Keeping staff and service users safe

We want to support providers to protect their staff and residents. Care workers have a vital role to play, especially during the response to coronavirus. We want to make sure you and your staff can continue to care for some of the most vulnerable in our society. With your help, we can keep them safe and cared for.

The Integrated Commissioning Service will continue to issue updates to providers. If you cannot find the advice you need email [email protected]

The symptoms of coronavirus are:

• a new, continuous cough
• a high temperature, or
• a loss of or change in their normal sense of smell or taste

Staff with coronavirus symptoms must:

• self-isolate for the recommended period of time
• follow government and NHS guidance.
• If your service users have coronavirus symptoms you should minimise the risk of transmission through safe working procedures and review the pages on Personal protective equipment (PPE) and Infection Prevention and Control Procedures and follow the specific guidance for your setting:
  • COVID-19: how to work safely in care homes
  • COVID-19: how to work safely in domiciliary care – including visiting homecare, extra care housing, and live-in home care.
  • Supported living services during coronavirus (COVID-19)

Health and social care partners have developed a tool and action planning template to help managers have risk management conversations with individual staff.

In recognition that coronavirus poses a higher risk for some groups of people, the tool supports a conversation to understand any concerns, taking into account different backgrounds, cultures and preferences. It provides an action planning template to support managers and staff to identify and take actions to mitigate risk.

Symptoms of the virus can include a fever, which can increase the risk of dehydration. The virus can also cause individuals to feel sleepier therefore they are likely to drink less.

Review the guidance produced by BOB Integrated Care Board (ICB) including Top Tips to Keep Care Home Residents Hydrated During COVID-19.

Refer to coronavirus testing for staff and residents.

Review the management of falls guidance that has been published by the Government. The guidance recognises that falls in care and residential homes are common and fortunately most do not require an emergency ambulance response.

It is particularly important that the 999 service is used only when someone is seriously ill or injured and their life is at risk, and that care home staff know how they can support residents who have fallen and are waiting for an ambulance.

The government has published guidance on policies for visiting arrangements in care homes. The guidance recognises that visits are important for those in care settings and suggests that any decisions around visiting should be based on a dynamic risk assessment to minimise risk wherever possible.

The guidance states the Director of Public Health in each local authority should make a regular professional assessment of whether visiting is likely to be appropriate within the local authority area. A letter from Jane O'Grady, Director of Public Health, sets out the current position in Buckinghamshire.

Refer to the government guidance to help you develop your visiting policy. This policy should be based on a risk assessment which is regularly reviewed and updated. The Care Provider Alliance has published a Visitors' Protocol which you may find helpful to support his work.

The MHA guidance on visiting a relative with dementia living in a care home provides additional advice with regards to dementia.

The Supported Living Guidance includes advice on visiting supported living settings.

When care homes call for emergency assistance from the Ambulance Service, it is important that staff are able to access the home as quickly as possible. Ambulance Service staff will be wearing appropriate PPE and following government infection control guidance.

Given this, staff should not be stopped or a temperature check before entering the care home. This will prevent any delay in providing treatment to residents.

The council and Integrated Care Board are committed to working with care and nursing homes to support infection control and ensure that staff time is focused on the immediate care and support needs of residents.

We will consider what activity can be carried out remotely – for example via phone or other digital means and would request provider support to facilitate this. However there will be times where health and social care professionals need to visit a care or nursing home. In particular:

• Planned safeguarding visits
• Best Interest Assessments
• Therapy provision as part of Discharge to Assess (D2A)

In such cases we will always call the home to explain why a visit is required and to agree a date and time for the visit. We then expect health and social care professionals to be admitted to the home for the agreed appointment.

In some cases unannounced safeguarding visits may be required. In this case we will keep to a minimum the number of people attending for the visit and expect them to be admitted to the home when they arrive.

All visitors should be expected to wash their hands for 20 seconds on entering and leaving the home and catch coughs and sneezes in tissues.

Any health and social visitors will be provided with and expected to wear appropriate PPE for the duration of their visit in line with current guidance, and to dispose of this appropriately.

This position will continue to be reviewed to ensure that we can return to business as usual activities once COVID-19 restrictions start to be eased.