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Hidmat Care

Covid-19 Policy

COVID 19 and other Infectious Diseases

Purpose

To provide advice and guidance for all employees of Hidmat Care Ltd (the Company) so that they may be alert to the causes of infectious diseases and understand how the risks to their health, and their Client’s health may be reduced.

Statement

Infection control is the discipline concerned with preventing the spread of infection within the workplace and protecting those working in close proximity to potential sources of infectious substances. All employees, (including office workers) may be at risk of infection, or of spreading infection, especially if their role brings them into contact with infected persons, or with blood or bodily fluids like urine, faeces, vomit or sputum. Such substances may contain micro-organisms such as bacteria and viruses which can be spread if staff do not take adequate precautions. 

These biological agents can be:

Also at risk of spreading infection are those involved in food preparation and handling. It is therefore important that strict hygiene precautions are observed. 

Our rules on controlling the risks of infectious diseases must always be followed. However, there may be times when it is more important than ever that they are strictly followed, for example, during the outbreak of a disease such as Coronavirus (COVID 19). The aim of this policy is to ensure, so far as is reasonably practicable, the health, safety and welfare of our employees and to outline arrangements we have in place for them, and any others affected by our work activities, (for example our Clients) that will reduce the risk of ill health arising from exposure to biological agents. We will take into account recognized principles of good practice and comply with all relevant legislation, including the:

Note: environmental legislation is also applicable to clinical waste.

GDPR

In all instances, the Company will observe the strict requirements of the General Data Protection Regulations (GDPR) so as to ensure the safety and integrity of information which is considered to be sensitive and entirely confidential.

Procedure and Guidance

In order to restrict and reduce the risk of infection in the workplace, the Company will:

In the most serious instances, such as a pandemic the Company will apply the following infection outbreak procedure to control the risk of infectious diseases in the workplace:

Suspected Infection

If any member of staff feels unwell, and suspects that they may have become infected, then they must report the matter immediately to the Registered Manager who will determine, in conjunction with the employee whether they may continue to work as per normal, or, as in most cases, must cease work immediately, seek medical attention and/or self-isolate. Any return to work will be in accordance with general Government guidelines and medical advice. All Care Workers will be advised of the situation regarding any Client who is suspected as having become infected, or has tested positive, and appropriate instructions, training and PPE will be provided in order that the risks of cross-infection are minimized. In certain cases, care workers may alert the Registered Manger to situations where Clients may need to be admitted to hospital, in which case medical advice may be sought immediately.

  KLOE Reference for this Policy    Regulation(s) directly linked to this Policy    Regulation(s) relevant to this Policy
  Safe    Regulation 12: Safe care and treatment    Regulation 15: Premises and equipment   Regulation 17: Good governance  

Appendix 1

Guidance from the Department of Health and Social Care – Unabridged – May 2020

Who this is for

This page aims to answer frequently asked questions from registered providers, social care staff, local authorities and commissioners who support and deliver care to people in their own homes, including supported living settings, in England.

In this pandemic, we appreciate that home care providers are first and foremost looking after the people in their care and frequently doing so under pressures of staff absence due to sickness or isolation requirements.

As part of the national effort, the care sector plays a vital role in looking after people as they are discharged from hospital – both because recuperation is better at home, and because hospitals need to have enough beds to treat acutely sick people.

Not all of this information is new, but aims to be a helpful resource that brings together all guidance related to coronavirus and home care in one place.

The guidance below has been informed by discussions with provider representative groups and many of the webinars that have been held to provide support to organizations working in health and social care during the coronavirus response. It will be reviewed and updated as further feedback is received and as the government and other agencies continue to refresh guidance.

There is separate guidance relating to personal assistants employed using direct payments.

What we mean by ‘home care’

By home care, we mean domiciliary care agencies that provide personal care (and sometimes other support) to people living in their own homes, whatever form this may take, which is regulated by the Care Quality Commission (CQC).

This is delivered by domiciliary care agencies, supported living and extra care housing services. These agencies vary significantly in size, scope, and the people that they care for. Most of these work with older adults, including adults with dementia. Others work with younger disabled adults, and some also work with children. Packages of care may be provided via the traditional route or as part of a third party or notional personal, personal health, or joint personal budget.

