This page contains the latest known information and advice for adult care providers in Somerset.

Information about COVID-19 is rapidly changing, as is the advice and support available.  Please return to this page regularly.

Current coronavirus restrictions:

Read (COVID-19) Coronavirus restrictions: what you can and cannot do (Cabinet Office, updated 10/05/2021)

Reporting cases of COVID-19 in care settings
If you suspect or have a coronavirus outbreak in a care setting (one or more resident/s or staff affected), contact Public Health England via 0300 303 8162 (option 9 for a Covid call).

All cases involving more than one person, or any residents, must also be reported to swhpt@phe.gov.uk immediately and the team kept informed of any escalations.

Contact Us
If you have a COVID-19 concern or query affecting your service, or are not receiving email briefings, please contact our Incident Room via ASCCOVID19@somerset.gov.ukYou can also phone us on 07790 577338.


Please note – Providers should continue to use Somerset Direct for individual cases / individual escalations that do not relate to COVID-19.

Webinars:

Local Alert Level for Care Home Visits:

The care home visit alert level that has previously been published on this page has been suspended for the duration of the current national lockdown.

Guidance on the Coronavirus is changing on a very frequent basis to reflect the latest advice and developing situation.

All Government updates can be found here:

Further information of particular interest and relevance to adult social care providers is listed here:

Public Health England Resources

  • Coronavirus (COVID-19) Resource Centre This is a repository of resources and communications toolkits coving all areas of the response to COVI-19, including infection prevention and control and vaccinations produced by Public Health England that is regularly updated, including some in partnership with other organisations including Carers UK, Rethink, the Stroke association and Mencap.
  • COVID-19 Resource Pack.  This will download a zip file that contains posters, letter templates and other resources produced by Public Health England
  • Community asymptomatic testing poster

Staff Vaccinations

As you will all be aware, the provision of three vaccines against Covid-19 has now received approval from the Medicines and Healthcare Products Regulatory Agency (MHRA), and as such we are now in the process of undertaking vaccination programme in Somerset.  A link to the regulatory approval for each vaccine has been included below:

Amongst our highest priority is the delivery of the vaccines to care home staff.  Through vaccinating all our staff, we aim to help protect individuals from becoming unwell with, or dying from, Covid-19 disease, and it is therefore vital that we communicate the importance of this programme with staff who work with some of the most vulnerable members of the community. Vaccination is key to reducing the risk of Covid-19 outbreaks occurring in the home.

Through the clinical trials on many tens of thousands of people people there were no significant adverse events.  Some people did experience a painful or heavy arm where they had the injection, felt tired or had a mild fever for a couple of days. These are common side effects following any vaccination, and staff in the vaccination centres will be mindful of these and do all they can to help staff remain as comfortable as possible following their vaccination.

During the vaccination delivery the vaccination teams will maintain the full range of measures to keep everyone safe from Covid-19, staff giving the vaccine will be wearing personal protective equipment and will abide by all the necessary cleaning and disinfection requirements.

We have included links bellow to the patient leaflets for you to share with your staff, these should address most of the questions that staff may have.  Vaccination is not mandatory, but we urgently need your help to encourage everyone to accept the vaccination, it not only protects them, but it significantly helps us all keep those most vulnerable in Somerset safe.

Please remember that the vaccine is designed to prevent serious illness and death from Covid-19.  However, even if you have had the vaccine, you can still catch it and might still be able to pass it on, so the hands, face, space guidance must still be followed to protect yourselves and others.

Social care workforce vaccinations

We are very pleased to say that the vast majority of social care workforce vaccinations are now complete for first dose, and want to say a huge thanks to you all for making this possible.  We do apologise for some cancellations that required us to rebook, but this was due to circumstances beyond our control with supply of vaccines.  As we approach the end of first dose vaccinations we are continuing to have to react to availability of vaccine and vaccinators and as such are now having to cancel appointments made at Musgrove Park Hospital for the 13th and 14th February.  We are though opening up availability for those staff to be vaccinated at the Taunton Racecourse, and all those affected have been emailed and a text sent to the mobile number provided.

In order to pick up the remaining staff who have yet to be vaccinated we are opening up provision through both the Taunton Racecourse and the Bath and West Showground.  Staff can self present once they have completed the request form at the link below.  We would ask that staff allow at least 24hrs between submitting the request and attending the two sites.  They will also need to provide ID which will be checked against the report that we will provide to the site on a daily basis.

Further information about booking a vaccination at Taunton Racecourse and the Bath and West Showground

If you have any questions or issues regarding vaccination please contact us at ASCCovid19@somerset.gov.uk and we will do all we can to support you.

Poor Vaccination Recording

We are rightly very proud of the joint working that has enabled us to achieve a very positive first dose vaccination programme.  However what is being reported nationally does not reflect this.  We have 27 homes who are reporting via the Capacity Tracker that significant numbers of residents that have not yet been offered a first dose vaccination.  We have 55 homes reporting that they have over 10 staff not yet been offered first dose vaccination.  It is absolutely critical that we have accurate reporting so we can support homes who may have issues with resident or staff vaccinations and we can only do this if the data being provided is truly reflective of the position on the ground.  We do very much appreciate how busy you all are, but it is important to note that the data from the capacity Tracker is being used nationally and is incumbent on all of us to try and ensure this is correct.

Vaccination for 17 year old carers.

We are aware that there are a small number of carers who are aged 17yrs and therefore only able to receive Pfizer vaccine.  We are working to provide opportunities for these individuals through the two hospital hubs who hold Pfizer towards the end of this month.

If you have any staff that are 17yrs and able to receive vaccine please can you collate details and forward them to us via asccovid19@somerset.gov.uk we will look to use them for short notice cancellations and as such we will need, name, date of birth, mobile contact number and email address.

Help with getting to vaccination appointments

If you have not yet had your vaccination, it might be worth preparing in advance how you will get there. If you are not able to drive yourself, but you have a family member or friend who might be able to support you – it’s always worth having that conversation now.

While many older and more vulnerable people will be able to attend a location close to their home, some will be relying on public transport.

Somerset County Council is working with bus operators and community transport providers to help vulnerable residents to get to their COVID-19 vaccination appointments.

  • A free Somerset County Council Taunton town centre shuttle service has been launched to get people straight to their vital vaccination slot. The Covid vaccination shuttle bus service runs every 30 minutes from Castle Way in Taunton town centre to Taunton Racecourse. The seven-day a week service uses one of the Council’s fleet of minibuses and will help to support those who don’t drive and will link easily with other operators coming into the town centre. The shuttle service is set to run every day throughout March and April except for the following dates when the vaccination centre is closed for race days: 4, 15 and 23 March; 8 and 21 April.
  • The new Taunton service starts at 8.20am each day, and will also serve bus stops along South Road and Shoreditch Road on route to the Racecourse. The last bus each day is 6.05pm from the Racecourse. There will be capacity for a maximum of four passengers on each journey due to the need for social distancing. The service is reserved for those who have a pre-booked vaccination appointment at the Racecourse and this will be verified before passengers board the bus. It’s recommended those using the service catch a bus to arrive approximately 10 minutes before their vaccination slot. You can view the timetable here
  • First West of England provides a bus service every 30 minutes from Wells Bus Station stopping at Shepton Mallet. The bus service terminates at the Bath and West Showground and operates seven days a week. The service provides connections to and from other bus services at both Wells Bus Station and Shepton Mallet Cenotaph. This service is free for bus pass holders. If you plan to use this bus service, please make sure that you take your appointment letter with you and try to use the timetabled journey which arrives at the Bath and West Showground as close to your appointment time as possible. This will avoid waiting time on site. You can view their vaccination centre travel guide here
  • Current concessionary bus pass rules have been suspended so that bus passes can be used on all public services before 9.30am. This came into effect from February 1.
  • Somerset County Council is working with Community Transport and Slinky Demand Responsive Services across Somerset to allow free travel for bus pass holders when attending vaccination appointments. You can find information and contact details for Community Transport Services on Travel Somerset

If you are concerned about getting to an appointment, or need other help or support during the pandemic, please phone the Coronavirus helpline on 0300 790 6275. Lines are open from 8am to 6pm, seven days a week.

Astra-Zeneca Vaccine

As we are sure you will be aware, there has recently been significant media coverage regarding the Astra Zeneca vaccine and an associated potential risk of the development of blood clots within the brain.  It is therefore important that we work with you and our staff to ensure that the correct information is provided and that any potential disruption to vaccine uptake is managed appropriately.

What is important is to stress that whilst a potential link between the Astra Zeneca vaccine and a very rare adverse event has been identified, we need to consider this in its entirety.  In a high exposure risk environment such as the Care Sector, as can be seen from the graphic below even in the highest risk group (20-29yrs) the relevant risk from the vaccine at 1.1 is significantly below the relevant risk from the vaccine at 6.9.  The vaccine remains very safe and staff within this group who have yet to accept first dose will have an option of an alternative vaccine

.

Second Dose

What is clear from the evidence provided is that all cases so far identified have followed first dose vaccination and generally all cases had identified symptoms within the first few days post vaccination and all within 21 days.  Therefore if you have had first dose vaccination with Astra Zeneca and have had no significant adverse effect, then there is very little risk from the second dose, your body has in many respects shown its tolerance of the vaccine through first dose and as such the risk reduces even further.

We are therefore very keen to support staff in continuing to accept second dose vaccination, we know that the link between Covid and deaths is being broken through vaccination, and it is vital if we are to continue to protect those we care for that we continue to follow clinical guidance and roll out second dose vaccination.

Further Information:

Further information:

  • Public Health Somerset has produced a ‘myth-buster’ sheet about some of the vaccine myths that we are aware of for you to share with your staff.
  • Please don’t contact your GP surgery to ask about vaccinations, they will contact you, unnecessary calls are jamming GP switchboards and as such are stopping people who need urgent appointments from getting through.
  • You cannot choose which vaccine you want, they are very safe and very effective.
  • The previous advice that anyone who carries an EpiPen or has a significant history of an anaphylactic-type reaction should not receive a vaccination has now been updated and now only contraindicates based on a specific allergy to one of the ingredients contained within the vaccine (see below).  This new guidance has been developed following the vaccinations carried out in the UK so far and the ever growing evidence base this generates.

Vaccine contra indications

Please click to expand to view the contra indications for each vaccine

The contra indications for the Astra Zeneca vaccine, other than the potential risk of the development of blood clots within the brain described above, is hypersensitivity to any of the ingredients shown below:

      • L-Histidine
      • L-Histidine hydrochloride monohydrate
      • Magnesium chloride hexahydrate
      • Polysorbate 80
      • Ethanol
      • Sucrose
      • Sodium chloride
      • Disodium edetate dihydrate
      • Water for injections

Astra Zeneca vaccine exclusions are now individuals who:

      • Are less than 18 years of age (with a preference for an alternative vaccine to be administered to those aged 18-29 years of age)
      • Have had a previous systemic allergic reaction (including immediate onset anaphylaxis) to a previous dose of COVID-19 Vaccine AstraZeneca or to any component of the vaccine or residues from the manufacturing process
      • Are pregnant
      • Are suffering from acute severe febrile illness (the presence of a minor infection is not a contraindication for vaccination)
      • Are participating in a clinical trial of COVID-19 vaccines
      • Have received a dose of COVID-19 vaccine in the preceding 28 days
      • Have completed a course of COVID-19 vaccination

The only contra indications for the Pfizer vaccine is hypersensitivity to any of the ingredients shown below.

      • This vaccine contains polyethylene glycol/macrogol (PEG) as part of ALC-0159
      • ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate)
      • ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide
      • 1,2-Distearoyl-sn-glycero-3-phosphocholine
      • Cholesterol
      • Potassium chloride
      • Potassium dihydrogen phosphate
      • Sodium chloride
      • Disodium hydrogen phosphate dihydrate
      • Sucrose
      • Water for injections

Pfizer vaccine exclusions are now individuals who:

      • Are less than 16 years of age
      • Have had a previous systemic allergic reaction (including immediate onset anaphylaxis) to a previous dose of COVID-19 mRNA vaccine BNT162b2 or to any component of the vaccine or residues from the manufacturing process
      • Have a history of immediate-onset anaphylaxis to multiple classes of drugs or unexplained anaphylaxis
      • Are pregnant
      • Are suffering from acute severe febrile illness (the presence of a minor infection is not a contraindication for vaccination)
      • Are participating in a clinical trial of COVID-19 vaccines
      • Have received a dose of COVID-19 vaccine in the preceding 21 days
      • Have completed a course of COVID-19 vaccination

It is important that we look to vaccinate as many staff as possible, we do appreciate some are nervous, but these vaccines ate incredibly safe.  Although it is true that they were completed in record time, we had a head start, Covid-19 is a Coronavirus and we have been working on Coronavirus vaccines for many years.  Vaccines are normally worked on by small groups of scientists with limited funding and infra-structure; this has been an international programme with unlimited resource, worked on by hundreds of scientists 24/7.

No staff who are currently symptomatic or isolating should attend for vaccination until such time as their isolation period ends.  Staff should attend individually and not share transport to the hospital.  Staff will need to wear a face covering when being vaccinated.  All staff will need to be registered with a GP and have an NHS Number (if staff can’t access their NHS Number it can be looked up on the day).

It is important that staff have access to and read the patient advice leaflets for further details of indications and contra-indications

General information about COVID-19 vaccines

Leaflets:

Videos:

Vaccination Frequently Asked Questions (FAQs)

Please click to expand to view the FAQs

Q: Can I have it if I’m vegan?
A:  Pfizer BioNTech vaccine is total synthetic – no animal products are included in the excipients or in the production (e.g. chicken eggs).  No cell line (human or animal) have been used in the development or production so is believed to be suitable for anyone with ethical (e.g. vegetarian, vegan, animal rights or pro-life) or religious concerns regarding some components or methods of production of some medicines.

Q:  I’m allergic to prawns / shellfish and last time I had the tiniest bit was quite ill but I have never been issued with an epi-pen. Can I have it still or is it too risky
A:  The exclusion is ‘severe allergic reaction’ by which we mean one severe enough to cause a hospital admission or need you to carry an EpiPen.  However, prescribers or vaccination centres have varying levels of caution regarding allergies (i.e. some centres may not administer the vaccine to people with less severe allergies) until we understand more about who and why a very people have had such a dramatic reaction to the vaccine – whether you can get a vaccine will depend on the individual clinical assessment of your particular allergy and it’s triggers by the healthcare professional prescribing or administering the vaccine .  The vaccine has been administered to EpiPen carriers without incident before the severe allergic reactions became apparent in the first few days of the vaccination programme.  It is hoped that as we get a better understanding of who and why a few people might react badly to the vaccine we will be able to be more specific about the allergies (and how severe they are) that stop people having the Pfizer BioNTech ‘Courageous®’ vaccine for their own safety: this could also mean that some EpiPen carriers who we’d currently advise shouldn’t have it may be able to have the Pfizer vaccine in the future.

