Coronavirus Policy

The following policy is written in conjunction with advice provided by Gov.co.uk.

This guidance will remain under review as further scientific information is published about COVID-19, but this is a very fast-moving communicable disease and government guidance is changing frequently.  For the most up to date information please visit the Gov.co.uk website.

Novel coronavirus (COVID-19) is a new strain of coronavirus first identified in Wuhan City, China.

Background

Coronaviruses are mainly transmitted by large respiratory droplets and direct or indirect contact with infected secretions. They have also been detected in blood, faeces and urine and, under certain circumstances, airborne transmission is thought to have occurred from aerosolised respiratory secretions and faecal material.

As 2019-nCoV has only been recently identified, there is currently limited information about the precise routes of transmission. Therefore, this guidance is based on knowledge gained from experience in responding to coronaviruses with significant epidemic potential such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV).

It is known that both SARS-CoV and MERS-CoV can transmit person to person; although this is not yet confirmed for 2019-nCoV, it is reasonable to assume that human-to-human transmission is possible.

Recommendation

The World Health organisation has declared the Corona Virus/Covid-19 a pandemic.

In the UK the government’s position is regularly changing as increased cases are identified.

The most vulnerable people to the Corona virus i.e. those who are most likely to suffer from severe symptoms are the elderly, those with weakened immune systems, and people with underlying health conditions.

Our entire resident population consist of people who are elderly, many of whom have underlying health conditions making them the most vulnerable population susceptible to this new virus.

South Coast Nursing Homes are putting in preventative measures daily as events unfold.

As of the 12th March 2020, we requested that no one enters our buildings except essential staff.  We request that visitors and relatives do not visit in an effort to prevent residents from contracting Coronavirus.

This was reviewed in June and we have since been able to allow visitors to visit.

Please see the separate visiting policy which is also subject to change depending on the rates of infection in the community or suspected or confirmed cases within the homes.

Essential staff

All staff will be required to monitor their temperature prior to the start of their working shift.

Should a rising temperature be identified or anything over 37.8 we will request that the staff member leaves the building and self-isolates for a period of at least 10 days- please see guidance on this below.

Any staff member who refuses is endangering all other staff and residents; we will therefore terminate their contract for being in breach company policy.

All staff in Health and Social care are now being offered a COVID-19 test every week. As a duty of care to residents and colleagues we request that all staff do this test weekly. Staff who refuse or repeatedly do not have their test done will be considered to be putting others health at risk and as such may be considered to be in breach of their contract. We may consider holding staff hours until they have completed their COVID-19 test so we can be assured they are safe to work among vulnerable adults.

Who this guidance is for – Staff

(Department of Health and Social Care)

This advice is intended for:

  • people with symptoms that may be caused by coronavirus, and do not require hospital treatment, who must remain at home until they are well
  • those living in households with someone who shows symptoms that may be caused by coronavirus

 Symptoms

The most common symptoms of coronavirus (COVID-19) are onset of:

  • new continuous cough and/or
  • high temperature
  • Loss or change of taste and smell (anosmia)

For most people, coronavirus (COVID-19) will be a mild illness.

Main messages for Staff

  • If you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 10 days from when you test positive or your symptoms start. (The ending isolation section below has more information)
  • 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 10 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. See the explanatory diagram
  • For anyone else in the household who starts displaying symptoms, they need to stay at home for 10 days from when the symptoms appeared, regardless of what day they are on in the original 14 day isolation period. The ending isolation section below has more information, and see the explanatory diagram
  • It is likely that people living within a household will infect each other or be infected already. Staying at home for 14 days will greatly reduce the overall amount of infection the household could pass on to others in the community
  • if you can, move any vulnerable individuals (such as the elderly and those with underlying health conditions) out of your home, to stay with friends or family for the duration of the home isolation period
  • if you cannot move vulnerable people out of your home, stay away from them as much as possible
  • if you have coronavirus symptoms:
    • do not go to a GP surgery, pharmacy or hospital
    • you do not need to contact 111 to tell them you’re staying at home
    • plan ahead and ask others for help to ensure that you can successfully stay at home and consider what can be done for vulnerable people in the household
    • ask your employer, friends and family to help you to get the things you need to stay at home
    • wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitiser

If you feel you cannot cope with your symptoms at home, or your condition gets worse, or your symptoms do not get better after 7 days, then use the NHS 111 online coronavirus service. If you do not have internet access, call NHS 111. For a medical emergency dial 999

Positive COVID-19 result from weekly testing

Staff who test weekly, and subsequently receive a positive test result must leave the building immediately.

Staff must consider who they may have come into contact with when not wearing a mask, for track and trace purposes.

