COVID-19 – FAQs
The FAQs below have been produced by Hertfordshire County Council in conjunction with HCPA and will be updated on a regular basis, therefore, we recommend you revisit this web-page daily for the most up-to-date guidance.
|Coronavirus: Advice for employers and employees inc SSP
|What changes to our cleaning regime do we need to consider at this point?
|You should consider frequent and thorough cleaning of well-used touchpoints such as door handles and lift buttons, with regular cleaning of surfaces in communal areas including phones etc. Also don't forget the pieces of equipment that are used by residents / clients such as hoists, weighing scales and thermometers. A combined detergent/disinfectant solution at a dilution of 1,000ppm available chlorine or a general-purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1,000ppm can be used (follow the manufacturers recommendations on dilution, making and storage). There is guidance on environmental decontamination within the national documents -
|Named clinical lead for Care Homes and Weekly Check in's
|NHS and social care organisations have been asked by Simon Steven’s to ensure that all care homes have a clinical lead and that care homes are made aware of their named clinical lead. It will be the responsibility of the clinical lead to conduct weekly check in’s with their allocated care home. The CCG has been working in close collaboration with Central London Community Healthcare (CLCH) our community providers, GP primary care, mental health and social care to develop a multidisciplinary approach to support care homes and their residents. To read letter https://www.hcpa.info/?p=61761 .For the weekly check in pathway https://www.hcpa.info/?p=61763
|Do you have any particular advice on supporting individuals with Dementia during Covid-19?
|Support guidance from NHSE - https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=4d8e89de47&e=b9895c5f2e Tips on supporting Walking with Purpose - https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=fccb7769ed&e=b9895c5f2e
|Information on CQC resuming on-site inspections
|As On-site Inspections are resumed, CQC have provided information on Testing for their Inspectors, PPE use during inspections, risk assessments ahead of inspections and disclaimers: https://www.hcpa.info/wp-content/uploads/CQC-updates-as-on-site-inspections-resume-Aug2020.docx
|Disclosure and Barring Service
|Are there any changes to the DBS process?
|Local Authority Updates
|Medication Errors Guidance
|Controlled Drug Stock Checks/ CD Cabinet Key security
|Please ensure your organisation has appropriate security and governance processes in place for Controlled Drugs
CD cupboards should only be used for the storage of CDs and no other medication or valuables should be stored in the cupboard. If medication is provided in a monitored dosage system (MDS), the MDS should be stored in the CD cabinet.
Access to the CD cupboard should be controlled. The CD cupboard keys should be kept under the control of an authorised, designated person and there should be a clear audit trail of the holders of the key.
An audit of the CD register and drugs cupboard should be carried out routinely. This should be done weekly, fortnightly or monthly at the discretion of the care home manager. Audits should be carried out by two authorised members of staff and recorded in RED pen. Any discrepancies must be reported to the manager immediately. It is good practice to carry out a balance check at the end of each shift.
Incidents involving CDs must be reported to the Care Quality Commission (CQC) and the local NHS England Accountable Officer for Controlled Drugs
1) CQC - Storing controlled drugs in care homes: https://www.cqc.org.uk/guidance-providers/adult-social-care/storing-controlled-drugs-care-homes#:~:text=You%20can%20store%20them%20in,controlled%20drugs%20within%20your%20home.
2) HVCCG Care Homes Newsletter, Controlled Drugs, Issue 7 (December 2019): https://hertsvalleysccg.nhs.uk/clinicians/care-homes/topic/102/Newsletter/539
|Do you have any guidance on administering from original packaging?
|As you are aware, the escalation of cases in the UK has meant increased pressure on all primary care services, including community pharmacy. Community pharmacies core responsibilities are to ensure that all patients receive their medication in a safe and effective way. Pharmacies have been asked to assess their ability to offer services to care homes if they have a reduced workforce, due to staff absences.
To support this recommendation, some pharmacies are proposing that until such time as COVID-19 is no longer a significant threat, care homes will receive medication in manufacturers’ original packs with pre-printed Medication Administration Record charts.
Please check in "medications" section of the following webpage - https://www.hcpa.info/guideline/covid-19-available-training-education/#eol
|Should we be carrying forward PRN Medication?
|Due to the existing national situation regarding Covid-19 and demands on health care provisions, Herts Valleys & East and North Hertfordshire CCG care home team would like to remind care home staff it is essential to carrying forward PRN / ‘when required’ medication such as Paracetamol to safeguard stocks and enable care home providers to continue to provide effective care. Guidance- https://hertsvalleysccg.nhs.uk/application/files/5615/8212/0501/When_Required_Medication_PRN_Guidance_For_Care_Homes_V1.0.pdf . Top Tips - https://hertsvalleysccg.nhs.uk/application/files/2415/5928/7578/Reducing_Medicines_Waste_in_Care_Homes_v1.1_February_2019.pdf
Reminder on Medicines Reconciliation and reviews- https://www.cqc.org.uk/guidance-providers/adult-social-care/medicines-reconciliation-medication-review
|Out of hours and EOL Pharmacists
|East and North Herts: https://www.enhertsccg.nhs.uk/pharmacies and https://www.enhertsccg.nhs.uk/sites/default/files/Participating%20Pharmacies%20Details%20updated%20August%202020.pdf
Herts Valley (and East of England): https://hertsvalleysccg.nhs.uk/application/files/2215/9782/6797/Interactive_Map_of_Palliative_Care_Pharmacies_in_East_of_England.pdf and https://pcm.prescqipp.info/
|Urgent Medication- When you need to inform pharmacists?
|Most prescriptions are sent directly from the GP to the pharmacy electronically using EPS. During the covid- 19 pandemic it is likely that there will be more remote consultations and more urgent medicines prescribed.