Q:  Can I wait for the Oxford vaccine?
A:  At this time the Pfizer vaccine is the only approved vaccine, it is not known when or if any other vaccine will be provided.  Earlier vaccination saves lives.

Q:  What format does going to have the vaccination take i.e. queuing in small rooms with others?
A:  Social distanced at all times, you will be received details checked, a pre-screening check will be conducted prior to vaccination.  A short period of observation (15 minutes) will be conducted after the vaccination.  All staff involved will be wearing full PPE and you will be required to wear a face mask or visor covering your mouth and nose.

Q:  What forms or questions will I be asked?
A:  Confirmation of personal details, some brief conversations regarding past medical history.

Q:  Will I have to take evidence of my NHS number with me even though Linden House will have provided it?
A:  If you have your NHS number that would be helpful, but it can be looked up on the day.  You may be asked to take ID to confirm who you are.

Q:  Will I be given the appointment for the second jab after I have had my first and before I leave the vaccine centre?
A:  Your second appointment will be confirmed 21 days after the first vaccination, at some vaccination centres this will be sent to you after the vaccination. Other vaccination centres are booking the date and time of the second vaccination at the centre at the time of your first vaccination.

Q:  Will I be sent a reminder for the second jab?
A:  You will be given a card with the date and time of you appointment slot.

Q:  Will I have to wait for a while after I have had the vaccine before I can leave?
A:  A short period of observation – 15mins – will be required.

Q:  Can I choose to go with someone I know as I don’t like needles?
A:  You will need to attend as an individual, but please ensure the vaccination team are aware of the phobia you have for needles.

Q:  What happens if I can’t drive or don’t have access to a car?
A:  All Primary Care Centre clinics are in the local areas, so that the need to drive or take public transport is kept to a minimum. There are also some plans in development for Covid-19 vaccination to be provided at community pharmacies so this might be an option at some stage in the future but isn’t available yet.

Q:  Am I only given one chance to have the jab?
A:  Additional opportunities may be provided, but this can’t be guaranteed.

Q:  My employer is asking for my NHS number but I am not prepared to provide it. I am happy to take it with me when I am vaccinated. Is that ok?
A:  Yes

Q:  How is the government going to ensure that everyone who wants a vaccine has had one? is there going to be one enormous database to ensure nobody is missed and if so, will this be able to be accessed by GPs, hospitals etc.
A:  This is a very complex process and as such there is some responsibility for individuals to identify themselves.  GP records will be used to identify all at risk individuals.

Q:  Will I get a Covid-19 passport / evidence that I have had the vaccine?
A:  No.

People aged 70 and over, including care home residents, identified by the new QCOVID risk assessment model will have received this letter advising them to shield. Please see information supplied by Government below regarding the QCovid model and the reasons for including more people at this time. You should continue to follow guidance on shielding and protecting people defined on medical grounds as extremely vulnerable (Public Health England and Department of Health and Social Care, updated 30/04/2021)already in place and if you have any concerns or queries please contact us via ASCCOVID19@somerset.gov.uk.

QCOVID

Summary

  • QCOVID is a new predictive risk model to help clinicians identify adults with multiple risk factors that make them more vulnerable to COVID-19.
  • Research was developed by subgroup of NERVTAG, led by the University of Oxford and funded by National Institute for Health Research.
  • Individuals identified through the COVID-19 population risk assessment, using the QCovid® model, have been added to the Shielding Patient List (SPL) on a precautionary basis.
  • Individuals aged 19-69 within this group started being added to the SPL last week, enabling them to be prioritised for a vaccination.
  • This week, individuals who are 70 and over, as well as residents of care homes, have been added to the SPL. Please note, this does not change any guidance already in place for care homes and their residents.

Development of QCOVID

  • We are continually learning more about COVID-19 and the factors that lead to poor outcomes including death and hospitalisation.
  • An expert subgroup of NERVTAG was commissioned by the Chief Medical Officer to develop a predictive risk model, to enable a more sophisticated approach to clinical risk based on multiple risk factors.
  • The new risk assessment model came out of research funded by the NIHR (National Institute for Health Research) and was published in the British Medical Journal (BMJ) on 20 October.
  • This model combines a number of characteristics to estimate the risk of catching and then being hospitalised or dying from COVID-19. These include age, sex registered at birth, ethnicity, body mass index (BMI), and specific health conditions and treatments.
  • Refining the model and working through how we might apply it as accurately as possible, has been complex and challenging. This world leading approach has been developed at unprecedented pace over some months, whilst simultaneously aiming to meet the highest standards of evidence, clinical safety and technical assurance.

Application

  • The model has been applied to medical records of NHS patients in England.
  • This has recently enabled us to help identify people who may be at high risk of becoming seriously unwell from coronavirus because of a combination of their individual characteristics and their underlying health conditions.
  • We want to provide vaccination more quickly to them and also offer further advice and support. The easiest way for us to ensure early vaccination for this group is to include them within the list of those who are clinically extremely vulnerable (also known as the Shielded Patient List).
  • People may feel that at this stage of the pandemic, when rates of infection overall are declining, the advice is not relevant. However, we think it is important that this group are aware of their risk status and of the support available to them, both now and for any future changes in the pandemic so they can make an informed choice themselves. Their GP will also be notified.
  • The COVID-19 Population Risk Assessment, powered by the QCovid® model, uses data held centrally by the NHS from a number of sources including general practice.
  • People who may be high risk who are not registered with a GP practice are included and will be communicated with and added to the SPL in the same way.
  • Recognising the current pressures on the health system, there is no action required of clinicians for these additions to the SPL to take effect. As now, GPs have the option to add or remove patients from the SPL, based on their clinical judgement.

Assurance

  • The new predictive risk model has been developed through research funded by the National Institute for Health Research (NIHR).
  • The findings from the development of the QCovid® model were published in the BMJ. The Office for National Statistics (ONS) independently validated the performance of the QCovid® model. The ONS has shown that the model performs in the ‘excellent’ range, and accurately identifies patients at high risk from COVID-19. This means we are fully confident that the model is robust and meets the highest standards of evidence.
  • NHS Digital have developed the COVID-19 Population Risk Assessment using the QCovid® model. It has been through a functional assurance process which aims to ensure that the QCovid® model has been used correctly, works as expected and produces accurate outputs.
  • The model has been approved for use as a Class 1 medical device with the Medicines and Healthcare products Regulatory Agency.

Guidance for Coronavirus (COVID-19): looking after people who lack mental capacity (Department of Health and Social care, updated 27/04/2021) for health and social care staff who are caring for or treating a person who lacks mental capacity during the pandemic was updated  on 27/04/2021.

The ability of our Local Authority DoLS team to carry out assessments and provide authorisations is severely impaired by understandable access restrictions imposed by care homes and hospitals.

The following approach has been adopted (from 18 March 2020) as Somerset County Council policy for the immediate future:

  • The DoLS team will make case-by-case decisions about whether any particular DoLS assessments must be completed, and will negotiate this accordingly.
  • This is only likely to be required in cases where to leave a person without authorisation would put them at some significant risk of harm. There are likely to be safeguarding cases.
  • Other part-completed assessments or those awaiting allocation will be put on hold and monitored until the current situation improves.
  • The DoLS team will look for alternative methods for conducting assessments where face-to-face contact is not considered appropriate. Discussions are underway about how to conduct some DoLS assessments by phone, but we are also mindful of the need to avoid placing any unnecessary additional pressures upon the time of staff in care settings

We have received guidance that support groups that have to be delivered in person can continue with up to 15 participants where these are formally organised groups to provide mutual aid, therapy or any other form of support, where it is necessary for these to take place in person. 

Day services are covered by the term ‘support group’, and are therefore can remain operating, and consequently day care providers are encouraged to continue to operate providing that the meet all the national government guidelines including:

  • A maximum of 15 people are supported in one building at any one time.  This cannot be a private dwelling. 
  • Social distancing is maintained and that the building remains Covid secure
  • Test and Trace information is recorded and confirmed
  • Providers liaise with people who use their service and their families to ensure that they do not fall in the over 60,  clinically vulnerable or extremely clinical vulnerable categories, and as a consequence may not want to attend their day care service during the lockdown period. If someone does not wish to attend their day care then providers should contact JCawley@somerset.gov.uk.

Should you require any further advice regarding the steps you should be taking to reduce the transmission risk, please email us at ASCCovid19@somerset.gov.uk.

The Social Care Institute for Excellence (SCIE) has released guidance (updated 30/04/2021) commissioned by the Department for Health and Social Care to support day services for vulnerable adults to re-open or continue to operate in a safe manner. Somerset County Council asks that all day service providers follow this guidance released by SCIE, drawing attention to the request for transparency with service users, families, the Local Authority and other providers regarding risk assessments both business wide and for individuals. We have also produced a summary guide which we hope will be of use to affected services which covers aspects including funding, PPE and transport.

All Local Authorities were asked by the Department of Health and Social Care to submit and make public a letter setting out a short overview of its current care setting support activity and forward plans by 29 May 2020. The letter should be accompanied by a short capacity tracker template confirming the current level of provider access to the support offer (self-reported by local regulated care homes), as well as details of issues and support needs.

View the letter and template here

  • Webinar with Mel Lock on 05/06/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care) to discuss grant funding.  Alison Bell (Strategic Manager for Public Health) will also be joining to provide an update of Care Home Testing, and Dave Partlow (Strategic Manager for Adult Social Care) will provide an update on PPE.

    • View the webinar 
    • View Alison Bell’s presentation
    • Responses to questions that were followed-up after the webinar had finished:
      • Q:  Could we use the funding for staff who are shielding.  It states that staff who self-isolate can be claimed but does that cover shielding staff wages also?
        • A:  Shielding staff members can be allocated to the staff cost under the category of isolation and protection of staff and residents from infection/vulnerability – the Director of ASC has agreed this can be signed off against the grant determination.
      • Q:  Can you confirm when the Infection Control Grant Applies from
        • A:  Start date is on signing and return of the grant agreement and the condition states that it cannot be used for expenditure already incurred.
      • Q:  With regards to the grant, is there any further guidance regarding specifics of what you can/can’t spent the grant on?  e.g. Is capital expenditure allowed?  For example with regards to transport for staff.
        • A:  Capital spend is not excluded (provided it meets one of the categories). Please check if you are unsure.
    • The Department of Health and Social Care have also released an Infection Control Fund Question and Answer document 
  • Webinar with Mel Lock on 16/06/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care) to discuss the remaining 25% of Infection Control Grant monies. This webinar was primarily for:

    • Domiciliary care providers
    • LD supported living providers
    • Extra Care housing providers
  • Webinar with Mel Lock on 01/07/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care) and Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team) to give an update on how we have progressed with exploring ways to help providers source PPE and use the bulk buying power of the council to do this at a favourable cost, and explained how providers will be able to purchase PPE going forward.

  • Webinar with Mel Lock on 25/09/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care), Alison Bell (Consultant in Public Health) and Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team) to give an update on testing, the Adult Social Care Winter Plan that was published on 18/09/2020 and PPE.

  • Webinar with Mel Lock on 16/11/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care), Alison Bell (Consultant in Public Health), Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team), Jo Howarth (NHS England and NHS Improvement) and Conner Dicks (NHS England and NHS Improvement) to give an update on the Covid-19 Vaccination programme, care home visits, the current public health position in Somerset and IPC Grant monies.

  • Webinar with Mel Lock on 18/12/2020

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care), Alison Bell (Consultant in Public Health), Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team) to give an update from Public Health  and on vaccinations, Lateral Flow Device Tests (LFTs), Care Home Visits, Business Continuity and out break planning, finance and grants and Christmas messages including #ConnectACareHome

  • Webinar with Mel Lock on 28/01/2021

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Tim Baverstock (Assistant Director of Adult Social Care), Alison Bell (Consultant in Public Health), Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team) to give an update from Public Health, and on outbreak management (planning for an outbreak, learning from recent experiences), Lateral Flow  Device Tests (LFTs, ) and testing, vaccinations, grant funding – Infection Control Grant 2 (ICF2) and testing funding support, proud to Care Somerset case study request and the Millbrook equipment return campaign and self-assessment portal.

  • Webinar with Mel Lock on 24/02/2021

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Councillor David Fothergill (Leader of Somerset County Council), Tim Baverstock (Assistant Director of Adult Social Care), Alison Bell (Consultant in Public Health), Liz Green (Health Protection Practitioner) and Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team), The agenda included:

    • Thank you from Cllr David Fothergill
    • Infection prevention and control – ventilation, cleaning etc.
    • Covid-positive discharges
    • Care home visiting guidance
    • Workforce capacity fund
    • Vaccinations
    • Flagging different vaccine brands
    • EU settlement
    • Any other business
  • Webinar with Mel Lock on 26/03/2021

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Alison Bell (Consultant in Public Health), and Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team), The agenda included:

    • Current situation, and need to remain vigilant
    • Testing in outbreaks
    • Vaccination update
    • Visiting in care settings
    • Funding
    • World Autism Awareness Week
    • Any other business
  • Webinar with Mel Lock on 20/04/2021

In this webinar Mel Lock (Somerset County Council’s Director of Adult Social Care) was joined by Alison Bell (Consultant in Public Health), and Dave Partlow (Strategic Manager, Adult Social Care COVID19 Response Team), The agenda included:

    • Testing
    • Vaccination stats and consultation
    • PPE usage and guidance
    • Grant funding and Capacity Tracker
    • Preparation for reopening of community services/respite
    • Any other business

The Government announced that it has moved to institute a policy of testing all residents prior to admission to care homes, starting with those being discharged from hospital with the NHS having the responsibility for testing these specific patients in advance of timely discharge, and has published Hospital discharge service guidance (02/02/2021) including leaflets for patients, the admission and care of people in care homes (updated 01/04/2021) and stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings (22/03/2021).  On 01/04/2021 the national guidance was updated on Discharge into care homes: designated settings for people leaving hospital who have tested positive for COVID-19 and are transferring to a care home (this includes working age adults who reside in a care home).

Somerset NHS Foundation Trust has confirmed that this process has been implemented for all  patients that are admitted (for more than 24 hours).  If they are simply seen on AMU or within the Emergency Department they will not be tested ahead of discharge back to care homes.  Following testing, timing of discharge will be with the agreement of the care home in question regarding if the individual can be accepted to an isolated area within the care home pending test result.  The same process is applicable for community hospitals as well. The Somerset NHS Foundation Trust process is detailed in this flowchart (updated 21/04/2020)

We are seeking further information from Yeovil District Hospital and will add further detail on the arrangements once it becomes available.