All staff are asked to maintain a 2-Meter distance on their breaks.

There are limited numbers of staff allowed into staff rooms and staff communal areas depending on the building they work in.  This information should be clear from individual managers to all staff.

Any staff member who has tested positive and thinks they have come into close contact with other staff members must inform the manager immediately.

We ask that staff isolate for 10 days upon finding out they have COVID-19.

Staff must be clear of raised temperatures for 48 hours before returning to work, at the end of the 10 day isolation.

Please see the following advice from Public Health England:

Staff who have tested positive for Coronavirus are asked to not take the test again for 6 weeks following the positive test. PHE recommends that you do not routinely re-swab an individual who has had a PCR positive result for at least six weeks. However, anyone who tested positive and fully recovered, but then goes on to develop symptoms should self-isolate and be retested for COVID-19 and other respiratory viruses even if this is within the six week period. This swab test looks for key fragments of the SARS-COV-2 virus that causes COVID-19, but it does not distinguish between virus that is able to replicate and transmit or inactive (broken or destroyed fragments that are not able to replicate or are ‘inactive’). Fragments of dead COVID-19 virus (inactive) can be commonly recovered from a person’s nose for six weeks following infection and sometimes longer. Where the person is well and has completed their initial isolation period after the first positive result they should not be a risk to others.

Staff may continue to have weekly tests following their positive result and isolation period, but as it states above, they may have a further positive result within 6 weeks of the initial test.

As long as staff remain symptom free, they can remain at work.  This must be discussed with your Manager and the Clinical Director. 

Things to help you prepare now

Make a plan for your household or family

The best thing you can do now is plan for how you can adapt your daily routine, and that of others in your household, to be able to follow this advice. Some of the ways in which you could prepare include:

  • talk to your neighbours and family and exchange phone numbers of household contacts
  • consider and plan for those in your home who are considered vulnerable
  • create a contact list with phone numbers of neighbours, schools, employer, chemist, NHS 111
  • set up online shopping accounts if possible

Will my household be tested if we think we have coronavirus symptoms?

Testing for coronavirus is possible for essential workers families.

https://test-for-coronavirus.service.gov.uk/register/start

Why staying at home is very important if you are unwell with specific/suspected symptoms.

It is very important that individuals with symptoms that may be due to coronavirus and their household members stay at home. Staying at home will help control the spread of the virus to friends, the wider community, and particularly the most vulnerable.

If you have a vulnerable person living with you

Minimise as much as possible the time any vulnerable family members spend in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated.

Aim to keep 2 metres (3 steps) away from vulnerable people you live with and encourage them to sleep in a different bed where possible. If they can, they should use a separate bathroom from the rest of the household. Make sure they use separate towels from the other people in your house, both for drying themselves after bathing or showering and for hand-hygiene purposes.

If you do share a toilet and bathroom with a vulnerable person, it is important that you clean them every time you use them (for example, wiping surfaces you have come into contact with). Another tip is to consider drawing up a rota for bathing, with the vulnerable person using the facilities first.

If you share a kitchen with a vulnerable person, avoid using it while they are present. If they can, they should take their meals back to their room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing up liquid and warm water and dry them thoroughly. If the vulnerable person is using their own utensils, remember to use a separate tea towel for drying these.

What you can do to help yourself get better

Drink water to keep yourself hydrated; you should drink enough during the day so your urine (pee) is a pale clear colour. You can use over-the-counter medications, such as paracetamol, to help with some of your symptoms. Use these according to the instructions on the packet or label and do not exceed the recommended dose.

If you or your family need to seek medical advice

Seek prompt medical attention if your illness or the illness in any household members is worsening. If it’s not an emergency, contact NHS 111 online. If you have no internet access, you should call NHS 111. If it is an emergency and you need to call an ambulance, dial 999 and inform the call handler or operator that you or your relative have coronavirus symptoms.

All routine medical and dental appointments should usually be cancelled whilst you and the family are staying at home. If you are concerned or have been asked to attend in person within the period you are home isolating, discuss this with your medical contact first (for example, your GP, local hospital or outpatient service), using the number they have provided. If your concerns are related to your coronavirus symptoms contact NHS 111 online. If you have no internet access, you should call NHS 111.

Wash your hands often

Clean your hands frequently each day by washing with soap and water for 20 seconds or using hand sanitiser. This will help protect you and the people you live with. This step is one of the most effective ways of reducing the risk of passing infection to others.

Cover your coughs and sneezes

Cover your mouth and nose with disposable tissues when you cough or sneeze. If you do not have one to hand, sneeze into the crook of your elbow, not into your hand.

Dispose of tissues into a disposable rubbish bag and immediately wash your hands with soap and water or use a hand sanitiser.

