Coronavirus COVID-19 Care Provider Information

Coronavirus Covid-19

Coronavirus Covid-19 and adult social care in Staffordshire

Message from Dr Richard Harling, Director of Health and Care - 6 August 2020

In my last update, I communicated that the COVID Alert Level has moved down but that COVID-19 was still in general circulation and local outbreaks were still likely. This remains the case whereby transmission is now more evident in pockets within different community settings across Staffordshire.  This means that we all need to consider that we can be exposed to COVID-19 as we mix with family and friends at home, go to pubs, gyms, cinemas or restaurants and other areas in which people gather together.  As you enjoy a well-earned summer break and a greater level of freedom associated with the lifting of many lockdown measures please do protect yourselves from any unnecessary risks.  The recent incident at the Crown and Anchor pub in Stone is a good example of the risks associated with letting our guard down.

Covid-19 testing and infection prevention and control

All Settings:

Any staff who are exposed within their own home, within the community or when working in community settings, must immediately self-isolate and arrange to be COVID-19 tested and only return to work if their test is negative and they do not have symptoms.  They should also remain extra vigilant about their use of PPE on their return to work.  Any staff with symptoms should stay away from work and get tested.  Those advised to be tested and self-isolate by the NHS Test and Trace service should indicate that they are working in a care setting and follow national guidelines regarding self-isolation and testing.  If you have any further queries about the guidelines, please go to the COVID-19: management of staff and exposed patients or residents in health and social care settings.(last updated 30 July 2020)

The UK’s chief medical officers have confirmed that people who display symptoms of coronavirus must now self-isolate for a minimum of 10 days (this was 7 days previously), in line with WHO guidance.  Scientists are reporting there is a possibility some people may still transmit the virus for up to 9 days after they become unwell. Please be aware of this change if your staff show symptoms and encourage them to follow COVID-19: Getting tested guidance (last updated 28 July 2020).

Care Home Settings:

Since 6 July 2020, a second round of COVID-19 blanket testing has been introduced in care homes caring for those over 65 and with dementia.  The intention was for this to be rolled out to all adult care homes by early August, however this has now been put back to September as detailed on the Covid-19 Testing and Infection Control page.  This involves care homes testing their staff weekly and their residents every 28 days.  Changes to eligibility for registration and some loss of registrations from the national care home portal where care homes apply for retesting, have meant kits have not been received by all care homes who were involved in the first round of testing in May/June.  We are responding to this by finding out which homes are eligible and have been affected and are applying an ‘opt out’ approach to ensure all homes eligible to register in this round are included.  Care homes wishing to learn more about this process can join the regular DHSC ‘whole home testing’ webinars.

To support testing, the Government has produced COVID 19: Guidance for taking swab samples (last updated 2 July 2020), including videos specifically for social care staff. Not all testing kits are currently available, however.  Some test kits produced by Randox laboratories have been identified as not meeting required safety standards for coronavirus testing. As a precautionary measure they are requesting that all settings pause the use of Randox test kits with immediate effect until further notice, which means not using unused test kits.  If you have Kingfisher / non-Randox swabs then you do not need to take any action, you can continue your testing programme as planned. For further information, please see our COVID 19: Staff testing and infection control webpage for further details.

The above testing is in addition to a new Government outbreak management process for care homes, involving rapid testing when a confirmed or suspected case of COVID-19 is identified.  In these circumstances, repeat blanket testing will be suspended and the local Health Protection Team will organise rapid testing of all residents and staff in your care home.  Our local Infection Control (IPC) Team will visit your home to conduct these tests, utilising their own swabs and will do so again on day 4 - 7 days later.  Retesting of all staff and residents will need to be undertaken by the care home 28 days after the last suspected case through the DHSC Regular Blanket  Testing Programme and any new outbreaks after this period handled by restarting the rapid testing process once again.  Further information on our testing programme can be found on our COVID-19 testing and infection control webpage.

Staffordshire allocation of the Adult Social Care Infection Control Fund

The Council has now received its second half of the national infection control fund and is currently distributing the second instalment of the fund to eligible providers.

The grant monies allocated to Staffordshire County Council has been used to support:

• 215 care homes

• 111 home care providers

• 2 communicator guide providers

• 1 shared lives provider

• 7 extra care providers

• 37 supported living providers

• 3 carer respite providers; and

• 65 day centres.

