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.
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 email@example.com immediately and the team kept informed of any escalations.
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 that do not relate to COVID-19.
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 on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 (Public Health England and Department of Health and Social Care, updated 30/04/2021)
- COVID19: ethical framework for adult social care (28/04/2021)
- Using direct payments during the coronavirus outbreak: full guidance for people receiving direct payments and personal assistants (Department of Health and Social Care, updated 27/04/2021)
- Guidance for local authorities and clinical commissioning groups in the delivery of direct payments and personal health budgets (Department of Health and Social Care, 27/04/2021)
- Guidance for care of the deceased with suspected or confirmed coronavirus (COVID-19) (22/04/2021)
- Overview of adult social care guidance on coronavirus (COVID-19) (Department of Health and Social Care, updated 01/04/2021)
- Coronavirus (COVID-19): support for care homes (updated 01/04/2021)
- Coronavirus (COVID-19): providing home care (Department of Health and Social Care, updated 01/04/2021)
- Getting help with daily activities outside your home during coronavirus (Department of Health and Social Care, updated 31/03/2021)
- Restricting workforce movement between care homes and other care settings (Department of Health and Social Care, updated 03/03/2021)
- Adult social care: our COVID-19 winter plan 2020 to 2021 (Department of Health and Social Care, updated 14/12/2020)
- Coronavirus (COVID-19): reducing risk in adult social care (01/12/2020)
- Leaflets for social care staff to support the annual flu programme (Public Health England, updated 19/11/2020)
- Social Care Sector COVID-19 Support Taskforce: report on first phase of COVID-19 pandemic (Department of Health and Social Care, updated 12/10/2020)
- Coronavirus (COVID-19): reuse of medicines in a care home or hospice (Department of Health and Social Care, NHS England, and NHS Improvement, updated 02/09/2020)
- Joint statement on personalised approaches to care and treatment (20/05/2020)
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
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:
- Regulatory approval of COVID-19 Vaccine Moderna (Medicines and Healthcare Products Regulatory Agency, updated 19/04/2021)
- Regulatory approval of COVID-19 Vaccine AstraZeneca (Medicines and Healthcare Products Regulatory Agency, 15/04/2021)
- Regulatory approval of Pfizer/BioNTech vaccine for COVID-19 (Medicines and Healthcare Products Regulatory Agency, updated 31/03/2021)
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.
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.
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 firstname.lastname@example.org 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.
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
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.
- COVID-19 vaccination and blood clotting (Public Health England, updated 07/05/2021)
- COVID-19 vaccination and blood clotting (Summary) (Public Health England, 07/04/2021)
- Communicating the potential benefits and harms of the Astra Zeneca COVID 19 vaccine (University of Cambridge, 07/04/2021)
- 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
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 Leaflets: Videos:
General information about COVID-19 vaccines
Vaccination Frequently Asked Questions (FAQs)
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
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 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.
- 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.
- 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.
