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Wednesday 3rd August 2022

 

COVID 19 - UPDATE

 

Access inside the care home

 

Contact with relatives and friends is fundamental to care home residents' health and wellbeing and visiting should be encouraged. There should not normally be any restrictions to visits into or out of the care home. The right to private and family life is a human right protected in law (Article 8 of the European Convention on Human Rights). When the home is not in outbreak, 2 visitors, at a time, can visit in the resident's room. Tea and cake are permitted but no main meals, at this time.

 

Visitors should not enter the care home if they are feeling unwell, even if they have tested negative for COVID-19, are fully vaccinated and have received their booster. Transmissible viruses such as flu, respiratory syncytial virus (RSV) and norovirus can be just as dangerous to care home residents as COVID-19. If visitors have any symptoms that suggest other transmissible viruses and infections, such as cough, high temperature, diarrohea or vomiting, they should avoid the care home untilat least 5 days after they feel better.

 

Precautions for visitors

 

All visitors are asked to have a lateral flow device (LFD) test before entering the home and to wear a face mask when visiting, particularly when moving through the home. Individual approaches may be needed as the wearing of face masks may cause distress to some residents. In circumstances where wearing a face mask causes distress to a resident, face masks may be removed when the visit is not in a communal area of the care home. Removal of the mask in non-communal areas may also be considered following a risk assessment if it is hindering communication, or in the case that the visitor is eating or drinking. However, other mitigations should be considered, including limiting close contact and increased ventilation (while maintaining a comfortable temperature).

 

Some residents may need support with personal care from a visitor (essential care giver ECG) with whom they have close relationship. This may include activities such as supporting someone with washing, bathing or cleaning themselves, getting dressed or going to the toilet. Visitors who are providing personal care should have a negative COVID-19 lateral flow test result from a lateral flow device before entering a care home, unless medically exempt. If these visitors attend once or twice a week, they should only test on that day (testing can be completed at home or on site). If they visit more than twice a week, they should test a maximum of twice weekly, 3 to 4 days apart.

 

Visitors providing personal care should show proof of their negative test result prior to entry. This may be an email or text from reporting the result, a date stamped photo of the test cartridge, or any other proof. If they are not able to produce a negative test, they may be asked to reschedule. Care homes do not need to retain records of proof.

 

In addition to negative test results, care homes should ask all visitors to wear face masks, in addition to other PPE if they are providing personal care, to ensure visits can happen safely. This should be based on individual assessments, taking into account any distress caused to residents by use of PPE or detrimental impact on communication.

 

Children under the age of 11, who are visiting a care home, may choose whether to wear face masks. However, they should be encouraged to follow the IPC guidelines such as practising hand hygiene.

 

Care home residents will no longer be asked to isolate following high-risk visits out of the care home (including following emergency hospital stays) and will not be asked to take a test following a visit out.

 

Outbreak Management

 

Outbreak handling

 

An outbreak consists of 2 or more positive (or clinically suspected) linked cases of COVID-19, within the same setting within a 14-day period (this means where the cases are linked to transmission in the care setting). This applies to both staff and residents and includes PCR and lateral flow test results

 

If an outbreak is suspected, the HPT (or community IPC team, local authority or CCG, according to local protocols) should be informed. A risk assessment should be undertaken with the HPT or other local partner to see if the clinical situation can be considered an outbreak and if outbreak management measures are needed.

 

If an outbreak is declared as a result of the risk assessment then measures will be taken. These will include testing and may also include:

  • temporarily stopping or reducing communal activities
  • closure of the home to further admissions
  • restriction of movement of staff providing direct care to avoid 'seeding' of outbreaks between different settings
  • proportionate changes to visiting: some forms of visiting should continue if individual risk assessments are carried out. One visitor at a time per resident should always be able to visit inside the care home. It is important that any visitor follows the IPC processes put in place by the care home, such as practicing hand hygiene and wearing appropriate PPE.
  • this number can be flexible in the case that the visitor requires accompaniment (for example if they require support, or for a parent accompanying a child). End-of-life visiting should always be supported and testing is not required in any circumstances for an end-of-life visit

In the event of an outbreak in a care home, outbreak restrictions will be place for different lengths of time, depending on the characteristics of the home, the outbreak and the results of outbreak testing.

 

(Taken from the COVID 19 Supplement to the Infection Prevention and Control Resources for Adult Social Care. Updated 01.08.22

 

 

Best Wishes.

 

Management team.