Please remember to contact your usual pharmacy to advise them that an urgent prescription has been sent by the GP as these are not highlighted to the pharmacist in any other way. Pharmacies are extremely busy at the moment and anything you can do to support them will be much appreciated and prevent delays in residents accessing the urgent medication that they need. Please see link for more detail
|What is the CQC guidance on Medication?
|All information from CQC on Medication- https://www.cqc.org.uk/guidance-providers/adult-social-care/medicines-information-adult-social-care-services
|Where do we obtain Just in case Medication?
|Pharmacies currently participating in the Immediate Access to Emergency Medicines Scheme. EN Herts Medication list- https://mcusercontent.com/7275e7980a25c4f5e4939ee06/files/3cec9a0b-54b2-491a-a8d7-efc5ac79bd72/Immediate_access_to_emergency_medicines_pharmacy_stock_list_updated_on_9.4.20.pdf?mc_cid=add61b66bd&mc_eid=3e0cd1f44a. EN Herts Pharmacies- https://mcusercontent.com/7275e7980a25c4f5e4939ee06/files/69b096e7-c774-4387-94a7-176812fcc376/Immediate_access_to_emergency_medicines_pharmacies_updated_on_9.4.20.pdf?mc_cid=add61b66bd&mc_eid=3e0cd1f44a. Herts Valley Pharmacies- https://hertsvalleysccg.nhs.uk/application/files/8015/8625/6724/Immediate_Access_to_Emergency_Medicines_Summary_v3.0_COVID19_Edition_April_2020.pdf?mc_cid=add61b66bd&mc_eid=3e0cd1f44a
|SCIE/NICE quick guide: Helping to prevent infection in Care Homes
|How should we manage concerns with weight loss, poor appetite or lack of interest in eating?
|Nutrition support resources
Undernutrition remains a concern for the older population in Hertfordshire, and isolation as a result of the current Covid 19 crisis is likely to increase this issue.
Local guidance which may be useful, both to help prevent undernutrition at this time and to support older adults recovering from Covid 19, includes:
• Food First – Eating well for small appetites focuses on enabling patients to increase their nutritional intake by at least 500 calories per day (in addition to other essential nutrients) and can be given out by any healthcare professional without additional explanation
• Food First – Quick guide is a short version of the above leaflet and shows how an additional 500 calories (in addition to other essential nutrients) can be consumed simply by making 3 or 4 small dietary changes each day
• Food First - Homemade supplements can be provided together with either of the above resources and is equally suitable for patients living in their own homes or in care homes. The homemade milkshake recipe is nutritionally almost identical to prescribed ONS
• Eating and drinking at end of life is designed for relatives and carers of people who are reaching the end of their lives. It has been written to help reassure carers that loss of appetite and reduction in food intake is a normal and expected part of the dying process, and that prescribed ONS are unlikely to be helpful at this stage
British Dietetic Association (BDA) resources on nutrition, older people and self isolation during Covid: https://www.bda.uk.com/food-health/food-facts/older-adult-food-facts.html
• Helping Older Adults Keep Well is a brief guide about maintaining nutrition during self-isolation
• Basic Store Cupboard Ideas gives a range of ideas about how to maintain a varied and balanced diet using long life products
|Nutrition Covid-19- Taste Changes, Feeling Breathless and Weight Loss
|A team of nutrition experts across Hertfordshire have created a series of posters to support you and your clients with some of the nutrition concerns that have been identified during Covid-19. They are created to give you some hints and tips to support your own service users and provide a range of ideas. You can print them and display them, share them with your teams and even next of kin who might be supporting older people. https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=646ebf1b42&e=3e0cd1f44a
|Business Continuity Plans – Your provider checklist
|If you have any concerns or wish to ask quetions about Business Continuity Planning, please email email@example.com
|Can overseas students work more hours during Covid-19 as they are not studying?
|Students must adhere to the rules as part of their clearance to study in the UK, which is as per government guidance- https://www.ukcisa.org.uk/Information--Advice/Working/Tier-4-work
|What do I do if I am concerned about management of staffing during the this period?
|If you have staffing issues, and require support over recruitment, or want access to temporary staff agencies, please contact the Care Provider Hub 01707 708 108 / firstname.lastname@example.org
|Care Home Resident testing referral form
|Do we have to swab all residents even if they are distressed?
If a resident does not have relevant mental capacity, for example, to make necessary decisions (including care, treatment and residence decisions), staff will need to consider the legal, decision-making framework offered by the MCA. The Department of Health and Social Care has issued guidance on the use of the MCA and Deprivation of Liberty Safeguards during this period. It can be found here: https://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-wholack-mental-capacity Care home staff will need to consider the MCA and this guidance, when making decisions for people who lack the relevant mental capacity to make them. This includes residents who cannot make their own decision about testing.
If a person lacks capacity to provide consent to be tested for COVID-19, the decision maker should where necessary make a ‘best interests decision’ under the MCA. When doing so, they must consider all the relevant circumstances and should make a record of their decision. This must be undertaken in relation to the individual and should never be determined in relation to groups of people. Additional time may be required to make the best interests decision in these situations.
If the resident is symptomatic you should isolate them for 14 days
|Testing for COVID-19 before a hospital procedure
|Information on translation services for Testing
Please see the following helpful documents concerning translation services for Covid Testing: https://www.hcpa.info/wp-content/uploads/2007009_Translation-Services_User-Guide_V1.pptx and here: https://www.hcpa.info/wp-content/uploads/200709_Translation-Service_Other-Country-Codes.pdf
|How to managing risks from wandering or walking with purpose during COVID- 19