The Somerset COVID-19 Local Outbreak Management Plan Dashboard is updated daily with the latest information about infection rates in Somerset.  To view the dashboard follow this link.

Visits in to care homes

Welcoming people into care homes from the community inevitably brings infection risk, but this is a risk that care homes can mitigate with appropriate control measures, tailored to each individual site. It is a risk that should always be balanced against the importance of visiting and the benefits it brings to care home residents and their families. 

Visiting should be supported and enabled wherever it is possible to do so safely, in line with this guidance and within a care home environment that takes proportionate steps to manage risks.  All visitors also have an important role to play – helping to keep their loved ones safe by carefully following the policies described in government guidance, and the practical arrangements that care homes put in place. 

In each care home, the registered manager is responsible for setting the visiting policy in that home, and they should do so on the basis of a dynamic risk assessment taking into consideration the needs of individuals within their home and with regard to the advice of the local Director of Public Health (DPH) and Director of Adult Social Services (DASS).

The Government has updated the guidance on care home visits (Department of Health and Social Care, updated 04/05/2021) to incorporate the new visitor scheme for care homes which has been put in place from 12/04/2021, the availability of self-testing for visitors and changes to PPE advice.  This includes summary of guidance for visitors (Department of Health and Social Care, updated 04/05/2021).  In summary, the details of these changes are:

  • Indoor visiting by up to 2 ‘named visitors’ for each resident. These visitors will need to take a rapid lateral flow test, and test negative before every visit (while visitors can now self-test at home the guidance states that a test taken onsite at the care home is preferable for assurance purposes). They should minimise physical contact with residents. They must observe social distancing and PPE use, and follow all necessary infection control measures.  An essential care giver (see below) may also take part in these visits.
  • The resident can meet with both of their 2 named visitors at the same time (for example, during the same visit as long as the care home is able to accommodate this) or can meet with them separately if that is what they prefer.
  • Visits including babies and very young children may also take place with the agreement of the care home manager. These children do not need to be counted as an additional visitor. Care home managers and families can agree to exercise some discretion here – but in general a child under the age of 2 need not be counted.
  • Additionally, residents with higher care needs can also choose to nominate an ‘essential care giver’ who can provide close contact personal care where it is critical for the resident’s immediate health and wellbeing. These ‘essential care givers’ will be supported to follow the same testing arrangements, and the same PPE and infection control arrangements, as care home staff.  The situation described for essential care givers is considered an exceptional circumstance, and the guidance stated that they should therefore continue in the event of an outbreak unless there are specific reasons not to do so.  The essential care giver does not need to be the same person as one of the named visitors.
  • Opportunities for every resident to see more people than just their named visitors, by enabling outdoor visiting or ‘screened’ visits incorporating appropriate screening to reduce the risk of infection .

As with the previous guidance:

  • Visits should take place in a well-ventilated room, for example with windows and doors open where it is safe to do so. Providers should consider the use of designated visiting rooms, which are only used by one resident and their visitors at a time and are subject to regular enhanced cleaning and ventilation between visits. Any areas used by visitors should be decontaminated several times throughout the day and providers should avoid clutter to aid cleaning.
  • Visitors should wear appropriate PPE as laid out in the guidance on how to work safely in care homes in England (Public Health England, updated 16/04/2021). This guidance sets out the appropriate levels of PPE for a range of scenarios, such as being in physical contact with a resident, or being within 2 metres of a resident but not touching.
  • Visitors should keep physical contact to a minimum. Visitors and residents may wish to hold hands, but should bear in mind that any contact increases the risk of transmission. There should not be close physical contact such as hugging
  • Visitors should also be careful to ensure they observe strict social distancing from other residents, visitors and staff at all times.
  • In the event of an outbreak in a care home, the home should immediately stop visiting (except in exceptional circumstances such as end of life) to protect vulnerable residents, staff and visitors. Essential care givers can continue to visit unless there are specific reasons not to do so.
  • Vaccination is not mandatory and is not a condition of visiting, although it is strongly recommended that all visitors and residents take up the opportunity to be vaccinated when they are invited to do so through the national programme.
  • The frequency and duration of the visits are at the care home’s discretion, and it is recommended that it is recommended that the care home has a simple booking or appointments system to enable visits

In all cases it is essential that visiting happens within a wider care home environment of robust infection prevention and control (IPC) measures, including ensuring that visitors follow (and are supported to follow) good practice with social distancing, hand hygiene and PPE use.

Where residents have particular needs (for example, those who are unable to leave their rooms, those living with dementia or those who may lack relevant mental capacity) which may make it challenging to follow some of the detailed advice in the guidance on the conduct of visits, the the provider should work with the resident, their family, friends and any volunteers to develop a tailored visiting policy within the principles outlined in the guidance.

The government has also published the following tips to prepare for visits:

  • Communicate expectations to families and visitors
  • Ensure you have appropriate PPE on site for visitors
  • Begin to schedule visits, the frequency and duration of visits are at the care home discretion
  • Prepare staff for visitation
  • Have devices available if visitors require assistance registering their result

Each care home is unique in its physical layout, surrounding environment and facilities and that residents vary in their needs, health and current wellbeing.  The guidance therefore recognises that care home managers are best placed to decide how their care home can best enable visiting in line with this guidance, and in a way that meets the needs of their residents both individually and collectively, and we will continue to support care home managers in making the right decision for their home.

It is important that the named visitors remain the same people as far as possible. This is important in reducing the risk of transmission, by limiting the number of different people coming into the care home from the community. However, we recognise that there will be situations in which a named visitor cannot continue to visit (for example because of illness).  The guidance advises that care homes and families take a pragmatic approach, with the aim of minimising change wherever possible.

The individual resident, their views, their needs and wellbeing should be taken into account when decisions about visiting are made, recognising that the care home will need to consider the wellbeing of other residents as well.  These decisions should involve the resident, their family and friends and the provider and other relevant professionals such as social workers or clinicians where appropriate. Throughout the guidance the phrase ‘family and friends’ is used, and this is intended to be a wide-ranging and inclusive term to describe the network of people around the resident who may wish to visit, or whom the resident may wish to meet.

All decisions should be taken in light of general legal obligations, such as those under the Equality Act 2010 and Human Rights Act 1998, as applicable. Providers must also have regard to the Department of Health and Social Care (DHSC) ethical framework for adult social care (Department of Health and Social Care, 28/04/2021).  The Care Quality Commission (CQC) has regulatory powers that can be used where they have concerns regarding visiting.

We recognise how important visiting is as residents approach the end of their lives, and this should not just mean at the very end of one’s life.  Families and residents should be supported to plan end-of-life visits, with the assumption that visiting will be enabled to happen not just towards the very end of life, and that discussion with the family should happen in good time. As has been the case throughout the pandemic response, visits in exceptional circumstances such as end of life should continue in all circumstances (including in the event of an outbreak).

Visiting is just as important for people living in supported living and extra care settings. This guidance does not directly apply to those settings – the diversity of the settings and the needs of those who live in them means it will not be suitable in all cases. However, supported living and extra care managers may wish to use the guidance to help them support safe visiting in these settings.

All visitors should be screened for symptoms of acute respiratory infection before entering. No one who is currently experiencing, or first experienced, coronavirus symptoms in the last 10 days, should be allowed to enter the premises, nor anyone who is a household contact of a case or who has been advised to self-isolate by NHS Test and Trace, or who is in a relevant quarantine period following return from travel.

Any potential visitor who tests positive should immediately leave the premises and self-isolate. They should be offered a confirmatory PCR test by the care home and their household contacts may also be required to self-isolate in line with current guidance. Screening questions that care homes may wish to ask visitors on arrival are:

  • Have you been feeling unwell recently?
  • Have you had recent onset of a new continuous cough?
  • Do you have a high temperature? A care home may consider providing a temperature check for all visitors to provide confidence to visitors and to staff.
  • Have you noticed a loss of, or change in, normal sense of taste or smell?
  • Have you had recent contact (in the last 14 days) with anyone with COVID-19 symptoms or someone with confirmed COVID-19. If yes, should you be self-isolating as a family member or as a contact advised to do so by NHS Test and Trace?
  • Have you returned from an overseas visit recently and are you still in the quarantine period?

Staff should discuss with visitors any items they wish to bring with them on their visit, such as a gift. It will need to be something that can be easily cleaned by the care home to prevent cross contamination. For example, a box of chocolates that could be sanitised with wipes.

Care homes should support NHS Test and Trace by keeping a temporary record (including address and phone number) of current and previous residents, staff and visitors (including the person/people they interact with – for example if a person visits their loved one who is also visited by a chaplain in the course of the visit), as well as keeping track of visitor numbers and staff.

Covid-19 has not yet been beaten, a single course of vaccinations does not mean that we can relax and risk further outbreaks, it remains our priority to work with providers to keep our vulnerable population safe and we continue to be very supportive of the measures that each provider has in place to control risk within each residential setting.

Visits out of care homes

Following the recent reduction in transmission rates and a gradual reduction in restrictions, national guidance on visits out of care homes (Department of Health and Social Care, 01/05/2021) has been updated to include visits out of care homes: supplementary guidance (Department of Health and Social Care, 01/05/2021) to support external visits and wider social contact with families that often forms an intrinsic part of the care package surrounding individuals.

Guidance from 12/04/2021

As such it is important that we consider social group contacts that are vital to the support for individuals in residential settings, including Supported Living, and that we enable individual risk assessments to be undertaken to support the balance between continued isolation and transmission risks associated with wider social contact.

This risk assessment should be clearly documented and would need to include information on such considerations as:

  • Two negative LFD tests in the preceding week on both family and individual visiting
  • LFD testing prior to return
  • Whether all parties have received their first dose of covid19 vaccination
  • Correct use/supply of PPE for the duration of the visit
  • An agreed cleaning schedule for any vehicle or home environment
  • An agreed isolation plan in the event of a positive case during or returning from the visit
  • That there is no active outbreak in the care setting at the time of the planned visit
  • That the individual is not travelling into or out of an area of high transmission or where there is a known variant of concern
  • That there is no increased risk of transmission introduced through transport, ideally parents to collect
  • Consideration of increased risk of transmission through increased social interaction (parties, large gatherings, foreign travel etc).

Supplemental guidance from 04/05/2021

From 4 May 2021, residents should be enabled to leave their care home to spend time outdoors, without subsequent isolation for 14 days, in the following circumstances:

  • residents may be accompanied by:
    • a member of care home staff
    • one or both of their nominated visitors
    • their essential care provider (where applicable)
  • care homes should discuss arrangements with residents’ nominated visitors, or essential care provider, in advance
  • visits should take place solely outdoors, except for the use of toilet facilities
  • there should be no visits to indoor spaces (public or private)
  • visits should not involve the use of public transport
  • Where a care home is situated in a local community with high, or rapidly rising, levels of infection, and/or where there is evidence of variants of concern (VOCs), care home managers should seek additional local advice from directors of public health.

National Guidance:

Partners in Care resources

To support the easing of restrictions on care home visits, the National Care Forum has led the creation of a new set of resources called Partners in Care. They’ve been produced in collaboration with Rights for Residents, Relatives and Residents, John’s Campaign and Age UK and backed by many others in the sector.

These resources can be used and adapted by care homes. They include a visiting charter setting out shared rights and responsibilities and a visiting pledge, covering commitments all parties can sign up to.

Some care home residents have received a letter advising them they have been added to the shielded patients list (because they are clinically extremely vulnerable). The Department of Health and Social Care has made an addition to the guidance to make clear being on the list does not prevent care home residents from receiving visitors in the same way as others

The Gold Standards Framework Centre CIC (GSF Centre CIC) which provides training for generalist frontline staff in health and social care, to enable the provision of ‘gold standard’ care for all people nearing the end of life, has published The Gold Signposting and guidance on the Coronavirus Epidemic.

Local Guidance
Join the Somerset Care Homes Palliative Care ECHO network

variety of participants can share best practice and learning – all staff from signed up teams are welcome.

Signed up professionals and care homes will have access to:

  • Ten facilitated ECHO sessions per year
  • Share knowledge and network with other professionals and care homes in Somerset
  • Access to a variety of specialists in palliative care
  • Certificate of attendance (following completion of feedback)
  • Opportunity to achieve a Champion Care Home award from St Margaret’s Hospice Care where minimum standards are met

The sessions are FREE, held remotely and coordinated by the Hub (St Margaret’s Hospice Care). All you need is a device that you can access the internet and emails on, with a camera, microphone and speaker. No special software is needed – a link will be sent in an email that allows you to join the session directly.  

The network will work slightly different for care homes and health and social care professionals and we have therefore added further information provided by St Margaret’s Hospice below: 

Easy Read Palliative Care Resources:

In response to COVID-19, the Home Office and the Disclosure and Barring Service (DBS) have put temporary arrangements in place to provide DBS checks and fast-track emergency checks of the adults’ and children’s barred lists free-of-charge to healthcare and social care workers being recruited in connection with the care and treatment of COVID 19 in England and Wales.

These arrangements will provide employers with the option to appoint new recruits into regulated activity with adults and/or children, as long as the individuals are not barred, and appropriate measures are put in place to manage the individual until the full DBS check is received.

Guidance has been developed for organisations who need to do these checks, setting out how who can have them and how to complete the applications so these can be easily identified and the right level of information provided as quickly as possible.

These checks will be free of charge to reduce the burden on services at this time of need.

The guidance can be found here (updated 22/10/2020) and all other DBS guidance relating to COVID-19 can be found here (updated 16/07/2020) .

Most EU citizens living in the UK (as well as those from the EEA and Switzerland) need to apply to the EU Settlement Scheme to gain Settled Status so they can continue to live and work in the UK after 30 June 2021.  This includes both employees and care home residents.  The pandemic is having an impact on application times to the EU Settlement Scheme, so it’s vital that people apply as soon as possible.

You can apply for settled status at https://www.gov.uk/settled-status-eu-citizens-families

You should consider the impact on your organisation or business if staff do not have Settled Status, as they will not be able to work after June 2021. You can also play an important role by sign posting your service users to the scheme, as some people in our community may not be aware of the need to apply or may need help.

Local charity Diversity Voice, in partnership with Somerset County Council, are working with the Home Office to provide help from regulated advisors for those who need it, including vulnerable people and employers.  They can provide posters, hand-outs for service users and 1:1 help for applicants in any language.  There’s no charge for this service.

Contact euss@diversityvoice.org.uk or 0300 075 0105.