Many adults and older people require support in their own homes. This is essential to maintain an individual’s health, wellbeing and independence within their own community.

1. Personal protective equipment (PPE)

The most recent guidance from Public Health England on the use of PPE can be found on GOV.UK.

Getting the right PPE

PPE supply has been an issue globally, including for many in the care sector and we are working around the clock to ensure staff on the front line can do their job safely.

If adult social care providers are unable to obtain PPE through their usual wholesalers and there remains an urgent need for additional stock, they can approach their local resilience forum (LRF).

PPE stock levels should be reported in CQC’s ‘Update CQC on the impact of COVID’ online form. Home care providers will have been contacted by CQC to advice on the process.

This short-term supply of critical PPE is intended to help respond to urgent local spikes in need across the adult social care system and other front-line services, in line with clinical guidance.

The government will continue to make drops of PPE for distribution by the local resilience forums to meet some priority need until the new parallel supply chain is widely operational.

National Supply Disruption Response

If local resilience forums are unable to supply, providers can also contact the National Supply

Disruption Response (NSDR) system to make emergency PPE requests by calling 0800 915 9964.

The NSDR does not have access to the full lines of stock held at other large wholesalers or distributors but can mobilize small priority orders of critical PPE to fulfil an emergency need.

Before calling the NSDR hotline, please ensure you can provide the following details to the call handler:

2. Shielding and care groups

How home carers can support the shielding of clinically extremely vulnerable people receiving home care during COVID-19

People who are ‘clinically extremely vulnerable’ will have received a letter from the NHS or their GP advising them to shield. If someone has not been notified but is concerned that they are clinically extremely vulnerable, they should contact their GP.

A wider group of people – including everyone aged 70 years or over and those with long-term health conditions of any age (anyone advised to get a flu jab as an adult) – are considered ‘at risk’ and are advised to carefully follow social distancing advice.

Dividing people who receive care into ‘care groups’

One way of reducing the risk of exposure to COVID-19 to people who require specific shielding measures is for providers to divide the people they are caring for into ‘care groups’ and allocate subgroups of their staff team to provide care to each.

The workforce and logistical challenges of doing this, especially within small and medium sized providers are acknowledged, and a decision about whether this is possible would need to be made locally. If providers are unable to divide their workforce into subgroups for each category, they may be able to divide the workforce into 2 groups: one to support the shielded, the other to support ‘at risk’ groups and everyone else.

This is being proposed as a practical suggestion that may be viable for some providers, rather than a direction all providers are expected to follow. 

We acknowledge that different providers are experiencing different pressures. If providers are unable to work in this way, local authorities may be able to provide support through their plan to provide mutual aid. Should local authorities be unable to provide assistance, providers should contact their local resilience forum. Commissioners, including local authorities and clinical commissioning groups (CCGs) should expect to support care providers with the costs of extra staffing and other costs incurred during the pandemic, for example donning and doffing PPE, time spent explaining to people with cognitive impairment why masks are being worn, and/or additional travel costs etc.  Detail on the different types of care groups can be found in the annex.

Reducing contacts for shielded and at-risk people

Home care providers should be working with agencies involved in the health and wellbeing of the people they provide care and support to, in order to develop a multi-agency plan to reduce the number of people going into an individual’s home. This should involve:

Where it is not possible to allocate specific care groups to specific staff subgroups, it may be possible to schedule for shielded and at-risk individuals to be seen before people from other categories. Again, it is acknowledged that this may not be fully possible given that personal care tasks are often required at similar points in the day.

Reducing contact between staff

When reducing contact between staff:

How home carers can manage people they are caring for safely

Decisions about reallocating tasks or reducing visits will need to be made with:

If a person receiving care or their unpaid carer wishes to suspend their care due to being asked to undertake shielding, the organization with responsibility for developing the care plan should be alerted to this. All involved parties should work together to agree whether this is an appropriate step and what can be done to ensure the person has access to essentials throughout this period, for example food, medicines etc. It is important to understand the reasons behind the request to cease care and provide reassurance around precautions taken to reduce the risk of transmission.

Providers will need to assess the risks posed by a reduction or suspension of visits. If you are concerned about the risks, or the capacity of the client to make this decision, you must seek advice from the commissioning authority. If the person receiving care is self-funding, contact the local authority for advice.

