Covid 19 and care homes

Liz Taylor 19/03/20 Dignity Champions forum

There is lots of information around but I came across this which people may find helpful

The dilemma facing Care Homes and Residential based services is relatively simple. How far do you go to protect, safeguard and mitigate the risks to residents in the current situation?

There are several factors which should be considered and the importance of involving other people cannot be overemphasised.

The legal context of a closure to visitors is clear in that there is no legal basis for a blanket closure, until or unless the government changes the advice.

However, you can mitigate risks by open and honest dialogue, good communication channels between you, as the Provider, the Resident and their Family or Representatives.

Visitors.

Signage should be clear on entry of the need to refrain from visiting if they have been to certain oversea areas, display Coronavirus symptoms, or, have within the previous 14 day period attended an unusual large event, such as the theatre, a concert, a large family gathering all of which have heightened the risk of contagion.

Where such visitors have been identified and are unable to visit, telephone communication, skype, social media exchanges should be facilitated with set scheduled access for easier management.
Consider if it’s possible to mitigate risk by agreeing a floor by floor access routine, one floor a day which reduces visiting and mitigates risk.
End of life visiting is the exception. Where possible this visiting should not be restricted except where medically required.
All visiting should be in the Residents own room whilst the current government guidance is in place; with consideration being given to a set number of visitors, with, if it’s easier to manage, a set visiting time, rather than open door visiting. This would be a protective measure for the visitors.
Health professionals whose visits you can’t control would benefit from as little contact with the general public and is a good reason to introduce set visiting routines e.g. 13.30 – 15.00 etc.
Contractors should be utilised only in situations of absolute need such as equipment or utility breakdowns, everything else can wait. This is especially important where contractors go from Home to Home.

In a care home, should you need to isolate, the resident’s room is used.

P.P.E should be in use. Aprons, gloves, and fluid repellent, and, where splashing may occur, eye protection should be used.

As this is an ever changing situation, government briefings are now in place for every day, to update the public, and government advice with change accordingly.

For Providers it is the Department of Health and Social Care for Individuals, it is the Public Health England.

Their websites should be checked daily.

Post a reply

Alexandra Hayward 20/03/20

We are offering free infection control training around Covid-19, especially to nursing and residential homes and domiciliary companies, none have yet taken us up on it!

Nicola Christianson 20/03/20

Hi, I am interested in this. I would need specific details about your company first as I am responsible for vulnerable adults.

Abdul Mohammed 20/03/20

Yes thank you, great idea
Kindly send me details of your available training

Once again, thanking you

Rosalie Smith 20/03/20

Hi your post was good reading. My mum is in extra care housing, and from the care provider within the building, there has been very little information and communication about visiting and what they are putting in place.
My mum is 97 and end of life care with Dementia and I visit her three times a week, and I do all her shopping.
No guidelines from care provider have really been given out, or communications to use family members,this we are finding very frustrating, surely by now they should be telling us about visiting and what they have been putting into place.

James Grant-Parkes 21/03/20

Hi Alexandra , this looks a great idea - how do I access the training ?

Kind Regards

James

Pikelele Ndemanga 22/03/20

Please send me more information on how to be enrolled in this course

Jessica Bingley 22/03/20

What a fantastic offer.

Mark Edwards 23/03/20

Great idea Alexandra
Can you please forward the details to me
Kind regards
Mark

Mark Edwards
Hospital Manager
0161 438 1750
/
07813 354 530
Monet Lodge
67 Cavendish Road, Withington, Manchester, M20 1JG
I always try to write my emails using plain English. This is generally more accessible for people with learning disabilities, sensory loss or other communication needs. If there is anything I can do to make this email more accessible for you please let me know.

ruth Pye 23/03/20

Alexandra - I'd be very interested in this also. We are based in Sefton is there a way we can contact you to get some information around this training?

Alexandra Hayward 23/03/20

In regards to the training, if you can let me have your emails I will send you links to the training.
Nicola Christianson, you are right to ask for details about us, we are a health & social care training company, owned and run by qualified nurses, our trainers are all qualified nurses who are still on the register, and are therefore covered by the Nursing and Midwifery Code of Conduct and have enhanced DBS checks in place.
As I'm sure you understand most of my trainers are working extra shifts at the moment, there are a few of us, who due to medical conditions are not able to do this, so we are trying to do our bit in another way.
My email is [log in to view email address] ( I hope I'm allowed to put this on here?)

Rosalie Smith 08/07/20

Can anyone find an answer to this question for me.
Why is testing not happening in extra care housing. It appears that this doesn't fall within the guidelines.
Staff who work in extra care housing, go home every day, and then return and are allocated to different Residents some with Dementia and other on going health issues,

Rosalie Smith 17/11/20

Does anyone know why extra care hosing staff are not being offered testing? My mum is in extra housing and has a number of different staff going into her for personal care etc a number of times a day,.The staff go into a number of different flat within the building, and their office is downstairs.
A number of the residents here are very frail.
I understand no testing has been forthcoming for the staff.