- Department of Health and Social Care:
- COVID-19: supporting adults with learning disabilities and autistic adults (updated, 10/05/2021)
- Supported living services during coronavirus (COVID-19) (22/04/2021)
- COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol (updated 07/04/2021)
- Temporary approval to suspend the need for signatures on prescriptions, dental and ophthalmic forms until 30/06/2021 (31/03/2021)
- Supporting people living with dementia through safeguarding processes (updated, 31/03/2021)
- Home delivery of medicines and appliances during the COVID-19 outbreak (16/02/2021)
- COVID-19 testing in general practice (04/03/2021)
- Vitamin D and care homes guidance (24/02/2021)
- NHS England and NHS Improvement:
- Mental health, learning disabilities and autism guidance (15/03/2021)
- Primary Care standard operating procedure (updated 03/03/2021)
- Urgent dental care guidance and standard operating procedure (updated 05/02/2021)
- Dementia wellbeing in the COVID-19 pandemic (26/01/2021)
- Standard operating procedure – Community Pharmacy (updated 27/10/2020)
- Third phase of NHS response to COVID-19 (updated 13/10/2020)
- South West Care Home Winter Readiness Pack (updated 14/09/2020)
- Guidance for healthcare teams on the release of adult patients from the secure and detained estate during coronavirus (19/05/2020)
- Workforce guidance for mental health, learning disabilities and autism, and specialised commissioning services during the coronavirus pandemic (08/04/2020)
- A letter clarifying the use of the Clinical Frailty Scale (CFS) and the use of do not attempt cardiopulmonary resuscitation (DNACPR) with younger patients, those with a stable long term physical need, learning disability or autism (03/04/2020)
- National Institute for Health and Care Excellence (NICE):
- COVID-19 rapid guideline: managing COVID-19 (updated 08/04/2021)
- COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders (updated 31/03/2021)
- Safeguarding adults in care homes (26/02/2021)
- Creating a safeguarding culture: A quick guide for registered managers of care homes (2021)
- Developing and implementing guidance for staff delegating clinical tasks to informal carers and relatives during the COVID-19 pandemic (September 2020)
- COVID-19 rapid guideline: dialysis service delivery (updated 11/09/2020)
- COVID-19 rapid guideline: interstitial lung disease (15/05/2020)
- COVID-19 rapid guideline: chronic kidney disease (15/05/2020)
- Association of Directors of Adult Social Services (ADASS)
- Social Care Institute for Excellence (SCIE)
- Delivering safe, face-to-face adult day care (updated 30/04/2021)
- Office of the Public Guardian
- Being a deputy or attorney during the coronavirus outbreak (updated 23/04/2021)
- Coronavirus (COVID-19): Office of the Public Guardian response (updated 12/05/2021)
- Making and registering an LPA during the coronavirus outbreak (updated 12/05/2021)
- How to register an EPA during the coronavirus outbreak (updated 23/04/2021)
- Medicines and Healthcare products Regulatory Agency
- Medical devices given exceptional use authorisations during the COVID-19 pandemic (updated 13/05/2021)
- British Geriatrics Society:
- Guide on Managing the COVID-19 pandemic in care homes (updated 18/11/2020)
- Coronavirus and older people resource series
- Identifying older people most vulnerable to COVID-19 (07/09/2020)
- Atypical Covid-19 presentations in older people – the need for continued vigilance (updated 14/04/2020)
- Managing a fall that may require an ambulance during the COVID-19 pandemic (May 2020)
- National Institute for Health Research (NIHR): Patients living with dementia who ‘walk with purpose or intent’ in the COVID-19 crisis (22/04/2020)
- Video (8 min): Meeting the Needs of People with Dementia Living in Care Homes during Covid-19
- The British Psychological Society: Supporting older people and people living with dementia during self-isolation (08/04/2020)
- Real Talk: COVID-19: Evidence-based advice for difficult conversations (23/03/2020)
- VitalTalk: COVID communication guide
- Digital Social Care: Covid-19 Guidance
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.
- 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?
- 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
- 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
- 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:
- 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.
- Visiting arrangements in care homes (Department of Health and Social Care, updated 04/05/2021)
- Summary of guidance for visitors (Department of Health and Social Care, updated 04/05/2021)
- Visits out of care homes: supplementary guidance (Department of Health and Social Care, 01/05/2021)
- Visits out of care homes (Department of Health and Social Care, 01/05/2021)
- Deputy Chief Medical Officer Blog: Dr Jenny Harries OBE, Deputy Chief Medical Officer, explains more about the approach to easing care home visiting restrictions in a blog (11/03/2021).
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.
- Poster giving contact information for if you need support or have questions about palliative or end of life care for your residents
- Essential COVID-19 symptomatic advice and care resources for healthcare professionals and care providers is available through St Margaret’s Hospice.
- NHS Somerset Clinical Commissioning Group COVID19 End of Life Support Guidance (April 2020)
- Use of oral/buccal medication for symptom control and a list of oral/buccal medication
- Carer administration of rectal suppositories
- Carer administration of scopoderm patch
- Carer administration of sublingual lorazepam
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.