There is further guidance available on how the Mental Capacity Act applies to a person’s ability to make decisions around receiving care. If you consider at any time that someone may be making this decision on behalf of any shielded person and not acting in their best interest, then contact your local safeguarding team.

If not all care tasks for people receiving care and support from the service can be delivered due to staffing capacity, interventions should be prioritized for those identified as highly vulnerable if they do not receive care. Where care is commissioned by the local authority then this must be the decision of the local authority in partnership with the person, and in accordance with Care Act Easements guidance and the ethical framework for social care. In this instance, mutual aid support should be urgently sought from the local authority, and escalated to the local resilience forum if required. This incident should be reported in CQC’s ‘Update CQC on the impact of COVID’ online form.

3. Hospital discharge and testing

COVID-19 testing for home care workers and individuals receiving home care

Every social care worker who needs a test can access one, as confirmed in the government’s adult social care action plan, and this includes those who work in the home care sector.

If you are a care worker and need a COVID-19 test because you have symptoms of COVID-19, you should be self-isolating and can access testing through the self-referral or employer referral portals (found on www.gov.uk/coronavirus). This applies to home care staff, domiciliary carers and unpaid carers.

Everyone over the age of 5 experiencing coronavirus symptoms can now be tested, which includes individuals receiving care. This can be accessed through the digital portal or through the NHS111 service to book testing.  

Testing for patients and discharge from hospital into the community

All people admitted to hospital to receive care will be tested for COVID-19, and hospitals should share care needs and COVID status with relevant community partners planning the subsequent community care.

Some people with non-urgent needs, who do not meet the clinical criteria to reside in hospital, will be discharged home for their recovery period. All individuals can be safely cared for at home by home care or supported living care providers, regardless of their COVID status, if the guidance on use of PPE is correctly followed.

Testing must not hold up a timely discharge as detailed in the COVID–19 hospital discharge service requirements.

Where a test has been performed in hospital, but the result is still awaited, the patient will be discharged as planned and, while the result is pending, home care providers should assume that the person may be COVID positive for a 14-day period and follow guidance on the correct use of PPE.

Similarly, as set out in the COVID–19 adult social care action plan, any individual being taken on by a home care or supported living care provider should be cared for as possibly COVID-positive until a 14-day period has passed, within their home. Providers should follow the relevant guidance for use of personal protective equipment for COVID-positive people during this 14-day period.

Safely discharging into the community

The guidance on discharge to assess is clear that the discharge to assess pathways must include NHS organizations working closely with adult social care colleagues, the care sector and the voluntary sector. No person should be discharged before it is clinically safe to do so.

Section 3.1 of the guidance advises the following:

All registered providers and managers will need to have confidence that legal requirements for assessments will be met, and that particular consideration will be given to safety and infection control related needs during this heightened period1. This will require hospital, community health, and social care providers to work together to make sure people have the right support in place.

Escalating inadequate discharge summaries

Where people are discharged from an acute or community hospital back to their own home, the requirements of the 19 March COVID–19 discharge guidance apply. The guidance requires that each locality appoints a local coordinator with accountability for all elements of the discharge process covered by the guidance, including the provision of discharge summaries.

Where home care agencies identify inadequacies in discharge summaries, these need to be escalated to the local coordinator. All areas are required to have a local coordinator during the COVID-19 response. Contact your local authority for clarity around who this person is if required.

How trusted assessors will work

A summary of guidance on trusted assessors and COVID–19 is available, and is a mandatory requirement as part of the High Impact Change Model.

Most hospitals already use trusted assessor schemes for discharges to care homes and care at home services in their areas. These should be kept up to date in local NHS Discharge to Assess (D2A) arrangements. This should be prioritized.

The COVID-19 hospital discharge service requirements set out amendments to the

existing CQC guidance on operation of Trusted Assessment within Annex C. Key changes from the existing arrangements are:

4. Government support for social care

On 18 April, the government announced £1.6 billion of new funding for councils, in addition to the £1.6 billion provided in March. This takes the total funding provided to councils to over £3.2 billion, which councils can use to address pressures produced by COVID-19 including in adult social care. We have also brought forward £850 million in social care grants to councils to help with cash flow.

