COVID-19 Practice guidance on Care homes

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Visiting and the law: a guide for care homes during COVID-19

The Relatives & Residents Association

This guide provides a summary of the current Government guidance on visiting inside care homes in England and the relevant legal duties on care providers. It provides an overview of the legal duties on care providers relevant to visiting, including the Care Act, Mental Capacity Act and Human Rights Act. Aiming to be practical, accessible and user-friendly, the guide also contains worked examples and pointer questions. The guide is not legal advice, but we hope it will help care homes to explore their visiting policies and practice, to help respect and protect the rights of residents.

Last updated on hub: 23 August 2021

COVID-19: normalising visiting in long term residential care facilities (LTRCFs)

Health Protection Surveillance Centre

Residents in nursing homes and other residential care facilities have a right to maintain meaningful relationships with people who are important to them. Visiting is an essential part of that right. In 2020 Government policy suspended visiting for the purpose of managing the risk of severe disease and death from COVID-19 in nursing homes. The vaccination rollout in nursing homes has greatly reduced the risk of severe disease and death due to COVID-19 in this setting. It is therefore appropriate to restore normal visiting rights as quickly and as completely as is practical while recognising that there is a continuing level of risk and uncertainty that did not exist prior to the pandemic. In particular there is a concern about the possibility of introducing a virus variant against which the vaccine may be less effective and which may therefore result in serious disease or death of residents. This guide is intended to support nursing homes and other LTRCFs to restore the right to visiting as completely and quickly as is practically possible in the context of the assessed level of risk at the time. There is a need for clear communication on these issues with residents and families to form a shared commitment to working together to maximise meaningful contact for residents with the lowest practical level of risk. This document replaces COVID-19 Guidance on visits to Long Term Residential Care Facilities (LTRCFs) V2.2

Last updated on hub: 19 July 2021

Coronavirus (COVID-19) testing for adult social care settings

Department of Health and Social Care

Outlines the COVID-19 testing available for testing staff, residents and visitors for all adult social care settings. Testing for COVID-19 in adult social care (ASC) is crucial to help protect those who receive care and adult social care staff. Testing programmes identify people who may unknowingly have the virus, enabling those who test positive and their contacts to self-isolate and break the chain of transmission. This page brings together testing guidance for a range of specific adult social care settings: testing for adult care homes; testing for extra care and supported living settings; testing for homecare staff; testing for personal assistants; and testing for day care centres. [First published 24 March 2021. Last updated: 9 July 2021.]

Last updated on hub: 07 July 2021

COVID-19 testing schedule for a suspected or confirmed outbreak in a care home

Department of Health and Social Care

Guidance for care homes dealing with a suspected or confirmed outbreak of Covid-19. Care homes should follow a regular staff testing regime of weekly PCR testing and twice weekly lateral flow testing. An outbreak is defined as 2 or more clinically suspected or confirmed positives (rapid lateral flow or PCR) among residents or staff detected in the same 14-day period. However, one positive test result may be the first sign of an outbreak, so you should contact your local health protection team (HPT) for advice in this instance. The guidance explains what to do In the event of an outbreak; and covers: rapid response daily staff testing; outbreak testing; determining the end of an outbreak; the 90-day window after a positive test; newly symptomatic people; and what to do if more test kits are needed. [Last updated: 7 July 2021]

Last updated on hub: 30 June 2021

Testing for professionals visiting care homes

Department of Health and Social Care

Health, social care and other professionals may need to visit residents within care homes to provide services. This guidance sets out the testing policy for these ‘visiting professionals’. Many visiting professionals work in a variety of different settings per day, including care homes. Given the substantial risks to care home residents if COVID-19 is introduced to the home, it is essential that professionals and all staff are tested regularly before visiting care homes to reduce the risk of transmission across different settings and to help keep residents and staff safe. The guidance covers: NHS professionals visiting care homes who are part of regular staff testing; testing for CQC inspectors visiting care homes; professionals not regularly tested through NHS or CQC staff testing; 90-day window; and void or invalid results. [Last updated: 7 July 2021]

