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Coronavirus (COVID-19) latest information and advice

Help for care providers

Local and national guidance 

Local guidance

NHS England has guidance and resources for managing common infectious diseases and outbreak management in care homes.

Isolation following outpatients’ appointments

There is no formal government guidance on the isolation of care home and supported living residents following an outpatient appointment. The following local policy has been developed with the help of colleagues in BANES, Swindon & Wiltshire Clinical Commissioning Group (BSW CCG) & Care Quality Commission (CQC), to help care homes take a risk-based approach.

GOV.UK has guidance for in-patient stays.

A risk-based approach for outpatient appointments

When a resident returns from an outpatient appointment, care providers should take a take a risk-based approach, based on the level of contact they have had with confirmed or suspected cases, and what type of contact has taken place.

When carrying out a risk assessment to decide whether or not a resident should be isolated for 14 days, please take the following into consideration and record the reasons for your decisions:

  • Contact with confirmed or suspected cases (low risk in outpatient department as people are triaged and assessed prior to attending)
  • The length of exposure
  • The proximity to the patient/resident
  • The activities that took place
  • Whether PPE guidance and requirements for health and social care workers were followed or breached

Waste management and receptacles in care homes

Care homes should have well-established processes for waste management and ensure clinical waste disposal systems are in place through a specialist collection service. Care homes must not place any hazardous clinical waste in the domestic waste stream.

The care home is responsible for providing appropriate waste receptacles that are legally compliant, and for providing adequate space for the amount of waste produced.

At the point of production, receptacles such as pedal bins for bagged waste and sharps receptacles are required. Where there is a risk of infection, the waste should be deemed to be clinical waste.

The placement of clinical waste bags should be designed to remove (or at least minimise) patient and visitor access to them.

All staff, including domestic cleaners, must be trained and understand how to dispose of and manage waste appropriate to their role to limit the spread of COVID-19.

Removing and disposing of PPE

All removed PPE should be disposed of as clinical waste. Aprons and gloves worn in residents' rooms should be removed whilst in the resident’s room, discarded in the bin provided and treated as clinical waste. This is of vital importance when barrier nursing. Leaving the resident's room wearing aprons or gloves breaks the chain of effective barrier nursing.

Waste receptacles and their location

Where practicable and safe to do so, clinical foot-operated, lidded waste bins should be in all residents' rooms.

Locating large clinical waste bins in all bedrooms isn’t always appropriate. There may be cases where they could make moving and handling procedures difficult, as they can restrict the space in bedrooms and for residents with dementia, they may pose a potential injury/harm risk.

In such cases, smaller foot pedal lidded bins should be located in resident’s rooms. These bins must be clearly labelled as clinical waste, and separate bins for domestic waste provided if required, to avoid mixing the two types of waste. It is recommended that clinical and domestic waste bins are different colours, to enable staff to easily distinguish between them.

As clinical waste bin liners only come in one large size, these smaller bins can be used with a standard bin liner, which should be taken (when full) to the sluice and put in a yellow clinical waste bag.

If you are unable to provide clinical foot-operated, lidded waste bins in all residents' rooms, you should carry out a risk assessment, record your actions and include details in your Infection, Prevention and Control Plan.

Disposing of personal waste in the domestic waste stream

Personal waste (such as used tissues, incontinence pads and other items soiled with personal fluids) and disposable cleaning cloths should be tied securely in disposable rubbish bags. These bags should be placed in another bag (double bagged) and put to one side for at least 72 hours before being placed in the usual general waste bins.

Dealing with media enquiries relating to coronavirus

During the UK coronavirus outbreak, journalists may contact your care home, or try to film outside. We strongly recommend that you don’t respond directly to any enquiries from journalists, even if they appear friendly and try to engage you in general conversation. If they can, they may use whatever information you provide in their stories.

What to do if you receive an enquiry from a journalist

Staff at care homes are asked refer any journalists' enquiries to an experienced communications team:

  • Your own in-house communications team, if applicable
  • B&NES Council Communications team. Please email or call on 01225 47 71 83, to ensure that any responses are joined up
  • If for any reason our communications team is not able to to answer your enquiry, or are not available, then you can email the BSW CCG communications team or call on 07500 12 17 20

How to handle enquiries from journalists

When speaking to a journalist, always be friendly and polite, but do not be drawn into making any comment. If they call you, please respond if you can as follows:

Thank you for your enquiry. As you are calling with a press enquiry, please contact the Communications team at B&NES council, who are best placed to respond. They can be reached by emailing communications_marketing@bathnes.gov.uk, or by calling 01225 47 71 83.