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 email@example.com or 0300 075 0105.
- Red, amber and green list rules for entering England (Department for Transport, updated 12/05/2021)
- How to quarantine when you arrive in England (Department of Health and Social Care, updated 11/05/2021)
- Travel abroad and coronavirus (COVID-19) (Foreign & Commonwealth Office and Foreign, Commonwealth & Development Office, updated 07/05/2021)
- Coronavirus (COVID-19): safer travel guidance for passengers (Department for Transport, updated 19/04/2021)
- COVID-19: guidance for arranging or attending a funeral during the coronavirus pandemic (Public Health England and Department of Health and Social Care, updated 12/05/2021)
- What parents and carers need to know about early years providers, schools and colleges during the coronavirus (COVID-19) outbreak (Department for Education, updated 12/05/2021)
- Maintaining records of staff, customers and visitors to support NHS Test and Trace (Department of Health and Social Care, 11/05/2021)
- Working safely during coronavirus (COVID-19) (Department for Business, Energy & Industrial Strategy, updated 11/05/2021)
- Actions for schools during the coronavirus outbreak (Department for Education, updated 10/05/2021)
- Coronavirus (COVID-19): guidance for local government (Ministry of Housing, Communities & Local Government, updated 05/05/2021)
- COVID-19: guidance for households with possible coronavirus infection (Public Health England, updated 30/04/2021)
- Guidance for contacts of people with confirmed coronavirus (COVID-19) infection who do not live with the person (Public Health England, 26/04/2021)
- How to stop the spread of coronavirus (COVID-19) (Cabinet Office, 23/04/2021)
- Face coverings: when to wear one, exemptions, and how to make your own (Department of Health and Social Care and Cabinet Office, updated 22/04/2021)
- Making a childcare bubble with another household (Department of Health and Social Care, 15/04/2021)
- Coronavirus (COVID-19): advice on accessing green spaces safely (Department for Environment, Food & Rural Affairs, updated 12/04/2021)
- COVID-19: Guidance for the safe use of multi-purpose community facilities (Ministry of Housing, Communities & Local Government, updated 12/04/2021)
- Making a support bubble with another household (Department of Health and Social Care, updated 29/03/2021)
- Somerset Local Outbreak Management Plan (Somerset County Council, 24/03/2020)
- Coronavirus: How to help safely (Department for Digital, Culture, Media & Sport, updated 05/03/2021)
- COVID-19: guidance for hostel services for people experiencing homelessness and rough sleeping (Public Health England and Ministry of Housing, Communities & Local Government, 06/01/2021)
- SAGE advice on reducing the risk of coronavirus (COVID-19) transmission in the home (Cabinet Office, 07/12/2020)
- COVID-19 Winter Plan (Cabinet Office 02/12/2020)
- The Cold Weather Plan for England: Somerset Delivery Framework (30/10/2020)
- Local COVID-19 outbreaks: lessons learnt and good practice (Ministry of Housing, Communities & Local Government, 14/09/2020)
- Care Act easements: guidance for local authorities (updated 01/09/2020)
- COVID-19 (coronavirus) absence: A quick guide for parents and carers (Public Health Somerset, September 2020)
- Coronavirus (COVID-19): local death management (Ministry of Housing, Communities & Local Government, 14/05/2020)
Infection Prevention and Control (IPC) and Personal Protective Equipment (PPE)
- How to stop the spread of coronavirus (COVID-19) including an easy read version (Department of Health and Social Care, updated 23/04/2020)
- COVID-19: how to work safely in care homes (Public Health England, updated 16/04/2021)
- COVID-19: infection prevention and control (IPC) (Public Health England, updated 15/04/2021)
- COVID-19: how to work safely in domiciliary care (Public Health England, updated 06/04/2021)
- COVID-19: management of exposed staff and patients in health and social care settings (Public Health England, updated 28/01/2020)
- COVID-19: Guidance for the remobilisation of services within health and care settings: Infection prevention and control recommendations and FAQs (Public Health England, 21/01/2021)
