Care homes, supported living, shared lives and extra care

Care homes

Devon care homes in visitor testing pilot

As well as the Director of Public Health is not issuing a restriction on visits to Devon care homes, a number of Devon homes have been participating in the high profile national pilot to test visitors to homes, as reported positively in the local media:

Devon care homes take part in rapid results Covid-19 test trial

Ingenious Devon care homes are reuniting residents with their families

Testing pilot in Devon and Cornwall aims to ‘reunite’ care home residents and families

Care home providers – national weekly Q&A session for the Capacity Tracker

The NHS England Commissioning Support Unit are holding weekly national calls for care home providers that have any questions about the Capacity Tracker system. The next meeting will be on 1 December between 1pm – 2pm, and every Tuesday at the same time until 22 December inclusive, via Microsoft Teams. To join please click on the meeting link.

Designated settings scheme: letters to directors of adult social services

The letters set out arrangements for the designated settings scheme for people discharged to a care home with a positive COVID-19 test.

How to work safely in care homes - guidance

Guidance for those working in care homes providing information on how to work safely during this period of sustained transmission of COVID-19 (update on the use of vinyl gloves).

Dementia wellbeing in the COVID-19 pandemic - Guidance

NHS England and NHS Improvement published guidance to help address the needs of people with dementia in the COVID-19 pandemic. It complements the existing dementia wellbeing pathway and identifies specific actions to be taken at each stage. In addition to identifying key considerations, it also provides links to a wide range of resources, including those developed by NHS England and NHS Improvement, regional dementia clinical networks, the voluntary, community and social enterprise (VCSE) sector and the Department for Health and Social Care. This resource is primarily for clinicians working with people with dementia but can also be used by carers and people with dementia.

iPad offer to care homes

NHSX has announced an iPad offer to care homes. Full details of the offer together with other links to FAQs, Terms of Use and Eligibility Criteria is available on their website.

Obtaining an iPad through this initiative will enable you to:

• Hold video consultations with health and care professionals
• Use NHSmail (a secure NHS internal email service)
• Connect care home residents with loved ones remotely
• Get direct access to any other tools or systems needed to support the care of resident

The deadline for applications is 23 October 2020.

New Guidance on single staff cases of COVID-19 in care homes

The new guidance covers the steps care homes need to take when they have single confirmed cases of COVID -19. With the introduction of whole home testing we are seeing significant numbers of care homes with single confirmed cases of COVID-19 in their staff members. When you have a single confirmed case in a staff member in your came home but no other cases (either symptomatic or on whole home testing), the HPT will no longer be ringing you to conduct a risk assessment.

Please read this information if you have a single member of staff with infection.

Devon care home visits testing pilot

Devon has been selected as a Department of Health and Social Care pilot for testing visitors to care homes. The pilot will use a combination of weekly testing of regular visitors and new tests, which visitors take before entering the home with results within 15 – 30 minutes. Devon homes were asked to volunteer via the WhatsApp group.
Further information is available from the press release.

Visiting care homes

Receiving visitors is an important part of care home life. Maintaining some opportunities for visiting to take place is critical for supporting the health and wellbeing of residents and their relationships with friends and family.

The national guidance for visiting arrangements in care homes  (first published on 22 July and updated on 5 November 2020), requires the local authority Director of Public Health to make a risk assessment about visiting care homes in their area. Devon’s Director of Public Health has stated that there are no restrictions recommended at the moment, as long as national guidance is strictly followed, including the need for a dynamic risk assessment. Our priority is to ensure that everyone is as safe as possible should we see a local increase in COVID-19 cases. We are monitoring the situation closely and if any restrictions are required, we will communicate them both directly to affected providers and via this website.

Care home visitor guidance must be in line with the government guidance on visiting care homes and on working safely in care homes. It must also comply with the advice of the Director of Public health and result from a dynamic risk assessment.