All providers will be receiving the second half of their allocation within the next 7 working days.  The Council will not be able to make the second half of payments to care homes who are not completing the NHS capacity tracker daily.

More information on the fund and its intended use to support the marketplace can be found on the Gov.uk website. 

Since my last update, key guidance has been issued to care homes to reduce the risk of transmission of COVID-19 from individuals visiting a care home. This includes:

• A new annex section entitled ‘Restricting workforce movement and minimising workforce transmission’ which has been added to the COVID-19: Care Home support package guidance (last updated 9 July 2020).
  
  
  • In June, the Care Provider Alliance had developed a visitors protocol for providers to help people using care and support to have the opportunity to safely receive visitors during the Covid-19 pandemic.  This complemented existing national guidance relating to family visits in care homes to residents who are end of life.  On 22 July, the Government updated its guidance for care homes on developing their policies for non-essential visits, indicating that care homes should take account of any local advice and guidance in developing their visiting policies.  For Staffordshire, the advice is that care homes should ideally be looking at alternatives to physical visits wherever possible, including telephone / video conferencing.  Non-essential visiting should ideally be limited and based on risk assessment, offered preferably outdoors, or indoors if there is no outdoor alternative on the basis that stringent infection control measures are in place.  However, these visits may need to be ceased on public health advice for example in circumstances in which a care home has current COVID-19 cases or there is an outbreak in the local community.  For further information on the local and national policies, please refer to our COVID-19: Information for care homes webpage.
  • The Council’s Care Market Development Team is currently working with all its training providers to see if they can move to a virtual method of delivery of their training programmes unless face to face training is unavoidable due to the nature of the training required.  If care homes are sourcing in-house training, we would highly recommend they do this virtually, again unless it is unavoidable or absolutely essential to deliver the training face to face.  Skills for Care has also recently produced Guidance for employers, learning providers and in-house trainers on face-to-face training and assessment during COVID-19 encouraging stringent infection control measures in such circumstances.

PPE

There have been some key government infection control guidance updates over the last fortnight linked to the use of facemasks in different settings.  Individuals infected with COVID-19 can have very mild or no symptoms and might pass on the virus to others without being aware of it.  Wearing a face mask reduces the risk of passing on the virus to other staff either directly e.g. by coughing, or indirectly after touching the mouth or nose and then touching surfaces such as door handles.  The guidance now states that face masks must be worn at all times in care homes and social care settings.  In response to this, we have updated on the PPE page our Adult social care settings: PPE summary document, our How to work safely in care homes and ourHow to work safely in home care  documents on this page accordingly (all of which have been updated on 23 July 2020).

Access to the Gov.uk online PPE portal for emergency top-up supplies is being extended to include large residential care and home care providers with effect from 3 August 2020.  The portal team will contact eligible providers during the week 3 – 7 August.  We are aware some providers are concerned about the authenticity of the email invitation to the portal.  If you're unsure of the source of such an email, please contact us for advice at ascincidentmanagement@staffordshire.gov.uk

Digital connectivity

The COVID-19 pandemic has brought about a significant improvement in information sharing between NHS and local authority commissioning teams and providers.  This is a good time to take stock of those and look at how we can make further improvements to our processes as we move forwards into the autumn and winter months.

1)    Capacity Tracker

• The national requirement is for all care homes to update their vacancy, Covid-19 statistics, their PPE status and their staffing status daily on the Capacity Tracker system (including at weekends).  This is being monitored and used to trigger support from local systems as required for care homes throughout the pandemic (now available 7 days a week).  However, regular use of this system also brings with it the following additional benefits to care homes:

• Access to a fast, secure and completely free portal for care homes to use (including on smartphones and tablets), allowing instant vacancy and other information updates to be made from any internet connected device.

• Delayed Transfers of Care are minimised and the amount of time discharge teams, local authority and NHS staff spend ringing around care homes searching for vacancies reduces.  It provides a view of care homes with vacancies across the country to support placements and makes it easier and faster for care homes to fill their vacancies much more rapidly.

• If you are not completing this system daily and have any questions or concerns about the use of it, care homes are now being invited to join weekly Q&A sessions.  Please contact your system champion via the healthandcare@staffordshire.gov.uk mailbox, should you wish to be involved in these.  

