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.

Report a care setting COVID-19 outbreak
If you suspect or have a coronavirus outbreak in a care setting (1 or more resident/s or staff affected), contact Somerset County Council Public Health via SCCPHincidentroom@somerset.gov.uk immediately and kept the team 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.uk.  You can also phone us on 07790 577338.

Please note – Providers should continue to use Somerset Direct for individual cases / individual escalations at this time.

Upcoming webinars:
•  Winter Webinar Series:  A series of webinars are being hosted by NHS England / Improvement as an opportunity to share with peers what is working well and get support and help in working through ideas to further improve practice. Sessions will be 3 weekly, on Wednesdays from 14:00 to 14:45 and hosted on Microsoft Teams.  Further information, including joining details.
• Care Home Testing Webinars:  The Department of Health and Social Care has set up regular care home testing webinars.  Please use this link to sign up to attend the webinars.  
•  Weekly infection prevention and control webinar – every Friday at 15:00.  Please use this link to register for the day/s you would like to attend the webinar or join by phone:  0208 495 3300  Conference ID: 7950138#

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:

Guidance for health and social care staff who are caring for or treating a person who lacks mental capacity during the pandemic was updated by the Government on 11/11/2020.  You can read this guidance here.

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

Further guidance:  Covid-19, the MCA, DoLS and Best Interests: Rapid Read (NHS England and NHS Improvement, August 2020)

The Council has considered the national guidance on the four week national Covid-19 lockdown from 05/11/2020-02/12/2020.

We have received guidance that support groups that have to be delivered in person can continue with up to 15 participants where formally organised to provide mutual aid, therapy or any other form of support. This includes, but is not limited to, support to victims of crime, people in drug and alcohol recovery, new parents and guardians, people with long-term illnesses, people facing issues relating to their sexuality or gender, and those who have suffered bereavement, and vulnerable young people, including for them to meet young workers.

Day services are covered by the term ‘support group’, and are therefore not a business that has been told must close during the 4 week lockdown period, 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
  • 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 during the lockdown period then providers should contact j.cawley@soemerset.gov.uk.

The Covid-19 pandemic is a changing situation and this advice may change if national guidance changes.

This advice will be for the period of 05/11/2020-02/12/2020 inclusive only.

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

Day care providers should continue to operate in safe environments and ensuring that  services are supporting people during these difficult times.  The Social Care Institute for Excellence (SCIE) has released guidance (updated 10/11/2020) 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.

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 (21/08/2020) including leaflets for patients, the admission and care of people in care homes (updated 26/11/2020) and stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings (30/07/2020).

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.

As you will all know, since the outbreak started, we in Somerset have remained hugely supportive of family visitation.  That has not changed and we would like to thank so many of you who have put additional precautions in place to enable families and residents to maintain contact.

We are however experiencing a significant number of positive cases within the care sector in Somerset and as such have a higher proportion of cases linked to residential homes than any other area in the South West; in the last 7 days 15.2% of Somerset cases were linked to a care home, compared to 8.9% across the South West as a region.  Combined with this, we are now moving into the new Tier 2 restrictions and as such need to adapt our position based on the current situation.

We have consulted with colleagues in Public Health and reviewed the latest government guidance that has been communicated within the last 24hrs and unfortunately must advise all residential homes that care home family visits should be paused. 

We do very much appreciate the difficult situation that this creates and the impact this will have in the short term, but must consider resident safety as the number one priority.

You will be aware that the Department of Health and Social Care are preparing to distribute new Lateral Flow Test kits and once delivered, can be used to support family visits in those homes without any active outbreak.  Where homes are experiencing active cases obviously the provision of family visits should continue to be paused.  Department of Health and Social Care have communicated that the first care homes in Somerset should be receiving their deliver of LFTs this week and the remainder will get theirs over the next 2 weeks.

Further guidance will be provided as soon as we have it regarding the likely delivery dates for the Lateral Flow test kits, how they are used and what training and competency will be provided to support their use.

As many of you will know, we are now seeing particularly high levels of viral transmission amongst university students and in areas with a University Campus.  Whilst this does not directly impact on Somerset, we are mindful that many students may be looking for work opportunities between their studies, and as such some may wish to enter the care sector providing care in both residential and non-residential settings.

It is vital if we are to stop the chain of infection and transmission of the virus that such temporary staff are included within weekly testing regimes in homes, and that such staff should not commence work until such time as they have been included within weekly testing and negative results returned.  Your support with the continued effort to protect the most vulnerable is very much appreciated.

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

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) .

