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NHS South West London CCG Covid-19 and Care Homes - Frequently Asked Questions – Sheet 13 Infection Prevention and Control Webinar: Tuesday 23rd June 2020 FAQ sheet finalised: Dear Social Care Colleagues The COVID-19 pandemic is an extremely challenging situation globally and we recognise that this is the case for staff working in Care Homes. We are offering our support in many different ways, and one of these is through running a weekly Infection Prevention and Control webinar Tuesday mornings at 11am. It is possible to ask questions during the webinar through the Chat function or via the phone if you are dialling in. At the end of the document is an additional information sheet that may be useful during COVID-19. We understand that the situation is changing daily and we are working hard to try to keep you updated with new guidance and information as quickly and clearly as possible. We would like to thank you all for your hard work and commitment during this incredibly challenging time. Thank you to Dr Laura Peck, Clinical Lead GP and Carolyn Moore, Infection Prevention and Control Nurse for SWLondon CCG. With best regards Viccie Nelson Senior Transformation Manager NHS South West London CCG
Your CCG Lead is:
Croydon Olu Odukale ([email protected])
Kingston and Richmond Brian Roberts ([email protected])
Merton Kudirat Fowewe ([email protected])
Sutton Caroline Pollington ([email protected])
Wandsworth Anca Costinas ([email protected])
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Contents
How has the process for transferring paper based DNACPRs changed when a resident is discharged from the hospital into the Care Home? ................................................................................................................ 3
What is Coordinate My Care (CMC) and what is the process for accessing it? ............................................ 3
How can a GP sign off a DNACPR which needs reviewing if they are not visiting? ...................................... 3
Who can I ask if I have other questions about the transfer of a DNACPR? .................................................. 3
Overview and update on Infection Prevention and Control national training in Care Homes ..................... 4
What do I need to do if a resident has coronavirus symptoms? .................................................................. 4
What is the process for testing and swabbing for residents and staff? ....................................................... 4
What if a resident receives a negative COVID-19 test result but is still showing symptoms? ...................... 5
What do I need to do if a resident is being discharged from hospital into my Care Home? ........................ 5
If a new/returning resident receives a negative COVID-19 test results, should they still be isolated?........ 5
How can I, or one of my household members get tested? ........................................................................... 6
What happens if the courier company does not collect the samples within the correct time limit? .......... 6
Is the antibody testing available yet? ........................................................................................................... 6
Do I still need to follow Standard Infection Control Precautions (SICP)? ..................................................... 6
What is the Hand Hygiene process? ............................................................................................................. 6
What should we do if PPE equipment is running low in our home? ............................................................ 7
What is the current advice regarding PPE? ................................................................................................... 7
How do I correctly don and doff my PPE?..................................................................................................... 8
Can we use reusable and washable masks? ................................................................................................. 8
Does everyone need to wear face mask even where there are no symptoms with the staff or residents? 8
If a staff member is allergic to the surgical masks is there an alternative? .................................................. 8
Can Dettol Clothes Spray be used on clothes instead of changing when using public transport to work? . 8
Can a disposable apron be worn over your uniform to remove the need to change at the end of the shift? ............................................................................................................................................................. 9
What happens if a member of staff is exposed to someone who tests positive for COVID-19? .................. 9
Can residents receive visits from family members? ..................................................................................... 9
Is a Perspex screen required when in an open area outside and keeping a 2m distance or using masks & face shield? ................................................................................................................................................... 9
How do we clean equipment, for example the hoist? ................................................................................ 10
How can we check that engineers are not bringing COVID-19 into the home? ......................................... 10
Where can I access environment and resident risk assessment? ............................................................... 10
Is there a specific risk assessment you can recommend for people in the BAME Group? ......................... 11
Can residents go to hospital for their routine appointments? Is it safe? ................................................... 11
Can I use a fan or air conditioner in the home? .......................................................................................... 11
How can care homes be kept cool during the heatwave? .......................................................................... 12
What help is available if my Care Home is short staffed? .......................................................................... 12
Do I need to use my NHS.net email account? ............................................................................................. 12
How do I register my Care Home on Capacity Tracker? ............................................................................. 12
Do I need to complete the Capacity Tracker? ............................................................................................. 13
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What are the benefits of the NHSE Capacity Tracker? ............................................................................... 13
Is there guidance from the NHS on Capacity Tracker? ............................................................................... 13
APPENDIX 1: PHE Care Testing Results: actions for care home residents and staff .......................................................
APPENDIX 2: Results letter from Public Health England ............................................................................................. 15
APPENDIX 3: Table Guide for Self-Isolation ................................................................................................................ 16
APPENDIX 4: Additional considerations, in addition to standard infection prevention and control precautions Error! Bookmark not defined.
