How to Prevent Cross-Contamination in Care Home Laundry

Care home laundry moves between resident bedrooms, bathrooms, corridors, laundry rooms and clean storage every day. Without clear procedures, used or infectious linen can come into contact with clean laundry, staff, equipment or surfaces and create opportunities for cross-contamination.

Preventing cross-contamination is therefore about managing the whole laundry journey — from the moment linen is removed from a bed through to washing, drying, folding, storage and its return for use.

This guide explains how care homes can separate clean, used and infectious laundry, organise laundry-room flow, handle contaminated items safely and identify the common points where cross-contamination occurs.

If your laundry process has become difficult to manage, Able can review your room, equipment, chemicals and workflow as part of a free Laundry Site Survey.

Why Cross-Contamination Matters in Care Home Laundry

Linen can become contaminated through normal resident care, bodily fluids, infectious illness and contact with the environment.

If it is handled incorrectly, contamination can potentially move through:

• Hands and clothing
• Laundry bags and containers
• Trolleys
• Sorting surfaces
• Washing-machine controls and doors
• Shared working areas
• Clean linen

The aim is not to treat every piece of used laundry as though it presents the same risk. Instead, staff need to understand the different laundry categories and follow the procedure appropriate to each one.

Clean, Used and Infectious Laundry: Know the Difference

Government adult-social-care guidance divides laundry into three broad categories.

Clean Laundry

Clean laundry has completed the laundering process and is ready for use.

Once an item is clean, the priority is protecting it from becoming contaminated again during handling, transport and storage.

Used Laundry

Used laundry has been used but is not contaminated with blood or other body fluids and has not been used by someone known or suspected to be infectious.

It still needs to be handled carefully and kept separate from clean items.

Infectious Laundry

Infectious laundry includes items used by someone known or suspected to have an infection and linen contaminated with blood or other body fluids such as faeces.

This category requires additional containment and handling controls.

Understanding these categories is one of the foundations of a good laundry system because staff need to know how an item should be contained, transported and processed before they handle it.

Prevent Cross-Contamination at the Point of Use

Safe laundry handling starts in the resident’s room, not when the bag reaches the laundry.

Government guidance advises care homes to avoid unnecessary handling of used linen.

Staff should:

• Place used laundry into an appropriate bag or receptacle as close as reasonably possible to the point of use
• Avoid shaking linen when removing it from beds
• Avoid putting used linen on the floor or other surfaces
• Avoid sorting or repeatedly handling used linen once it has been bagged
• Avoid overfilling laundry receptacles
• Keep clean laundry away from used items

Taking these steps prevents contamination being unnecessarily spread around a bedroom, corridor or other care area before the laundry process has even begun.

How Should Infectious Laundry Be Bagged?

Infectious laundry requires more controlled handling than ordinary used laundry.

Current government guidance advises care homes to place infectious laundry into a water-soluble bag suitable for the washing machine being used immediately on removal, and then place that inside an impermeable outer bag.

The water-soluble bag should then be placed directly into the washing machine without staff opening it.

This reduces the amount of direct handling after the item has been identified as infectious.

Exact bag colours can vary between systems and local procedures. The important requirement is that the home’s system makes the categories clear and staff understand how each type of laundry should be managed.

Do Care Homes Need Colour Coded Laundry Bags?

Colour coding can make segregation easier for staff, but care homes should not assume that one universal red, white and blue system applies everywhere.

National adult-social-care guidance focuses primarily on:

• Correctly identifying clean, used and infectious laundry
• Containing items appropriately
• Using a suitable water-soluble bag for infectious laundry
• Keeping categories separated throughout the process

A local colour-coding system can support this, provided it is clearly documented and everyone follows the same procedure.

Labels, posters and clear instructions can also help temporary, agency and newly recruited staff understand the system quickly.

Use Separate Containers and Trolleys

Clean laundry should not travel around the home in the same unclean container that has just carried used or infectious linen.

Government linen guidance advises using separate trolleys or containers for different categories of laundry to reduce opportunities for cross-contamination.