The national guidance sets out measures that can be put in place to provide COVID-secure opportunities for families to meet using visiting arrangements such as substantial screens, visiting pods, and window visits. We encourage care homes to communicate their policy to the family and friends of their residents.

Principles for visiting health and care professionals

Aim: NHS and Local Authority health and care staff including therapists, who are required to visit care homes across Devon will provide a consistent approach in ensuring the ongoing protection and welfare of residents in care home settings by minimising the infection risks.

What can the care home expect from visiting health and care staff

1. Virtual visits will continue to be used for routine interactions wherever possible, using telephone or video conferencing.

2. Face to face visits will only be made where necessary for clinical assessment /treatment; or deemed necessary for the health and wellbeing needs of individual residents. Where a face to face visit is required to support the health and wellbeing of a resident, a pre-visit planning call and check discussion will be undertaken a minimum of 1 hour in advance. This call may include:

• Request for information about any current symptomatic or COVID-19 positive (+ve) cases in the home
• Environmental factors and risks e.g. car parking or home entry routes
• Estimated ‘time window’ that the visit will take place within

3. Infection Prevention and Control – All visiting health & care  staff will follow national and local infection prevention & control policies including the use of appropriate PPE in all face to face situations. We will ensure that our staff who visit have not had unprotected contact with people who have tested positive for COVID-19 or other symptomatic individuals.

4. Care Home Policies – We will support each care homes visiting policy wherever possible but recognise that these may differ. We will complete any visiting document required to support the NHS Track and Trace process.

Expectations of care homes

1. The care home is contactable by telephone to assist with the pre- visit planning and checks.

2. All visits – virtual or planned face to face will be supported by a member of the home staff in relation to the individual needs of the resident. Resident will be ready within a well-ventilated room with good lighting. The exception would be an emergency visit.

3. Hand washing facilities to be made available when entering and leaving the building

4. Minimising time by visitors walking through other parts of the care setting and social distancing at all times.

5. Appropriate PPE must be worn at all times in all face to face situations.

Free iPads for care homes from NHS

Care homes will be given iPads to help residents keep in touch with their loved ones and reduce the risk of loneliness as part of plans to ensure the social care sector is supported throughout winter.
Details about the scheme and how to apply for the iPads are available from the NHS website.

Quality assurance of swabbing

The Department of Health and Social Care recommend that carer staff and nurses who will be swabbing residents in care homes complete the online care home swabbing competency assessment provided by the national quality assessment provider GenQA.

Individuals can register at GenQA or care home managers can create an organisational account by contacting info@genqa.org

Promoting weekend testing in care homes

A campaign is being launched this week to promote weekend testing in care homes. The Government are asking care homes to consider testing at weekends where possible to help them get a test to everyone who needs it. Additionally, if homes test at the weekend, the labs are less busy, and result will be quicker.

Devon County Council would like to encourage care homes to test over a full seven days wherever possible to make full use of the testing capacity.

Information on testing can be found on the testing part of the PEN website.

Infection, Prevention and Control (IPC) Compliance Assessment Tool

This compliance assessment is a simple tool which has been developed using the most recent information from the CQC and others. It will help you know how well you are doing, identify areas in which you need to improve and bring the guidance together into one place.

Remote Mental Capacity Assessments

The Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) are still fully in effect and the government has issued guidance on the application of the MCA and DoLS during the Covid-19 pandemic.

Further guidance is available from the independent Mental Capacity Law and Policy website

Care homes are reminded that the local guidance relating to mental capacity assessments remains that assessments should be carried out by remote means wherever possible at this time. It may be appropriate for someone who is able to communicate directly with the person to assist with or carry out a capacity assessment.

National hospital discharge guidance

Please refer to government guidance about changing your arrangements – Coronavirus (COVID-19): hospital discharge service requirements.

Admission and care of residents in a care home during COVID-19

This note outlines the changes made to ‘Admission and care of residents during COVID-19 incident in a care home’. Updated on 2 September 2020.