APPENDIX 5: Public Health England Guide to donning and doffing of standard PPE ................................................. 17
APPENDIX 6: Useful Links, contact details and telephone numbers .......................................................................... 18
APPENDIX 7: Useful Information ................................................................................................................................. 19
APPENDIX 8: Mental health and wellbeing support for care home and NHS staff .................................................... 21
Appendix 8: Beat the Heat ........................................................................................................................................ 234
How has the process for transferring paper based DNACPRs changed when a resident is discharged from the hospital into the Care Home? In South West London until the end of August 2020, in response to the COVID pandemic, the Clinical Advisory Group have agreed that a paper based DNACPR can transfer between hospital and community settings, including Care Homes, without a time limit. Should the DNACPR require a review, the hospital will indicate this on the DNACPR. Where this is indicated, please ensure that you advise your GP that the DNACPR needs review. The hospital should indicate on the DNACPR whether conversations have taken place with the resident and their family, or if any processes have been undertaken to support people with limited capacity. It is good practice to liaise with the family or loved ones on return to the Care Home to ensure they are aware of, and understand that a DNACPR is in place. It is also recommended to ensure that the GP is aware that a paper based DNACPR exists. Across London there is an intention to eventually have all DNACPR forms on Co-ordinate My Care (CMC)
What is Coordinate My Care (CMC) and what is the process for accessing it?
Co-ordinate My Care is an electronically shared Care Record which is accessible to all NHS and Primary Care Services. CMC has historically held a patients Advance Care Plan (ACP) and is also being used to share a patients Treatment Escalation Plan (TEP). As it is available to all sectors of the NHS it is an important record if a resident needs urgent care. To gain access to CMC Care Homes need to have firstly published at Standards Met on the Data Security and Protection Toolkit (DSPT) and secondly to undertake registration with CMC. If you are interested in gaining access to CMC, please speak to your clinical lead and to your CCG commissioning lead (listed on page 1). If you are unsure of who your clinical lead is, please ask your CCG commissioning lead.
How can a GP sign off a DNACPR which needs reviewing if they are not visiting?
The form must be signed by the patients GP so they will need to either visit the home or it will need to be delivered to the practice for signature. Alternatively it can be signed and scanned and sent via NHS Mail.
Who can I ask if I have other questions about the transfer of a DNACPR?
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If you have any further questions, please speak to your clinical lead and/or GP.
Overview and update on Infection Prevention and Control national training in Care Homes
The NHS is providing ALL Care Homes with access to FREE Infection Prevention and Control training via a network of local trainers to support the COVID pandemic. The Super Trainer for your area will make contact with you and the training will be:
Arranged by the Super Trainer and discussed in full with the Care Home Manager Provided for all members of staff working in the Care Home, not just care workers Arranged at a suitable time for your Care Home Delivered either face to face or virtually to suit the Care Home requirements Require that a set of slides are read in advance of the training.
Please contact your CCG commissioning lead if you have not yet heard from your Super Trainer.
What do I need to do if a resident has coronavirus symptoms?
Isolate the resident and keep them isolated in their own room and away from other residents for 14
days. Close the door if possible or consider moving the resident's bed 2m away from the door. The
resident should preferably have a room with an en-suite. If this is not possible then the resident will
need to use a commode. Contact the resident’s GP, or access 111 services online. For a medical
emergency dial 999. If ONE resident displays COVID symptoms you need to contact the South London
Health Protection Agency/London COVID Response Cell to advise them of a suspected outbreak.
SWL Health Protection Agency 0344 326 2052
London COVID-19 Response Cell 0300 303 0450 / [email protected]
What is the process for testing and swabbing for residents and staff?
After the first outbreak, The Department of Health and Social Care will provide further testing for all
care home residents (both asymptomatic and symptomatic) and staff who are asymptomatic through
the new online care home testing portal (https://www.gov.uk/guidance/coronavirus-covid-19-getting-
tested#care-home). There is an online swabbing competency assessment for those staff members who
will be required to undertake this type of swabbing. There is an accompanying video that will take you
through the whole process step by step.
Learning Disability, Mental Health Homes and the under 65s can now access the online portal and order swab kits for all their service users/clients
To order the swabbing kits you will need to provide: • The care home’s CQC registration number • The total number of residents, including number of residents with coronavirus symptoms • The total number of staff, including agency staff • Your contact details
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Once you have placed the order you will receive a confirmation email to let you know when the swabs
will be delivered. You will be sent nose and throat swab tests.
If a combined nose and throat swab CANNOT be undertaken or is not possible, then a nasal swab can
be taken. All swabs need to be taken between 6am and 4pm. You will be informed of when the swabs
will be collected. Please note collection will be between 4pm and 9pm.
You should receive the results via a direct email from the lab within 72 hours. (See Appendix 1 for
letter that you will receive) You will need to inform the residents GP of the results. No further swabs
will be sent during the following 14 days i.e. during the established outbreak. See Appendix 2 for Public
Health England Flow Chart that show the action you will need to take following a COVID-19 test result
for both residents and staff.
The website below will take you directly to a one page summary of who to contact and how, should a staff member or resident require testing: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/884284/Adult_social_care_COVID-19_testing.pdf
IMPORTANT - PPE required for swabbing a resident include Gloves, disposable apron, Fluid Resistant
Surgical mask and a face Shield/Visor. This is required because the swabbing process may cause the
resident to cough or sneeze
What if a resident receives a negative COVID-19 test result but is still showing symptoms?