Do not have visitors in your home if you think you have Coronavirus

Do not invite or allow social visitors, such as other friends and family, to enter your home. If you want to speak to someone who is not a member of your household, use the phone or social media.

If you or a family member receive essential care in your home, then carers should continue to visit. Carers will be provided with facemasks and gloves to reduce the risk of you passing on the infection.

If you have pets in the household

At present, there is no evidence that companion animals/pets such as dogs and cats can be infected with coronavirus.

Reason behind self-isolation

Many people find it helpful to remind themselves why what they are doing is so important. Hopefully, none of your family will suffer more than flu-like symptoms. But some people are badly affected by coronavirus, and particularly the elderly and those with certain medical conditions. By staying home, you are protecting the lives of others.

Ending self-isolation and household-isolation

Self-isolation: If you have been symptomatic, then you may end your self-isolation after 10 days. The 10-day period starts from the day when you first became ill or tested positive.

Please see below the graph to help you understand the principles around household isolation.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874011/Stay_at_home_guidance_diagram.pdf

A cough may persist for several weeks in some people, despite the coronavirus infection having cleared. A persistent cough alone does not mean someone must continue to self-isolate for more than 10 days.

Guidance for caring for residents

This guidance is written bearing in mind the following, and any individual circumstances must be discussed and agreed with all relevant parties:

Please note that this guidance is of a general nature and that an employer should consider the specific conditions of each individual place of work and comply with all applicable legislation, including the Health and Safety at Work etc Act 1974.

Everyone with responsibility for the admission and care of care home residents must always be mindful of the needs and rights of those residents. This guidance should therefore be considered alongside the wellbeing principles outlined in the Care Act 2014, the ethical framework for adult social care, and relevant equalities-related legal and policy frameworks. Any assessment of a resident’s needs and subsequent decisions made must consider individual circumstances and ethical implications, ensuring that the resident is treated with respect so that their human rights, personal choices, safety and dignity are upheld. 2

DHSC acknowledges that care home settings differ significantly. That is why care home managers and proprietors need to undertake a balanced risk assessment when considering the implementation of this guidance. This must consider the needs of all residents and staff in the care home to ensure that they’re taking timely and proportionate measures for each setting (Department of Health and Social Care 2020).

Please bear in mind that elderly and frail residents may present in uncharacteristic ways, so any symptoms that appear to be spreading in a home which appear consistent with another resident should be treated with isolation measures and strict PPE.

Vigilance for respiratory symptoms, temperatures, coughing, must still be acted upon.

Residents who are suspected Covid-19 must be isolated from other residents, it must be explained to them what is happening in the most appropriate way for that individual, and they must also have a full set of observations.

Contact the residents GP, family if they wish you too.  Please consider Appointed Power of Attorney’s if the resident does not have capacity.

All residents suspected of having Covid-19 must be tested, if they are not already being tested every 28 days, and if they will allow you test them.

Whole home testing is occurring for residents every 28 days.  There may be some exceptional circumstances where this is not happening.  This should be discussed with the person if possible, their GP and their family/appointed representative.

In cases where resident’s test positive please follow guidance from their General Practitioners.  If safe to do so (checking for allergies) offer residents feeling unwell Paracetamol, and ensure they have access to a drink at all times, encouraging a good fluid intake.  For those who cannot drink themselves please offer them frequent drinks throughout the day and night.

Residents who lack capacity will be difficult to isolate if they are still ambulatory.  Please try and isolate them as much as possible and keep them to a certain area.  As much as possible please try and keep them from going near other residents but manage the situation to the best of your ability given that they may find the isolation distressing and difficult to comprehend.

All suspected/confirmed residents should be isolated where possible in their rooms.  Their rooms should ideally be well ventilated.  Residents must be monitored carefully for signs of deterioration. Please set up a sign to inform staff outside that there is a potential infection in the room and that Personal Protective Equipment is required on entering and leaving the room.

Hands must be washed before and on leaving.

All waste must be disposed of in clinical yellow bags before leaving the room.

Where COVID-19 is suspected/confirmed staff must wear a face mask, gloves and apron.  If there is risk of fluids splashing into your eyes please wear goggles or a face shield.

Staff sending residents who are COVID-19 positive into hospital for admission must pre warn the hospital and ambulance of the infection status before departure/admission.

All residents admitted from hospital must be tested for Coronavirus before admission into one of our homes.  We reserve the right to refuse admission until we have a result from that test to provide the most appropriate care for that individual.

All residents regardless of their test result prior to admission should still self-isolate for 14 days when being admitted from hospital, where possible.