Infection Prevention and Control (IPC) and Personal Protective Equipment (PPE)

National Guidance

PPE Resources:
Local Guidance and Resources:

National Guidance 

The NHS has set up a supply distribution helpline which can answer PPE calls and emails 24/7:

Phone: 0800 915 9964
Email supplydisruptionservice@nhsbsa.nhs.uk

PPE Portal:

  • The DHSC has launched a guidance page on the PPE Portal, to help provide information to those invited to register and order emergency PPE through the site.
  • Please find the page at this address:  https://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment (Department of Health and Social Care, updated 27/04/2021)
  • The customer service team can be contacted on on 0800 876 6802 if you have any questions about using the PPE portal
  • The page details who is eligible to register with the portal, how the order process works and what customers should expect from the portal.
  • Please ensure that all eligible providers regularly check their email accounts registered with the Care Quality Commission (CQC) / Medicines and Healthcare products Regulatory Agency (MHRA) in order to ensure that the email invitation is received and actioned.

Personal Protective Equipment (PPE) Strategy:

On 28/09/2020 the Department of Health and Social Care published a Personal protective equipment (PPE) strategy: stabilise and build resilience (updated 29/09/2020).

Local process

While we appreciate that many providers are now procuring PPE via the PPE Portal, the Local Authority is still available to support providers with any PPE shortfalls, however this will be on a chargeable basis.  Please contact ASCCOVID19@somerset.gov.uk should you wish to purchase PPE through the Local Authority. 

Resuscitation during the Coronavirus public health crisis presents those undertaking it with additional risks. Advanced life support procedures are considered aerosol generating, and should therefore only be undertaken by those wearing FFP3 masks and the highest level of PPE.

The Resuscitation Council UK are advocating compression only CPR at this time due to the inherent risks, further guidance can be found at:  https://www.resus.org.uk/media/statements/resuscitation-council-uk-statements-on-covid-19-coronavirus-cpr-and-resuscitation/covid-community/ (updated 13/05/2020)

  • The appropriate use of PPE will protect uniforms from contamination in most circumstances
  • Change at work – it is best practice to change in to and out of uniforms, or dedicated work clothing, at the workplace
  • Uniforms should be brought home in a disposable plastic bag and laundered separately

Public Health England South West are holding weekly webinars at 3pm each Friday to answer questions about infection prevention and control.  If you have yet to have an cases these webinars are provided to help you prepare and we would strongly urge you to participate.

Please use this link to join using Microsoft Teams or join by phone: 020 8142 8939 then phone conference ID: 447 183 299#

Please don’t throw empty hand gel/sanitiser bottles away, particularly small ones. You need to use these to decant gel from large bottles if you receive these as part of your PPE requirement. There is an increasing shortage of small bottles so we must reuse them.

When doing this, ensure that:

  • The bottle is cleaned thoroughly before refilling
  • You use a funnel to refill the bottle

Don’t forget:  Hand gel/sanitiser is only used where you cannot wash your hands with soap and water. This remains your best defence against COVID-19. Wash them for 20 seconds, and wash them frequently.

The main symptoms of coronavirus are:

  • high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal

Most people with coronavirus have at least one of these symptoms.

Further information

The Government launched a new NHS Test and Trace service on 28/05/2020.  The service is expected to evolve over the coming weeks and further information will be added as it becomes available.

General information

A summary has been produced of Coronavirus (COVID-19) tests available for adult social care in England (HM Government, updated 24/03/2021) that details the different requirements for each type of service.

Please see below for more specific information on testing within different service types.

National Information on getting tested for COVID-19

Everyone in England who is not currently displaying symptoms of COVID-19 infection, can now access free lateral flow tests to enable them to test twice weekly.

There are several routes available to receive twice weekly testing:

Local Information on getting tested

Labelling of tests for staff

We have received feedback that sometimes it can be unclear which setting a test relates to where the information completed only shows the care provider name rather than care setting.  Please could you there ensure that you complete as much detail as possible (setting name(s) and postcodes) as well as the name of care provider associated with it.  This will enable the location that the staff member is working at to be more quickly identified.

Additional step to the self-report registration

There has been an additional screen added to the user’s journey when you are registering a test result online. The user will now be prompted to input their occupation during registration.   Please note, this is an optional screen and therefore if you do not wish to disclose your occupation, you do not need to do so.

Procedure on discovering leaking vials or buffer solution

We have been informed of a small number of test kits that contain leaking vials, or vials without the lid securely fastened. Should this be discovered, the affected kit should be discarded. Once any immediate safety concerns have been dealt with, take photos of the affected kits, including batch numbers and any other information from the kit and also the outside of the delivery box. Report the incident to 119 and request a replacement order if required.

Care Homes (updated 14/05/2021)

Please click to expand to view information specific to care homes

Daily testing in the event of a positive test in a care home

Please be aware that current guidance states that, in the event of a positive test in a care home, all staff must be tested daily for at least 7 days

Guidance

The government has published guidance for all care homes without outbreaks that includes information about testing for coronavirus (COVID-19) (HM Government, updated 25/03/2021), Your step-by-step guide for COVID-19 self-testing: Lateral Flow Device Test Kits (HM Government, updated 22/04/2021), on-site testing for adult social care services: rapid lateral flow test guide (HM Government, updated 22/04/2021) and Rapid lateral flow testing in ASC settings: an overview (HM Government, updated 22/04/2021).  

If your scheduled courier (booked at https://test-kit-collection.test-for-coronavirus.service.gov.uk/ – see below) does not arrive to collect your test kits please call the contact centre on 119. They will be able to book urgent replacement couriers for you, and will be able to escalate any other concerns that you may have.

Please note that all couriers should still be booked at https://test-kit-collection.test-for-coronavirus.service.gov.uk/, and 119 should only be called if one does not arrive as scheduled between 4pm and 10pm.

The Department for Health and Social Care has also published guidance and spreadsheet to record the details of up to 100 people who you’ve tested for coronavirus on that day (Department for Health and Social Care, updated 13/05/2021).

The whole home testing cycle is:

  •  Staff testing: Weekly Polymerase Chain Reaction (PCR) and twice weekly Lateral Flow Device Test (LFT) (one of the LFT on the same day as their PCR)
  • Resident testing: Every 28 days with PCR When test kits are sent these are enough for four weeks and you can re-order more kits 21 days after your last order was dispatched.

Any care home workers with symptoms should be self-isolating and can access testing via the self-referral portal or be referred by their employer in the usual way.

Actions and testing frequency after a positive result

  • If there is a positive case in the care home from either staff or residents with a PCR or LFT test, conduct rapid response LFT testing on staff daily and report to the Public Health England Health Protection Team 0300 303 8162 (including out of hours) they will provide public health advice, and arrange urgent testing of all symptomatic residents. 
    • If no further positives are found within 7 days or the confirmatory PCR test (for the initial positive LFT test) is negative
      • Stop daily LFT and return to the regular staff testing regime of weekly PCR testing and twice weekly LFT testing
    • If further positive cases are found, or the Public Health England Health Protection Team advises that it is required after the first positive tests (where it is unclear whether there is an outbreak, the Health Protection Team should err on the side of caution and recommend
      outbreak testing.)
      • PCR tests for all staff and residents on day 1 of the outbreak and once between
        days 4-7.
      • Start (or continue, depending on your circumstances) of daily LFT testing of all staff until there has not been a positive result in 5 days
      • When you carry out the outbreak PCR for residents (day 1 and once again between day 4-7), also test the resident with LFT on the same day
      • Any positive LFT tests from either staff or residents should be followed by a
        confirmatory PCR.
      • PCR test any newly symptomatic people.  Continue to isolate and ensure contract tracing has been completed.
  • Once outbreak PCR and resident LFT testing is complete, continue with the regular testing cycle. Daily staff testing may continue in this scenario until no new cases have been identified for 5 days.

If staff are on annual leave, they are not required to join the daily testing until they return to work.

If staff develop symptoms, they should be tested at a test centre or by ordering a kit to be sent direct to their home. They can do this at:

https://www.gov.uk/apply-coronavirus-test-essential-workers 

Testing within 90 days of a positive PCR test

Following a substantial clinical review of the latest evidence and testing data, the Department of Health and Social Care (DHSC) has changed the advice for retesting within 90 days of a positive. From now on, if someone tests positive with a Polymerase Chain Reaction (PCR) test, they should not be tested using PCR or Lateral Flow Device Tests (LFTs) for 90 days, unless they develop new symptoms during this time, in which case they should be retested immediately using PCR. This 90 day period is from the initial onset of symptoms or, if asymptomatic when tested, their positive test result.

The previous policy to continue LFT testing following a positive PCR result was because although very unlikely, it is possible to be re-infected within 90 days. However based on the latest testing data and clinical advice, the policy has now changed.

The clinical view is that during this 90 day window from a positive test, given the low rate of reinfection during this window, it is significantly more likely that a positive LFT test would be a false result, rather than someone being re-infected, causing people to isolate unnecessarily. Therefore we are now stopping the regular testing using LFT during this 90 day period. The individual should return to the regular LFT and PCR regime once 90 days has passed.

This means that the policy for retesting within 90 days for Adult Social Care is now the same as the policy for NHS staff. The policy also applies to professionals visiting a care home who have received a positive PCR result in the last 90 days.

The 90 day period is from the initial onset of symptoms or, if asymptomatic when tested,  their positive test result. Individuals should use evidence of their positive PCR test to show  they are currently exempt from asymptomatic testing

A set of Frequently Asked questions (FAQs) has be produced about this change.

Testing in a confirmed or suspected outbreak.

In line with Scientific Advisory Group for Emergencies (SAGE) and Public Health England advice, the Department of Health and Social Care has introducing some changes to the testing procedures in the event of an outbreak.

In the event of a confirmed / suspected outbreak, you should immediately contact the local Health Protection Team (HPT) for advice using swhpt@phe.gov.uk.

An outbreak is defined as two or more confirmed or clinically suspected cases within 14 days – detected by either Lateral Flow Device Test (LFT) or Polymerase Chain Reaction (PCR) testing.  However, one positive test result may be the first sign of an outbreak, so you should also contact your health protection team for advice in this instance.

Please read the full guidance for all care homes without outbreaks that includes information about testing for coronavirus (COVID-19) (HM Government, updated 25/02/2021) detailing the outbreak testing process and how you can best prepare your care home in the event of an outbreak. This guidance should be followed unless advised otherwise by the HPT. The outbreak testing section starts from page 39.

What is changing?
  • Rapid response LFT testing for staff is being extended (from 22 February). This should no longer automatically stop after 7 days. Instead care homes should continue with rapid response testing until 5 days have elapsed since the date of the last positive LFT
    (confirmed with PCR). Staff should only be tested on the days they are due to attend work.
  • LFT testing for residents is being introduced (from 22 February). This should be undertaken at the same time as the PCR testing in an outbreak – on day 1 and on an additional day between days 4 and 7. The usual principles of consent and best interest decisions apply to inform your decision whether this is appropriate for each resident.
  • With immediate effect, PCR outbreak testing is moving from Pillar 1 to Pillar 2. The policy for when to carry out the outbreak PCR remains the same. All staff and residents should be tested on day one and on an additional day between days 4 and 7.

These changes are based on SAGE advice for how to use testing in a care home outbreak to reduce transmission and save lives. Rapid response daily LFT testing following a positive result has already helped care homes to get on top of outbreaks since it was introduced in December.

A one page summary has also been produced for Coronavirus (COVID-19) testing in a suspected or confirmed outbreak in care homes (HM Government and NHS Test and Trace, 16/02/2021)

Testing is only one part of the outbreak response. The local HPT will provide advice on how to manage the outbreak including the necessary Infection Prevention and Control measures such as cohorting, proper use of PPE, good hand hygiene and distancing.

Returning PCR tests in an outbreak

As you are already engaged in the National Coronavirus Testing Programme for staff / resident testing – you may already have couriers booked for the days that outbreak testing is taking place. If this is the case, you should return PCR tests through this regular channel – no additional return courier booking will be needed. Should this not be the case, you can arrange a courier for the next day on https://test-kit-collection.test-for-coronavirus.service.gov.uk/ and if required, you are able to call 119 to book a same day courier.

Please remember that no personally identifiable information should be included with the PCR test kit. All we need to process the test is the barcode on the test kit.

As a reminder, used LFT kits do not have to be sent to labs and should instead be disposed of in health care waste bins.

Ordering Test Kits

The Department of Health and Social Care has said that it will continue to send care homes more Polymerase Chain Reaction (PCR) and Lateral Flow Device Test (LFT) test kits than necessary to carry out the recommended weekly testing for both staff and residents. This means you should have spare LFT and PCR kits that you can use in case of an outbreak.  It will also will continue to monitor kit levels as the current lockdown restrictions evolve to ensure you continue to have enough test kits to meet your testing needs.

If you are in an outbreak and do not have enough stock to last until your next routine order, you can place an additional order via 119. You should receive these kits within 48 hours.

If you are not in outbreak you can place an order via the ordering portal, gov.uk/coronavirus, in line with your normal 21-day reordering cycle. After 21 days, automatic emails will remind you that your home is eligible to place an order.  You should make sure to re-order before running low – you can reorder every 3 weeks.  Please note that you will need your organisations Unique Organisation Number (UON) in order to place an order.

New return boxes to help improve the test kit tracking process for organisations

To improve the testing process and save you time, the Department of Health and Social Care (DHSC) has introduced a new outer return box for sending individual test samples and a new record keeping spreadsheet for multiple registration.

To enable this, the new outer return boxes will have a barcode attached, which will be used to link the test kit samples to the outer return box so that the samples can be tracked throughout the testing process.

There will be some minimal changes to the single registration journey so you can link each test kit to the outer return box, and a new record keeping spreadsheet is also being introduced for those of you using the multiple registration feature to register more than one test kit at a time.

The DHSC has also improved the packaging of test kits: Test kits will be delivered in clear plastic bags rather than the grey bags, and you will no longer need to return test kits in the small individual UN3373 boxes – simply put them all in the new larger UN3373 return box. The bundles of outer return boxes and test kits will now be delivered in one box rather than separately.

The outer return box replaces the need to put the samples in the smaller individual test kit boxes. These individual test kit boxes can be recycled via your standard recycling route

What will you need to do as a result of of this change

Please note that from Friday 26th February, if you want to register multiple kits at once, you will have to use this spreadsheet (Department for Health and Social Care, updated 13/05/2021) to register your kits – previous versions of this spreadsheet will no longer work from this date.

What you will need to do once the new outer return boxes are delivered

When registering each test kit, you will need to link the test sample/s to the outer return box via the registration portal and place test samples directly into the outer return boxes. There will no longer be the individual test sample boxes. For multiple registrations, you can start to populate the new record keeping spreadsheet using the link outlined above. This contains an additional column to add the outer return box barcode.

Please write the number of test samples contained in the outer return box on the outside. The box will then be ready for collection by the courier who will scan the box and deliver to the lab.