Continue to provide care to your resident as you would if they had received a positive result (see question 2). Arrange for another swab to be taken and sent for testing. Contact the resident’s GP to ascertain if there is another cause.
What do I need to do if a resident is being discharged from hospital into my Care Home?
The resident will have been swabbed prior to discharge, please note the results may not be available
prior to discharge. Regardless of the result, the resident should be placed into isolation for 14 days. If
the result was negative, continue to monitor the resident for any symptoms during the 14 days in
isolation.
If a new/returning resident receives a negative COVID-19 test results, should they still be isolated?
It is advisable to have a policy in place that ensures that ALL new admissions or returning residents who have been discharged from hospital or coming from another setting are placed into isolation for the recommended 14 days regardless of the test result. They maybe incubating or have acquired the infection after the swab was taken and there have been incidences of false negative results. This applies even if a resident has tested positive while in hospital as we do not have enough information about immunity.
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How can I, or one of my household members get tested?
A National testing programme has recently been launched see website below for details, which
includes home testing kits:
https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested
What happens if the courier company does not collect the samples within the correct time limit?
If this happens please contact your national portal. The phone line is available from 7am until 11pm. The phone number is 0300 303 2713. If you have any issues with the nation portal please contact them using the following email address: [email protected]
Is the antibody testing available yet?
SWL are currently discussing the antibody testing and are raising the importance of Care Home staff receiving the testing. A blood test will be required for any person requesting an Antibody test when they become available. Please be aware that a positive antibody test does not indicate immunity to COVID 19 and full PPE and precautions as per the guidelines should still be undertaken. Further details will be shared once plans have been agreed. There have been some discussions around there being a finger prick test – this test is not as effective as the blood test and is not recommended.
Do I still need to follow Standard Infection Control Precautions (SICP)?
Yes, they are the basic infection prevention and control measures necessary to reduce the risk of
transmission of all (not just COVID-19) infectious agents and still apply in the current pandemic. They
should be followed by all staff, in all care settings, at all times, for all residents. Transmission-Based
Precautions are additional precautions for residents who have suspected or confirmed COVID-19 to
prevent further spread.
What is the Hand Hygiene process?
Hand hygiene is one of the most important ways of preventing infection. You must be bare below your
elbows (exposed forearms). It is now recommended that hand washing is extended to include both
forearms as these may have been contaminated with respiratory droplets. Wash the forearms first and
then wash the hands.
Before performing hand hygiene:
remove all hand and wrist jewellery (a single, plain metal finger ring is permitted but should be
removed (or moved up) during hand hygiene)
ensure fingernails are clean, short and that artificial nails or nail products are not worn
cover all cuts or abrasions with a waterproof dressing
Ensure you follow the ‘5 moments of hand hygiene’ guidance for performing hand hygiene before 1)
touching a patient, 2) before clean/aseptic procedures, 3) after body fluid exposure/risk, 4) after
touching a patient, and 5) after touching patient surroundings.
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Ensure you take care of your hands – use a mild soap, dry them thoroughly and use hand creams. You
need to assist residents to wash their hands, if required, particularly before meals and after toileting.
What should we do if PPE equipment is running low in our home?
If you have exhausted your usual supply routes and have a need for further PPE, please use the Mutual
Aid Assistance programme:
NB: If you request is urgent please use the telephone line.
Due to high demand a new Delivery Schedule has been put in place. Please check when your location will be delivered to next as you may have to organise for collection if you need stock sooner.
What is the current advice regarding PPE?
Care Home fills out an online enquiry form at http://swlpp.uk online access 24/7
or call 0203 322 3912 between 08:30 and 17:00
If stock is not available, Helpdesk will advise the
Care Home
If stock and transportation are available arrange a deliver with the Care Home within 2 days
If stock and transportation are available and a delivery is required sooner than 48
hours, a separate arrangement is made with
the Care Home
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PPE is only protecting you and effective if you are carrying out hand hygiene, avoid touching your face,
take it off carefully and follow standard infection control precautions
There is currently sustained transmission of COVID-19 and the guidance is that PPE is worn regardless
of whether there are any known or suspected cases in your care home or whether any resident has
previously tested positive.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/8
81329/COVID-19_How_to_work_safely_in_care_homes.pdf
See Appendix 4 for Additional considerations, in addition to standard infection prevention and control precautions
How do I correctly don and doff my PPE?
There is an excellent video on the GOV.UK website, which all staff should watch, demonstrating the
correct way to put on (DONNING) and taking off (DOFFING) the PPE. Please encourage all staff to
watch the video:
https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes/covid-19-
putting-on-and-removing-ppe-a-guide-for-care-homes-video
Please remember to take your time when taking off your PPE as this is when you are most likely to
contaminate yourself. Appendix 5 provides a visual guide for donning and doffing PPE.
Can we use reusable and washable masks? Masks must be worn at all times and cannot be reused or washed. During the hot weather hey may need to be changed more often so it is the Care Home Managers duty of care to ensure that there are enough and that they are being worn correctly.
