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To help those responsible for care home provision to plan and prepare in the event of a COVID-19 outbreak, Public Health England (PHE) has put together a helpful guide on best practice to help prevent the spreading of the virus.

The guidance is aimed at local authorities, CCGs and registered providers of accommodation for people who need personal or nursing care. This includes registered residential care and nursing homes for people with learning disabilities, mental health and/or other disabilities.

Importantly, if any member of staff is concerned that they have the Coronavirus, they are advised to follow NHS guidance and self-isolate, and only resume care duties when it is safe to do so.

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Collaboration

To help maintain high levels of care services, PHE advises that care home providers and local authorities work together to help one another. This includes sharing the workforce between providers and to consider deploying volunteers.

The guide also suggests that care home providers explore the different avenues available to help keep their local community safe, including:

  • using tools to report capacity for bed vacancies (such as the Capacity Tracker or Care Pulse) to support system resilience.
  • using tools for the secure transfer of information (such as NHSMail) to reduce face-to-face contact.
  • using Skype and similar tools for secure video conference calls to relay information from GPs, acute care staff, PHE health protection teams and community health staff.

PHE adds: “Care home providers will routinely be procuring personal protective equipment (PPE) such as gloves and aprons. In addition, there will be a free issue of PPE to support adult social care providers to support compliance with the updated advice. This will be issued from the pandemic influenza stockpile. Arrangements will be put in place for adult social care providers to access further PPE as necessary.”

Minimising risks

To reduce the chance of spreading the Coronavirus, the guide says care home providers should ask that no one visit if they have suspected COVID-19 or are generally unwell. Good hand hygiene for visitors also needs to be emphasised, the guide adds.

However, the guidance does note that providers should recognise the positive impact that seeing loved ones has on the wellbeing of their residents.

Isolation precautions

PHE says care homes should implement isolation precautions when a resident displays symptoms of the Coronavirus. It says that a resident’s own room is suitable for isolation purposes and that, ideally, the room should be a single bedroom with en-suite facilities.

The guidance adds that care home staff will be trained in hand hygiene as a lot of the care delivered in homes relies on close personal contact.

Personal protective equipment (PPE)

If a resident displays symptoms of COVID-19, PHE says that staff should wear PPE for activities that bring them into close personal contact, such as washing and bathing, personal hygiene and contact with bodily fluids. Aprons, gloves and fluid repellent surgical masks should be used in these situations. If there is a risk of splashing, then eye protection will minimise risk.

The guidance adds: “New PPE must be used for each episode of care. It is essential that used PPE is stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal. Care homes have well-established processes for waste management.”

Cleaning

Frequently touched surfaces need to be cleaned thoroughly, Public Health England advises. It also says personal waste and disposable cleaning cloths should be stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal.

Washing

PHE also says that care staff should not shake dirty laundry before washing as this can increase the chance of the Coronavirus spreading through the air.

Although dirty laundry that has been in contact with an ill person can be washed with other people’s items, the guide stresses that items heavily soiled with body fluids or items that cannot be washed should be disposed of, with the owner’s consent.

COVID-19 testing

According to the guide, testing of residents may be organised if care homes have several cases at a time.

Increased interventions

Although the guidance states that PPE is not necessary when the care worker and the individual receiving care are showing no symptoms, it says that increased cleaning activity to reduce risk of retention of virus on hard surfaces and keeping property properly ventilated by opening windows whenever safe and appropriate is advised.

Steps the NHS can take to support care homes

CCGs, NHS providers and local community services and primary care will be working with and supporting local authorities and care home providers in the provision of care, the guide outlines.

Community service providers are taking steps to:

  • contact all local care home providers and local authorities to share plans for local support networks and care provision across the area, including identifying local capacity.
  • explore how local community health services and primary care providers can support care home provision, agreeing with local authorities and care home providers how and when this can be triggered, and what the role of the NHS is in that circumstance.
  • support local authorities in planning around resilience, including plans to share resources locally in an outbreak of COVID-19.
  • consider, in cases where there may be isolated outbreaks within certain providers, how best the NHS can support in recovery.
  • think about what measures may be put in place to support care home providers in maintaining residents’ independence and mobility and prevent or delay deterioration and loss of function.

Government support

To find out more about the emergency £5 billion COVID-19 Response Fund, which is designed to help the NHS, local authorities and public services plan and prepare for the Coronavirus, read about the most important healthcare announcements from the 2020 Budget here.

In addition, the Government also recently announced £2.9 billion more in funding to help relieve pressure on the NHS and local authorities during the Coronavirus pandemic.

Steps local authorities can take to support care home provision

According to PHE, local authorities, working with their Local Resilience Forums and drawing on their pre-existing plans for pandemic influenza, should:

  • contact all registered providers in their local authority area and facilitate plans for mutual aid. These plans also need to include care homes that provide services mainly or solely to people who fund their own care and are not limited only to providers from whom the local authority directly commissions care.
  • consider the need to work closely with local community health services and primary care networks to support care home provision and draw up a plan for how and when this will be triggered. This should include planning with all of the assets available to the community, including the voluntary, community and social enterprise sector.
  • take stock of how to maintain viable care home provision during the outbreak of COVID-19, including financial resilience.

To read the full guide, visit: https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-residential-care-provision

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