Care homes should consider:

• Dedicated containers for used or infectious laundry
• Separate clean-linen trolleys
• A clear method for identifying each trolley
• Cleaning reusable containers and trolleys appropriately
• Keeping clean trolleys out of dirty handling areas wherever practicable

Simply laundering the textile correctly is not enough if it is immediately returned to a contaminated trolley afterwards.

Dirty-to-Clean Flow in the Laundry Room

Government guidance advises care homes with in-house laundries to consider a dirty-to-clean flow system so clean and used laundry can remain physically separated.

A practical workflow may look like:

Used or infectious laundry → washing → drying → folding/finishing → clean storage

The exact room arrangement will vary between homes. The objective is to minimise unnecessary crossover between dirty handling and clean processing.

This may involve:

• Clearly designated dirty and clean work areas
• Separate work surfaces
• Clear signage
• Dedicated trolleys
• Defined staff movement
• Keeping clean laundry away from incoming used laundry
• Hand-washing facilities positioned to support the workflow where possible

For a detailed look at room separation, see our guide to separating clean and dirty laundry in care homes.

Does a Care Home Need Separate Clean and Dirty Laundry Rooms?

Not necessarily.

The main objective is effective separation and prevention of cross-contamination. A home may achieve this through room design, physical zoning, working practices or a combination of controls.

However, current government linen-processing guidance says an in-house laundry should have clear separation between clean and dirty areas and clear separation of clean and dirty linen within the workflow.

New laundry-room designs and refurbishments should therefore consider infection control at the planning stage rather than attempting to fit a safe workflow around poorly positioned equipment afterwards.

Handle Used Laundry for the Shortest Practical Time

Used laundry should not sit unnecessarily around resident areas, corridors or the laundry room.

Government guidance recommends storing used linen for the shortest practical period before washing or transportation.

Prompt processing helps:

• Reduce unnecessary handling
• Prevent bags accumulating in working areas
• Keep the dirty side of the laundry manageable
• Reduce the chance of items being mixed or misplaced

The laundry’s washing and drying capacity therefore needs to match the amount of linen generated by the home.

Do Not Sort Infectious Laundry by Hand

Once infectious laundry has been appropriately bagged, staff should avoid reopening and sorting it manually.

Water-soluble bags containing infectious laundry should be placed directly into the washing machine.

Infectious items should also be laundered separately from other laundry.

This is another reason why staff should check pockets and identify inappropriate items before something enters an infectious-laundry bag wherever that can be done safely.

What Temperature Should Infectious Laundry Be Washed At?

There is no single wash temperature that should simply be copied onto every care-home procedure regardless of textile or wash system.

Current adult-social-care guidance says that where staff are laundering clothing from someone with an infectious illness, items should be washed at the highest temperature recommended by the textile manufacturer.

For delicate infectious items that cannot tolerate a high-temperature wash, an appropriate laundry bleach or alternative laundry disinfectant may need to be considered.

Heavily soiled items should use an appropriate pre-wash or sluice cycle where available.

The washing process as a whole contributes to decontamination, including:

• Detergent
• Temperature
• Agitation
• Rinsing
• Appropriate laundry chemistry
• Correct programme selection

For more detail on the regulatory and technical background, see our UK care home laundry regulations guide and the official HTM 01-04 linen decontamination guidance.

Load Washing Machines Correctly

Correct loading matters because the laundry needs enough movement, water, chemistry and rinsing to complete the selected programme effectively.

Overloading can restrict mechanical action and reduce washing performance.

Staff should therefore follow:

• The washing-machine manufacturer’s load guidance
• The programmed cycle requirements
• The laundry chemical supplier’s process
• The home’s own laundry procedures

Consistently overloading equipment can also increase rewashes, create bottlenecks and contribute to unnecessary wear.

Our laundry cost-per-wash guide explains how inefficient processes can affect the wider cost of running an in-house laundry.

Dry Laundry Properly Before Storage

The cross-contamination process does not end when an item comes out of the washer.

