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COVID-19 guidance for home care, residential care and supported living

Information, guidance and advice for independent providers of adult social care services. 

Keep us updated

Whatever type of care service you are providing, we would like regular updates from you as the situation is ever changing.

Providing us with accurate information as soon as you are able to will allow us to manage this situation to the best of our ability and effectively identify where there is the most critical need.

Social Care Institute for Excellence

The Social Care Institute for Excellence (SCIE) is an independent agency, operating at policy and practice levels with a huge database of 'what works' good practice, eLearning tools and resources. They offer a wide range of tailored and flexible improvement support, working collaboratively with associates and partner organisations.

PPE procurement advice

When ordering PPE stock directly from suppliers, it is imperative for the safety of both staff and clients that the PPE items meet the national required standards. You can also find information about PPE minimum standards.

Advice note for private, voluntary and independent care providers regarding face protection - PPE

On 6 May 2020 we updated our PPE advice to our own employees to include enhanced face protection for care work.

Our new guidance for staff recommends that employees should wear a full-face visor in addition to a surgical mask when carrying out all personal care within less than 2 metres of a client.

We have received reports that the stitching or ear loops on some surgical masks are breaking or becoming loose. In addition, some masks manufactured outside the EU do not distinguish between surgical masks and fluid-repellent surgical masks on the quality assurance information shown on the packaging. As a result we cannot guarantee that all face masks we supply to you are fluid-resistant, hence the updated advice to our own employees.

The issue with the quality of some surgical masks is not unique to Derbyshire – unfortunately it's a national concern.

As a responsible employer, we acted quickly by changing our guidance to ensure our care workers have the maximum level of protection by using full-face visors in addition to surgical face masks.

We recommend that the guidance for our employees is taken into consideration by PVI providers when making their own judgement on PPE for their own staff.

There's more information about the updated PPE guidance for our employees.

PPE suppliers

The list of suppliers' contact information is compiled from a wide range of sources. As such we cannot provide any guarantees or warranties about any of the suppliers on the list or the products they supply. It's the responsibility of each individual organisation to exercise due diligence, to ascertain the suitability of the supplier and their products, and to carefully consider any associated risks before entering into any agreements with a supplier to purchase their products. Particular caution should be exercised when payment is requested upfront.

This list is not exhaustive and there are other suppliers throughout the UK.

Personal protective equipment guidance

Public Health England have support for putting on and taking off personal protective equipment. For immediate concerns about access to appropriate personal protective equipment (PPE) you should contact the national supply disruption or distribution line for providers:

Our Derbyshire has information on how to use and order PPE for our employees.

You can find more guidance around PPE and the latest PPE guidance for home care workers.

Safeguarding

Our responsibilities for safeguarding vulnerable adults have not altered following the implementation of the Coronavirus Act 2020.

It is imperative that we remain vigilant, and adhere to established processes of reporting safeguarding concerns in accordance with current safeguarding policies and procedures.

End of life support

Accessing support - dedicated advice line

The care home advice line is a designated line that is hosted by Derbyshire Health United (DHU) which is manned by a nurse with end of life care expertise from 8am to 8pm 7 days a week, for advice and support relating to end of life care. Tel: 111, 9,*6,*6.

For care home staff to get to a clinician directly the staff need to ring 111, press 9 to continue then immediately *6, then wait for the message, there may be a short pause, then immediately press *6 again.

If the query is made between 8pm and 8am then the number can still be used and you will get a quick call back by a clinician on the out of hours service.

Domiciliary service providers can access this support by calling NHS 111.

A guide to end-of-life visiting in care homes during the pandemic is attached to this page.

Latest government guidance

There is guidance from government on the admission and care of people in care homes, care care home guidance, home care provision and a social care action plan.

The NHS are working with tech firms to help care home residents and patients connect with loved ones.

There is information for the social care sector on responding to the coronavirus pandemic.

Dedicated app for social care workers launched

A new government app has been developed specifically for the social care sector. Downloading the app will enable all care workers to access government guidance, learning resources, discounts and health and wellbeing information.

Testing care staff for COVID-19

Derbyshire has moved quickly to extend the COVID-19 staff testing programme for key workers and these are defined as anyone who is critical to the provision of health, care and other services. In addition to NHS staff working in our hospitals, community trusts, GP practices, care homes and hospices the programme is extended to include public service key workers across Derby and Derbyshire.

The process is being co-ordinated by Derby and Derbyshire Clinical Commissioning Group as part of supporting key workers back to work at the earliest opportunity. From 20 April 2020 the vast majority of testing will be done from 2 new sites at the Burnaston Toyota plant in Derby and the Proact football stadium in Chesterfield.

