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Staffordshire will move to very high COVID alert level on 2 December

Winter Plan 2020/21 Webinar

This page contains the contents of the slide pack from our webinar on the national adult social care winter plan which was held on 13 October 2020. 

Watch the webinar

Introduction

This webinar aims to make sure you are aware of the actions for providers set out in the recently published adult social care winter plan

It’s important to make sure that you are still giving us the right email address for us to use for our emails from the ascincidentmanagement@staffordshire.gov.uk inbox.

We will review questions received during the presentation after the webinar and produce FAQs.

Information in this presentation is as of 13 October 2020 – like all our information, it is subject to changes and updates

On 18 September, the Government published an Adult Social Care Winter Plan.  You can find this at  Adult social care: our COVID-19 winter plan 2020 to 2021.  It contains national actions, and actions for local authorities, the NHS and for providers.

This webinar covers the actions for providers.  Many of these are existing actions.

Providers should check that the actions are in place – we can provide a “gap analysis” tool – and strengthen those areas where there is a gap.


 Key actions for providers

  • Providers must keep the needs and safety of the people they support and their staff at the forefront of all activities
  • Providers should review and update their business continuity plans for the autumn and winter, of which workforce resilience should be a key component
  • Providers should utilise additional funding available to implement infection prevention and control measures, in accordance with the conditions of the Infection Control Fund and those given by local authorities, and should provide all information requested on use of the funding to local authorities
  • Providers must provide data through the Capacity Tracker or other relevant data collection or escalation routes in line with government guidance and the conditions of the Infection Control Fund
  • Providers should ensure that both symptomatic staff and symptomatic recipients of care are able to access Covid-19 testing, as soon as possible. Care homes should adhere to guidance on regular testing for all staff and care home residents
  • All eligible care providers can register for and use the new PPE portal. All providers should report any PPE shortages through the capacity tracker, local resilience forums (LRF) where applicable, or any other relevant escalation or data collection route (in Staffordshire use capacity tracker first; and/or, if tracker not relevant to your service, use ascincidentmanagement@staffordshire.gov.uk
  • Providers ineligible to register for the portal (such as personal assistants) should contact their LRF (if it is continuing to distribute PPE) or their local authority to obtain free PPE for COVID-19 needs
  • Providers should proactively encourage and enable people who receive care and social care staff to receive free flu vaccinations and report uptake
  • Care home providers should develop a policy for limited visits (if appropriate), in line with up-to-date guidance from their relevant Director of Public Health and based on dynamic risk assessments which consider the vulnerability of residents. This should include both whether their residents’ needs make them particularly clinically vulnerable to COVID-19 and whether their residents’ needs make visits particularly important.

Preventing and controlling the spread of infections in care settings

Guidance on infection prevention and outbreak management

All care providers should:

  • continue to follow all relevant guidance on how to prevent, control and manage an infection in their care setting
  • undertake a learning review after an outbreak, with support from their local authority
  • liaise fully with their PHE local health protection team and other local partners as needed
  • report shortfalls in support or equipment, to local authorities, and through established data capture portals
  • ensure all care staff have ongoing training on infection prevention and control, the appropriate use of PPE, and can engage with online training for learning reviews when available. The CQC’s registration requirements support this approach during the Covid-19 pandemic in line with the relevant guidance and code of practice
  • ensure staff are carrying out all relevant infection prevention and control procedures to a high standard through a robust system of audit and quality assurance 
  • identify and support an individual to be the lead for infection prevention and control for Covid-19 to ensure adherence to infection prevention guidance
  • Ensure staff do not work if they have Covid-19 symptoms, or a member of their household has symptoms or a recent positive test, or they have been told to isolate by NHS Test and Trace

Managing staff movement 

  • Care home providers should limit all staff movement between settings unless absolutely necessary to help reduce the spread of infection, including by reviewing exclusivity arrangements with recruitment agencies, and considering the recruitment of additional staff over the winter period 
  • All care providers should use funding from the Infection Control Fund to meet additional costs associated with restricting workforce movement for infection control purposes, in accordance with the conditions on which it is given by local authorities

PPE 

Providers should:

  • follow all relevant guidance on use of PPE, including recommendations for those providing support to people with learning disabilities or autistic people
  • make use of free Government-funded PPE stocks where needed and in line with Covid-19 PPE guidance. Care homes and domiciliary care providers, along with some others, are eligible to register for the PPE portal guidance and can obtain free PPE through this route.
  • providers ineligible to register for the portal (for example, personal assistants), should obtain PPE from their LRF (if it is continuing to distribute PPE), or their local authority
  • in the event of urgent need for PPE stocks, use the National Supply Disruption Response (NSDR) or contact the LRF to access free emergency supply from the LRF stockpile
  • Report shortages via Capacity Tracker and/or the CQC community care survey