The DHSC believes that this new process will:

  • Save time as you don’t have to make up smaller boxes for returning individual test kits, test kits can be placed directly in to the outer return box in sample bag
  • Help the Test & Trace programme track your samples from when they are collected and leave your premises
  • Help the Test & Trace programme better manage test kit volumes across the network of laboratories
  • Reduce cardboard waste
  • Reduce the number of missing tests

FAQs around New Return Boxes:

Q:  Will I be getting new PCR kits?
A: No – you are using the exact same PCR test kit, it will just be delivered and returned in improved packaging to improve the user experience

Q:  What happens if my new outer return boxes haven’t arrived by 26th February, or if I don’t have enough?
A: You can continue to use any existing return boxes that you have, if your new return boxes have not arrived – the courier will still collect them. If you are using the bulk registration spreadsheet you can leave the return box column blank.

Q:  Does the barcode on the outer return box replace the individual test barcode?
A: No, this is an additional barcode so both need to be registered if you are using the outer return box.

Q:  I don’t think I have enough outer return boxes to return the test kit samples, what should I do?
A: If you do not think you have enough outer return boxes, you can ring 119 who will be able start the process for an order of additional outer return boxes to be placed on your behalf.

Next Steps

Staff and residents must continue to follow the usual testing regime.  You should have received 8 new outer return boxes. You will also be sent additional boxes with your kits when you place your next standard order. The number of boxes will be calculated based off the size of your kit order, to ensure you will have enough.   If you have not received your supply of outer return boxes by 8th March please call 119.

The DHSC have updated the user agnostic instructions which shows you the full process of packing test samples into the outer return box. This is also complemented by a short training video that you can find at: https://youtu.be/IVOpW3cRJ6U

You will find more information about the outer return box changes in the updated testing guidance on Page 24.

If you are having issues with the single or multiple registration journeys, please call 119.

Labelling of tests for staff

We have received feedback that sometimes it can be unclear which setting a test relates to where the information completed only shows the care provider name rather than care setting.  Please could you there ensure that you complete as much detail as possible (setting name(s) and postcodes) as well as the name of care provider associated with it.  This will enable the location that the staff member is working at to be more quickly identified.

Simplification of the registration journey

From Thursday 11th March the single registration journey has been be simplified. The DHSC has combined some screens to remove unnecessary steps, which will save you time and make the registration process easier. The updated screens are as follows:

  1. Personal details
  2. Where to send the results
  3. Address
  4. Work details
  5. Check answers submitted

Further to this, the DHSC have updated the mobile number entry option in the second screen; ‘Where to send the results’. You will now have the option to confirm your mobile number, ensuring that it is entered correctly and results are received safely.

Priority Post Boxes

If an individual tests positive with an LFT, they will need to take a confirmatory PCR test. Your home has been provided with additional PCR tests for this purpose, which come with Royal Mail return labels. You can affix these to the confirmatory PCR test kit and post them via your nearest priority post box. You can find your nearest priority post box at:

https://www.royalmail.com/priority-postboxes

Please make sure the label is affixed to the test kit box before posting.

If you cannot post the confirmatory PCR test kit for whatever reason, the care home manager can ring 119 to book a same day courier to collect the test kit from the care home – however, we would encourage you to post the test kit if at all possible to avoid needing a courier for only one test kit. The turnaround time for results for test kits returned via Royal Mail are in line with those returned via courier.

Your regular PCR staff and resident test kits still need to be returned via courier. We do not provide Royal Mail return labels for regular PCR tests and a test kit cannot be posted without a Royal Mail return label.

If you already have a courier booked for your regular PCR testing, and you complete a confirmatory PCR kit at the home on the same day, you can include the confirmatory PCR kit along with the regular PCR kits.

Wording of results

The testing programme no longer uses wording for ‘void’ or ‘inconclusive’ results. This has been replaced with the wording below:

We could not read your coronavirus test sample. This means it’s not possible to say if you had the virus when the test was done.
We’re sorry, but you’ll need to get another test as soon as possible.
Keep self-isolating (and stay off work if relevant) if:

  • You have or develop symptoms of coronavirus
  • Someone you live with has symptoms or tests positive
    You’ve been traced as a contact of someone who tested positive

Registering LFT test results

All lateral flow device tests must be registered (whether positive, indeterminate/void, or negative) as a legal requirement at:  https://www.gov.uk/report-covid19-result

Understanding results, and the prevalence rate is crucial for public health teams to understand the prevalence of coronavirus in care homes across the country and be able to support the care sector appropriately. It is therefore very important that care homes have made the necessary arrangements with staff self-testing at home to ensure that all results from lateral flow device tests are registered online, and the DHSC has informed us that it will be monitoring compliance.

Registration should be done within 24hrs to ensure that results can assist NHS Test and Trace in understanding transmission and prevalence.

Please note that LFT tests should not be returned with a courier under any circumstances – returning LFT tests can affect the safety of laboratory staff and result in a temporary closure of the lab. Used LFT tests must be disposed of in your healthcare waste.

User account function for LFT registration

The Department of Health and Social Care has been working to improve the LFT registration process to make it simpler and less time consuming.  It has been looking to remove the need to navigate through a number of screens capturing personal details every time you complete the registration of your LFT result.

As a result of this the ability to create a user account when self-registering your LFT is now live, please follow the guidance on page 16 of the your step-by-step guide for COVID-19 self-testing: Lateral Flow Device Test Kits self-test guidance (UK Government, updated 22/04/2021) to set your account up.

Please note you will need to enter all your personal details when creating the account. You will be required to input an email address and phone number, as part of the account creation and verification process, so please make sure you have access to an email address and phone.

Once you have created your account, the amount of time taken to register your LFT result will decrease significantly, as your personal details will be saved.   If you do not want to create an account, the single registration process will still available.

Changes to the online registration portal which took effect from 25th February

Test kits with barcodes prefixed with SAT can only be registered up until 24th February 2021. After this date these test kits cannot be used and registered.

Organisations are asked to check their stock of test kits as barcodes with the prefix SAT will not be accepted after 24th February 2021

Organisations that only have test kits with the prefix SAT should please order more test kits via the link below:

https://request-testing.test-for-coronavirus.service.gov.uk/

Testing training

Whole home testing webinar

The Department of Health and Social Care has set up regular care home testing webinars. The webinars will last 90mins and give detailed information about all aspects of care home testing, including: registering to receive tests, preparing for testing, test kit delivery, the testing process itself, testing certain care groups, registering test kits, booking your collection, and results and what they mean for you home

The session will include a Q&A with representatives from the national care home testing team, who will be able to answer your questions and address any concerns in the session.

Use this link to sign up to attend the webinars.  If you are not able to attend the webinars please sign up and a recording of the session will be made available to you after the session

The government has published a set of Frequently Asked Questions (FAQs) that have been asked at webinars.

LFT Testing Training

All care home staff members that are using LFT tests must have completed the training on the NHS Test and Trace online training portal. The training videos last about 15 minutes followed by a competency assessment.

Link: https://go.tessello.co.uk/TestDeviceTraining/

Token: 3wkcVi4UTX

Any care home staff member who has not yet completed the training can use the above link to create an account, access the training videos, and complete the competency assessment. Once the training is complete, screengrabs of the competency assessment can be sent to the care home manager to be stored for internal records.

Please note, the registration process on the training portal is different to the one described above. You must follow the registration process highlighted in the section above (please see pages 16 to 19 in the self-test guidance for further detail on the registration process).

It is critical that your care home staff member does not begin LFT testing until they have completed the assessment.

Lateral Flow Device Tests (LFTs) approval for self-test granted

Approval has now been received care home staff in England to conduct self-test LFTs. This means your staff are now able to take and register their twice weekly LFT tests at home, before they arrive at the care home to start work.  This only applies to care home staff and not to other settings in adult social care at this time.

The Department of Health and Social Care (DHSC) has said that it is are working with care homes to ensure they have enough LFT kits to enable the provision of a box of 25 LFT tests to care home staff. These are the same LFT kits that care homes have been using previously.

If you have enough LFT tests to be able to provide each care home staff member with a box of 25 LFT tests, please feel free to start this process. If you do not have enough kits, please do not ring 119, as the DHSC will launch the online replenishment portal w/c 1st February, which will allow you to place an order for LFTs.

The online replenishment portal is very similar to the current process you follow for ordering the standard Polymerase chain reaction (PCR) test kits that are used for regular staff and resident testing. The only difference being that from this portal you will select LFT test kits, rather than your standard PCR test kit order. You should continue to order regular PCR kits for staff and residents as per usual.

Once you have placed an order, your delivery will provide you with enough LFT test kits for you to provide each staff member with one box of 25 test kits, which should last them 1 month of testing. Within this order you will also be provided with a confirmatory PCR, for each staff member, which will be part of the replenishment package, and is used should an individual receives a positive LFT.

Please only place an order if you require a replenishment of LFT test kits. There is no obligation to place an order if you have enough LFT test kits already in your home.

As a reminder, these LFT test kits are a new technology which provide a rapid Covid-19 test result in 30 minutes and do not require a lab to process. These should be used in addition to regular PCR testing.

Self-test Guidance

Please share the published your step-by-step guide for COVID-19 self-testing: Lateral Flow Device Test Kits self-test guidance (HM Government, updated 22/04/2021) to all your staff members who will be testing at home. It is the care home manager’s responsibility to maintain records of the kits that are distributed, including the LOT number, which can be located on the box of 25 LFT tests.

Can I share test kits with another provider, friends or family

  • Test kits for a setting must not be shared with anyone outside of the setting
  • Sharing test kits may lead to issues with test kit registration, courier collection and also contact tracing
  • If you have any spare test kits, they should be stored between 5 and 22 degrees Celsius until their expiry date, which is displayed on the swabs
  • Anyone that is symptomatic can get a test here: https://www.gov.uk/get-coronavirus-test

Safety notice: Checking the barcodes on your test kits

The Department of Health and social Care have informed us that  they have received a small number of reports that the four barcodes in some test kits have not matched.

It is critical that all barcodes in each test kit match, so that registration data and results are correctly associated with the right person.

When using your test kits, please check that all four barcodes (found on the vial, the bag, the box and the loose barcode for your records) are identical.

If they do not match, please do not use the test kit and contact the Test and Trace contact centre on 119 to inform them of the issue and request replacement kits.

Domiciliary Care Services (updated 23/04/2021)

Please click to expand to view information specific to domiciliary care services

The Department of Health and Social Care (DHSC) has updated its guidance a testing service for homecare workers in England (Department of Health and Social Care, 22/04/2021)

About the service

The service involves:

  • weekly testing of all homecare workers in adult social care using polymerase chain reaction (PCR) test kits. This includes all carers in domiciliary care organisations
  • agency managers should order tests every 28 days for their homecare workers
  • 4 tests are delivered for each homecare worker to the agency, for a 28-day testing cycle
  • each homecare worker should be given 4 test kits every 28 days
  • every 7 days a care worker should take a test, register it online, and return it by post between Thursday and Sunday
  • homecare workers will receive their results in 2 to 4 days by email and text message (SMS)

Why testing is important

Testing:

  • identifies homecare workers who currently have COVID-19 so they are able to self-isolate if positive
  • protects those receiving care from infection passed to them by homecare workers who are confirmed positive
  • prevents and controls the spread of the virus by identifying asymptomatic cases

Eligible organisations

Your organisation is eligible if you are a Care Quality Commission (CQC)-regulated homecare organisation in England providing personal care.

This is defined in the CQC data as locations with the primary inspection category ‘Community based adult social care services’ and providing the service type ‘Domiciliary care service’.

If you believe you match this criterion and have not been contacted by NHS Test and Trace with information on ordering test kits, please call 119.

Ordering Test Kits

The agency manager is responsible for ordering test kits for the homecare workers in the team.

Each agency manager must register for test kits.

In order to apply, you will need:

  • your Unique Organisation Number (UON)
  • total number of homecare workers for testing

When ordering you will be asked to enter the number of residents or non-staff. You should enter zero for this.

Once you have placed an order, you will receive a confirmatory email from organisation.coronavirus.testing@notifications.service.gov.uk.

The agency manager will receive an email from organisation.coronavirus.testing@notifications.service.gov.uk when their test kits have been dispatched, informing them of their delivery date.

Test kits will be delivered in boxes of 40 to the address of your homecare agency, as registered with CQC.

The agency manager is responsible for taking delivery of the test kits.

The agency manager must then order kits every 28 days for their homecare workers.

If you have any issues ordering test kits, please call 119.

Webinars 

For more information you can join live webinars, which will be hosted every week by the DHSC.

These live webinars will talk you through the end-to-end process for homecare worker testing and include a live Q&A with the homecare testing team, who will be happy to answer your questions.

Sign up for the webinars

Lateral Flow Device Testing for domically care staff

We acknowledge that currently the national focus on testing with domiciliary care is weekly testing with PCR, in line with the guidance above.  Providers have though raised concerns with regards the lack of parity with care homes, where additional testing is available with Lateral Flow Device Testing (LFTs). 

LFT testing kits can be ordered and utilised by individual staff, although we appreciate this requires staff compliance and agreement to manage this independently. 

How to get a lateral flow test:  Coronavirus – Get a test if you do not have symptoms (somerset.gov.uk)

Everyone in England who is not currently displaying symptoms of COVID-19 infection, can access free lateral flow tests to enable them to test twice weekly.

There are several routes available to receive twice weekly testing:

Extra Care Housing and Supported Living Services (updated 30/04/2021)

Please click to expand to view information specific to Extra Care Housing and Supported Living Services

The government has published guidance on regular retesting for extra care and supported living settings that meet the eligibility criteria (Department of Health and Social Care, 22/04/2021).

From the 09/12/2020 eligible Extra Care and Supported Living settings will be able to place orders to regularly test their residents and staff.

The Department of Health and Care (DHSC) has rolled out regular testing for staff and residents to extra care and supported living settings that meet the following criteria:​

  • a closed community with substantial facilities shared between multiple people, and ​
  • where most residents receive the kind of personal care that is CQC regulated (rather than help with cooking, cleaning and shopping)

Eligible Extra Care and Supported Living settings in England should conduct regular testing over a period of 4 weeks.

Staff should be tested on a weekly basis and residents should be tested every 28 days. Orders should be placed every 28 days.

Ordering Test Kits

Test kits should be ordered via the online portal: gov.uk/coronavirusLines are open from 7am – 11pm daily.  Please note that you will need your organisations Unique Organisation Number (UON) in order to place an order.

Please be aware that you will not be able to place another order until 21 days have passed from when your order was processed. The online replenishment portal will highlight the date that you can place your next order.

Webinars

The DHSC would like to invite providers to regular Extra Care and Supported Living testing webinars and are strongly encouraging providers and those involved in the testing process join the webinar.