The test slots are available at both sites in the afternoons from 1pm and these are for public sector organisations including mental health and community provider trusts, staff from GP practices, care homes and hospices, local authorities including borough councils, the fire service, Highways England, the prison service and others.

One of the most important criteria is that tests must be carried out within 5 days of becoming symptomatic as tests delivered after 5 days will not be accurate. This test can also be carried out on adults and children who are symptomatic and living in the same household as the key worker. Please ensure that any referral falls within the definition of a key worker and the following eligibility criteria are important to minimise inappropriate referrals which may deprive others of a testing slot:

  • a member of staff who is self-isolating because they are displaying symptoms
  • a member of staff who is self-isolating because an adult or child household member is showing symptoms, then that adult or child (over 5 but under 18) is eligible to be tested
  • the test is only accurate if conducted at day 5 or before from the person displaying symptoms (antigen test) so referrals that cannot receive a test by 5 days are ineligible

To request a test slot and confirm eligibility please email: ddccg.covid19keyhcwtesting@nhs.net including name and contact telephone number for the person requesting a test and indicate which location they will be accessing (Chesterfield or Derby).

Once the email with contact details has been received there will be a return contact to obtain further information.

Members of staff or their household members who meet the criteria and are able to be transported by car to the test centre (it is a drive through-only testing facility) will be offered a booking at the appropriate location when the next available slot is free. If you do not have access to a car to go to either site, please discuss this with your line manager who will look at alternative options with you.

Results are sent directly to the member of staff and not to their employing organisation.

Please remember the test is only viable up to 5 days after a patient first shows symptoms. It is of great importance that you begin the process of requesting a test without any delay, ideally from day one of showing symptoms.

Employer guidance

Guidance for employers and business on coronavirus is available from the government, which includes the Business Emergency Relief Fund.

Government advice also includes key worker guidance and changes to DBS ID checking guidelines. There is also interim guidance on DBS and other recruitment checks from the Care Quality Commission.

There is information about staff and volunteering to help fill workforce gaps.

A national database of volunteers to help with the coronavirus effort has been devised. Thousands of people have signed up to be an NHS Volunteer Responder, and have people available to help support providers with various tasks such as housekeeping and telephone befriending, depending on previous experience. Employers and providers will be responsible for assessing the volunteer's individual experience and skill level when assigning tasks (not for providing direct care to clients). You can make a request for a volunteer or tel: 0808 196 3382.

A coronavirus awareness course is available from Skills for Health.

Infection prevention and control is vital to the wellbeing of people who need care and support.

NHS and clinical commissioning group guidance

Capacity tracker for hospital discharge services

Providers of care homes, hospices, in-patient community rehabilitation and end of life care are required to register onto the care home capacity tracker and to keep it updated during the COVID-19 outbreak.

Data collected includes:

  • number of beds
  • number of bed vacancies
  • current status (open, closed to admissions)
  • workforce and staffing levels

Hospital discharges

In response to managing COVID-19 in our hospitals, national guidance has been issued that says hospital discharges must be carried out within 2 hours of a patient becoming medically fit.

Local NHS and adult social care services have made the decision that all hospital discharges requiring ongoing support will use a Trust Assessment Approach/D2A documentation, which is attached to this page.

This decision will take effect immediately. It is our intention that the assessment will provide a clear and accurate view of the client's needs and how then can be best met.

The following documentation will no longer be used:

  • hospital core information
  • short term support assessment and plan
  • hospital discharge short term placement
  • interim care at home

Attached to this page is the leaflet being used by the hospital teams for people who are being discharged as part of this arrangement.

If you have any questions or feedback, please email: asch.adultcare.contracts@derbyshire.gov.uk

If your request is for a service in Derby, please contact Derby City Council adult social care commissioning and market management team, email: carebrokerage.duty@derby.gov.uk

Top tips for caring for people with dementia

The Northern Health and Social Care Trust has advice about supporting people with dementia during the COVID-19 Pandemic.

Yorkshire and the Humber clinical network has a guide on Getting a COVID swab when a person has dementia.

You can also download the advice from Worcestershire County Council on providing support for residents living with dementia who need to be isolated in care homes.

Get psychological first aid (PFA) training and help people with different needs to cope with the emotional impact of COVID-19.

Dementia resources

The impact of COVID-19 pandemic on people living with dementia in China, their carers and health and care services has potentially important lessons for us in Derbyshire.

