Guidance and Webinars

Herts Original Covid-19 Fund - Open to contracted providers only - Funding available to cover PPE (extra to that which the National free PPE portal supplies AND for covid-use only), Cleaning costs and Equipment that was previously reused but due to IPC is now single use (e.g. call bell mats)
If applicable, please fill this claim form and return to your usual HCC Contracts Officer / Monitoring Officer / Commissioner: https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=b7eb5479d2&e=9b7f8bd309
Information on proportionality of your claims may be requested from your HCC Commissioning or Monitoring Officer

If you have any questions about contacting your Commissioning or Monitoring Officer at HCC, or other questions about this fund, please contact the HCPA Care Provider Hub 01707 708 108

For the most up to date information of the second round of the Infection Control Fund, please visit www.hcpa.info/covid-19 and look in the big piink box marked "Latest Infection Control Funding letters here".
Further details, and a recording of the recent HCC HCPA webinar can be found here: https://www.youtube.com/watch?v=DxBxD75IJ3g&feature=youtu.be and more info can be found here: https://mailchi.mp/hcpa/covid-19-daily-update-1281588?e=9b7f8bd309 . PLEASE NOTE THIS FUNDING DOES NOT COVER PPE

Key message:
Each care home (the registered manager) is responsible for setting the visiting policy in that home. 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).

All care homes – regardless of Tier – and except in the event of an active outbreak – should seek to enable:

- indoor visits where the visitor has been tested and returned a negative result – (section 2.1 of guidance)
outdoor visiting and ‘screened’ visits – (section 2.3 of guidance)

- Visits in exceptional circumstances including end of life should always be enabled – (section 2.4 of guidance)

- 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 Personal Protective Equipment (PPE) use.

- 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 (section 1.4 of guidance)

Care Home visits guidance: https://www.gov.uk/government/publications/arrangements-for-visiting-out-of-the-care-home/visits-out-of-care-homes and Lateral Flow Testing and Visiting guidance here: https://www.hcpa.info/guideline/care-home-visitor-guidance/

If you have been in close contact with, but do not live with, a person who has tested positive for coronavirus (COVID-19), follow this guidance. This may include people in your support bubble.

Guidance for Home Care: https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-domiciliary-care
Guidance for Residential settings: https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes

For advice on services provided to those shielding or considered Clinically Extremely Vulnerable (CEV): https://www.hcpa.info/guideline/shielding/ If you have further questions please contact the Care Provider Hub: 01707 708108 / assistance@hcpa.info

This guidance provides advice on the management of staff and patients or residents in health and social care settings according to exposures, symptoms and test results: https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings
How long do we wait before we can declare an outbreak is over?
The Covid-19 outbreak can be declared over firstly once no new cases (staff or residents) have occurred in the 28 days since the appearance of symptoms in the most recent case, or if case is asymptomatic then the date the swab was taken. All residents should have completed their 10 days isolation period.
And secondly to confirm the outbreak is concluded, please order swabs via the national portal and swab all residents and staff. If the results are negative, then the outbreak can be defined as having concluded.
When the outbreak has been declared concluded the home should complete a post outbreak deep clean of the Home.
Information on processes (National and local): https://www.hcpa.info/guideline/swabbing/
Note: Self Isolation period for residents in care settings remains at 14-days:
The national guidance has been revised and now recommends that health and social care professionals who are contacts of a case should self-isolate for 10 days. Please refer to Section 8. This is also applicable to in-patient contacts of a positive case (Section 10). Care Home residents who are contacts of a case will also need to isolate for 14 days. https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings#patient-exposures-in-hospital
PHE East of England
Following on from the Government’s decision to reduce the isolation period down from 14 days to 10 days. The Government has made further changes to the guidance for health and social care professionals and Care Homes, the guidance can be found here: https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=85027ff6fa&e=9b7f8bd309
• Any health and social care professionals who is a contact of a case should self isolate for 10 days
• Care Home residents who are contacts of a case will also need to isolate for 14 days
• In-patients who are known to have been exposed to a confirmed COVID-19 patient while on the ward, should be isolated or cohorted with other similarly exposed patients who do not have COVID-19 symptoms, until their hospital admission ends or until 14 days after last exposure

The information for adult social care providers delivering services to Hertfordshire residents is set out below:

The Department of Health and Social Care (DHSC) has set up a PPE Portal which will supply PPE free of charge to care providers who are registered to use the portal. This is open until March 2021 and should be the first port of call for all COVID-19 PPE needs. Accessing government-funded PPE this way will help to reduce the council’s financial burden and will be a requirement before accessing council support.

The amount of PPE that can be requested from the PPE Portal varies by sector. Please refer to the government guidance. If you are experiencing problems with the PPE Portal, or the limits do not meet your needs please contact the PPE Portal Customer Service team on 0800 876 6802.

PPE available through the PPE Portal is for COVID-19 needs only. Your business-as-usual (pre-Covid) PPE requirements should continue to be sourced from your usual business supply channels.

If you have COVID-19 PPE requirements that cannot be met by the PPE Portal or require PPE in an emergency, please contact our Provider Hub (01707 708108 / assistance@hcpa.info).

A note about ordering from Govt PPE Portal (0800 876 6802)
Depending on the type and size of Care service, Providers have limited quotas for Fluid repellent surgical masks (IIR), aprons, gloves, hand gel and visors.
Ordering is best managed every 7 days, to meet your covid IPC needs.