Does everyone need to wear face mask even where there are no symptoms with the staff or residents? . As there is sustained transmission of COVID-19 we recommend you use PPE regardless of whether residents or staff in your care home have symptoms. Please refer to the ‘The How to Work Safely in Care Homes’ guidance https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892466/How_to_work_safely_in_care_homes_v3_15_Jun.pdf
If a staff member is allergic to the surgical masks is there an alternative?
The staff member will need to be referred to their GP for an allergy test. There is currently no alternative available.
Can Dettol Clothes Spray be used on clothes instead of changing when using public transport to work?
It is best practice that staff should change into their uniform when they arrive at the Care Home and then change back into their own clothes when they leave the Care Home. Used uniform should be put into, either a plastic carrier bag or a pillowcase, taken home and then washed – including the pillowcase on theHottest temperature that the material can withstand, then ironed/tumble dried.
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Can a disposable apron be worn over your uniform to remove the need to change at the end of the shift? Disposable aprons protect your uniform or clothes from contamination when providing care. You must wear disposable plastic aprons when providing personal care and when exposure to body fluids is likely. Disposable plastic aprons are single use and you must dispose of them immediately after completion of a procedure or task and after each resident, and then wash your hands.
Staff should still change their clothes at the end of the shift.
What happens if a member of staff is exposed to someone who tests positive for COVID-19?
Here is the link to the guidance on RIDDOR reporting for COVID-19 cases amongst staff https://www.hse.gov.uk/news/riddor-reporting-coronavirus.htm The national guidance says that if a staff member is exposed to anyone who has tested positive for Covid-19 but is wearing PPE equipment correctly they do not need to isolate. If PPE is breached, they must isolate for 14 days. If they become symptomatic during those 14 days, they must isolate for 7 days from the day they become symptomatic.
In regards to coronavirus in a care home setting you should only make a report under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) when one of the following circumstances applies:
a person at work (a worker) has been diagnosed as having COVID-19 attributed to an occupational exposure to coronavirus. This must be reported as a case of disease
a worker dies as a result of occupational exposure to coronavirus. This must be reported as a work-related death due to exposure to a biological agent
For further guidance and details on the circumstances when a RIDDOR report must be made and how to make a RIDDOR report please see the HSE’s website: https://www.hse.gov.uk/news/riddor-reporting-coronavirus.htm
Can residents receive visits from family members?
One family member could meet with one asymptomatic resident if staff feel that the resident’s mental or emotional health is declining and should be at the discretion of the Care Home Manager. A decision needs to be made if this is an essential visit. The visit should preferably be outside and the social distancing guidance of at least 2 metres must be followed at all times. Staff should ensure that the family member is not symptomatic (record the visitor’s temperature) and has not come from a symptomatic household. Any visitor should be offered a fluid resistant mask and hand hygiene must be carried out before and after the visit (alcohol hand rub) Visitors should be discouraged if there is an outbreak in the Care Home and alternative ways for letting residents see their relative’s e.g. social media, relatives staying outside behind windows etc. should be considered.
Is a Perspex screen required when in an open area outside and keeping a 2m distance or using masks & face shield?
There is no requirement for Perspex screens to be used. if a resident is shielding or vulnerable, they can be visited but through a window or by an open door keeping the two-metre distance. Visitors should be
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carefully managed by the care home staff by ensuring they wash their hands with Alcohol hand gel provided and have their temperature taken upon arrival. Also check if they are symptomatic or live with someone who is symptomatic before they are allowed to enter the home. Visitors should not be allowed in the home if a resident is coughing. Currently there is no change to the guidance all the above is to be done under manager’s discretion.
How do we clean equipment, for example the hoist?
All equipment must be cleaned following the IPC instructions for decontamination of reusable non-invasive equipment cleaning hard surfaces. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877533/Routine_decontamination_of_reusable_noninvasive_equipment.pdf · Remember to clean underneath equipment, like hoists and commodes, as well as the top. For hoists, ideally there needs to be a dedicated sling for each resident with their name on it Reusable slings needs to be washed in the washing machine, following the manufacturer’s instructions, and a risk assessment carried out for how frequently it will need washing. If there isn’t a sling for each resident, then it must be washed in the washing machine between residents following the manufacturer’s instructions. Disposable slings should be thrown away after the appropriate amount of use, as per the manufacturer’s instructions and cannot be shared between residents. If the sling can’t be washed in the washing machine then new slings will need to be purchased so that each resident has his or her own sling, and the home will have to carry out a risk assessment as to the frequency of purchasing a new sling for a resident.
How can we check that engineers are not bringing COVID-19 into the home?
All Care Homes should have a visitor policy during COVID-19 which ensures that anyone who is entering the care home for any reason is checked for COVID symptoms, including a temperature check. If they are symptomatic or have been in contact with anyone who is symptomatic, they cannot enter the home. All staff should be following the policy and should ensure that there is adequate signage at the entrances and within the care home. If the engineer is not symptomatic and does not have a temperature they can enter as normal. Many companies will supply their employees with their own PPE for their own protection, however, if the engineer arrives without PPE protection you must provide them with a mask and ensure it is worn correctly in order to protect your residents, staff and the engineer. When they remove their gloves, they must wash their hands. There is no requirement to swab test engineers. Engineers do not need to wear foot protection but may bring their own to protect flooring (as per company policy) .