Managing falls in care homes during the pandemic

The National Falls Prevention Co-ordination Group has produced guidance in the form of a managing falls poster, which also contains links to moving and handling video resources.

GP support for care homes from Devon Doctors 111 out of hours service

Urgent GP support for care homes from Devon Doctors / NHS 111 out-of-hours period i.e. from 6pm to 8am overnight, as well as at weekends and on bank holidays.

• Dial 111
• Follow the prompt asking you to ‘Press 9 to continue’ and, having done so, immediately press the * button and then 6.
• You will be connected to a Call Handler at Devon Doctors who will arrange for you to receive a clinical call back.

To feedback on this service contact ddooh.projects@nhs.net

Hospital Emergency Department process for care homes

Message sent on behalf of Northern Devon District Healthcare NHS Trust, Royal Devon and Exeter NHS Foundation Trust and Torbay and South Devon NHS Foundation Trust.

The NHS takes all possible measures to shield care home residents, care home staff (including domiciliary workers) and NHS clinical staff if they present to the Emergency Department (ED).

To follow the necessary coronavirus testing procedures, hospitals must ensure there are dedicated areas to treat and test patients who present in their ED.

This means that the risk of being exposed to the infection in ED is kept to an absolute minimum.

COVID swabs will only be taken from patients who require admission to hospital, or those who have COVID symptoms. Swabs would be taken before they are discharged back to their care home, even if they are not admitted.

Devon Residential and Nursing (DRN) WhatsApp group

A WhatsApp group has been set up for Devon residential and nursing home managers and owners.

We would encourage all registered managers and owners to join the group using the online registration form.

National care home safety guidance

Public Health England guidance on how to work safely in care homes during this period of sustained transmission of COVID-19, including a video and clear instructions about putting on and removing PPE.

Support to care homes to order medications through proxy access

NHS England has published a step-by-step guide to granting authorised care home staff proxy access to their residents’ GP online services accounts.

Managing medication in emergencies

DCC’s Quality Assurance & Improvement Team have issued Emergency planning guidance for medication administration in care homes.

Please also see the NICE guidelines for managing medicines in care homes.

DEVON CCG Caring for Care Homes team information, guidance sheets and resources.

NHS Devon care homes newsletter

NHS Devon’s Caring for Care Homes Team produce a quarterly newsletter for care homes.  It can be viewed online and care homes can join the mailing list by emailing them.

RDE, Northern Devon and Torbay Hospital process for care home patients and staff

Message sent on behalf of Northern Devon District Healthcare NHS Trust, Royal Devon and Exeter NHS Foundation Trust and Torbay and South Devon NHS Foundation Trust.

The NHS takes all possible measures to shield care home residents, care home staff (including domiciliary workers) and NHS clinical staff if they present to the Emergency Department (ED).

To follow the necessary coronavirus testing procedures, hospitals must ensure there are dedicated areas to treat and test patients who present in their ED.

This means that the risk of being exposed to the infection in ED is kept to an absolute minimum.

COVID swabs will only be taken from patients who require admission to hospital, or those who have COVID symptoms. Swabs would be taken before they are discharged back to their care home, even if they are not admitted.

Supported Living

National Supported Living guidance

The Government has published guidance for providers of Supported Living, covering safe systems of working including social distancing, respiratory and hand hygiene, enhanced cleaning and how infection prevention and control and personal protective equipment applies to those settings.

In addition, more detailed information is available in the infection prevention and control guidance.

Housing with Support Forum

The Housing with Support Forum meets fortnightly on Wednesdays from 10am until 11am. It‘s a chance for organisations who provide supported living, extra care, shared lives and the homeless support services that are commissioned by DCC, to get together to discuss issues, overcome barriers, share the all good stuff that’s happening and test ideas. If you deliver these services and would like to join the forum then please contact us: socialcarebusinessrelations-mailbox@devon.gov.uk

Future forum dates:

Devon Housing with Support WhatsApp group

We would encourage all registered managers and owners to join the group using the online registration form.