Liz Taylor 18/11/20

My view is that extra care housing is being treated the same as domiciliary care where testing is also not available in the same way as care homes. In both cases carers are visiting multiple individuals as well as potentially having contact with the general public between visits. I think extra care should be treated the same as residential as contacts are more traceable.

Rosalie Smith 18/11/20

Hi Liz,

Thanks for your reply, any suggestions how this can be taken forward, would it be work getting in touch with the local council in the area?
I do feel very stronger about this,

Liz Taylor 18/11/20

That might be a route to try, I also think it might be worth contacting DHSC specifically Helen Whately. I am not sure if UKHC the trade body for Domiciliary Care are doing anything which might be another angle. Will post again if I come up with anything else Good luck

Rosalie Smith 18/11/20

Hi liz,

Thanks for information , yes I will go down that route as well,

Rosalie

kevin SLATER 18/11/20

This case is similar to supported living support workers, we had an initial trial roll out 3 weeks ago, this was not mandatory so the take up was far less the thing is when you are visiting several clients within a day, the test would prove useless as you would be working within different areas, the emphasis would be from my experience make full use of all PPE following guidelines for donning and doffing,
and following strict personal hygiene rules when going from client to client and when returning home.

Rosalie Smith 18/11/20

Hi Kevin,
Thanks for your information. My mum is supported Living/Extra care Housing, the care provider have their office downstairs so staff are not traveling around to go to clients, only clients within the building.
I thought the practice would be for managers of care staff to arrange for them to be tested. Where my mum is very little continuity of care appears to be taken into account.
It appears easy to blame the family members visiting if their loved ones gets the virus rather then look closer to who else is going into make visits.
Care staff where my mum is have said the care provider has not offered them to go and have a test.


kevin SLATER 18/11/20

Hi Rosalie,
If they are a group of staff based in the same building then their Managers should be requesting testing as in care homes. The providers are failing in there duty of care to staff and clients, oh and the old chesnut of continuity of care, this is held as paramount in person centred care and we regularly see different staff delivering care, NHS England have stated this should only be so in an emergency. I would contact the provider firstly and get some answers. Staff are more at risk of taking this virus in because unfortunately we do not know where they have been outside of work. Good Luck and both of you stay well.

Liz Taylor 18/11/20

while I don't disagree with you Kevin we need to be mindful that a lot of effort has been put into making sure that Extra Care Housing is not seen as residential care and this may influence the approach of managers. I will be interested to see if when OVID vaccine becomes available whether it will be offered to care workers in settings other than residential care.

LORRAINE HARDCASTLE 18/11/20

Hi Everyone,
I would reccomend we all do some reserch on whats happening in our country,


LORRAINE HARDCASTLE 18/11/20

Sorry sent before finishing, I work in care, and love my work ,but before all this covid, winter a time when we all caught horrid viruses , which could be passed on to older generation, I'm really concerned that we are doing more harm than good to our loved ones at this time,just hope and pray this situation is true, we all listen to BBC, read newspaper, maybe we should do some research..
The situation with a daughter taking her mum away from a nursing home really worried everyone, please give me your thoughts on thisx


Rosalie Smith 19/11/20

Hello Lorraine,
I did watch the interview and read in the newspaper about the mum taking her daughter out of the care home.
I feel there was a lot more to this story.
My background is in care, community and working in a care home setting.
I feel the home were right in calling the police when this happened, there must have been another procedure to go down rather then just go into the home and take the lady out. How frightening for the staff and the lady herself.
I just feel care home managers will try and work with family,
I know it was her daughter taking her out, but maybe some underlining issues had gone on that we are not hearing about.
I note you mentioned research,?
Yes it is a concern this virus being passed on to the elderly and frail.
What research do you feel we should be looking into?
Keep safe,

Rosalie Smith 19/11/20

Hello Liz,

I can see what you are saying, However where my mum is it is classed as extra care housing, but more like Residential/nursing, so a fine line being called extra care housing. A number of the Residents living there are very frail, Dementia and require a lot of looking after.
The office for the care staff is allocated downstairs, so I feel care staff based there and going in and out of different flat should be tested.
however i now understand that because this is known as extra care housing staff do not qualify to have a test.?
I feel this is down to the care provider to ensure all there staff are safe while working.
I am looking into this more now.


Rosalie Smith 19/11/20

Hi Kevin,

Thanks for your reply yes I agree with what you say,I was interested in your comments as to what NHS England have said, where did you find this information?
I feel strongly about the continuity of care for people will care staff going into them and not being tested.
I am taking this up with the care provider now, not that I will be very popular as also have raised issues with a person centered care plan being in place.