- Why fresh air is so important in controlling the spread of Covid-19 (Public Health Somerset, February 2021)
- Covid-19 deep cleaning guidance in Care Homes
- Your 5 Moments For Hand Hygiene Poster
- Care home mutual aid IPC training support
- COVID-19 Super trainer competency document
- CQC Inspection Information Gathering Tool: Infection Prevention and Control
- Hand Gel Use sheet
- Hand Washing sheet
- Homemade Masks poster
- Putting on personal protective equipment (PPE) for non-aerosol generating procedures
- Taking off personal protective equipment (PPE) for non-aerosol generating procedures
- Effectiveness of Correct Hand Washing
- Trainers Resources on Infection Prevention and Control (IPC) in Care Homes
- Supporting fit testing: steps and actions to be taken where staff may require the use of FFP3 masks (NHS England and NHS Improvement, 29/10/2020)
- COVID-19: personal protective equipment use for non-aerosol generating procedures including posters and a video showing how to safely don (put on) and doff (take off) the personal protective equipment (PPE) (Public Health England, updated 21/08/2020)
- Personal Protective Equipment (PPE) illustrated guide for community and social care settings (Public Health England, updated 31/07/2020)
- Facial hair and FFP3 respirators poster (26/02/2020)
- NHS Guidance on How to wash your hands (18/10/2019)
- Portable fans in health and social care facilities: risk of cross infection (NHS Improvement, 11/01/2019)
- Best Practice Hand Wash Poster
- Best Practice: management of blood and body fluid spillage
- Routine decontamination of reusable non-invasive patient care equipment
- Helping to prevent infection: A quick guide for managers and staff in care homes (National Institute for Health and Care Excellence)
- NHS Property Services: Alcohol-Based Hand Sanitiser – Vehicle Fires
- Highways England Safety Alert: Alcohol Based Hand Sanitiser
Local Guidance and Resources:
- Summary of the Position Statement for Personal Protective Equipment (PPE) (Somerset County Council)
- Personal Protective Equipment (PPE) for the COVID-19 Pandemic – Guide for Staff Working in Local Authority, Education, Community and Social Care Settings (Somerset County Council, updated 11/06/2020)
- Template Example Risk Assessment of PPE Requirement (Somerset County Council)
- Template Example Risk Assessment of PPE Requirement – Household (Somerset County Council)
- Template Example Risk Assessment of PPE Requirement – Community (Somerset County Council)
- Personal Hygiene – Hand cleansing for remote workers (Somerset County Council)
The NHS has set up a supply distribution helpline which can answer PPE calls and emails 24/7:
Phone: 0800 915 9964
- 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).
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.
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.
- NHS Test and Trace: what to do if you are contacted (Department of Health and Social Care, updated 13/05/2021)
- NHS test and trace: workplace guidance (Department of Health and Social Care, updated 11/05/2021)
- NHS Test and Trace: how we test your samples (Department of Health and Social Care, updated 26/02/2020)
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
- How tests and testing kits for coronavirus (COVID-19) work (Medicines and Healthcare products Regulatory Agency, updated 27/04/2021)
- Coronavirus (COVID-19): getting tested (Department of Health and Social Care, updated 23/04/2021)
- On Site Testing for Adult Social Care Services – Rapid Lateral Flow Test Kits (UK Government and NHS Test and Trace, updated 02/03/2021)
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:
- Book a test at a local Community Test Site – Check this map of test site locations, dates and times for the nearest service to you. You can also find the addresses of the sites using this link.
- Collect a home test kit from a local Community Test Site – You do not need to book to collect a test, but the tests will only be available for collection at specific times. Check this map of test site locations, dates and times for the nearest service to you.
- Get a test kit sent to your home – If you are unable to get to a test centre to collect a test kit you can order a home testing kit to be sent to your home. You can order a test online here.