Last updated on hub: 30 June 2021

Coronavirus (COVID-19) testing available for adult social care in England

Department of Health and Social Care

Outlines the COVID-19 testing available for testing staff, residents and visitors for all adult social care settings. The guidance covers: regular testing cycle for care home residents and staff (England); outbreak testing for care home residents and staff (England); care home family and friend visitors; visiting professionals in care homes; extra care and supported living settings; home care testing; day care centres; and universal testing. [Published: 24 March 2021; Last updated: 29 June 2021]

Last updated on hub: 30 June 2021

Extended use of face mask guidance in social care settings including adult care homes

Scottish Government

The purpose of this document is to provide guidance to the social care sector, visiting professionals, residents and service users and their family and friends on the wearing of face masks when in social care settings. The key points of this guidance are: face masks are the final layer of protection from COVID-19, the other layers of protection include physical distancing, hand hygiene, enhanced cleaning, and good ventilation remain paramount; remember “hand hygiene” – every time you change or touch your mask or face covering; all staff providing direct care should wear a Fluid Resistant Surgical Mask (FRSM) throughout their shift as per the guidance; all staff working in non-direct care roles - such as domestic, administration, or management - who work in offices, laundry or kitchen areas, should wear face coverings when working within 2 metres of another person, and should wear an FRSM if in contact with care home residents; in office areas where there is good ventilation and 2 metres physical distancing face coverings are not required; residents in a care home are not required to wear a FRSM or face covering within the care home, which is first and foremost their own home; individuals receiving care within their own home are not required to wear a FRSM or face covering within their home.

Last updated on hub: 28 June 2021

Social Care Working Group consensus statement, March 2021

Department of Health and Social Care

Outlines the SAGE Social Care Working Group’s methodology for determining the minimum level of vaccine coverage in care home settings. Modelling analysis in March 2021 estimated that 75% of staff (given that 90% of residents in each individual care home had been vaccinated) provided a level of protection sufficient to limit outbreaks assuming other mitigations are in place. During March this analysis was updated to 80% coverage in staff and 90% in residents reflecting a slight change in evidence for efficacy of vaccination. This statement indicates that the calculations on recommended coverage should be taken as the best estimate at the time of writing. Given the changing epidemiological situation, they should be continually reviewed as evidence emerges. There is no certain threshold for protective vaccine coverage levels – the 80% to 90% coverage values previously calculated were based on single dose reported AZ efficacy rates. Vaccine is not a silver bullet, just part of our armoury against COVID-19. There is a risk that vaccination may lead to a reduced use of testing, PPE and IPC at a time that vigilance is needed against new variants with poorer vaccine efficacy.

Last updated on hub: 26 May 2021

COVID-19: interim public health, infection prevention and control guidelines on the prevention and management of COVID-19 cases and outbreaks in residential care facilities

Health Protection Surveillance Centre

Managing the risk of COVID-19 can be thought of as three elements. The first is to take all practical measures to reduce unintended introduction of the virus into the residential care facility. If the virus is not introduced by a person with infection, then it cannot spread. Even when all practical precautions are taken it is still possible that the virus will be introduced unintentionally therefore the second element is to take all practical measures to reduce the risk of the virus spreading if introduced. The third element is having processes in place to minimise the risk of harm to residents and staff if both other elements fail and the virus is introduced and spreads. This guideline addresses measures needed to achieve all of the above elements. Controlling the risk of introduction, spread and harm from COVID-19 is challenging particularly as there is a need to balance the management of risk with respect for the autonomy and rights of residents.

Last updated on hub: 26 April 2021

Care home COVID-19 testing guidance for testing of staff and residents

Department of Health and Social Care

This guidance explains what care homes should do in the event of a suspected or confirmed Covid-19 outbreak. Care homes should follow a regular staff testing regime of weekly PCR testing and twice weekly lateral flow testing. An outbreak is defined as two or more clinically suspected or confirmed positives (rapid lateral flow or PCR) among residents or staff detected in the same 14-day period. However, one positive test result may be the first sign of an outbreak, so care homes should contact your local health protection team (HPT) for advice in this instance. [Published: 24 March 2021; Last updated: 7 July 2021]

Last updated on hub: 26 April 2021

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