Covid-19 Testing

All providers should:

  • ensure all staff are aware of how to access symptomatic testing 
  • contact their local HPT if they suspect an outbreak within their service

All care homes should additionally ensure that they are following the guidance regarding regular testing of staff and residents

Seasonal flu vaccines

All care providers should:

  • support and promote, to all staff, the importance of receiving a free flu vaccination 
  • proactively encourage and enable staff to receive a free flu vaccination, either by providing vaccines in the workplace, through an occupational health scheme, direct arrangement or with at a community pharmacy or general practice
  • report their staff flu vaccination rate via the Skills for Care Adult Social Care Workforce Data Set and flu vaccination status for staff and residents in the Capacity Tracker (when the relevant question is made available shortly)

Care home providers should additionally:

  • take all reasonable steps to support residents to receive a flu vaccination through the NHS scheme or occupational health schemes, where in place.

 Collaboration across health and care services 

Safe discharge from NHS settings and preventing avoidable admissions

Care home providers should accept people discharged from hospital only when able to do so safely. They should:

  • isolate all residents discharged from hospital or interim care facilities for 14 days regardless of Covid-19 test result, unless they have already undergone isolation for a 14-day period in another setting, in line with the admission and care of people in care homes guidance 
  • alert their local authority if they have been requested to receive an individual from hospital with a confirmed Covid-19 positive test result 
  • advise their local authority if they assess they cannot accept an individual from hospital with a confirmed Covid-19 positive test results as they are unable to safely isolate or cohort the individual, or if they cannot manage the needs of the individual due to other challenges impacts on infection control capability (such as staffing issues)

Care home providers should accept people discharged from hospital only when able to do so safely. They should:

  • alert their local Health Protection Team in the event of positive Covid-19 test results 
  • continue to update the Capacity Tracker daily or more frequently if something changes

Other care providers should:

  • work with adult social care contract leads to identify capacity that can be used for hospital discharge purposes or follow-on care from reablement services
  • work collaboratively with NHS primary and community care services
  • follow latest home care and supported living guidance on managing discharges as relevant. This includes guidance that any individual discharged from hospital into a supported living setting or their own home should be supported as if they were possibly Covid-19-positive until a 14-day period has passed.

Enhanced health in care homes

Care home providers should:

  • familiarise themselves with the enhanced health in care homes (EHCH) service requirements and what they can expect from NHS agencies
  • work collaboratively with clinical leads to delivery optimum care and support to their residents 
  • work with the local CCG to determine local need for oximeters

  Technology and digital support 

All care providers are asked to:

  • consider how technical or digital solutions may help them to protect the people they support from Covid-19 and connect them to their loved ones
  • engage with the NHSX DSPT support offer and register with DSPT by 30 September 2020 

Care homes are advised to:

  • take advantage of time-limited connectivity deals, and complete the simple order form to apply for a tablet device.

Acute hospital admissions

All care providers should:

  • work together with NHS partners to address issues in order to reduce unnecessary emergency admissions

If needed, care home providers should:

  • support residents to self-isolate prior to admission for an elective care procedure

Social prescribing

Care providers should:

  • work closely with Social Prescribing Link Workers to co-ordinate support for people identified by health and care professionals as most needing it, especially those impacted by health inequalities.

Supporting people who receive social care, the workforce, and carers

 Visiting Guidance

Care home providers should:

  • develop a policy for limited visits (if appropriate), in line with up-to-date guidance from their relevant Director of Public Health and based on dynamic risk assessments which consider the vulnerability of residents. This should include both whether their residents’ needs make them particularly clinically vulnerable to Covid-19 and whether their residents’ needs make visits particularly important. Social workers can assist with individual risk assessments, for visits, and can advise on decision-making where the person in question lacks capacity to make the decision themselves 
  • set out the precautions that will be taken to prevent infection during visits and ensure these are communicated in a clear and accessible way 
  • ensure the appropriate PPE is always worn and used correctly – which in this situation is an appropriate form of protective face covering (this may include a surgical face mask where specific care needs align to close contact care) and good hand hygiene for all visitors.
  • limit visitors to a single constant visitor wherever possible, with an absolute maximum of two constant visitors per resident to limit risk of disease transmission
  • supervise visitors at all times to ensure that social distancing and infection prevention and control measures are adhered to.
  • wherever possible visits should take place outside, or in a well-ventilated room, for example with windows and doors open where safe to do so 
  • immediately cease visiting if advised by their respective Director of Public Health that it is unsafe