- Collect a test from a pharmacy – A new pharmacy collect service is now available in Somerset with 99 pharmacies signed up and more to come online soon. You will be able to use this if you are over the age of 18 without symptoms. Participating pharmacies will provide a box of 7 rapid tests to use twice a week at home. Find a pharmacy where you can collect tests.
Local Information on getting tested
- Somerset County Council: Coronavirus – Getting tested
- Somerset County Council: Coronavirus – Get a test if you do not have symptoms
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)
Domiciliary Care Services (updated 23/04/2021)
Extra Care Housing and Supported Living Services (updated 30/04/2021)
Day Services (updated 30/04/2021)
Personal Assistants (28/04/2021)
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.
- 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.
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?
- 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 firstname.lastname@example.org 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 email@example.com again should the situation escalate, as shown in the flowchart below.
- Care providers can undertake the swabbing of residents themselves. The Government has published COVID-19: guidance for taking swab samples (Public Health England, 02/07/2020) and additional guidance has also been published on how to take the required respiratory swab/swabs (added 27/11/2020). A video has also been published by the Government with information about administering COVID-19 tests to care home residents and . Please ensure that GPs are informed of test results.
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 and a draft ethico-legal framework to support decision-making relevant to Covid-19 PCR testing in hospital in-patients who may lack capacity to consent.
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
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
- Coronavirus (COVID-19) testing for adult social care settings (Department of Health and Social Care, 28/04/2021)
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.
- Testing for professionals visiting care homes (Department of Health and Social Care, updated 22/04/2021)
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.
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 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.
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)
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.
- Protect, respect, connect – decisions about living and dying well during COVID-19 (15/04/2021)
- Joint statement from CQC’s Chief Inspectors, and Deputy Chief Inspector and lead for mental health services (24/03/2021)
- Innovation and inspiration: examples of how providers are responding to coronavirus (COVID-19) (12/02/2021)
- Review of Do Not Attempt Cardiopulmonary Resuscitation decisions during the COVID-19 pandemic – Interim report November 2020 (02/02/2021)
- Right support, right care, right culture: How CQC regulates providers supporting autistic people and people with a learning disability (updated 06/11/2020)
- Coronavirus (COVID-19) pandemic: information for providers (updated 19/10/2020)
- Emergency support framework: what to expect (updated 01/10/2020)
- COVID-19: interim guidance on DBS and other recruitment checks (updated 29/05/2020)
- An update on how Care Quality Commission is monitoring the Mental Capacity Act and people who are subject to the Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic (21/05/2020)
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
Net 2021/22 Increase
You can read the full decision on the Somerset County Council website: http://democracy.somerset.gov.uk/ieDecisionDetails.aspx?Id=1796
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:
- 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.
- 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.
- 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.
- 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:
- Help and support if your business is affected by coronavirus (COVID-19) (HM Revenue & Customs, updated 10/05/2021)
- Coronavirus (COVID-19): business support grant funding – guidance for local authorities (Department for Business, Energy & Industrial Strategy, updated 07/08/2020)
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.
- Provider Care and Support Changes Form (Excel 365)
- Provider Care and Support Changes Form (Excel 97-2003)
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 firstname.lastname@example.org
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.
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.
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:
- Coronavirus (COVID-19) infection control for care providers (SCIE, updated 05/05/2021)
- Safeguarding adults during the COVID-19 crisis(SCIE, updated 29/03/2021)
- Infection control e-learning course (SCIE, updated Mary 2020)
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)
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:
- Send this link to your mobile phone: https://chat.whatsapp.com/Hx0gyX0rIDy6ijN5GoIVqd (you will need to have What’sApp installed already or download directly through the link) and join the group.
- Download What’sApp to your computer / laptop / tablet and follow the link: https://chat.whatsapp.com/Hx0gyX0rIDy6ijN5GoIVqd
- Forward this email to Christiana Evans email@example.com along with your mobile phone number and Christiana will add you to the WhatsApp
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.