Where can I access environment and resident risk assessment?
Here is guidance regarding the types of PPE and the circumstances in which it should be used: https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes Your local Environmental Health team can be contacted for advice on risk assessments.
Here is the general guidance on risk assessment and templates: https://www.hse.gov.uk/risk/ Here is guidance regarding the types of PPE and the circumstances in which it should be used: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
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Is there a specific risk assessment you can recommend for people in the BAME Group?
HSE currently has no specific guidance with relation to risk assessments; however the following links give useful information for owners and managers on issues to address for BAME staff in the workplace during COVID: https://www.nhsemployers.org/news/2020/06/access-resources-to-tackle-racism-and-discrimination https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892376/COVID_stakeholder_engagement_synthesis_beyond_the_data.pdf
Can residents go to hospital for their routine appointments? Is it safe?
Hospitals are beginning to restart their routine appointments. If there are any concerns about any resident, please contact their GP. Please check the requirements for residents wearing a face mask for any hospital or GP appointments.
Can I use a fan or air conditioner in the home?
The risk of air conditioning and fans spreading Covid-19 in the workplace is extremely low. You can continue using most types of air conditioning system as normal. But, if you use a centralised ventilation system that removes and circulates air to different rooms it is recommended that you turn off re-circulation and use a fresh air supply. You do not need to adjust air conditioning systems that mix some of the extracted air with fresh air and return it to the room as this increases the fresh air ventilation rate. Also, you do not need to adjust systems in individual rooms or portable units as these operate on 100% re-circulation. If you’re unsure, ask the advice of your heating ventilation and air conditioning (HVAC) engineer or adviser. Employers must, by law, ensure an adequate supply of fresh air in the workplace and this has not changed. Good ventilation can help reduce the risk of spreading Covid-19, so focus on improving general ventilation, preferably through fresh air or mechanical systems. Where possible, consider ways to increase the supply of fresh air, for example, by opening windows and doors (unless fire doors). Also consider if you can improve the circulation of outside air and prevent pockets of stagnant air in occupied spaces. You can do this by using ceiling fans, desk fans or opening windows, for example. It is important to undertake a risk assessment to reduce the risk of transmission. To minimise the risk you must ensure that the fan is clean and dust free, preferably fans should be dismantled and cleaned before use; avoid using in shared areas, it is preferable to use in the residents room and the fan should not be positioned in a way that directs air out into another area within the home e.g. from the resident’s room out into a corridor. Place the fans so that they do not circulate in infected areas, this means that they are not near to a room where there are COVID positive patients.
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How can care homes be kept cool during the heatwave?
There is guidance from Public Health England below (Appendix 8). This guidance includes a checklist.
What help is available if my Care Home is short staffed?
SWLondon schemes to support your workforce capacity If you are having difficulty covering staff sickness or recruiting into vacancies, there are 3 local schemes in SWL that may help:
Prince’s Trust workforce project: Provides care homes a pool of ready candidates for virtual interviews, for positions including Health Care Assistant roles, Volunteer Roles, Manager Roles, Administrative Roles, Kitchen staff, Cleaning staff and potentially any other vacancies you have.
London Workforce Hub: A scheme which can fast-track healthcare professional roles (e.g. nurses) into care homes where required
Allied Health Professionals (AHP) Hub: A scheme which can fast-track AHP roles (e.g. psychologists, occupational therapists, physios/rehab staff) into care homes where required
All of the above schemes are available for short term, permanent or bank positions. The next online recruitment day for the Prince’s Trust scheme is the 30th July. If you are interested in taking part in this recruitment day please get in contact with Andre Chagwedera ([email protected]), who is available to provide this support. These days tend to get fully booked weeks in advance, so it is strongly advised to get in contact early.
Do I need to use my NHS.net email account?
Yes, the nhs.net secure email should be used when sharing patient identifiable information.
How do I register my Care Home on Capacity Tracker?
Have you registered with the Capacity Tracker?
If you have registered on the Capacity Tracker, please update the following areas today:
• Business continuity • Vacancies • Infection prevention and control • Testing • Personal Protective Equipment and
Equipment supply • Workforce support • Clinical support
If you have not registered for the Capacity Tracker, please do so urgently.
The helpdesk can support you 0300 555 0340 or 0191 691 3729 open 8am to 8pm
Or watch this 15-minute video on YouTube to help you with registration: https://www.youtube.com/watch?v=qm9kX7tVO08&feature=youtu.be and then register here: https://carehomes.necsu.nhs.uk/
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Do I need to complete the Capacity Tracker?
Yes, this needs to be completed on a daily basis. There is currently funding from the government provided to the Local Authorities to support Infection Prevention and Control in Care Homes. One of the criteria for a Care Home to be eligible for this support is that they Care Home is updating Capacity Tracker daily. Information from Care Homes across the country is gathered via Capacity Tracker and is given to the Cabinet office on a daily basis.