The webinars will last 1 hour and give detailed information about all aspects of testing, including:

  • Ordering tests
  • Preparing for testing
  • Test kit delivery
  • The testing process itself
  • Registering completed test kits
  • How to send test kits back to our labs
  • Results and what they mean for your organisation.

The content of the webinars will largely be the same for each session, however will include key updates on testing so is subject to change.

The session will include a Q&A with representatives from the testing team, who will be able to answer your questions and address any concerns in the session.

Use this link to sign up to attend an Extra Care and Supported Living testing webinars.  If you are not able to attend the webinars, a recording of the session will be made available to you after the webinar has been completed using the same link.

Can settings share test kits with another provider, friends or family

  • Test kits for a setting must not be shared with anyone outside of the setting
  • Sharing test kits may lead to issues with test kit registration, courier collection and also contact tracing
  • If you have any spare test kits, they should be stored between 5 and 22 degrees Celsius until their expiry date, which is displayed on the swabs
  • Anyone that is symptomatic can get a test here: https://www.gov.uk/get-coronavirus-test

How can settings store spare tests?

  • The DHSC will send test kits in batches of 40 to Extra Care and Supported Living settings, so we appreciate that you may have a few spare
  • Test kits must be stored at an ambient temperature of between 5 and 22 degrees Celsius
  • You can store spare kits for future use if you have received a result that states ‘we could not read your sample’, or if you are directed to use your kits in the case of an outbreak

Can settings test throughout the whole week?

  • Yes, eligible settings can conduct testing throughout the whole week
  • Testing can be spread out throughout the week, settings do not have to test everyone on one day
  • If you are using the courier return method for 9 or more test kits, you can test throughout the whole week, including on weekends. You can book a courier at https://test-kit-collection.test-for-coronavirus.service.gov.uk/   
  • If you are using the post-box return method for 8 test kits or less, you should not test on Sunday unless the post box has a Sunday collection time. Please join our webinars for more information

Rapid Lateral Flow Testing available to support visits in and out of settings

The Department of Health and social Care (DHSC) has announce that visits in and out of extra care and supported living settings can now be supported by rapid lateral flow testing.

Testing is one tool that can be used to help mitigate the risks to identify asymptomatic visitors who are likely to be infectious before they visit so they are able to self-isolate immediately.

For full guidance on visits in and out, please use the following link:  https://www.gov.uk/government/publications/supported-living-services-during-coronavirus-covid-19/covid-19-guidance-for-supported-living (Department of Health and Social Care and Public Health England, updated 22/04/2021)

For the on-site testing rapid lateral flow test guidance, please use the following link:  https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-in-adult-social-care-settings (Department of Health and Social Care, updated 28/04/2021)

Key messages from the DHSC for Extra Care and supported Living services
  • Extra care and supported living settings will be able to access rapid Lateral Flow Tests (LFTs) to support safer visits
  • Managers can place an order for tests using their Unique Organisation Number (UON) from the standard test kit ordering portal
  • Each setting will receive four test kits per person living in the setting per week which can be used to support both visits in and visits out
  • Setting managers may decide to use some of their additional rapid lateral flow testing allocation for testing of the person being supported to support safer visits at their discretion and with the consent of the person being supported
  • All testing for visitors and people receiving visits should be conducted on site assisted by trained staff. Test kits must not be given out for self-testing.
  • Testing and PPE should be viewed as a tool to mitigate risk, rather than a requirement for people to visit settings or receive visitors. Managers may wish to provide visitors with appropriate PPE where visiting is judged to be high-risk and the PPE can be tolerated by both the visitor and the person being visited
  • In the event of an outbreak, managers should take advice from the local health protection team who will undertake a risk assessment and determine subsequent next steps. Your HPT might recommend some visiting restrictions, these should continue until such time as it is understood that the outbreak has been brought under control
DHSC tips to prepare for visitation:
  • Communicate testing offering and expectations to the people living in these settings, families and visitors
  • Prepare staff for visitation, including appropriate training and reading the guidance for rapid lateral flow testing in adult social care settings
  • Have devices available if visitors require assistance registering their result
Visitor testing is a tool to help mitigate the risks of visiting

Testing is not a requirement for visiting and managers should not refuse visits to visitors who have not taken a test unless they are symptomatic or should be self-isolating for another reason (e.g. if they are a contact of someone who has tested positive).  The DHSC recommend visitors participate in on the door testing to reduce risk of introduction of infection through asymptomatically infected people, in particular for higher risk settings with shared living accommodation spaces which have more potential for outbreaks.

Registering LFT results

All LFT results (negative, positive, or void) must be registered online and this can either be done by the visitor themselves or a staff member.
You should register all LFT results at:  https://www.gov.uk/report-covid19-result

Registration should be done within 24hrs to help NHS Test and Trace understand results. This is crucial for the DHSC to understand the prevalence of coronavirus in care homes across the country and be able to support the care sector appropriately. It is therefore especially important that you have made the necessary arrangements to make sure that all LFT results are registered online.

Day Services (updated 30/04/2021)

Please click to expand to view information specific to day services

Summary

NHS Test and Trace is now offering weekly Polymerase Chain Reaction (PCR) home testing to adult day care centre workers in England in an effort to reduce infection risk in adult day care centres that are currently open for essential activities and to identify any positive cases in these settings as early as possible.

COVID-19 testing for adult day care centres guidance for day services on how to access testing has been published by the Social Care Institute for Excellence (SCIE).  This guidance also includes information about an Adult Day Care Centres Testing Webinar – Please use this link to sign up to attend.

The link for day care centres to sign-up on the self-referral portal is https://request-onboarding.test-for-coronavirus.service.gov.uk/. Day Centres should sign-up using the referral UON 99915258 and select that they are an “adult day care centre”. Once reviewed and accepted they will then receive an email containing their own specific UON to order test kits.

Further Information

PCR staff testing

Weekly routine staff PCR testing is currently available for all adult day care centres that are run by paid day care staff and deemed critical to be open during lockdown by Local Authorities. Services must be for adults over 18 and provided within non-residential care settings that support the health and wellbeing of adults. This includes settings such as:

  • purpose-built day centres
  • day centres attached to or part of a care home or supported living
  • other buildings in communities specifically used for regular adult day care

Full information can be found here: https://www.gov.uk/government/publications/coronavirus-covid-19-testing-for-adult-day-care-centre-workers (Department of Health and Social Care, updated 30/04/2021)

How can adult day care centres get access to testing via the self-referral portal?
  • Day care centre managers that meet the eligibility criteria set out above can navigate to https://request-onboarding.test-for-coronavirus.service.gov.uk/
  • Managers will need to enter the referral UON of ‘99915258’ and provide details of their adult day care centre. Please note, this is only a referral code and cannot be used to order test kits. Centres will receive a separate UON via email once they have been accepted for them to be able to order test kits.
  • Organisations which run multiple day care centres at various locations will need to register each centre separately to receive multiple UONs, even if the contact details for each of these are the same.
  • Once they have received an acceptance from the Local Authority, NHS Test & Trace will email day care centre managers with their UON and instructions to place orders from the test kit ordering portal
Rapid Lateral Flow Testing is now available for all staff and service users in adult day care centres in England

After the completion of a successful pilot study, NHS Test and Trace is making regular lateral flow (LFT) testing available to all staff and service users in adult day care centres in England, to be conducted alongside the existing weekly staff Polymerase Chain Reaction (PCR) testing.

In addition to the current regular PCR testing regime, the new guidance advises all staff to:

Undertake an additional two rapid lateral flow tests per week, ideally before they begin their shift:

  • One rapid LFT should be completed on the same day as the PCR test;
  • One rapid LFT test should be taken 3-4 days later.

If any member of staff tests positive with a rapid LFT, they must take a confirmatory PCR test and self-isolate at home immediately until they receive their result.

Staff members may self-test or test with the assistance of another adult.

The guidance is clear that service users attending a centre does not depend on them taking a test, however, we advise service users who are able to test to:

  • Test twice a week, with 3-4 days in between using rapid LFT.  If a service user is only visiting once or twice per week, they only need to test on the day of their visits.
  • Service users should ideally test before attending the centre if travelling by shared or public transport.

Testing can be completed either at the day care centre, or at home by themselves or with the support of a parent or carer. This is at the discretion of the day care centre.

The Department of Health and Social Care (DHSC) understands that not all service users will be able to test, and testing should not be considered mandatory for entry into the day care centre. Service users can still visit the centre if they have not tested. However, if a service user tests positive, they should self-isolate immediately, take a confirmatory PCR test and not attend the day care centre.

Please use the following link to order rapid LFT kits using the same Unique Organisation Number (UON) that you use to order PCR tests:  https://request-testing.test-for-coronavirus.service.gov.uk/

Tests can be ordered immediately. Please be aware, similar to when you place an order for a PCR test, you will not be able to place another rapid LFT order until 21 days have passed from when your order was processed. The online replenishment portal will highlight the date that you can place your next rapid LFT order.

For further support and information, please attend one of the DHSC’s rapid lateral flow testing webinars at 11:00am on Tuesday 4th May and then recurring weekly on Mondays (see below).  We strongly encourage providers and those involved in the testing process to join the webinar, which can also be attended by service users and carers/parents.

Sign-up to regular adult day care centre testing webinars

The Department of Health and Social Care hosts regular interactive testing webinars every Monday, including a live Q&A, to go through test kit ordering, conducting testing, registering, returning test kits and results.  If centres are not able to attend the webinar, they are able to sign up and a recording of the session will be made available after the session.

Sign up for the webinars

Personal Assistants (28/04/2021)

Please click to expand to view information specific to domiciliary care services

Personal Assistants (PAs) in England are entitled to regular weekly PCR testing, from 17/02/2021.  This applies to all PAs in England who provide care and support to individuals in their own homes, where they come within 2m of the person they care for.

This is in addition to the existing support available to PAs to keep themselves and those they provide care and support to as safe as possible.

This includes guidance on Infection Prevention and Control (IPC) measures and the availability of free PPE in government guidance on using direct payments during the coronavirus outbreak: full guidance for people receiving direct payments and personal assistants (Department of Heath and Social Care, updated 27/04/2021)

PA’s will be able to order a month’s supply of test PCR kits every 28 days, delivered to their home address, enabling them to conduct weekly coronavirus testing at home.

This is part of the Department of Health and Social Care (DHSC) commitment to protect frontline workers, their loved ones and the people they care for and reduce the spread of coronavirus.

Further guidance about how PAs can order tests, how to conduct testing and what the results mean is available in government guidance on Coronavirus (COVID-19) testing for personal assistants (Department of Health and social Care, updated 22/04/2021).  A Guidance document and  summary has also been produced, along with a User Guide and FAQs.  The DHSC are also running a Personal Assistant testing webinar on Wednesday 14/04/2021 at 10:00.  Please use this link to sign up to attend the webinar.

Please note that this testing programme is only for directly employed or self-employed carers who support people in their own homes.

If you are already part of a regular national testing programme through your employer or another organisation (e.g. through the homecare, or extra care and supported living testing programme), please continue.

The collection of completed tests should be booked using the following link: https://test-kit-collection.test-for-coronavirus.service.gov.uk/

The courier booking portal has been updated to improve the service. This update introduces three new changes:

  • There will be a new afternoon slot between 2:00pm – 4:00pm
  • At the moment, your organisation is designated a single slot.  However, now, you can book any collection window that best suits your organisation. The collection windows are:
    • Morning (9:00am – 1:00pm)
    • Afternoon (2:00pm – 4:00pm)
    • Evening (6:00pm – 9:00pm) (this slot for specialist Ministry of Justice locations only, please do not use it if it is displayed)
  • Please note that you can only book one slot a day.
  • There is now a regional cap for each collection window each day.  Once these are full the option will no longer be shown to your organisation. However, you can book a slot 28 days in advance, so please book a slot in advance to avoid being capped.
General guidance
  • This service enables you to arrange a courier to collect your COVID-19 testing kits, which will be taken to the lab for processing.
  • This is the only way that care homes can send test kits to the labs
  • This service is for the collection of used kits only, and not for the ordering of new testing kits.
  • You will be asked to provide your care home ID or equivalent unique identifier to access this service.
  • When arranging your courier you will be asked to predict the number of kits you expect to send back.  You will not be able to change it after submitting, but please do not worry if you end up testing a different number – it is only there to help plan volumes and does not need to be exact.
  • You can now make courier booking 28 days in advance, but it must still be booked by 7pm on the day before testing. Couriers are available seven days a week.
  • Please do not start testing until you have completed your courier booking.
  • If you require support with your courier booking, please contact the customer care team via COVIDCareHomeTesting@dhsc.gov.uk.

Please contact the Test and Trace contact centre on 119 the following morning if your courier has not arrived, and they will book you an urgent replacement courier. 119 opens at 7am every day.

Missed collections

If you are noticing that pre-booked couriers are regularly not turning up to collect your PCR tests, there may be some confusion as to where the driver should go to collect your kits.

To help avoid this issue for your care home, please help us to understand how to access your care home.

When booking a courier, there is a section to add any notes that might help couriers find your care home – please populate this notes section if possible.

This may include:

  • Specific directions to the home
  • Which door to collect the kits from (if not labelled)
  • If your care home is near to another care home or other facility, you can specify which is which Day Centre Testing:  How can adult day care centres get access to testing via the self-referral portal?

Symptomatic Residents:

  • If you have a symptomatic residents (new continuous cough and/or a high temperature and/or a loss of, or change to, the sense of smell or taste) or receive a positive test result from whole home testing please ensure you inform Public Health England via swhpt@phe.gov.uk as COVID-19 is a notifiable disease.
  • Infection prevention and control advice will be given, and PPE provision checked.
  • Please remember to notify Somerset County Council Public Health via swhpt@phe.gov.uk again should the situation escalate, as shown in the flowchart below.

Swabbing:

Mental Capacity guidance:

Local Information

Please follow the flowchart below (updated 23/04/2021) if you have identified possible or confirmed case(s) of COVID-19:

 

A pdf version of the flowchart (updated 23/04/2021) with links is available here

Care Homes

These are sometimes called rapid tests as they produce results very quickly, within 30 minutes. You will receive these tests in addition to the  tests that the Department of Health and Social Care (DHSC) already send you for weekly staff and monthly resident testing.

The LFT test kits will be used for scheduled visitor testing.  The DHSC will send further information as soon with details of when your LFT test kits will arrive, and guidance on how many you will get, how to use them, how you can order more, and what support available.

The DHSC is providing a webinar on LFT test kits.  Please sign-up to it to find out more: https://event.webcasts.com/starthere.jsp?ei=1408929&tp_key=d2a77c17e3

Guidance

Every day, many care home residents across the country require essential care from healthcare professionals, who visit care homes to provide this care.