If the journalist provides any details and you have time to record them, please try take down their name, publication and contact number. Please pass these details to our Communications team.

How to handle journalists who may attempt to visit a care home

If a journalist arrives at your care home and attempts to enter, politely explain that there is a non-essential visitors restriction policy in place, and therefore you are not able to grant access to the home.

You may also remind them that the home is both private property and a home to vulnerable older people, who have a right not to be disturbed.

Please alert our Communications team or your in-house communications team if there is a media presence outside the home.

Do not feel pressured to answer any questions. If journalists refuse to leave, you should call the police.

How to handle journalists who may film near or outside the home

There may be instances where a journalist is seen filming outside the front of your care home.

Unfortunately, as long as the journalist is not on private property, there is nothing that can be done about this and it is best to just leave them.

Please remind all colleagues to not engage with the journalists or film crew, and to provide the contact details of our Communications team if they need further information.

Testing people who lack the mental capacity to consent

With the drive to now regularly test all residents in care home settings for COVID-19, we have set out some basic guidance for staff in cases where the relevant person may lack the capacity to consent to this procedure.

Start with the basics

The first thing to remember is that where you have doubts about a resident’s capacity to consent to a test for Covid 19, this decision should be approached in just the same way as any other procedure or intervention that is made in connection with their care and treatment - namely applying the practice and principles of the Mental Capacity Act (MCA) 2005.

You must establish whether the person concerned does lack capacity to make this particular decision. In doing so you must support them, and take all practicable steps, to help them make their own decision.

This will include giving the person all relevant information e.g. what the test is for, what the procedure involves and what the risks are of not being tested and what the benefits would be.

The information should be given in an accessible way that is suited to the individual’s level of understanding. For example, is there an ‘easy-read’ version for those with learning difficulties?

The capacity assessment must be evidenced, and recorded in the person’s care notes.

Lasting Power of Attorney (LPA) for Health and Welfare, or Court Appointed Deputy

If it is established that, on the balance of probabilities, the person concerned lacks capacity to consent to the Covid 19 test then you should check whether that individual has a Lasting Power of Attorney (LPA) or deputy for health and welfare who can consent on their behalf.

A best interest decision

If they do not have a relevant LPA or deputy, then you will have to decide on whether you reasonably believe that it is in the person’s best interests to have the test - the best interests decision.

In making this best interest decision, you must consider the best interest checklist. This includes:

  • Trying to ascertain the person’s views as much as is possible
  • Encouraging the person’s participation in the decision
  • Consulting others involved e.g. family members and carers
  • Identifying the relevant factors that the person themselves would taken into account if they were able to make the decision themselves. For instance the risk of harm to them should they not be tested
  • Use your knowledge of the resident to identify whether they would have likely to have wanted the test had they been able to make the decision for themselves.

Taking all these views and factors into account you can then make a best interest decision on behalf of the individual. This should be evidenced and recorded in the individual’s care notes.

Implementing the best interest decision

If it is established that it is in the person’s best interests to be tested, then hopefully this can be completed in the course of daily care routines without the use of any kind of force or restraint.

If the person is resisting in any way and restraint is required, then you must be satisfied that it is a necessary and proportionate response to the likelihood and seriousness of the harm that they would suffer should they not be tested.

Any restraint used should obviously be for the shortest time possible necessary to perform the test.

In reality, if restraint and force is required to perform a Covid 19 test then questions will have to be asked if the risk of harm is actually great enough to justify this and whether testing that individual is really in their best interests given the level of distress it is causing. This can only be decided on a case by case basis and clearly documented.

A best interest decision on testing must be person centred

A final point on testing is that, it goes without saying, there can be no ‘blanket decision making’ on the issue of testing a group of residents. This would be contrary to the person centred nature of the Mental Capacity Act - capacity is an individual issue and what may be in the best interests of one resident may not be in the best interests of another.

Further guidance on testing, capacity and COVID-19 can be found on the mental capacity law and policy website.

Public Health England COVID-19 resource pack

PHE have a resource pack which includes videos, posters, letters, and notices.

National guidance

Key guidance

Public Health England guidanceCOVID-19 for care homes, supported living and home care.

Public Health England guidanceInfection prevention and Control for COVID-19 ( includes PPE).

Care homes

National guidance on the admission and care of people in care homes is available on GOV.UK.

View guidance on the management of staff and patients or residents in health and social care settings according to exposures, symptoms and test results.