Clean laundry needs to be dried appropriately and protected while it is folded, finished and stored.

Where tumble drying is suitable for the textile, effective drying also reduces the opportunity for damp items to remain sitting within clean-laundry areas.

Staff should avoid:

• Putting clean laundry onto dirty work surfaces
• Mixing clean and incoming used laundry
• Returning clean textiles to dirty containers
• Leaving clean linen exposed unnecessarily
• Storing items while still damp

How Should Clean Linen Be Stored?

Once laundry is clean, it should stay clean.

Government guidance recommends keeping clean linen:

• Separate from used and infectious laundry
• Above floor level
• In a clean, cool and dry area
• Within a designated storage area
• Preferably in enclosed storage

Stock should also be rotated so older clean linen is used before newly processed items where practicable.

Clean linen should not be stored in an area where used laundry is being sorted or waiting to be washed.

Hand Hygiene Between Laundry Tasks

Hands are an important potential route for contamination between dirty and clean processes.

Government guidance specifically advises workers to clean their hands between handling clean, used and infectious laundry.

This means staff should not move directly from handling dirty bags or contaminated items to folding clean linen without performing appropriate hand hygiene.

Hand hygiene facilities should therefore support the way the laundry actually operates.

What PPE Should Laundry Staff Wear?

PPE should be selected according to the task and the anticipated risk of exposure.

An apron can protect staff clothing while handling used or infectious laundry, and gloves may be required where there is a risk of contact with blood, body fluids, hazardous chemicals or other contamination.

The important point is that PPE should follow the home’s risk assessment and current guidance rather than staff automatically wearing the same PPE for every laundry activity.

PPE used on the dirty side should not become a route for contamination into clean handling areas.

Staff should know when to:

• Put PPE on
• Change it
• Remove it
• Dispose of or decontaminate it appropriately
• Perform hand hygiene afterwards

Clean Laundry Rooms, Equipment and Trolleys

The laundry room itself can become part of the contamination pathway if surfaces and equipment are neglected.

Government linen guidance recommends having a cleaning schedule for all areas used in linen processing, including:

• The laundry room
• Used-linen areas
• Clean-linen storage
• Work surfaces
• Trolleys and containers
• Relevant equipment

The cleaning frequency should reflect the area, use, risk and manufacturer’s instructions rather than relying on one universal daily or weekly timetable.

Particular attention may be needed around:

• Washer and dryer doors
• Machine controls
• Handles
• Worktops
• Sorting surfaces
• Trolley handles
• Floors
• Areas where lint or residues accumulate

Laundry Chemicals and Cross-Contamination Control

Laundry chemistry is part of the washing process, but using more chemical does not automatically produce a safer wash.

The detergent and any destainer, emulsifier or laundry disinfectant need to be suitable for:

• The textile
• The type of contamination
• The wash programme
• The water conditions
• The washing machine
• The required hygiene outcome

Incorrect dosing can contribute to poor wash results, residues, textile damage or unnecessary chemical use.

Automatic dosing can improve consistency and reduce staff handling of concentrated laundry chemicals, but it is not a substitute for an appropriate wash process or good infection-control procedures.

For chemical safety, see our COSHH risk assessment guide.

Staff Training Is Critical

Cross-contamination often occurs because different people interpret the same process differently.

Laundry staff should understand:

• The difference between clean, used and infectious laundry
• Which bags and containers to use
• How infectious laundry should be handled
• Why linen should not be shaken
• Where each category should be taken
• How the laundry-room workflow operates
• When hand hygiene is required
• Which PPE applies to different tasks
• Which washing programmes to use
• How clean linen should be handled and stored
• How to report machine or process problems

Training should include the actual equipment and procedures used in the home rather than relying entirely on generic written guidance.

New, temporary and agency staff should also be able to understand the system quickly.

Common Care Home Laundry Cross-Contamination Mistakes

Some of the most common problems happen during the transitions between different stages of the process.