The document called 'Dementia care during COVID-19 - lessons from China' is attached to this page. It shows the challenges related to continuing care as usual for people living with dementia during this time, how the Chinese services tried to manage the situation and what was thought to be effective. We are sharing this summary as helpful information for you, whatever your role in dementia care.

A resource to help improved palliative care for people living with advanced dementia, complex mental and physical health needs in care homes or supported living is attached.

A toolkit of resources has been developed by the CCG which gives details on a whole range of useful resources for supporting people with dementia during the pandemic. This is attached to this page.

People with advanced dementia

The Dementia Palliative Care Resource is designed to provide extra support for care homes during the pandemic. It's for all staff working in care homes and supported living services across Derbyshire and Derby to support with people with advanced dementia and palliative care needs.

They offer consultancy and advice, assessment and care planning for people with advanced dementia, palliative and end of life care needs:

  • identify and manage symptoms associated with advanced dementia and end of life, such as pain, terminal agitation, nausea and vomiting, secretions, breathlessness
  • palliative care needs holistic assessment
  • end of life care planning
  • advance care planning
  • support and management of co-morbid conditions
  • delirium
  • COVID-19 pandemic guidelines support such as where managing the demands of guidelines is compromised by individual residents needs
  • behaviour that challenges
  • maintaining activities during COVID-19
  • polypharmacy and medication rationalisation (where appropriate)
  • offer education and signpost to further educational resources

This is provided by:

  • phone triage and immediate signposting
  • phone or digital assessment, care planning, care evaluation and review
  • face to face assessments and visits can be arranged when triaged as required

To contact the team tel: 01332 980124 from 9am to 5pm on Monday to Friday.

Residential care homes

The COVID-19 pandemic raises particular challenges for care home residents, their families and the staff that look after them. There is guidance attached to this page that has been developed to help care home staff and NHS staff who work with them to support residents through the pandemic.

The government has issued new guidance for care entitled COVID-19 Admission and Care of People in Care Homes. This is attached to this page - it needs to be read in conjunction with a social care action plan.

Posters

Public Health England has published posters in various formats to be displayed at entrances to hospitals, GP practices and community pharmacies and other settings to provide people with advice on what to do if they have the symptoms of coronavirus (COVID-19).

Looking after your health and wellbeing

The ongoing contributions made by staff across the care sector during this pandemic is both valued and admirable, and our appreciation for all that you do cannot be measured. However, we acknowledge that the current situation can inflict pressures that can have a detrimental impact on both your physical and emotional health.

We always advise to discuss any concerns that you have with your line manager, in the first instance. However, in addition please look at our guidance and support.

There are a many resources available to support your mental health at this difficult time. This includes an offer from our local hospices who have set up a support line for care staff who are struggling and would like to talk to someone. See the How are YOU flyer attached to this page.

There's also information on health and wellbeing information for social care staff attached to this page.

Psychological first aid course - free online training

Get psychological first aid (PFA) training and help people with different needs to cope with the emotional impact of COVID-19.

Psychological First Aid (PFA) is the globally recommended training for supporting people during emergencies and offers guidance on delivering psychosocial care in the immediate aftermath of the emergency event.

On this course, you’ll explore the psychological impact of the COVID-19 pandemic and what you can do to help people cope. The course will teach you the key principles of giving psychological first aid in emergencies.

This course has been produced by Public Health England and is based on international guidance from the World Health Organisation, United Nations and partners. This course is aimed at frontline or essential workers and volunteers dealing with the public during the COVID-19 pandemic.

Most FutureLearn courses run multiple times. Every run of a course has a set start date but you can join it and work through it after it starts.

CARE workforce app

A wellbeing package for social care staff is also being rolled out today on the new CARE app including 2 new helplines, led by the Samaritans and Hospice UK. This will help support care staff with their mental health and wellbeing and support those who have experienced a traumatic death as part of their work or help with anxiety and stress.

Wobble room

The Wobble room is a virtual space available to all care home and domiciliary care staff currently working in North Derbyshire. It's a place where people can go for a wobble, pause and recharge or be supported to pause, recharge and move on. The room will be staffed for some of the time, virtually by the supportive care team members. 

Contractual obligations

Moving and handling and medicating clients with confirmed cases

Social, community care staff should ascertain if a person is in self-isolation and if they are asymptomatic or symptomatic prior to their visit. If they are self-isolating and a visit is deemed necessary, then a full risk assessment should be undertaken with managers and infection control specialist to decide the best course of action. If during a telephone consultation with a patient or their representative to assess their suitability for a domiciliary visit, it is thought that COVID-19 is possible (based on the PHE criteria for a possible case), call NHS 111 and arrange for a clinical assessment to be made before proceeding.