On 14 May, we announced an additional £600 million to support providers through a new infection control fund. The fund will support adult social care providers to reduce the rate of transmission in and between care homes and support wider workforce resilience. This will be allocated to local authorities and is in addition to the funding already provided to support adult social care sector during the COVID-19 pandemic.

Social care recruitment

The Department of Health and Social Care adult social care action plan describes the ambition to attract 20,000 people to work in social care over the next 3 months.

The government is supporting providers’ workforce needs through this £4 million social care recruitment campaign, encouraging job seekers to work in the care sector and giving access to free initial training.

The campaign highlights the vital role that the social care workforce is playing right now, during this pandemic, along with the longer-term opportunity of working in care.

It targets returners to the sector, as well as new starters who may have been made redundant from other sectors, and those able to take up short-term work (including those who have been furloughed). It directs people to the national campaign website which links to advertised social care jobs on https://findajob.dwp.gov.uk/.

We are developing a new online platform which will give people who want to work in social care access to online training and the opportunity to be considered for multiple job opportunities through a matching facility. This will streamline the recruitment process for candidates and employers.

Training to support those moving into the social care workforce

Key elements of the Care Certificate are available from Skills for Care, free of charge, to make it easier for employers to access rapid online induction training for new staff. Details of the training and frequently asked questions can be found on the Skills for Care website.

Getting DBS checks for staff

NHS and many local authorities have set up local volunteer schemes and providers can deploy volunteers where it is safe to do so. The government has put in place arrangements for fast track DBS checks that are free of charge for a list of roles, including emergency volunteers for health and social care services.

CQC also has guidance on interim DBS checks in this time.

Support from commissioners

Business continuity planning

All local areas are required to have arrangements in place for responding to emergencies under Civil Contingencies legislation. These specify the roles of the different agencies involved and who takes responsibility for what.

In relation to adult social care, the lead role in responding to incidents is with the local authority. As more people will now be living at home with COVID-19 and those who have been hospitalized with the virus will be increasingly discharged from hospital, the strategic coordinating groups of the local resilience forum will be working with and responding to unresolved issues from local

Authorities, CCGs and safeguarding adults boards (SABs). These organizations are already working on:

Monitoring

To ensure the system can deal with unprecedented pressures, local authorities need to have the strongest possible intelligence about emerging risks to continuity of service, and at the center we need to have robust information about risks to enable a national-level response where necessary.

CQC has developed a tool for home care providers to update daily about the impact of COVID-19 on their service. This will support local resilience forums and local authorities to direct mutual aid to providers where needed. Most local authorities have mutual aid protocols in place to get support from neighboring and non-neighboring councils.

Financial framework and payment mechanism support

Agreements are in place for commissioners to:

The LGA has published guidance on mechanisms for commissioners to enhance the resilience of their providers during the COVID–19 response period.

Steps for local authorities to support home care provision

Local authorities, working with their local resilience forums and drawing on local resilience and business continuity plans, should:

NHS support for home care provision

CCGs, NHS providers and local community services and primary care, will be working with and supporting local authorities and home care providers in the provision of care.

Community service providers are already, or will be taking steps to:

5. Information collection and governance

How information and data will be collected during this time

To enable us to understand the impact of COVID-19 on the people providers care for, their workforce and their ability to deliver services, we need to collect data to ensure resources are targeted most effectively where they are needed. Read the latest guidance on information governance.

This will mean that:

(From Monday 13 April) – this will be rolled out to Shared Lives services, Extra Care and Supporting Living services soon and we will be in contact with them directly when the service is available to them

If this information is provided daily, through the appropriate route, local authorities, CCGs and other local bodies will receive that data. This means they will not need to make the same request and should not be contacting individual homes or services for this data.

This way of working is a requirement for our collective handling of the crisis but no doubt we will learn valuable lessons from taking this approach that might provide longer term benefits for all. We will want to identify and discuss those together.

6. Other areas

What to do if someone being cared for develops COVID-19 symptoms

If anyone being cared for by a home care provider reports developing COVID-19 symptoms they should be supported to contact NHS 111 via telephone, or online.