What are the benefits of the NHSE Capacity Tracker?
You will be better connected to local health and care professionals that can help you find solutions to problems like PPE, workforce and COVID 19 related matters
Local NHS staff can log in to review the status of your care home and can provide you with local support, which will be coordinated with local authority colleagues
The locality NHS staff can see what is happening across the area and escalate issues that are covering their whole area
The national NHS staff and central Government can monitor the country’s position across all care homes in England and suggest solutions to national and regional issues
It is part of the eligibility criteria for the Infection Prevention and Control fund being allocated by the Local Authorities.
Is there guidance from the NHS on Capacity Tracker? Yes, there is guidance from NHS London Region on Capacity Tracker. Please follow the link to Capacity Tracker: https://carehomes.necsu.nhs.uk/resources/category/51/london-regional-guidance
At the left-hand top of the page there are help videos available for viewing. The videos will take you through the process for registering your home and how to update Capacity Tracker.
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APPENDIX 1: PHE Care Testing Results: actions for care home residents and staff
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APPENDIX 2: Results letter from Public Health England
Information for care home staff who participated in PHE COVID-19 testing You have recently had a COVID-19 coronavirus test and your result has been shared with you by the manager. Unfortunately, we are unable to feed back results on an individual basis. Please read the guidance below which details what you and your household should do next, in line with the national guidance for COVID-19. 1. IF YOUR RESULT IS POSITIVE
This means you have COVID-19 infection. You may already have developed some symptoms (such as a new and continuous cough and/or fever), or you may not have any symptoms yet. Please inform your GP of your result.
If you do not have symptoms
-Please now self-isolate at home for 7 DAYS from the date that the test was taken.
If you develop symptoms during this 7-day period
-Self-isolate for another 7 days from the day your symptoms start. -Inform your care home manager on the date that you develop symptoms. Your household members should self-isolate for 14 days from the date that your test was taken. If they develop symptoms, they should self-isolate for another 7 days from the day of symptom onset. The UK Stay at Home guidance provides further information on self-isolation. https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection 2. IF YOUR RESULT IS NEGATIVE
This means COVID-19 infection could not be detected at the time of the test.
If you currently do not have any symptoms
-You can continue working as normal.
If you now have symptoms (a new and continuous cough and/or fever), you should:
-Self-isolate for 7 days from the day of symptom onset and your household members should self-isolate for 14 days. -Inform your care home manager on the date that you develop symptoms. Your household members should self-isolate for 14 days from the date that your symptoms started. If they develop symptoms, they should self-isolate for another 7 days from the day of symptom onset. This is in line with the Stay at Home guidance, linked above.
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APPENDIX 3: Table Guide for Self-Isolation
X = day of first symptoms = end of isolation period, if no temperature for 48 hours. NB – this table shows four household members. The same rule applies to every member of the household, sharing the same living space.
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APPENDIX 4: Public Health England Guide to donning and doffing of standard PPE
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APPENDIX 5: Useful Links, contact details and telephone numbers
HOW TO WORK SAFELY IN CARE HOMES (Updated 15th June 2020) Information on PPE simplified, flowchart removed, PPE for COVID-19 currently recommended for all care homes during sustained COVID-19 transmission, further text changes and additional FAQs added. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892466/How_to_work_safely_in_care_homes_v3_15_Jun.pdf
SUPPORTING ADULTS WITH LEARNING DISABILITIES AND AUTISTIC ADULTS – Guidance issued 24th April 2020 Guidance for care staff who are supporting adults with learning disabilities and autistic adults during the coronavirus (COVID-19) outbreak. https://www.gov.uk/government/publications/covid-19-supporting-adults-with-learning-disabilities-and-autistic-adults?utm_source=c568004c-c7be-4185-81cf-5cbb09807001&utm_medium=email&utm_campaign=govuk-notifications&utm_content=daily HELPFUL COVID-19 RESOURCES WEB PAGE https://www.mentalcapacitylawandpolicy.org.uk/resources-2/covid-19-and-the-mca-2005/
GUIDANCE PACKS FOR CARE HOMES
Lines are open from 7am – 11pm daily.
The telephone number is the same regardless of the testing kit you are using.
Tel: 0300 303 2713
PHE SOUTH LONDON HEALTH PROTECTION TEAM
If there are any enquiries about testing because of a suspected outbreak then the government guidance states to
contact the local Health Protection Team:
PHE South London Health Protection Team,
Floor 3C Skipton House, 80 London Road,
London,
SE1 6LH
[email protected]; [email protected]
Phone: 0344 326 2052
THE DEPARTMENT FOR HEALTH AND SOCIAL CARE
General Enquiries number 0207 210 4850.
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APPENDIX 6: Useful Information
NHS MAIL
NHS Mail is available free of charge to all Care Homes and allows you to send personal identifiable information securely
between your Home and the NHS services. Once you have NHS Mail set up your Home has access to Microsoft Teams which
has video conferencing facilities, allowing you to connect with GPs, Health Care staff as well as family and friends of the
resident.
