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.
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.
The World Health organisation has declared the Coronavirus/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 Coronavirus 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. We have put this measure in place to reduce the risk of Coronavirus, although we except we will not be able to totally eliminate the chance of this entering our buildings.
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 7 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.
The following guidance has been taken from the gov.co.uk
Who this guidance is for – Staff
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
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.
2. Main messages for Staff
- if you live alone and you have symptoms of coronavirus illness (COVID-19), however mild, stay at home for 7 days from when your symptoms started. (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 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. See the explanatory diagram
- for anyone else in the household who starts displaying symptoms, they need to stay at home for 7 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
- testing for coronavirus is not needed if 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
Things to help you prepare now
3. 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
4. Will my household be tested if we think we have coronavirus symptoms?
Testing for coronavirus is not needed if you’re staying at home.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. Do not have visitors in your home
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 face masks and gloves to reduce the risk of you passing on the infection.
12. 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.
13. 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, as well as making sure the NHS does not get overwhelmed.
14. Ending self-isolation and household-isolation
If you have been symptomatic, then you may end your self-isolation after 7 days. The 7-day period starts from the day when you first became ill.
Please see below the graph to help you understand the principles around household isolation.
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 7 days.
Guidance for caring for residents
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 and coughing must still be acted upon.
Residents who have suspected Covid-19 must have a full set of observations. Their NEWS II score should be shared with the 111 team. 111 have a dedicated line for Covid-19 but we must also contact Public Health England for advice, and guidance. PHE will also be responsible for arranging testing within the home. Testing for Covid-19 is being carried out in nursing/residential homes. The current time for results from the day of testing is 72 hours.
Please also contact the resident’s General practitioner to inform them of the situation. The resident must agree that a relative can be called to inform them, or in the case that capacity is lacking the next of kin or power of attorney should be informed.
Please follow guidance from the 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. 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 residents should be isolated where possible in their rooms. Their rooms should ideally be well ventilated. Residents must be monitored carefully for sign 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.
General practitioners are currently in the process ensuring that all residents have specific advanced care plans in place specifically for Covid-19.
In the case where residents are not for hospital admission or the hospital are unable to accept residents the clinical team must ensure that residents are symptom free.
Guidance on the use of end of life medication in the case of COVID-19 is anticipated soon.
In residential homes and homes that are not clear how to manage a symptomatic resident not for hospital please contact the Clinical Director.
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.
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 suspected Covid-19 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 are able to 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.
Where COVID-19 is suspected staff must wear a face mask, gloves and apron. If there is risk of fluids splashing into your eyes please wear googles.
All domestic staff must wear PPE between resident’s rooms at all times. Full PPE though 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.
Self isolation and SSP
Some important information:
- If you present with symptoms and you are the first person in your home to do so you will need to self-isolate for 7 days. You will receive SSP for those 7 days, If you qualify. If your symptoms persist you made need to self-isolate for longer. The maximum of 14 days SSP will be paid to you and you can receive this only once. The rule of isolation assumes you have recovered from the virus and therefore will not spread the virus further.
- 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. You will then qualify for 12 weeks SSP. 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 SSP. You may also be in breach of your employment contract.
- 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.
The link below should guide you to the form for self isolation proof for SSP.
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.
All deliveries for any home must now be left outside for staff to bring inside. Deliveries must not be left on the doorstep but brought in immediately.
All front doors are preventing anyone from entering the building.
Procurement at this time is prone to delays. All homes must continually review their stocks and inform the operations managers as soon as stocks of anything look like they may run out in the near future. Do not run out of items, then ask for it as there is a high chance there will be a delay in procuring any items at present. We advise all homes to manage their stocks carefully and anticipate the usage of items.
All mandatory training has now been postponed until further notice. The induction of new staff will continue where it is deemed safe to do so.
All training from outside agencies have been postponed.
We have contacted all agencies supplying us with additional staff to ensure they have a policy in place for Coronavirus.
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.
We are aware that our homes continue to be affected by numbers of staff self-isolating, impacting hugely on our ability to run with safe numbers.
CQC have been asked to coordinate priority testing for Covid-19 for ASC staff.
Tests are primarily designed to help get key workers who are self- isolating back to work as soon as possible.
They must meet the national criteria of being symptomatic and having gone off with symptoms within the last 4 days. They must be swabbed in 5 days or less, otherwise it does not work. Ideally we want them in less than 3 days.
Or their household member must meet these criteria.
The central booking team must be contacted who can arrange appointments.
Identification of candidates is the responsibility of the employing organisation. A spreadsheet containing a list of eligible candidates should be sent to Sxccg.Covidtestingreferrals@nhs.net
This information must include –
- Full Name
- Date they went off work with symptoms
- Mobile contact number
- Email address for confirmation of appointment
- Criteria Met
- Vehicle registration if applicable
Managers need to complete the spreadsheet. The member of staff will then be contacted and provided with a date and time to visit the centre. They must then inform the manager of such.
Key Workers will only be eligible for testing if they are symptomatic.
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 denied and may be in breach of their contract. Their absence will be unauthorised.
As always, we understand that not all circumstances are the same. Any anomalies must be discussed with your ops director and discretion applied where appropriate.
Staff Travel (outside the UK)
Currently foreign and commonwealth office does not recommend any but essential travel outside the UK. This includes going on holiday. Essential travel can be discussed with your manager, as the only exemptions from this 14 day isolation period upon return is for registered health care professionals travelling to the UK to provide essential healthcare.
You will need to do the following in order to enter the country; complete the Public Health passenger locator form before you travel to the UK.
You will need to provide evidence
- you’ll start work within 14 days of your arrival in the UK
- proof of professional registration with a UK-based regulator
- an employment contract or letter of confirmation from either an:
- NHS Trust
- independent healthcare provider
- independent social care provider
Any member of staff who travels abroad for non essential travel, who is then required to self-isolate for 14 days will be in breach of their contract for travelling in the first place given the current foreign and common health advice. Staff who do not follow the 14 day isolation advice following travel may be fined in line with government guidance.
This does not apply to anyone taking their holiday within the common travel area (Ireland, Isle of Man and the Channel Islands).