Home care workers should report suspected cases of COVID-19 to their managers. Providers should work with community partners, commissioners and the person to review and impact on their care needs.

Suspected cases of COVID-19 should be reported in CQC’s ‘Update CQC on the impact of COVID’ online form.

Mental health support for staff

Working closely with people, building trusting relationships, and delivering compassionate care are at the heart of home care provision. This is emotionally challenging work, and the difficulty of the circumstances people are working under at the current time are unprecedented. We want everybody working in social care to feel like they have somewhere to turn, or someone to talk to, when they are finding things difficult.

Social care staff can send a message with ‘FRONTLINE’ to 85258 to start a conversation. This service is offered by Shout and is free on all major mobile networks and is a direct support for those who may be struggling to cope and need help.

The Samaritans has extended its confidential emotional staff support line to all social care staff who might be feeling increasingly stressed, anxious or overwhelmed. This service offers care workers the opportunity to speak with a trained volunteer who can help with confidential listening and signposting to further support. To access this support, please call: 0300 131 7000

Hospice UK has extended its bereavement and trauma line to provide support to social care staff. This service offers a safe space for care workers to talk to a professional if they have experienced bereavement, trauma or anxiety as a result of the COVID-19 pandemic. To access this support, please call: 0300 3034434

We recognize that guidance is being updated frequently for the social care sector, and we need to make sure it is easy for frontline staff to access. We have introduced a new CARE branded website and app, CARE Workforce, developed in partnership with NHSX and NHS BSA, for the social care workforce, aimed at providing timely information and signposting to support. 

It contains a range of resources to help individuals and their teams manage in this new situation, understand what they might need to be doing differently to support each other and pay attention to their mental and physical wellbeing. The site contains bite size videos as well as guides to help staff access the information quickly.

Guidance to support and maintain the wellbeing of those working in adult social care has been published on GOV.UK. It provides advice and resources on maintaining mental wellbeing and how employers can take care of the wellbeing of their staff during and beyond the COVID-19 pandemic. This resource can also be accessed on the CARE Workforce app.

Safeguarding people where local authorities may not be subject to Care Act duties temporarily

Under the Care Act Easement guidance, local authorities will still be required to deliver their safeguarding responsibilities. Escalation of oversight over any decisions to withdraw aspects of services are described in the guidance. If there are any safeguarding concerns about an individual, local safeguarding teams should be contacted in the normal way.

The government has published an ethical framework to guide local authorities in the event that they need to priorities between competing needs. This states that decisions need to be made in a way that ensures people are treated with respect, minimizes harm and is inclusive.

Any concerns that the guidance is not being followed should be raised with the relevant local authority. This could be done through usual contacts or any established complaint process where relevant. If it is felt Care Act easements have been operationalized without the correct process or authorization taking place, then this can be raised with the Principal Social Worker (PSW) and ultimately the Director of Adult Social Services (DASS).

Additional resources

Further guidance is available on the Social Care Institute for Excellence (SCIE) website, including on supporting autistic people and people with learning disabilities, and supporting those living with dementia.

Annex: care group definitions

1. Shielded ‘clinically extremely vulnerable’ people

Doctors in England have identified specific medical conditions that, based on what we know about the virus so far, place someone at greatest risk of severe illness from COVID-19. People with these conditions have been advised by their GP or hospital specialist to practice shielding. Shielding, in this context means, remaining at home always and avoiding any face-to-face contact for at least 12 weeks. More guidance is available on GOV.UK.

Channels of communication should be developed locally to enable care providers to understand who has been placed within this category. This group includes:

2. People who are ‘at risk’

This group have been advised to strictly follow social distancing guidance.

Review caseload lists to identify people aged 70 years or over and those with long-term health conditions of any age (i.e. anyone advised to get a flu jab as an adult each year on medical grounds) this group includes:

3. People with confirmed positive or suspected COVID-19

All confirmed and suspected cases of COVID-19 should be reported daily in CQC’s ‘Update CQC on the impact of COVID’ online form.

4. All other people receiving care and support

1. Annex 3 of the discharge to asses guidance.

This policy was implemented/reviewed on: 9th June 2020 – The next review for this policy is: 1st December 2021 Fairdale House, 100 Nuthall Road, Aspley Nottingham, NG8 5AB

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