More Season's Greetings and thank you again
Welcome to the weekly newsletter for adult social care providers, issued on behalf of Devon County Council's Director of Adult Social Care Services and Director of Public Health and NHS Devon’s Chief Nursing Officer.
We were expecting that last week's issue would have been our last of this year, but there is so much information being published that we are sending you another newsletter, which we hope you will find helpful.
We are doing our best to keep our Provider Engagement Network website as up to date as possible in today’s fast-changing environment.
COVID-19 vaccination and care homes
Please look out for a Care Homes Vaccination Mobilisation Support Pack and a Vaccination Communication Pack which are being emailed direct to care homes.
On Friday 18 December we sent the following message to care homes:
"A great amount of work is taking place across health and social care to roll out the COVID-19 vaccination to all those who are eligible. Thank you for your continued patience on what is a very complex and fast moving programme.
Care home staff and residents remain a priority group to be vaccinated, as set out by the Joint Committee on Vaccination and Immunisation. However, the number of vaccinations available is limited and the Pfizer/Biontech vaccine is complicated to deliver, so the details of how and when care homes will receive the vaccine for both staff and residents is still being worked through.
It’s likely that some early pilot sites will be trialled in the next couple of weeks, where smaller amounts of vaccine will be delivered directly to a limited number of care homes. We will update as soon as we have any further information.
Please be assured, every care home will be contacted when the vaccination is ready to be delivered from your site or when an alternative site becomes available where you can access vaccinations".
Some frequently asked questions about the vaccine
Vaccination update webinar
There will be an update on mass vaccination roll-out at the next health and care webinar on Thursday 14 January 2021 between 1.30pm – 2.40pm. Invitations will be shared closer to the time.
The national roll-out of mass vaccination has continued at pace with the following headline messages:
- Primary Care Networks now have the facility to apply for smaller doses of vaccines to offer to care homes in their areas
- The first care homes have had their vaccinations and NHS Devon, pharmacy and nursing staff are working closely with GP practices and care homes to learn from the first sites
- Plymouth and Exeter hospitals are also now offering vaccinations to care home staff in their areas
- The most important NHS message to care homes remains the same as the message to the public: please wait to be contacted when it is your turn.
Vaccination preparation
While waiting for your turn in the vaccination process, here are simple steps you can take to help prepare:
- put together staff lists, including basic details (name, gender, date of birth, NHS number, GP details) for each staff member
- be ready to provide each staff member with a letter confirming their employment in the care sector
- keep staff records of vaccinations and report via the Capacity Tracker (as you do with flu vaccination)
- consider the covid-secure logistics of releasing staff to receive their vaccine, while maintaining staffing levels within their home
- take steps now to ensure that staff understand need for obtaining consent, so that they in turn can help residents and families to complete the necessary forms when a vaccine is ready to be delivered within a care home.
Standard Operating Procedure and programme launch letter
More detailed guidance to support this preparation is part of the national Standard Operating Procedure.
A letter from the Minister for Care explains the national care homes vaccination programme COVID-19 vaccinations and care homes: programme launch.
Christmas arrangements for out of care home visits
The government guidance for Christmas visiting arrangements in England changed on 19 December 2020.
The guidance states you should only see people in your Christmas bubble on Christmas Day. Do not stay overnight and keep your visits as short as possible.
In relation to care home residents, the guidance remains that visits out of care homes should only be considered for care home residents of working age. Care homes should, however, support visits out for older people in exceptional circumstances, such as to visit a friend or relative at the end of their life.
A care home resident may form a Christmas Day bubble with one other household and should not form a three-household Christmas bubble. Arrangements need to be in agreement with the care home based on their dynamic risk assessment. A care home is considered one ‘household’ for the purposes of the guidance.
Where arrangements were already in place for planned Christmas visits, they should be reviewed in light of the updated guidance. For care homes in Devon, the Tier 2 restrictions continue to apply at all times other than Christmas Day, meaning that indoor mixing with other households is not allowed.