Guidance is available from the DHSC on the Prevention and control of infection in care homes, and the NHS has a national hand hygiene and personal protective equipment policy.

There is also guidance available on the routine decontamination of reusable non invasive patient care equipment.

There is also a package of support available from the government for care homes.

Domiciliary care

Guides on the use of PPE for domiciliary care workers can be found on GOV.UK.

Further guidance on the provision of home care is also available.

Care issues

The British Geriatric Society has produced a series of advice relating to older people and the current COVID-19 pandemic.

The NHS has produced clinical guidance for frontline staff to support the management of patients with a learning disability, autism, or both, during the coronavirus pandemic.

GOV.UK have produced guidance for care of the deceased.

DHSC COVID-19 Hospital Discharge Service Requirements

Care providers as employers

There is information about business responsibilities on our website.

GOV.UK have produced guidance about redeployment of vulnerable staff, and guidance on working safely for businesses and employers.

Responding to COVID-19: the ethical framework for adult social care has been produced by GOV.UK.

PPE and supplies

Personal Protective Equipment (PPE)

Ordering emergency PPE supplies for social care providers

Social care providers should continue using their business-as-usual and wholesaler routes to access PPE. The PPE portal, council & CCG supplies are emergency top-up systems.

Small social care providers

Small social care providers are categorised as:

  • small residential social care providers with 24 beds or fewer
  • domiciliary social care providers with 99 clients or fewer.

Step 1 - Use your business-as-usual and wholesaler routes to access PPE and explore all the options open to you in the first instance. If you are not able to access PPE then move onto step 2.

Step 2 - Order emergency supplies through the PPE portal.

What is the PPE portal?

The Department of Health and Social Care (DHSC) has partnered with eBay, Clipper Logistics and Royal Mail to develop this service.

Providers who can use the service will receive an email invitation to register. You can only log in and place an order if you’ve received an email.

Orders will be managed in line with Public Health England (PHE) guidance and wider availability from the NHS Supply Chain’s central PPE logistic operations.

The PPE portal can be used by:

  • GPs
  • small residential social care providers with 24 beds or fewer
  • domiciliary social care providers with 99 clients or fewer

If you’re a provider in one of these categories, your invitation to register will be sent to your email account registered with the Care Quality Commission (CQC) or the Medicines and Healthcare products Regulatory Agency (MHRA).

WarningThe portal cannot be used by large social care providers, as they are more likely to be registered with a wholesaler.

Step 3 - Contact your Commissioning Manager by emailing ASC_commissioning@bathnes.gov.uk. They will triage the request and then pass it to either our PPE ordering team, or to the CCG PPE ordering team. Both the council and the CCG will only be providing PPE to those providers where they have a confirmed outbreak and/or where their own levels are below 48 hours (or 72 hours ahead of a weekend) and they have given assurances they have followed steps 1 and 2.

Large social care providers

Large social care providers are categorised as:

  • large residential social care providers with 25 beds or more
  • domiciliary social care providers with 100 clients or more.

Step 1 - Use your business-as-usual and wholesaler routes to access PPE and explore all the options open to you in the first instance. If you are not able to access PPE then move onto step 2.

Step 2 - Contact your Commissioning Manager by emailing ASC_commissioning@bathnes.gov.uk. They will triage the request and then pass it to either our PPE ordering team, or to the CCG PPE ordering team. Both the council and the CCG will only be providing PPE to those providers where they have a confirmed outbreak and/or where their own levels are below 48 hours (or 72 hours ahead of a weekend) and they have given assurances they have followed steps 1 and 2.

Guidance on the use of PPE

COVID-19 Testing

Book a test

When should care providers notify Public Health England (PHE) of suspected and confirmed cases of COVID-19?

Please contact the PHE Health Protection Team 0300 303 8162 if you have:

  • One or more residents with confirmed or suspected COVID-19 or Influenza or
  • Two or more staff with suspected or confirmed COVID-19 or Influenza or
  • An escalation of an outbreak that you have already told us about

If you need to notify us about a single confirmed case in care staff, or have any other urgent enquiries you can email Ask.SWHPT@phe.gov.uk.

Webinars and online learning

Webinars and training

The Skills for Care website offers COVID-19 training through a variety of providers.

Health Education England has information and training resources aimed at a variety of health professionals.

East Kent Hospitals University Trust has produced a video showing how to wash your hands properly.

B&NES support for care providers

We have been providing support to care homes, and were asked by MHCLG to set out what support we have provided.

Communications 

If you have any concerns or want to make an enquiry, you can email our commissioning team ASC_Commissioning@bathnes.gov.uk