To minimise risks, all NHS community based front line staff have access to twice weekly lateral flow device testing through the NHS.

To help keep staff and residents in your care home safe, you may request evidence of this test from any NHS front line staff visiting your care home, and we have therefore asked that staff take a photo of the test result so it can be presented.  It is vital that appropriate face to face assessments continue and that you allow appropriate access to the home for professional staff.  We do appreciate the nervousness regarding increased visitation, but do need to ensure that appropriate assessment and intervention is provided.  If the staff member has proof of test results, it is not necessary to retest them on arrival.

If they are unable to provide evidence, or if they are not employed by the NHS you should follow the guidance below request that they conduct a Lateral Flow Device Test (LFT) using your care home supply before admitting:

  • The default position is that without a negative test, the professional should not be allowed into the care home, (unless in an emergency, unless overridden by the care home manager following a risk based decision, or unless their entry is required by law such as CQC inspectors).
  • For NHS professionals, care homes should see evidence from the professional of a negative LFT within the last 72hrs, which shows they are following the NHS staff testing regime.
  • Professionals who are not part of regular testing for NHS staff or CQC inspectors (for example professionals such as podiatrists or engineers) will need to be tested at the care home in the same way as visitors.
  • If they are visiting multiple care homes in one day, these professionals will only need to be tested at the first care home they visit that day and can use evidence of this test at the next care home they visit that day.
  • CQC inspectors will now test at home using a LFT on the day of a care home inspection, in addition to their weekly PCR.
  • Like care home staff, visiting professionals are exempt from testing for 90 days following a positive PCR test, unless they develop new symptoms.
Guidance:

We have seen a small number of cases where care home staff have continued to work whilst symptomatic and this has in turn created an outbreak within the care home environment.  It is really important that all providers ensure that they have processes in place to ensure that staff do not work whilst they are experiencing any symptoms that may indicate Covid-19.  Some staff may have financial concerns, others may be acutely aware of the pressure on colleagues and believe continuing to work is in their best interests.  Clearly this needs to be addressed and we would ask all providers to please ensure that they provide staff with reassurance that Infection Control Grant monies are available to ensure staff continue to be paid whilst isolating, and that continuing to work when experiencing symptoms can lead to a significant outbreak and potentially far greater risk to residents and colleagues.

Any staff member who receives a positive test result (via a LFT or a PCR) or who displays symptoms should not be in work and must isolate at home, without exception – they cannot continue to work in any capacity, even with adults who have tested positive for COVID-19, or have been vaccinated.

If you have COVID-19 symptoms or have received a positive test result

Stay at home and begin to self-isolate for 10 days from when your symptoms start. Arrange to have a test for COVID-19 if you have not already had one. The result of the test will determine how long you must stay at home and self-isolate.

Stay at home while you are waiting to be tested or are waiting for test results.

A positive test result means you must complete a 10-day isolation period.  If your test is negative, you can stop self-isolating as long as you are well.

If you do not have symptoms, but have tested positive for COVID-19, stay at home and self-isolate for 10 days from the day the test was taken.  If you develop symptoms after your test, restart your 10-day isolation period from the day the symptoms start.

Stay as far away from other members of your household as possible, especially if they are clinically extremely vulnerable. Avoid using shared spaces such as kitchens and other living areas while others are present and take your meals back to your room to eat.

This image describes a typical coronavirus incubation timeline

 

If you live in the same household as someone with COVID-19

Stay at home for 10 full days. The 10-day period starts from the day the first person in your house developed symptoms or, if they do not have symptoms, from the day their test was taken.

If you do not have symptoms of COVID-19 yourself you do not need a test. Only arrange a test if you develop COVID-19 symptoms.

If you develop symptoms and your test result is positive, follow the same advice for people with COVID-19 to stay at home and self-isolate for 10 days from when your symptoms started, regardless of where you are in your 10-day period.  This means that your total isolation period will be longer than 10 days.  If you have a negative test result during your 10 day isolation period, you must continue to self-isolate until it has been completed.

This image describes a household self-isolation timeline

We are unfortunately seeing an increased number of outbreaks in Somerset, and whilst this is very difficult for all involved it is vital that we look to identify any learning from these cases to support the wider system. 

We would like to outline some of the points that have been raised during discussions:

  • Care homes should consider what measures they should put in place to mitigate for for a situation where almost the entire staff team has to self-isolate.  For example, how would agency staff or those who normally work in different setting access records, know about each resident’s individual needs, Treatment Escalation Plans, the medication round etc?  Are your care plans in place and easy to follow, would clinicians easily be able to identify what the normal state of each resident is and whether therefore they have deteriorated?  Do you have baseline observations recorded so any drop in oxygen saturations could be identified? 
  • It’s often the simple things that get overlooked.  Cleaning schedules and rosters of cleaning staff, how are these organised, do your cleaning staff all work the same day shifts?  Does this mean cleaning is restricted to the 9-5 and could this be extended to ensure that cleaning is provided throughout the day and into the evening?  Are you using the right cleaning products, preferably chlorine based?  Do your staff share coffee cups?  Do you have a tin of biscuits that they all reach into; by sharing we increase contact between staff and this simple act could help spread the virus.
  • We need to please remind staff that they should not be working when they are unwell, Infection Control Grant monies are available to ensure those who are unwell and isolated are paid.  In addition, we need to remind staff that previous behaviours of coming to work when unwell because of an awareness of the impact of staff shortages and doing what you think is right, is actually a risk to residents and potential a route into the home for the virus.
  • Staff ideally should be cohorted such that they work in teams or bubbles.  For example one staff group per floor in larger homes, or the allocation of cleaning staff to specific areas.
  • Activities outside of the working environment must stop whilst we are in the pandemic, staff meeting and in particular car sharing should not be happening at this time.
  • Staff should come to work and change into uniform once in work, social distancing must be observed in any changing rooms and any towels must not be shared.
  • Staff must be socially distanced and during any breaks, if possible stagger breaks to reduce any transmission risk and ideally any staff areas should be well ventilated.

Information about the government’s coronavirus antibody testing programme (Department of Health and Social Care, updated 24/02/2021)

At-home antibody testing

The Department of Health and Social Care has launched an at-home antibody testing service which is now available to all paid staff in the adult social care sector in England. This at-home antibody testing service is supporting surveillance studies that are helping the government to understand COVID-19 and how it has spread in the adult social care sector.

Two sets of information have been produced, one for staff working in care homes, and one for staff working across the rest of the adult social care sector both of which contain the link to sign up for an at-home antibody test.

Please remember that antibody tests are different to COVID-19 swab tests. Swab tests tell someone if they currently have COVID-19, whereas antibody tests tell someone if they have previously had COVID-19 and have developed antibodies. They do not tell you if someone currently has the virus and swab retesting in care homes must therefore continue to be prioritised as normal.

Regardless of the result of an antibody test, individuals are not immune from infection, and must continue to comply with government guidelines, including wearing PPE and social distancing.

Providers must tell the Care Quality Commission about the death of a person using their service without delay if either of the following has happened:

  • the person died while a regulated activity was being provided;
  • their death may have been a result of the regulated activity or how it was being provided.

For further information and the notification form please visit: Death of a person using the service – notification form (updated 29/04/2021)

Verification of Death, Death Certification and Registration procedures

In addition, where the person who has died had a learning disability a notification must also be completed for the Learning Disability Mortality Review (LeDeR) Programme using the following link:  https://www.bris.ac.uk/sps/leder/notification-system/ 

The Government is asking employers to let the Department of Health and Social Care (DHSC) know if an employee or volunteer in the adult social care sector has died.

Please follow steps to take following the death of a person who worked in adult social care in England (updated by the Department of Health and Social Care on 07/07/2020) where deaths have already occurred, and if there are any further deaths.

Employers are encouraged to tell the family, friends or colleagues of the care worker who has died that they’re submitting this information.

There is no legal duty on employers to submit this information to DHSC, but the Government has said that submitting this information will help to make sure the appropriate steps can be taken following the death of a care worker, including support for employers.

Please see the useful advice and guidance below from the CQC to care homes who are wanting to increase their bed capacity as part of the COVID-19 response.

If providers are making an application to increase their capacity and help meet DHSC or CCG COVID-19 contingency plans, it’s important they tell the CQC in their covering email and clearly mark it ‘COVID- 19 application’.

Further information (updated 15/12/2020).

The Care Quality Commission announced that it would be moving to a Transitional monitoring approach in September 2020.  This focuses on safety, how effectively a service is led and how easily people can access the service. It includes:

  • a strengthened approach to monitoring, based on specific existing key lines of enquiry (KLOEs), so CQC can continually monitor risk in a service
  • using technology and local relationships to have better direct contact with people who are using services, their families and staff in services
  • targeting inspection activity where CQC have concerns

Prior to this CQC had written to all registered health and social care providers about how they are adapting their regulatory approach in response to the coronavirus outbreak.  The letters (dated 16 March 2020) expanded on an update they sent previously on 4 March 2020.  The changes they describe included:

  • stopping routine inspections from 16 March 2020;
  • a shift towards other remote methods to give assurance of safety and quality of care;
  • some inspection activity in a small number of cases (for example, where there are allegations of abuse);
  • giving extra support to registered managers in adult social care.

They clarified further that there are no changes to the requirements to make notifications / or the systems used to make them.

You should continue to notify the CQC of deaths and events stopping them from carrying on their service ‘safely and properly’ (Reg 18) – this will mean letting them know if your service operation is being negatively affected by COVID-19.

It does not mean that you’ll need to notify the CQC of every single COVID-19 related issue. Aside from making notifications in the usual way, you should stay in touch and contact them if there are specific concerns and issues that they need to be aware of.

For further information visit: https://www.cqc.org.uk/news/stories/routine-inspections-suspended-response-coronavirus-outbreak (updated 15/04/2020)

COVID-19 Insight: Issue 9: In this month’s report, we look at the impact of the pandemic on urgent and emergency care services and pharmacy services in NHS trusts.

COVID-19 Insight: Issue 8: In this month’s report, we look at the evidence so far about how urgent and emergency care services have been affected by the pandemic during this winter, and discuss what action CQC is taking to provide constructive support.

COVID-19 Insight: Issue 7: In this month’s report, we share further data on the designated settings scheme for adult social care, and also look into more detail on data on deaths from COVID-19.We want these insight reports to help everyone involved in health and social care to work together to learn from the pandemic.

COVID-19 Insight: Issue 6:  In this month’s report, we share regional data on the designated settings that allow people with a COVID-positive test result to be discharged safely from hospital, and also the latest data on registered care home provision. We also look at how providers have collaborated to provide urgent and emergency care during the pandemic.

COVID-19 Insight: Issue 5:  In this month’s report, we build on the learning about good practice in infection prevention and control that we discussed in the last issue by focusing on care homes. We also present the key findings from a survey to understand the experience of inpatients who were discharged from hospital from April to May 2020, when the first wave of the pandemic was at its height.

COVID-19 Insight: Issue 4:  In this month’s report, we explore some of the learning about good practice in infection prevention and control, and share some of the good examples we have encountered in understanding how providers have worked together to tackle COVID-19.

COVID-19 Insight: Issue 3:  In this month’s report, we explore further the need for providers and other organisations to collaborate to tackle COVID-19. We look at what concerns have prompted us to carry out a number of inspections in recent months, and at the challenges that providers have faced in caring for people detained under the Mental Health Act or subject to a deprivation of liberty.

COVID-19 Insight: Issue 2:  In this report, we explain the information we have gathered on the pressures that services and local systems have faced and the efforts that have been made to tackle them.

COVID-19 Insight: Issue 1: This first insight document focuses on adult social care: reviewing data on outbreaks, deaths and availability of PPE, and in particular highlighting the impact of COVID-19 on staff wellbeing and the financial viability of adult social care services. 

We recognise many provider organisations in Somerset may suffer financial losses as a result of the challenges and consequences of COVID-19.

During COVID Somerset County Council’s Adult Social Care service committed to providing financial support to providers it contracted with, whether they were operational or not, and also provided additional funding to cover shortfalls created by services that had had to close due to COVID-19.

Many services have now resumed operation under the ‘new normal’, and this funding has now ended.  However, we recognise that some people may want or require a change in their support package or additional support, and this should be initiated by contacting Somerset Direct on 0300 123 2224 to request a care review.  We also recognise that some providers may still be experiencing difficulties as a result of the pandemic, and while our position is now that we are unable to offer the same level of support as we did previously (and as a result of this any additional invoices submitted for COVID support are no longer able to be paid), we will work with providers that are experiencing significant financial difficulties who contact ASCCOVID19@somerset.gov.uk to try to support them to find a solution as far as is practicable.

Adult Social Care Fees and Charges 2021-22

The impact of Covid-19 on providers has been profound and at every point they have stepped up and delivered superb care for those we support, amid very trying circumstances.  However, the financial implications will be felt throughout 2021/22, reflecting loss of income; higher running costs and staffing shortages.

To assist in market recovery and to continue in a sustainable way, Somerset County Council will award an additional one off 3% rise to all providers, on top of this years substantive fee increases.  This should allow plans for recovery as well as change, mitigating the impacts of an incredibly tough 12 months.  This covid premium will be paid in advance and as a lump sum at the beginning of the financial year to enable it to support cashflow at a time when it will be most needed.  We recognise that all additional central government grant funding must be spent by the end of March 2021 and this leaves an immediate gap in support.  Should there be any further announcements of central government funding, we reserve the right to be flexible in its usage, given the guarantee we are providing via a local covid premium.

The regular and cumulative fee increase for 2021/22 reflects the areas where costs are higher and the capacity and demand in each sector.  Nursing Care Homes are receiving a slightly higher increase than residential ones due to the nursing shortages and the current rates required for temporary staffing.  Domiciliary care providers are having to spend more time on preparing and travelling to clients due to infection control measures and we have an increasing number of people wishing to be looked after in their own home.  We feel that the rises across the sector, coupled with the one off recovery support, represent a fair reflection of our continued support and partnership with care providers in the County.  They exceed many of the plans of neighbouring authorities and represent a clear signal from Somerset’s Councillors to support Adult Social Care.

This year’s settlement is conditional on a number of key lines of enquiry being jointly worked on during 2021/22. These are:

  • A sustainable solution for client contributions
  • A fee increase/payment mechanism for all areas of provision to avoid future yearly negotiations
  • Modelling different models of care in Domiciliary care and Care Homes
  • Exploring fee levels for multiple occupancy provision (no travel costs etc) – Extra Care Housing, Supported Living

We intend to set up working groups in each of these areas, but they will only work if providers can be active within them and help co-produce solutions for the future.