Direct Payments

All care providers should:

  • consult the new guidance for the actions that they should take to ensure that people receiving direct payments, their families and carers are able to meet their care and support needs this winter

Support for unpaid carers

Community and respite services could consider the following options:

  • provision of outreach support or support based in outside community spaces
  • digital support 
  • support provided less often in smaller groups 
  • cohorted or isolated support

End of life care

All care providers should: 

  • have regard to the guidance in delivering personalised approaches to care (including those on the NHS website and those published by the Royal Colleges of GPs).  This is applicable to all providers of end of life care in all scenarios, including where care is being provided in an individual’s home
  • ensure they make every effort, wherever practicable and safe, to enable a dying person to be with their loved ones, particularly in the last hours of life

If a care provider is concerned about pressures to put in place DNACPRs, they should escalate, in the first instance, using their internal whistleblowing policies.

Care Act Easements

All care providers should continue to:

  • be aware of local authorities operating under easements, listed on the CQC website 
  • work with local authorities to meet the most urgent and acute care needs if they are in an area operating under easements

Staff training

All care providers should:

  • engage with the training offer (rapid online induction training to help induct and train redeployed staff, new starters, existing staff and new volunteers in social care services. This training is provided free of charge when accessed through Skills for Care, meaning staff can be trained quickly ahead of winter) and support staff to undertake training, as soon as possible 
  • support staff to access guidance relevant to the needs of people in their care

Supporting wellbeing of the workforce

All care providers should:

  • continue to promote the CARE workforce app and other available resources to support their employees
  • undertake a workplace risk assessment, with a view to protecting the health, safety and welfare of all staff. Employers should have individual conversations, about COVID-19, with all members of their workforce who may be at increased risk. A risk reduction framework for adult social care has been published to provide guidance, for employers, on how to sensitively to discuss and manage specific risks to their staff – this includes risk by ethnicity, but also age, sex and underlying health conditions. This guidance will be reviewed as new evidence emerges

Workforce capacity

All care providers should:

  • ensure they have read the section in the national plan on managing staff movement
  • put arrangements in place to ensure they have sufficient staff to provide safe, high-quality care even in the event of increased staff absence
  • consider recruiting to fill vacancies via the Department for Work and Pensions ‘Find a Job’ website, as well as using local recruitment methods. Free recruitment campaign materials are available on the national campaign website
  •  continue to ensure staff receive normal wages while self-isolating in line with government guidance. The Government has provided funding to support this through the Infection Control Fund 
  • consider how volunteers could help support service delivery and link-up with the NHS Volunteer Responder’s programme and the wider voluntary sector 
  • ensure they complete the capacity tracker and update their ASC-WDS records to ensure effective planning for local, regional and national capacity issues

Shielding and people who are clinically extremely vulnerable

All care providers should:

  • complete a workplace risk assessment to secure the health, safety and welfare of all staff 
  • have individual conversations, about Covid-19, with all members of the workforce who are Clinically Extremely Vulnerable (CEV), or are otherwise identified as being at an increased risk, before a return to work or a return to their previous role 
  • follow government advice on safe working to take the maximum steps to ensure the safety of everyone in their workplace

Social work and other professional leadership

  • All care providers should continue to support social workers and other qualified staff that they employ, by ensuring they are aware of professional duties, the latest guidance and training opportunities and by supporting them to protect their wellbeing.

 

Supporting the system

Funding

All providers should:

  • spend the initial Infection Control Fund by the end of September 2020, in accordance with the grant determination letter 
  • provide data through the Capacity Tracker, or through other relevant data collection or escalation routes in line with government guidance and the conditions of the Infection Control Fund 
  • implement the recommended infection prevention and control measures 
  • provide information to local authorities about spending supported by the Infection Control Fund in line with the grant conditions 
  • maintain robust financial records about their use of the Infection Control Fund

Market and provider sustainability

All care providers are asked to:

  • review and update their business continuity plans leading into winter, and proactively engage with the relevant local authorities or NHS commissioners and CQC if they have concerns or need support

 CQC support: Emergency Support Framework and sharing best practice

All care providers should:

  • proactively approach their local authority or the CQC if they have concerns or need support 

Providers should take note of findings arising out of the provider collaboration reviews.

Local, regional and national oversight and support

All care providers should:

  • review and update their business continuity plans leading into winter and proactively engage with the relevant local authorities or NHS commissioners and the CQC if they have concerns or need support 
  • continue to complete the relevant sections of the capacity tracker or the CQC community care survey

 

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