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

We acknowledge that the provision of PPE has been, and continues to be, a significant challenge and we continue to make every effort to address this and support local care providers with regular PPE supplies wherever possible.

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 19/11/2020)
  • 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 strategy for preparing for a second wave of COVID-19 covering supply and logistics for distribution of PPE (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.

To join the webinar follow the link or use the joining details below:

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.

This government had published guidance for all care homes without outbreaks that includes information about testing for coronavirus (COVID-19).

Test kits should be ordered via the online portal for care homes: gov.uk/coronavirus

There is now a specialist team trained to support care home queries at the 119 coronavirus testing contact centre.  Lines are open from 7am – 11pm daily.  Please note that this team has replaced the COVIDCareHomeTesting@dhsc.gov.uk mailbox for care home testing queries.

To be directed straight to the dedicated care home team please listen to the following dialling options and select your answer:

Select whether you’re calling from England, Scotland, Wales or Northern Ireland
Select your language requirement for the call
Select whether to hear what data is captured, or continue
Select ‘1’ for calling about a test
Select ‘3’ for calling from a care home facility

If your scheduled courier (booked at https://testkitcollect.co.uk – see below) does not arrive to collect your test kits, you can now contact 119 the following morning, where they will be able to arrange an urgent collection. Please do not call 119 the evening the courier is scheduled to arrive.

Please note that all couriers should still be booked at https://testkitcollect.co.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 50 people who you’ve tested for coronavirus on that day (Department for Health and Social Care, 26/08/2020)

The only exemption to this is if a care homes identifies their first symptomatic resident and is concerned that they may have an outbreak.  In these circumstances they should contact their local 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.  Information on the local process can be found below under “Coronavirus testing for residents and reporting suspected COVID-19 cases”.

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.  As with residents, information on the local process can be found below under “Coronavirus Testing for staff”

Testing frequency and retesting after a positive result

In care homes, all staff should be tested every seven days and all residents every 28 days. 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.

If staff are on annual leave, they are not required to join the weekly 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 

Where staff or residents have tested positively previously, completed their isolation period and returned to work – those individuals should not re-join the regular asymptomatic testing for 90 days.

As residents are on a 28 day retesting cycle, the 90 day retesting exemption period should be the minimum period and homes can wait until day 112 to re-join testing in order to maintain the regular testing cycle.

If they develop new COVID-19 symptoms in this time, they should isolate and be tested again as this could be a new infection.

See full guidance in section 5 here:

COVID-19: management of exposed staff and patients in health and social care settings (Public Health England, updated 28/09/2020)

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.

Care home testing webinars

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

New wording for results

The 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

The collection of completed tests should be booked using the following link: https://www.carehomecollect.co.uk/ 

Couriers arrive between 4pm-10pm, so testing should be complete in time for you to hand over the kits to the courier by 4pm. Swabbing, couriering and registering of test kits all need to happen on the same day.

  • 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 book your courier up to 6 days in advance and it must be booked before 7pm 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.

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 Somerset County Council Public Health via SCCPHincidentroom@somerset.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 SCCPHincidentroom@somerset.gov.uk again should the situation escalate, as shown in the flowchart below.

Swabbing:

Mental Capacity guidance:

  • Testing patients does not bring any specific benefit to them as individuals, a positive or negative test does not of itself direct a change treatment.  If an individual has symptoms suggested of COVID 19, they should be treated as positive.  Therefore there are no decisions that can be made in the best interests of individuals to enforce testing where consent cannot be given and where the individual indicates that they do not wish to be tested.   If a home has other positive cases, or if the individual is themselves symptomatic, the least restrictive approach in line with the Mental Capacity Act would be to assume they are positive, and use pragmatic isolation techniques and appropriate PPE.  If a home has no cases and the individual is not symptomatic, it would be reasonable to assume they are negative and treat them in as they would all other residents.  Local guidance has been produced to support care homes to apply the principles of consent and Mental Capacity to the Covid-19 test.

Local Information

Please follow the flowchart below (updated 31/10/2020) if you have identified possible or confirmed case(s) of COVID-19:

Outbreak notification process

A pdf version of the flowchart (updated 31/10/2020) with links is available here

We are aware of some instances where care homes have been told to test staff less frequently than once a week. This is against national policy.

Even with the recent delays in test results, it is really important that staff are tested weekly. Testing staff less often than weekly means that the infection could go undetected for longer and spread to many more people within the care home. For example testing staff fortnightly could mean there is an additional week of spreading the infection within a care home before the infection is detected.

