Hygiene support is part of personal care: washing, bathing, mouth care, continence care, dressing, and looking after hair, nails and skin. The table shows what good practice usually looks like and what a family can ask.

For continence, see dementia and incontinence and free NHS incontinence products. For skin, see bed sores and pressure ulcers. Hairdressing is often an extra, as our guide to what care home fees include explains.

NICE guidance on oral health for adults in care homes asks homes to assess mouth care needs when a resident arrives, record the results in the care plan and update it when needs change. A full oral health assessment must be done by a dental professional. Untreated dental pain can change the behaviour of residents who cannot describe it, such as some people with dementia.

How should staff protect dignity and choice?

Help with washing and toileting is among the most personal things one person can ask of another, so how it is done matters as much as whether it is done. Regulation 10 puts privacy, independence and respect at the centre of this. Good practice includes:

• Closing doors and curtains, covering the person and explaining what is about to happen.
• Asking about preferences, including whether the person would rather be helped by a carer of a particular gender, and recording the answer.
• Encouraging residents to do what they can for themselves, rather than doing everything for them.
• Respecting religious and cultural practices, and not rushing.

Homes cannot always guarantee a specific carer on every shift, but they should ask, record and try. Our guide to dignity in personal care covers the detail, and equality and diversity in care homes looks at faith and cultural needs. If a relative with dementia resists help, why people with dementia refuse care explains approaches that often help.

How do care homes prevent infection?

Preventing infection is meant to be part of everyday routines, not only an outbreak plan. The UKHSA resource sets out standard infection control precautions for adult social care and separate guidance on managing outbreaks. In practice, a well-run home will typically:

• Train staff in infection control and have someone leading on it.
• Make hand hygiene easy for staff and visitors, and clean shared equipment such as hoists, shower chairs and commodes between residents.
• Handle soiled laundry separately from clean items, and keep bedrooms, bathrooms and communal areas visibly clean and in good repair.
• Have a written plan for outbreaks that explains how residents are protected and how visiting will be handled.

Outbreaks can still happen in well-run homes, so judge how quickly the home responds and how openly it talks to families. See norovirus in care homes and care home visiting rights.

What should you look for when you visit?

The NHS lists clean buildings, rooms and bathrooms among the signs of a good care home. Visit more than once, at different times of day, and look at the detail. Our questions to ask when visiting a care home gives a fuller checklist.

Good signs

• Residents look cared for, with clean hair and nails and clothes suited to the weather and their own taste.
• Bathrooms and toilets are clean and stocked with soap and towels, without a lingering smell.
• Staff knock, ask and explain before helping, and doors are closed for personal care.

Warning signs

• A persistent smell of urine or faeces in communal areas, rather than a passing one.
• Residents in stained clothing, or in night clothes late in the day without a reason.
• Unexplained sore or broken skin, dry mouths, missing dentures or long waits for the toilet.
• Staff who are unwilling to discuss hygiene or infection control.

One of these does not prove poor care, but a pattern deserves a direct conversation with the manager. Our guide to reading a CQC inspection report shows how to check what inspectors found.

What can you do if standards slip?

1. Raise it with the home. Speak to the senior carer or manager, give specific examples and dates, and ask what will change and by when.
2. Make a formal complaint. If the response is not good enough, use the home’s complaints procedure. Our guide on how to complain about a care home has the steps.
3. Go to the council or the Ombudsman. The NHS advises contacting the council if it funds the care. Otherwise, or if you are still unhappy, contact the Local Government and Social Care Ombudsman.
4. Tell CQC. CQC regulates adult social care in England, and what families report helps inform inspections.
5. Act quickly if someone is at risk. If you think a resident is being harmed or neglected, contact the council’s adult safeguarding team. In an emergency, call 999.

Frequently asked questions

How often should a care home resident be washed or bathed?

There is no fixed legal frequency. The care plan should record how often the person wants and needs to wash or bathe, based on their preferences, health and skin condition. Families can ask to see the plan and request changes at a review.

Can my relative choose a male or female carer for personal care?

Regulation 10 requires dignity, privacy and due regard to protected characteristics. Homes should ask about preferences and record them, but staffing on a given shift may limit what can be promised. Raise it when the care plan is written.

Who is responsible for a resident’s mouth care?

The care home should assess mouth care needs on admission and support daily care, including brushing and denture cleaning. Care staff can assess needs, but a full oral health assessment must be done by a dental professional, so the home should help arrange dental appointments.

What if my relative refuses help with washing?

Staff should stay patient, offer choices, try again later and record what happened. If refusal becomes frequent, ask for a care plan review and discuss causes such as pain, fear or confusion.

Where to get help next

Use our care home search to shortlist homes, then compare their inspection reports. Related guides: duty of care in social care, how to choose a care home and the care glossary.

Sources

• legislation.gov.uk: Regulation 10, dignity and respect
• legislation.gov.uk: Regulation 12, safe care and treatment
• legislation.gov.uk: Regulation 15, premises and equipment
• GOV.UK: Code of practice on the prevention and control of infections
• NICE: Oral health for adults in care homes (NG48)
• NHS: Care homes

New guides: How to Choose Incontinence Pads: Types, Fit and NHS Help

More guides: Protecting skin with continence products · Incontinence pants or pads

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.