Where any outward visit does take place, the resident and whoever they spend time with on their visit must adhere at all times to the local rules as set out in the tier system in place at the time of the visit. See guidance on tiers.
For those in care homes and supported living, this note should be read in conjunction with the relevant sector guidance which can be found here:
Providers are best placed to define their overall policy for how outward visits are supported in the care home safely and in a way that takes into account the needs of their residents and what is possible within the facilities and resources. Decisions about the specific arrangements for an individual resident’s visits outside of a care home (assuming the visit still complies with local tier restrictions) should be taken by the provider on an individual-by-individual basis with the resident’s personal needs and circumstances considered in line with the Mental Capacity Act where applicable.
If any person intends to arrange an out of care home visit that does not accord with the local tier regulations, the person should be provided with a copy of this guidance and the commissioner of care should be notified in order that any necessary further guidance can be given to that person regarding the lawfulness of such a decision.
Care homes are not asked to block or prevent out of care home visits that do not accord with tier restrictions as the decision will ultimately sit with the person who intends to take that course of action. Should family members fail to return residents when expected following a Christmas Day visit, care homes should notify the commissioner of care but are not expected to seek the return of the resident themselves.
EU exit preparation and COVID related disruption to supplies
The transition period for the UK leaving the EU ends on 31 December 2020. Deal or no deal, things are going to change after the transition period. Because of the end to the transition period there was already potential for some delays in the supplies of goods in the coming weeks and months. There is now also potential for some delays in the supplies of goods resulting from countries restricting transport and travel from the UK. It is difficult to assess at this point the impact in both the short and longer term for the care and health system and which supplies might be affected. Contingencies that were in place during the first wave of the pandemic to enable care providers to have access to essential food and supplies in the event of disruption to normal arrangements are still in place. Support for services own contingency planning is also available on the PEN website (business continuity section).
The Department of Health and Social Care has issued guidance that it is not necessary for local services to stockpile medicines or for clinicians to write longer prescriptions for patients.
Further guidance for local businesses on preparing for EU exit is available from the Heart of the South West Growth Hub UK Transition website and from Devon County Council Preparing for EU Transition web page. For national guidance, visit the government Transition website.
Care home testing of staff
Updated guidance for testing of residents and staff (page 20) advises that staff members returning from a period of leave which has resulted in someone missing their weekly PCR test, should undertake a LFT.
Remember: do not return test kits containing personally identifiable information A reminder not to include any personally identifiable information when returning test kits as these samples are handled by multiple organisations. This includes not writing any personally identifiable information on test kit vials, test kit bags, individual return boxes, or by slipping bits of paper with personal information into the outer return boxes.
Lateral Flow Device (LFD) replenishment details will be released in January DHSC have provided enough test kits to last through Christmas and the New Year. Replenishment details for being able to order more LFD kits will be released in January.
Changes to PCR test kit packaging for home care and supported living From January 2021, there will be ONE leak proof bag for the packaging of swab samples included in every PCR test kit with the exception of kits for care homes, university cohort pooling and pharmacies. This leak proof bag will replace the zip-lock and biohazard bags formerly included in PCR test kits. Unfortunately due to a printing error, numerous leak proof bags have incorrect instructions printed on them asking staff to double bag their swabs. To mitigate the potential for confusion, there is a slip with every box of test kits telling recipients to follow the instructions in the instruction booklet and ignore the incorrect instructions on the bag.While this change will start to become visible to users from w/c 11 January, existing stocks of PCR kits with two bags will also need to be rundown, so there will be a period of time when both kit types will be in circulation at once.
Business Continuity Planning Test Template Domiciliary Care
As part of organisational resilience, it is vital for providers to have a robust and up to date business continuity plan in place, that supports them to manage risk effectively at a point of crisis. To assist providers to achieve this, the Market Management Team have put together a helpful template to allow providers to assess and test the effectiveness of their current business continuity plans against some core criteria. Please use this information for a ‘desk-top’ review to ensure your business continuity plan effectively supports you to maintain services, so that you can identify and address any potential gaps.
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