Watch for:

• Used linen being placed on floors or work surfaces
• Laundry bags being overfilled
• Staff shaking or manually sorting used linen unnecessarily
• Infectious bags being reopened before washing
• Clean and dirty laundry sharing the same unclean trolley
• Staff moving between dirty and clean tasks without hand hygiene
• Clean laundry being folded on contaminated surfaces
• Clean linen being stored in the dirty laundry area
• Different shifts following different bagging procedures
• Machines being routinely overloaded
• Poorly cleaned work surfaces and trolley handles
• Clean and dirty activities occurring together without adequate separation
• Staff being unsure which wash programme should be used

These are useful areas to observe during internal laundry audits because they show whether the written procedure is actually being followed.

What Does CQC Look for Around Laundry?

CQC considers laundry within the wider assessment of infection prevention and control.

Its published care-home guidance looks for:

• A designated area for managing and storing laundry
• Laundry processes that follow national guidance
• Correct management of clean, used and infectious laundry
• Processes that minimise the risk of infection

That means managers should be able to explain not only what the laundry policy says, but how the home’s actual workflow prevents clean linen becoming contaminated.

The wider legal and regulatory context is covered in our care home laundry regulations and compliance guide.

Audit Your Laundry Process from Bedroom to Clean Storage

A useful internal audit follows the same route as the laundry itself.

Check whether:

• Staff correctly identify used and infectious laundry
• Suitable bags are available where linen is removed
• Used linen is kept off floors and other surfaces
• Infectious laundry is appropriately contained
• Clean, used and infectious laundry use appropriate separate containers
• Dirty-to-clean flow is maintained within the laundry room
• Hand hygiene is performed between dirty and clean handling
• PPE is selected and removed appropriately
• Wash programmes are appropriate and consistently followed
• Machines are loaded according to their requirements
• Clean laundry is handled only in clean areas
• Trolleys and work surfaces are appropriately cleaned
• Clean linen is stored separately and protected
• Staff can explain the procedure they are following

Our separate care home laundry audit checklist can be used for a wider review of the complete laundry operation.

What to Do During an Outbreak

An outbreak may increase both the volume of infectious laundry and the pressure on the laundry team.

Managers should make sure:

• Staff understand which residents’ laundry requires infectious-linen procedures
• Adequate bags and containers are available
• Infectious items are processed separately
• Hand hygiene and PPE procedures remain consistent
• Clean and infectious laundry do not accumulate in the same working areas
• Laundry capacity is sufficient to prevent excessive backlogs
• Current guidance for the relevant infection is followed

The home’s infection-prevention lead or relevant health protection professionals can provide additional advice where a particular infection requires additional measures.

Choosing Laundry Equipment That Supports Good Workflow

Good procedures become much harder to follow when the equipment is badly matched to the home.

When planning or upgrading an in-house laundry, consider:

• Daily laundry volume
• Washer capacity
• Dryer capacity
• The programmes needed for the linen being processed
• Available utilities
• Room dimensions
• Dirty-to-clean workflow
• Machine loading and unloading space
• Chemical dosing arrangements
• Clean finishing and storage space
• Access for servicing and repairs

A barrier washer may support physical dirty-to-clean separation in some installations, but it is not the only way a care home can create effective segregation. The appropriate solution depends on the building, laundry volume and workflow.

Explore our commercial laundry equipment range for washing machines, tumble dryers and complete laundry-room solutions.

Care Home Laundry Support from Able

Able works with care homes on the complete in-house laundry setup, including commercial laundry equipment, servicing, breakdown support, laundry chemicals and automatic dosing.

Our free Laundry Site Survey allows us to look at the laundry as a complete system, including:

• Existing equipment
• Room layout
• Dirty-to-clean workflow
• Laundry volumes
• Wash and dry capacity
• Chemical setup
• Dosing arrangements
• Utilities and ventilation
• Any recurring operational problems

That means recommendations can address the cause of a laundry problem rather than simply replacing a machine or changing a chemical.

If you are concerned about cross-contamination, planning a laundry refurbishment or want an outside view of your current process, speak to our laundry team.

Preventing Cross-Contamination in Care Home Laundry FAQs