2)   NHSmail

• All providers who have an ODS code starting with a ‘V’ (I.e. all care homes and the majority of our homecare provides), can currently apply to access this secure email system.  It is free of charge and is being made available during the COVID-19 pandemic to ensure secure platforms for the sharing of patient-sensitive information and to allow for video conferencing facilities to be accessed with NHS staff.  If you are not using an NHS approved email system, your system is not considered secure for the purposes of sharing patient-sensitive information, so I would urge you to make the most of this offer by following the guidance and useful tips on our Enhancing care provider communications during the Covid-19 outbreak webpage.

• NHSX have issued an update on NHSmail access and the Data Security and Protection Toolkit (DSPT) waiver for social care.  All social care providers using NHSmail must register with DSC by 30 September 2020 to ensure ongoing NHSmail access although you are not required to complete or comply with the toolkit by this date.  Updated guidance on how to register will be issued on 14 August.  You can find out more about this plus NHSX’s plans to consult on the timescales for reintroducing DSPT compliance requirements and its planned programme of support for social care providers to enable DSPT compliance on the Digital Social Care website.  The DSPT remains a requirement for organisations who wish to hold Continued Healthcare contracts. It is a free, online self-assessment tool allowing organisations to demonstrate their compliance with data protection standards.  Please click on this link to complete a short survey to help the NHS adapt the toolkit so that it more closely reflects the needs of the adult social care marketplace.

3)    Staying ahead: social care in a digital world

 If you are interested in developing your business digitally, we would also recommend you participate in the following:

• Skills for Care pre-recorded webinars on ‘Secure mobile working in social care’ and ‘Cyber security as we adapt to the ‘new normal’.

• Skills for Care ‘Developing digital leaders and digital skills’ research to help identify a route forward to ensure digital working becomes an essential part of working in care, to help provide the right resources, support and development to you.

Apprenticeship funding

Up until now, employers have been receiving £1,000 to support those apprentices aged 16-18 and those under 25 with an Education, Health and Care Plan (new employees only). New Department for Education payments have now been introduced for employers in England for each new apprentice they hire between 1 August 2020 and 31 January 2021.  These are:

• £2,000 for each new apprentice aged under 25

• £1,500 for each new apprentice aged 25 and over

Guidance and best practice updates

• PPE guidance: National COVID 19- How to work safely in care homes and COVID 19: How to work safely in domiciliary care in England guidance (both updated 20 July 2020) underpins our local summary guidance on our PPE webpage.
• Day services guidance / best practice: Kings College London and the Social Care Institute for Excellence have produced useful guides to support managers and staff working in adult day centres, community-based day services, and specialised day centre environments.
• Death verification resources: Skills for Care has also developed a range of resources to support adult social care providers and Registered Managers with verifying an expected death during Covid-19 with clinical remote support.  Resources include infographics, pocket cards, short videos and supporting guidance.
• Guidance to support adult social care employers: COVID-19: reducing risk in adult social care supports employers by providing a framework to assess and support members of their workforce who may be at an increased risk of the virus.

I hope you are all able to enjoy the remainder of the summer and the good weather and you can get a chance to recharge your batteries after such a busy and challenging few months.

Dr Richard Harling, Director of Health & Care

Covid-19: Staffordshire County Council Care Market Development Team update

Please see the Covid-19 and adult social care in Staffordshire, Care Market Development Team update pages to find information and links to further information on:

• planned key engagement events (such as Managers Quality Networking Forum and the Staffordshire Dignity in Care Awards)

• training and development opportunities

• information, advice and guidance

• the opportunities and support available to help you with your recruitment and retention needs

National guidance for adult social care

There is a range of national guidance documents available via the link below to support you in managing your service and supporting customers:

• Coronavirus Covid-19 - guidance for health professionals and other organisations

 Additional guidance has been issued on:

•  Verifying death in times of emergency. 5 May 2020

• The Mental Capacity Act (2005) (MCA) and deprivation of liberty safeguards (DoLS) during the Coronavirus (Covid-19) pandemic 15 June 2020 

• CQC delegating medicines administration guidance

• Adult social care - infection control fund 27 July 2020