Health professional input

Care homes or home care providers unable to assess individuals prior to agreeing to support the individual

A trusted assessor nursing assessment will be completed in the hospital discharge hubs which will identify the care and support needs of each patient. This will be shared with you as care home or domiciliary care providers in order that you are able to determine whether you can meet the patients’ needs. Additionally a review will be built in to the discharge process to ensure you are supported to move the patient to alternative provision if you are unable to meet long term needs.

Information sharing

Staff members confirmed positive with COVID-19 with no testing

Check if you have coronavirus symptoms with the NHS service which will guide you through a series of questions to assess your symptoms, and therefore the likelihood that you have contracted the virus. Advice and guidance will be provided, which includes self-isolation from immediate effect and robust hygiene practices. Formation and the issuing of testing kits are underway, and further information can be located on Public Health England.

Reporting the number of staff self-isolating as per government guidance due to themselves or family members presenting with symptoms

Please report confirmed COVID-19 cases to Public Health England as previously advised. For Derbyshire providers, please update our adult care contracts team, email asch.adultcare.contracts@derbyshire.gov.uk. This will help us to have an understanding of the issues providers are facing in relation to staffing and workload pressures.

Please notify the health protection team of any confirmed cases or suspected cases of COVID-19, email: icc.eastmidlands@phe.gov.uk or tel: 0344 2254 524 option 1.

Reporting the number of staff self-isolating as per NHS guidance due to complex underlying health conditions that can increase risk of infection

For Derbyshire providers, please update our adult care contracts team, email asch.adultcare.contracts@derbyshire.gov.uk. This will help us to have an understanding of the issues providers are facing in relation to staffing and workload pressures.

Please notify the health protection team of any confirmed cases or suspected cases of COVID-19, email icc.eastmidlands@phe.gov.uk or tel: 0344 2254 524.

Staffing

Statutory Sick Pay for staff self-isolating

As part of the government's emergency legislation measures, Statutory Sick Pay (SSP) will be paid from day one of sickness to support those affected by COVID-19. This will be a temporary measure to respond to the outbreak and will lapse when it is no longer required. Read the government's COVID-19: guidance for employees.

Statutory Sick Pay for staff members self-isolating due to a member of their household presenting symptoms

If you are staying at home because of COVID-19 you can now claim SSP. This includes individuals who are caring for people in the same household and therefore have been advised to do a household quarantine. Read the government's COVID-19: guidance for employees.

Ending self-isolation and returning to work

If you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, but all other household members who remain well must stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the house became ill. Read the government's COVID-19: guidance for employees.

Waiving staffing restrictions

Waiving staffing restrictions, for example, when 2 male staff are needed however, are unavailable, needs to be assessed on a case by case basis. Please liaise with your contract manager for further guidance.

Special measures for a pregnant members of staff

A full risk assessment is required. Discuss with employees who are at risk or are pregnant, the need to be deployed away from areas used for the care of those who have, or are clinically suspected of having, COVID-19.

Procedure if large amounts of our staff are unable to attend work

Your organisation's business continuity plan ideally would cover what action should be undertaken in situations such as this. For services commissioned by us, it is imperative that a RAG rating of all service users to whom you provide a service is to be completed, to enable you to establish the high need cases and aid in the management of risk. Once completed, please advise our adult care contracts team of the RAG ratings, email asch.adultcare.contracts@derbyshire.gov.uk

For individuals funded through continuing healthcare you should forward to both mlcsu.derbyshirechcfastrack@nhs.net and donnyokoh@nhs.net

Please refer to email sent out from us on 16 March 2020 entitled ‘Home care - planning for impact of COVID-19’.

Recruitment process and security checks for volunteers

The safety of our clients is at the forefront of all that we do. We must ensure that the team members who we deploy are suitable to work with the most vulnerable of clients, therefore DBS checks are still to be undertaken. Read the interim guidance on DBS and other recruitment checks. See the government guidelines COVID-19: Changes to DBS ID checking guidelines.

Arrangements for self-isolation

Self-isolation guidance is to be followed at all times. This is imperative to minimise the risk of the spread of infection. Please see the NHS self-isolation guidance.

ID badge for key workers getting stopped

ID badges will be sufficient proof that care staff are key workers going about their duties, in case they get stopped.

Mandatory training

For providers who are commissioned by us, please offer online training wherever possible. If training has been undertaken by staff members previously but is now out of date, please maintain up to date records and prioritise updates and refresher training when the COVID-19 situation settles.

The government has produced flow charts to help staff to establish when it is safe to return to work following COVID-19 testing.