There is currently a free support offer to help you to set this up. Please contact: [email protected]
CAPACITY TRACKER
All Care Homes are being asked to submit daily information on staffing, bed vacancies, number of COVID cases and PPE so that
the NHS can support your homes more effectively, if you are not yet set up, or have more questions, please contact your local
lead listed on the front of the FAQ.
WORKFORCE AND STAFFING
We know that it is currently a challenging time for maintaining staffing levels in the Care Homes. We have a project running
with Princes Trust to provide Care Support Workers, Kitchen and Domestic staff, administrative staff and other roles into Care
Homes. We also have a project running with the South West London workforce hub to redeploy Nurse Returners to Care
Homes. If you are struggling with workforce and would like some support please contact: Andre
END OF LIFE CARE SUPPORT FOR RESIDENTS
If you need support to manage residents at the End of Life due to both COVID-19 or non COVID-19 conditions, there are
currently 24 hours clinical support lines available.
BEREAVEMENT AND SUPPORT FOR STAFF
We know this is difficult time for staff, residents and family members. There are a number of free services available for staff
employed in South West London, as well as people living in South West London. Please share these services with your staff.
Borough
Name of Service
Contact details
All SWL Marie Curie Call 020 7091 3656 for emotional and bereavement
support.
Service opening hours:
Monday – Friday, 08:00 – 18:00
Saturday – Sunday, 11:00 – 17:00
Sutton Sutton Uplift https://www.suttonuplift.co.uk/psychological-therapies
Wandsworth Talk Wandsworth https://www.talkwandsworth.nhs.uk/
Kingston iCope https://www.icope.nhs.uk/kingston/
Richmond Richmond Wellbeing Service https://www.richmondwellbeingservice.nhs.uk/
Kingston and
Richmond
Bereavement Support https://www.kingstonbereavementservice.org.uk/contac
t-us/
Richmond Cruse Tel: 0749 5776 401
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EOLC CLINICAL SUPPORT FOR STAFF
Provider Service
Borough
What’s on offer
Operating Hours
Contact Details
St Raphael’s Hospice
Sutton and Merton
Clinical Advice from Clinical Nurse Specialist on triage team. Access to Medical team advice. Clinical Advice from Palliative Care Nurses covering inpatient wards.
Monday - Sunday 09:00-17:00 Monday-Sunday 17:00-09:00
Central Hospice Switch: 020 8099 7777 Ask for CNS triage team. Ask for inpatient unit.
Royal Trinity Hospice
Wandsworth
A Clinical Nurse Specialist to provide expert advice and support for GPs, HCPs, patients and carers. Medical on call cover (Registrar and Consultant)
24 hours a day, 7 days a week
Single Point of Access: 020 7787 1062
Marie Curie
All SWL Boroughs
Professional Information and Support
Monday – Friday 08:00 – 18:00 Saturday – Sunday 11:00–17:00
Tel: 020 7091 3656 www.mariecurie.org.uk/southwestlondon
Princess Alice Hospice
Richmond and Kingston
Careline which has a triage process with access to senior staff and Community Nurse’s
24 hours a day, 7 days a week
Tel: 020 8744 9414
St Christopher’s Hospice
Croydon
Professionals helpline for clinical support Patient support line
24 hours a day, 7 days a week
Professionals: 020 8767 4582 Patients: 020 8767 4500
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APPENDIX 7: Mental health and wellbeing support for care home and NHS staff
Dear NHS Colleagues,
Re: Mental health and wellbeing support for care home and NHS staff residing in Merton, Sutton and Wandsworth
during COVID-19 crisis
The current COVID-19 outbreak is currently causing particular distress among staff working in care homes and for the NHS, with many feeling anxious, stressed, worried, low and helpless in the context of great uncertainty. These feelings are an understandable reaction to the current very difficult circumstances. In most instances, with support from colleagues, friends and family, these feelings will likely fully resolve once the outbreak subsides. However, now is a time when we all may need some extra support. We are therefore writing to you to make you aware of our free offers of wellbeing and mental health support during this very difficult time, and to provide you with information on how to access them.
Offer of local mental health and wellbeing support
Our IAPT (Improving Access to Psychological Therapies) and Wellbeing services offer a range of online talking therapy options to help you manage symptoms of stress, worry, low mood and helplessness, and to build your emotional resilience. Anyone who is a resident of the boroughs of Merton, Sutton or Wandsworth can access our services. If you are a resident in another borough you can contact their services directly using details at the bottom of this letter. To contact us, simply call our telephone hotline, email us, or complete an online self-referral form by using the self-referral function on our website. There will be no requirement for you to contact your GP and ask them to make a referral to us.