Testing staff weekly is therefore essential in order to identify the infection quickly and take action to limit the spread, and is of increasing importance given the rise in prevalence in the community.

To support care homes to take action quickly to reduce the spread, we are continuing to take action to provide quicker test results.

The only exceptions to weekly testing of staff are:

  • In the case of a new outbreak in a care home your local health protection team will conduct rapid outbreak testing whereby the whole home will be tested, with follow up tests after 4-7 days for all those who had a negative test result
  • Where staff and residents have tested positively previously, completed their isolation period – those individuals should not rejoin the regular asymptomatic testing for 90 days. If they develop new COVID-19 symptoms in this time, they should isolate and be tested again as this could be a new infection. See full guidance in section 5 here: https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings

National Information

The Government has announced that it will enable the testing of social care workers and those in their household who have symptoms consistent with COVID-19 and published the following information:

Local Information

Symptomatic Care Staff / symptomatic household members of care staff:

Since the launch of the national portal we are no longer supporting local testing for care staff

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 IPC 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.

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.

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

Stay at home for 14 days. The 14-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 14-day period.

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:

  • We need to please remind staff that they should not be working when they are unwell, Infection Control Fund 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 01/10/2020)

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: https://www.cqc.org.uk/guidance-providers/notifications/death-person-using-service-notification-form (updated 17/11/2020)

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 this process (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’.

The CQC are prioritising these applications.  Further information (updated 22/06/2020).

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 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.

To support the Adult Social Care market with its response to the Covid-19 outbreak, a one-off payment totalling the equivalent of a 10% increase in fees for a 3-month period was made to all SCC contracted personal care provision across homecare and residential/nursing care in May.  This included all Learning Disability and Mental Health services in these categories.

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 25/06/2020) and the Government has also developed a tool for businesses to find coronavirus financial support.  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 16/09/2020).

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.

Test and Trace scams

Devon County Council have alerted us to attempted scam where a care home manager received a text to say that he had tested positive following a recent swab, and that he needed another test.  He phoned the number in the text and was told that he’d have to pay for the test.  He was asked for his bank details but did not give them.

We have also been alerted to a second scam by colleagues nationally where the perpetrator clams to be a contact tracer from NHS Test and Trace. We have included an example that has been circulated to us below.

Please help the people that you are supporting recognise if they are contacted by a scammer and that real contract tracers will not ask for payment, bank details or passwords.

The Metropolitan Police have produced information on how to stay safe in relation to Test and Trace

We have included an example of the scam call that was provided to us below:

The Adult Social Care Winter Plan, published on 18/09//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.  

Going forward a number of the questions on the Tracker are being updated, with the first changes coming in to effect on 14/10/2012; these are:

  • How many staff and residents are known to have had a flu vaccination
  • Where there may be issues accessing flu vaccinations
  • The COVID19 status of residents received from NHS Trust hospitals.

The following guidance has been issued in relation to the new questions:

Two surveys have also been added to the Capacity Tracker for 1 week from 14/10/2020 to be completed by care homes.  These surveys only need completing once. Please access the surveys via the Care Home Providers Setup/Details tile and select the Surveys column from the page displayed.  The following guidance has been issued in relation to the surveys:

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 

The latest data being provided from the Care Home Tracker appears to show that Somerset is an outlier in terms of Tracker completion.  We must stress that the new IPC Grant Funding is reliant on questions that are being added to the Tracker and as such it is absolutely vital that all providers complete the Tracker.  If you are having difficulties please ensure you advise us so we can support you in understanding how to enter your data.

The Tracker also appears to show that Somerset’s compliance with paying staff while isolating or shielding appears to be poor. Can we please reiterate again that providers should be doing so with full pay using the IPC Grant.

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:

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. 

Optional badges that can be used to show the carrier may have difficulties or concerns in maintaining social distancing.

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:

Documents

Posters:

keepsafe have developed a range of posters for people with learning disabilities.  These include:

  • Keep safe from 4th July
  • New rules about wearing face masks on public transport
  • Are you exempt from wearing a face covering? (including card to use when using public transport)
  • Support bubbles
  • New rules from 1st June 2020
  • Getting tested
  • Rules for May to June
  • Coronavirus…how to stay safe
  • Coronavirus…and health issues
  • Coronavirus…what if you get ill?
  • Coronavirus…staying at home
  • Coronavirus…you must stay at home
  • Coronavirus…please don’t spread it
  • Coronavirus…shielding
  • Coronavirus…being on your own
  • Coronavirus…why we wear PPE

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