All residents who have suspected symptoms for Coronavirus can be added to the Nourish interaction Covid-19 Observation.  There is no defined time for how often this should be filled out but residents who are clinically deteriorating must be monitored using a NEWSII score dependent on their health status, and agreed care pathway.

There are further interactions for COVID-19 testing and COVID-19 results.

For further guidance on how to manage with the outbreak of COVID-19 please see guidance from PHE attached below.

Regardless of Covid-19 status, all homes must currently ensure that communal areas are cleaned more frequently using chlorinated tablets.

Hand hygiene is vital for both residents and staff. Staff must ensure they are always washing their hands between residents.

Residents who wash their own hands need to be reminded of how often they should be doing this, and those who cannot wash their own hands should be having their hands cleaned the best way possible before all meals or snacks and frequently throughout the day.

All domestic staff must wear PPE between resident’s rooms at all times.

Full PPE must be worn when cleaning the rooms of those suspected or confirmed with COVID-19.  Current guidance for cleaning is the same as for any other for communicable disease.  Please follow these guidelines.

Guidance still maintains that face masks should be worn in general when caring for residents anytime within a 2-Meter distance.  Because of the nature of our work we therefore advise that everyone wears a mask at all time when working within the nursing and residential homes.

Self isolation

Some important information:

  • If you test positive for COVID-19 you will inform the home of your self-isolation so your pay can be worked out accordingly.
  • If you have been specifically requested by your GP or NHS to self-isolate for 12 weeks you will need to provide some proof or evidence of this. Most or many GPs will provide this.  You cannot decide yourself to self-isolate for 12 weeks because you feel you are at high risk. If you decide to do this you will not receive any payment. You may also be in breach of your employment contract. We will do everything we can to protect staff and residents.
  • If before your 12 weeks mandatory or self-select isolation is up and you wish to return to work, you will need to contact your Home Manager who will refer the case to a Director. You must not attend your shift until you have been given approval.
  • If you are over 70 years old have chosen to follow government advice and self-isolate for 12 weeks you will not receive SSP. You will not be in breach of your contract.

Please be very mindful of this criteria before you decide to stay at home unnecessarily.

Staff laundry and uniforms

Any staff doing anything with residents must wear uniform tunics.

Where possible all uniforms should be labelled and laundered at each home site. All uniforms will be laundered between shifts. This may mean staff need more uniforms please discuss this with your manager.

Please pay attention when residents have suspected or confirmed COVID-19 to clothes, bed and towel linen. Face masks must be worn. Place all linen in red bags and be careful not to shake the bedding out.

Deliveries

All deliveries for any home must now be left in an appropriate place to be brought in.  Deliveries must not be left on the doorstep but brought in immediately.

All front doors are preventing anyone from entering the building.

Training staff

All mandatory training has now been re written for this year in the form of booklets and online training.  The induction of new staff will continue where it is deemed safe to do so.

All training from outside agencies is likely to resume for some staff from September.  Group sizes will be kept smaller and there must be an ability to maintain social distancing of 1-2 meters.

Where training does go ahead the groups will be small where staff are able to socially distance themselves.

Agency Staff

We have contacted all agencies supplying us with additional staff to ensure they have a policy in place for Coronavirus.  Most agency staff should also be getting regular testing please enquire about this prior to the start of their shifts.

Any agency personnel must be questioned upon entering the building to ensure they are fit to work, have no symptoms of illness, however mild, understand our request that PPE is worn and carry out good hand hygiene between all residents.

Please ensure they are wearing a clean uniform.

Where possible we would ask that all agency staff read, but as a minimum have access to our policy.

Resources and Weblinks

Gov.co.uk have the most current and update to date information on the current COVID-19 situation please visit this site or request that we find specific information for you.

https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-residential-care-provision

www.Gov.co.uk/covid-19

Testing

Testing is now available to all staff and residents in care homes.

All staff displaying the symptoms of COVID-19 or concerned that they may have contracted the virus are eligible to get a test on the following website which is through the gov.co.uk

https://test-for-coronavirus.service.gov.uk/register/start

Staff have a duty of care to be tested.

Any staff member wanting to self- isolate and who refuses to be tested will have their application for SSP/payment denied and may be in breach of their contract. Their absence will be unauthorized.

As always, we understand that not all circumstances are the same. Any anomalies must be discussed with your manager and discretion applied where appropriate.

Staff Travel (outside the UK)

Please see the Corona virus travel quarantine policy.

Staff who have travelled within the UK but consider they may have visited an area where cases are significantly rising should have a COVID-19 test before returning to work.  Again this should be discussed with the manager.

For further information please see the following guidance for Winter 2020-2021.

https://www.gov.uk/government/publications/adult-social-care-coronavirus-covid-19-winter-plan-2020-to-2021

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