Merton
Telephone hotline (9 am – 5 pm): 020 3513 5888
Self-referral: https://www.mertonuplift.nhs.uk/
Email: [email protected]
Sutton
Telephone hotline (8 am – 5 pm): 020 3513 4044
Self-referral: https://www.suttonuplift.co.uk/psychological-therapies
Email: [email protected]
Wandsworth
Telephone hotline (8 am – 5 pm): 020 3513 6264
Self-referral: https://www.talkwandsworth.nhs.uk/
Email: [email protected]
Once you have made contact with us, our admin team will book you into an initial 30-40 minute telephone assessment with one of our clinicians. The aim of this will be determine what kind of support will be most helpful to you at this time. Please note that due to the risk of infection all our support options are currently delivered online via video call or via telephone, rather than face-to-face. Throughout May and June, our staff are prioritizing care home and NHS staff for treatment. This means we will aim to start your treatment as soon as possible after your initial telephone assessment.
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FREE offer of online support you can access directly right now
Our partner organisation SilverCloud is offering a range of online self-help programs that can help ease stress and
anxiety, improve sleep and build emotional resilience. The programs are approved by the NHS and are confidential
and secure. To get free instant access please sign up at:
https://nhs.silvercloudhealth.com/signup/
To log in, please use this access code: SWLSTG2020
Please note: You can access SilverCloud directly, without needing to contact our IAPT and Wellbeing services.
How SilverCloud works
You can choose from several programs, with each providing content, tools, videos, and suggestions for
activities to help you to feel better
Topics covered include: (1) Sleep: Learn how to fall asleep faster and stay asleep with healthier habits, (2)
Stress: Manage stress & learn new coping skills, and (3) Resilience: Enhance wellbeing & your ability to
bounce back from challenges
You can access the online content anytime and on any device – i.e. mobile phone, computer or tablet, and
you can work through the programs at your own pace
Each program is built on proven scientific methods such as cognitive behavioural therapy (CBT) and positive
psychology
All information you enter into the system is anonymous, confidential and secure
Our Trust does not provide IAPT services in Kingston and Richmond. If you live in either of these boroughs you can
contact the local IAPT services using the links below:
Kingston: https://www.icope.nhs.uk/kingston/
Richmond: https://www.richmondwellbeingservice.nhs.uk/
Our IAPT and Wellbeing services will continue to offer support during this outbreak and after it has subsided. Even if
you choose not to use the support offered at this time please remember that we will be there to help when you
need it.
Yours sincerely,
Dr Hendrik Hinrichsen
Clinical Lead, Trust IAPT and Primary Care Services
Alexandra Roger
Operational Lead, Trust IAPT and Primary Care Services
Page 23 of 24
Appendix 8: Beat the Heat
Beat the Heat Keep residents safe and well during COVID-19
During previous heatwaves, people in residential and care settings have been at particularly high risk of illness and
death. During the COVID-19 pandemic, it is especially important that you know what actions to take to keep
residents safe from high temperatures.
Many people at high risk from
heat are also at risk of severe
illness if infected with COVID-19.
Some medications can also place
people more at risk from heat.
Identify those at highest risk
Know your care home response
plan
Monitor temperatures in all rooms
Keeping cool is vital in hot
weather. There are actions you
can take to help residents
remain well. Signs of heat
related illness include nausea,
drowsiness and headache.
Recognise heat related illness
Monitor hydration Fans only for use in and fluid intake single rooms with
COVID-19 free residents
There are simple actions to
take to reduce overheating in
care homes.
Use blinds to reduce heat gain and create cross ventilation if possible
Turn heating systems off
Treatments for heat-related
illness are always the same. Cool
the person down and get help if
they are unresponsive.
Move to somewhere cooler if safe to do so
Cool showers, wet skin, fluids
Get help or Call 999 in an emergency
For more information go to www.nhs.uk/heatwave
Page 24 of 24
Are you and your care home prepared for hot weather?
Do you know the content of the plan and where to find it?
Can you store all medicines, according to the instructions on the packaging,
even if indoor temperatures rise above that stated on the packaging? If not,
what is your organisation’s plan for managing this?
Do you know how to keep residents cool in hot weather?
Y/N
Are any of your residents unable to adapt their own behaviour and/or
environment to stay cool?
Does your facility have external awnings to provide external shade? Do you know
how to operate them?
Do you know if indoor temperatures in bedrooms and common areas in your facility
are monitored (ie are there indoor thermometers)? Who is responsible for this?
Do you know how to turn off the heating in individual bedrooms and common
areas? Who is responsible for taking this action?
If the answer to any of the questions is ‘no’, see the Heatwave Plan for England and
associated documents for further information, and ask your line manager for advice.
www.gov.uk/government/publications/heatwave-plan-for-england
PHE publications gateway number: GW-1289
Do you know what to do if it becomes hot inside the care facility?
Do you know that you are also responsible for identifying if a room is
overheating?
Do you know who to report an overheating issue to?
Are fridges and freezers working properly? If not, do you know who is
responsible for taking action?
Are you able to ventilate the rooms eg, can windows or vents be
opened to create a through-flow of air whilst ensuring the safety of
residents?
Do you know who is responsible for managing the heating system in your
care home?
Notes/ responsible person
Notes/ responsible person
Notes/ responsible person
Y/N
Does your care home have a plan in place should hot weather be
forecast and/or occur?
Do you know how to keep rooms cool during hot weather?
More residents than usual may be at risk from heat due to COVID ill-
health and COVID restrictions. Review who is at high risk
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