- 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
- 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:
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:
- Health and wellbeing of the adult social care workforce (Department of Health and Social Care, updated 19/04/2021)
- Workforce wellbeing resource finder: Skills for Care has launched a tool to help the social care workforce quickly find trusted resources to support their own or others wellbeing. This simple tool holds different resources suited to social care from Skills for Care’s national trusted partners. Whether you’re looking for self-help, support for others, needing someone to talk with confidentially or support with mental health, the results filtering system gives the user a few choices to reduce time and energy searching for resources.
- Health and Wellbeing at Work Summary Toolkit (Business in the Community, 21/01/2021)
- A new confidential support line for NHS and social care workers in England has been launched by the Samaritans in partnership with the NHS in England to help staff cope during the pandemic. The confidential support line is open 7am to 11pm, 7 days a week, and is run by dedicated and trained Samaritan volunteers. Support can be accessed by calling 0800 069 622.
- Staying mentally well: winter plan 2020 to 2021 (Department of Health and Social Care, 23/11/2020)
- Samaritans wellbeing support line for health and social care workers
- Letter from NHS Somerset Clinical Commissioning Group regarding Pastoral Support for Care Home Staff
- Somerset Health and Wellbeing: How to stay healthy, happy and safe at home
- Every Mind Matters
- Mental Health at Work: Support For Social Care Workers
- Public Health Somerset are working with BBC Somerset and Spark to broadcast a weekly slot with Charlie Taylor on Wednesday evenings 7-8pm
- A Listening Chaplaincy Phone line which is being offered by the Faith Communities within the Avon and Somerset police area
- FutureLearn has published a COVID-19: Psychological First Aid course (15/06/2020)
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.
- Free tablets to improve lives of thousands of people with learning disabilities (Department for Digital, Culture, Media & Sport and Caroline Dinenage MP, 25/02/2021)
- Easy read answers to questions about the coronavirus vaccine
- Easy read information about the Covid-19 vaccine (Mencap)
- Virtual Resource Hub and Introduction (Somerset NHS Foundation Trust)
- DNACPR Support Pack (Learning Disability England and Turning Point)
- Health Education England Accessible Formats Library
- Covid-19 support pack: Supporting people with a learning disability during the Covid-19 pandemic (Somerset NHS Foundation Trust)
- Somerset Health Passport template
- Covid-19 Hospital Passport template and Guidance.
- Easy read information published by Inclusion North
- Easy to read (not easy read) information published by EasyRead.info
- Easy Read Online: New Government rules about staying at home 24 March 2020
- Easy Read Online: Advice on self-isolating
- Purple All Stars Hand Washing rap video
- Easy Read information developed by Photosymbols to support people with a learning disability, their families and carers is also available here
- Downloadable easy read resources produced by Beyond Words including “Beating the Virus”, Good Days and Bad Days during Lockdown” and “when someone dies from coronavirus”
- A list of resources and links identified by Learning Disability England
- Videos produced by SignHealth for people who use British Sign Language (BSL)
- Public Heath England guidance for households with possible coronavirus infection (includes Easy Read and translated versions)
- Public Heath England guidance on social distancing and for vulnerable people (includes Easy Read and translated versions)
- NHS guidelines translated into 32 languages by Doctors of the World
- Easy read information on COVID-19 from Mencap
Easy Read Palliative Care Resources:
- Government information about Face Masks poster (Devon & Cornwall Police)
- Coronavirus Vaccine – follow Liz Hunt as she has her COVID-19 vaccine while in hospital
- Coronavirus Vaccine – follow Bradley Whitaker as he goes for his COVID-19 vaccine
- Coronavirus Vaccine – who gets it first?
- Coronavirus Vaccine – please don’t call
- Vaccines are coming
- Coronavirus – too many deaths
- The NHS is open
- Back in lockdown
- Keeping safe
- If you get ill
- Being on your own
- A support bubble
- Why we wear PPE
- Get tested
- Food banks
- Domestic abuse
For urgent requests for CHC help/support related to COVID-19 and CHC funded packages of care, please email: mailto:firstname.lastname@example.org