The headline rate increases are shown in the table below.  Direct Payments and Shared Lives will also benefit from the equivalent annual rise, but not the lump sum covid premium.

 

Permanent % increase

Covid premium

Net 2021/22 Increase

Residential

2.5%

3%

5.5%

Nursing

3%

3%

6%

Domiciliary Care

3.2%

3%

6.2%

Day Care

3%

3%

6%

 

You can read the full decision on the Somerset County Council website:  http://democracy.somerset.gov.uk/ieDecisionDetails.aspx?Id=1796

Other guidance 

We would like to reassure the businesses we work with that we will seek to find flexible solutions to help them continue to deliver services people who use servicers.  Government guidance can be found here (updated 12/01/2021) and the Government has also developed a tool for businesses to find coronavirus financial support (updated 21/01/2021).  It has also published new information about financial support for voluntary, community and social enterprise (VCSE) organisations to respond to coronavirus (Department for Digital, Culture, Media & Sport and Office for Civil Society, updated 22/01/2021).

We are taking the following practical steps to help businesses in need of our assistance:

  1. If a business faces loss of income, we will discuss with them the available options where we continue to pay for the services they are contracted to provide. If we make payments for these services, we will work with these businesses, and where appropriate, look for support to redeploy their resources or personnel to support the Somerset community. We recognise that some businesses may not be able to operate as normal due to workforce or supply issues, and we will work to support them.
  2. We may need to ask businesses to provide additional resources and in some cases businesses may incur additional costs.  Again we will seek to agree a solution which takes account of need and cost in a balanced way.
  3. Payment will be made as promptly as possible.
    – We will look at all payment options on a case by case basis to support business sustainability.
    – We will work flexibly with providers occupying buildings which we own.
  4. We will be directing businesses we work with to the Government’s Covid-19 emergency financial support packages. We would ask you to be patient as these are developing on a daily basis. Any businesses in need of advice and support can visit the Local Growth Hub website at Heart of the South West Growth Hub. If any of our business suppliers are encountering difficulties due to COVID 19 we would encourage them to contact us to discuss how we can best assist you.  If any of our business suppliers are encountering difficulties due to COVID 19 we would encourage them to contact your Contract Manager to discuss how we can best assist you.

You may also find this SCC site helpful as a business in Somerset

Further Government guidance:

As part of the support to our homecare market in-relation to COVID-19, Somerset County Council agreed to support our homecare providers, by funding the level of activity, prior to COVID-19.  As from the 1st of August 2020, and with current homecare demand increasing, Somerset County Council will be returning to paying for deliverables, rather than previous levels of activities. 

The Care Act (2014) states client contributions should be only paid when receiving a service.

This means that if a service has been temporarily closed due to COVID-19 then no client contributions are payable by the person using the service for the duration of the temporary closure.  We appreciate that providers will continue to have costs, and we will work with providers that are experiencing significant financial difficulties who contact ASCCOVID19@somerset.gov.uk to try to support them to find a solution as far as is practicable.

Nationally there have been reports of business being targeted by scams.  With many people now working from home, increased stress, less opportunities to talk to colleagues and a different working environment are all things that criminals are using to their advantage to commit fraud. Employees are having to make decisions on their own without verification from their colleagues, making businesses more susceptible to scams and fraud.

Businesses Against Scams is a national initiative to help all businesses be aware of scams.  Sign-up here access to access a training session that takes around 10 minutes to complete, and which provides information on these frauds, what to look out for and how to prevent your company from falling victim to them.

Devon, Somerset and Torbay Trading Standards have produced an article for you to share with you staff about vaccine related scams.

The Adult Social Care Winter Plan, updated on 14/12/2020, set out the key elements of national support and actions for local authorities, health organisations and providers for this coming winter.  A large part of this support will continue to be based on the information from providers to Capacity Tracker, and it is therefore essential that all providers register to use it and regularly complete it.  

All care homes are reminded of the Government requirement to register on the national Capacity Tracker and update it on a daily basis in order to make vacancy and other critical information available to NHS and social care colleagues in real time 

Please also note that when responding to questions this should always be on the basis of your position since the last time you competed it.  There have been instances of providers responding based on the situation that they were experiencing earlier in the year, which have resulted in concerns being raised about whether current guidance has been followed.

A collaborative staffing solution in Somerset has now been launched with Somerset NHS Foundation Trust, Yeovil District Hospital NHS Foundation Trust and Somerset County Council working in partnership to supply needs-led staffing throughout the county.  The aim is to provide a seamless staffing solution across all health and social care settings, starting with a focus on care settings affected by the COVID-19 outbreak.  

The temporary staffing team at Somerset NHS Foundation Trust will take the lead role in the coordination of this service for care providers.  

In the event that a care provider identifies concerns re: safe staffing levels, that cannot be resolved through implementation of its own existing business continuity plans and arrangements, care providers are now able to then contact the Temporary Staffing Team (by email or phone) and submit a staffing request.  Bank / Agency staff cover will be sought by the team, with the provider invoiced at existing Somerset Foundation Trust rates.  

To access the process, contact details and staffing request form, please visit: Somerset Care Sector Procedures COVID19 Temporary Staffing

In response to your request to be able to manage existing clients as effectively as possible during this Covid-19 period, we have simplified the process of making changes to existing packages of care.

You can now make any necessary changes to your existing clients’ care without needing to contact Adult Social Care for authorisation.

We ask only that you provide us with a weekly update of the changes that you have made for any clients in your care.

As the online form did not work effectively for some care provider colleagues, we have created the following spreadsheet to help you record any changes.

Please update this and submit to the Sourcing Care team on a weekly basis, returning every Friday before 12pm midday.

We really appreciate your co-operation with this, as this will help us keep our records up to date. Please invoice as per normal process; monthly is fine.  If you have any queries, contact the Sourcing Care team on sourcingcareservice@somerset.gov.uk

It is now more important than ever that organisations and agencies within the health and social care system are able to efficiently and securely communicate with each other.

That is why we are asking all care homes in Somerset to obtain and utilise the following approved, free-of-charge, digital tools as soon as possible.

NHSmail

What is NHSmail?

NHSmail offers a recognised secure email system which will allow patient identifiable data to be shared with healthcare services. You will be able to use your NHSmail accounts to communicate securely by email with GPs, pharmacies, the CCG and the Local Authority.

More than half of all care homes in England are now using NHSmail and case studies have shown a range of benefits, such as:

  • Being able to receive referrals and discharge summaries without delays
  • Significant time saved by not having to post/fax and chase information
  • The ability to meet the expectations of partners in relation to secure email
  • More efficient, better informed hospital discharges
  • Reduced risk of important information being lost or unavailable when required

There is also the opportunity for all NHSmail account holiders to have access to Microsoft Teams which offers a video conferencing facility to enable video consultations during periods of social distancing. A series of video conferences will be held over the coming weeks to support social care providers to make use of their new email account and video conferencing facilities.

If you would like to discuss NHSmail or the application process in more detail, please contact Russell Hilton, Somerset CCG Lead Information Governance Officer on 07771 988691.

If you already have NHSmail, you do not need to complete this form, but please be aware that the deadline for your DSPT submission has been pushed back from 31st March to 30th September 2020.

Fast-track Application Process for Care Homes and Domiciliary Care Agencies
It is now more important than ever that organisations and agencies within the health and social care system are able to efficiently and securely communicate with each other.

That is why we are asking all care homes in Somerset to obtain NHSmail, free-of-charge, by completing a quick and easy form.
You may be aware that care providers had previously been required to complete a Data Security & Protection Toolkit (DSPT) submission prior to obtaining NHSmail. This requirement has been temporarily lifted in light of the COVID-19 pandemic and the process for obtaining NHSmail is now very quick and simple.

To obtain NHSmail, just complete this form: Social Care Provider NHSmail Form and email it to russell.hilton1@nhs.net. 

Applications are processed by an automated system and will be rejected/delayed if incorrectly filled out. Therefore, please refer to the How to complete the NHSmail Form guidance notes, when filling out your application.

During the coronavirus outbreak we recognise it is even more important for us all to support each other and offer assistance wherever we can.
The care of the elderly departments across Somerset’s Acute Hospitals are preparing to answer clinical concerns from staff at residential and nursing homes.
This might be for issues such as: a person has fallen over and hit their head; do they need to be seen in the hospital? or a person is becoming more confused than usual and it’s not clear why.
Whilst they might not have all the answers or be able to offer hands-on support, they do have experience in these matters and may be able to provide reassurance or talk through a management plan to support you and GP colleagues.
Homes will be contacted soon via the CCG or Consultant Connect with further information and specifics about routes in to this service.

New e-learning resources have been published by on e-Learning for Healthcare (eL-fH) on Infection Protection and Control support available to the Care Sector. Whilst most are geared towards Care Homes, several have been adapted for use with Home care as well.  The resources include:

  • Social distancing , Hand hygiene , PPE
  • Taking care of residents and yourself 
  • Taking care of the environment
  • Planning ahead 

NHS Health Education England has developed a Covid-19 e-learning programme and the resources are freely available to colleagues working in the NHS, independent sector, and social care.  This includes resources for Health and Care Staff in Care Home Settings.

To access the e-learning programme follow the link, then select “Resources for Volunteers Supporting Health & Social Care”, then “Volunteer Learning Passport” – there are a range of topics, including Safeguarding Adults / Safeguarding Children.

Skills for Care has also identified training that remains a priority during this period to ensure there is a skilled and competent workforce, as well as outlining how to access training locally, and are also funding an essential training programme that includes IPC training that is being delivered virtually by 12 endorsed providers free of charge.  Skills for Care has also issued  guidance for employers, learning providers and in-house trainers on face-to-face training and assessment during COVID-19.

A new dedicated app for the adult social care workforce in England has been launched to support staff through the coronavirus pandemic.  Care workers will get access to guidance, learning resources, discounts and other support in one place.  Support will be offered on mental health and wellbeing through toolkits and other resources.  The app will be available to download on the Apple App Store and Google Play Store, as well as being accessible online at https://workforce.adultsocialcare.uk

The Social Care Institute for Excellence (SCIE) have also developed the following resources including webinars and e-Learning:

Somerset County Council continues to work closely with and supports the RCPA to be the main facilitator to provider discussions. During the Covid-19 pandemic they have played an important role in supporting providers through engaging with the Care Sector cell and other regional networks. They are also the key reference point for fee discussions and the future role of social care providers in Somerset, including new models of care and innovation.

Please find information below from the Registered Care Provider Association (RCPA)

Dear colleague,

We are experiencing the most challenging period of time that the social care sector has ever faced. A combination of underinvestment, significant changes in commissioning and the onset of the pandemic have placed care providers under the most extreme pressure. The impact is being seen among front line staff and the people they care and support, among managers and in the financial health of organisations.  In these challenging times therefore, we would like to invite you to become a member; take part in our work and benefit from being part of something bigger.

As the Somerset-wide care provider association, the RCPA is proud to be taking a central role in supporting our members on a daily basis with the challenges they face, in being able to contribute to the joint planning and management of the crisis and in representing them in ongoing discussions with health and social care commissioners.

This past year we have been pleased to introduce the following services:

  • A comprehensive range of policies and procedures available free of charge to our members
  • Distributing the Workforce Development Fund
  • Holding fortnightly member calls to support you through the pandemic
  • An online member forum

Collective action, a louder voice and mutual support are the strengths of collaboration are the key benefits of being a member of the RCPA.  As a new member in 2021 we would like to offer you a 10% discount of the annual fee and this can either be paid in one lump sum or via monthly direct debit.

Full use these links to see details about our member benefits along with an application form should you wish to join.

If you have any queries or would like to join, please contact Laura Stooke, our Business Manager at laura.stooke@rcpa.org.uk

We look forward to hearing from you,

Simon Blackburn, CEO, RCPA

The Registered Manager Network is organised by the Registered Care Provider Association (RCPA) in Somerset and any enquires about the network should be made to the RCPA.

The last meeting of the network took place virtually on 08/09/2020 and we have been asked to share the following information:

The next meeting will take place virtually on Tuesday 10th November 2020 from 14.00-15.30 and we have been asked to share the following information:

The Somerset Corona Virus Support Helpline – 0300 790 6275 – was launched on 6th April, opening between 8am – 6pm seven days a week including bank holidays. This single helpline across the districts and county will offer support with: Personal Care and support including food and prescriptions, Transport, Housing, Waste, Financial, as well as emotional well being for those who are worried or anxious. 

Skills for Care are able to create a local WhatsApp group for those of you who are keen and who feel this could be a good way of staying in touch and networking with others. The purpose of the group will be to provide a mechanism where you can all communicate with each other over issues affecting you as Registered Managers. You can share ideas, resources and support.

There are a number of ways that you can join this group:

During the COVID-19 outbreak we are, together, facing a loss of life, often under very difficult circumstances. Two important new resources are now available to help people through these distressing times.

  1. A new Bereavement and Coronavirus Guide has been produced to help with practical information such as how to register a death, through to planning a funeral and information on bereavement and grief. There is also a section on further advice and support.  If a person who has bereaved would like a paper copy of the guide, please telephone 0300 790 6275 and ask for the bereavement booklet to be sent to them and give their name and address
  2. Together with the booklet, Somerset has developed additional bereavement support services that have a quick and easy referral process.  If anyone would like to talk to someone about their loss then please contact the Marie Curie Helpline  0800 3047 412 Monday – Saturday 09.00-17.00. They are there to help and would welcome your call.  The service also has qualified bereavement support workers available for more in-depth support if needed. Professional referrals can be taken with the person’s permission.

Two posters have also been produced that can be downloaded below:

Parking

On-street parking patrols restarted in Somerset on 01/06/2020 following the easing of coronavirus restrictions.

The Government has published information for a health, care and volunteer workers parking pass and concessions pass for those on duty as an NHS staff member, health or social care worker, or NHS Volunteer Responder, and while there are ongoing discussion nationally about how this will work in the future parking enforcement staff will honour a permit if legible and displayed where easily visible.  However, it is important to emphasise that it should only be used where the purpose of parking is to support the response to COVID-19 rather than free day to day parking.  All drivers should also only park in permitted areas, such as parking bays, car parks and uncontrolled areas. It is also vitally important that drivers don’t block the path of emergency vehicles and others involved in delivering services to those in need. 

In these extraordinary times, we are all very aware of the importance of supporting both physical and mental health needs.

Find guidance, advice and tips on how to maintain mental wellbeing if you are anxious about the outbreak:

Mindline

Mindline Somerset is also available 24 hours a day, 7 days a week, if anyone wishes to talk to someone about their anxieties or worries.

Documents
Easy Read Palliative Care Resources:

For urgent requests for CHC help/support related to COVID-19 and CHC funded packages of care, please email: mailto:somccg.chc.contracts@nhs.net