As there has been some confusion about ordering and quotas, please note the following illustration:

• Care Provider (fewer than 10 beds) has a quota of 200 fluid repellent surgical masks (Type IIR).
• Care Provider orders 199 fluid repellent surgical masks on Monday.
• Care Provider then tries to order a further 199 fluid repellent surgical masks on Sunday, but can only order 1 fluid repellent surgical mask.
• Care Provider would have been able to order 200 fluid repellent surgical masks if they had waited for a full 7 days to elapse between orders (i.e. only order every 7 days)
• Quota limits will never be reduced, only ever increased. If you wish to speak about increasing your order, please call the Portal 0800 876 6802

An important note – Deliveries of PPE should NEVER arrived opened. If the boxes have been opened, the PPE items may no longer safe to use. Always call the PPE Portal if your deliveries arrive opened 0800 876 6802

Full details and quota limits can be found here: https://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment#orthodontists-order-limits

For websites and contact numbers: https://www.hcpa.info/wp-content/uploads/Local-Authority-websites-and-Contact-phone-numbers-for-self.docx
Details from National website: https://bit.ly/36Sfu1v

Flyer can be found: https://www.hcpa.info/wp-content/uploads/Homecare-worker-flyer.pdf
Full details and slides from DHSC webinar: https://www.hcpa.info/wp-content/uploads/Homecare_Worker_Webinar_Slides.pdf
NOTE: Testing is strongly encouraged (but is not mandatory) for those who provide care and any others within the organisation who they are in contact with
Regsiter for tests here: https://request-testing.test-for-coronavirus.service.gov.uk/ Instructional video for taking swabs: https://www.gov.uk/government/publications/covid-19-guidance-for-taking-swab-samples/how-to-use-the-self-swabbing-kit-for-a-combined-throat-and-nose-swab-video - Any problems with this service or with registering swabs, please call 119

PPE Portal - Homecare - Updated 4th December 2020 - Change made: Updated order limits for domiciliary care providers.

Domiciliary care providers with between 100 and 149 clients can order up to (per week):
• 2,000 IIR masks
• 3,000 aprons
• 6,000 gloves (3,000 pairs)
• 8 bottles of hand hygiene (usually 500ml)
• 200 visors
Domiciliary care providers with between 150 and 500 clients can order up to (per week):
• 8,000 IIR masks
• 6,000 aprons
• 12,000 gloves (6,000 pairs)
• 24 bottles of hand hygiene (usually 500ml)
• 1,000 visors
Domiciliary care providers with between 500 and 999 clients can order up to (per week):
• 12,000 IIR masks
• 14,000 aprons
• 24,000 gloves (12,000 pairs)
• 24 bottles of hand hygiene (usually 500ml)
• 1,000 visors
Domiciliary care providers with more than 1,000 clients can order up to (per week):
• 16,000 IIR masks
• 20,000 aprons
• 28,000 gloves (14,000 pairs)
• 48 bottles of hand hygiene (usually 500ml)
• 1,000 visors

Please note: Clients returning home from hospital to an existing package of care will be swab tested and the folloiwng options apply:
If Positive results are returned, they will be discharged to full barrier Service for a 14 day isolation period, so long as the ward can confirm they are Medically Optimised and the Home Care Provider has sufficient PPE and the ability to meet the discharge care needs.
If Negative results are returned, the ward must ensure the patient is Medically Optimised, and the Home Care Provider has sufficient PPE and the ability to meet the discharge care needs.
If Inconclusive results are returned, they will be discharged to full barrier Service for a 14 day isolation period (as if positive results has been received) until further testing and results are available, while ensuring patient is Medically Optimised, and the Home Care Provider has sufficient PPE and the ability to meet discharge care needs.
For further information https://www.hcpa.info/wp-content/uploads/Covid-19-testing-for-service-users-discharged-or-transferred-home-with-home-care-services-clarification-16-07-2020-TP-JM-alterations-1.pdf

Frequently asked questions for Family Carers: https://www.hcpa.info/wp-content/uploads/Carers-what-you-need-to-know.pdf
Letter to Family Carers: https://www.hcpa.info/wp-content/uploads/Letter-for-carers-03Nov2020.pdf

Bengali - https://www.youtube.com/watch?v=PSUdVSuNXiU&feature=youtu.be
Sylheti – https://www.youtube.com/watch?v=OBXP3xhlI9k
Urdu - https://www.youtube.com/watch?v=CXDC6ozl8Hk

The national guidance has been revised and now recommends that health and social care professionals who are contacts of a case should self-isolate for 10 days. Please refer to Section 8. This is also applicable to in-patient contacts of a positive case (Section 10). Care Home residents who are contacts of a case will also need to isolate for 14 days. https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings#patient-exposures-in-hospital
PHE East of England
. The Government has made further changes to the guidance for health and social care professionals and Care Homes, the guidance can be found here: https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=85027ff6fa&e=9b7f8bd309
• Any health and social care professionals who is a contact of a case should self isolate for 10 days
• Care Home residents who are contacts of a case will also need to isolate for 14 days
• In-patients who are known to have been exposed to a confirmed COVID-19 patient while on the ward, should be isolated or cohorted with other similarly exposed patients who do not have COVID-19 symptoms, until their hospital admission ends or until 14 days after last exposure

Are you aware of the current HR requirements for Pregnant Care Staff and how employers can use the IPC funding to support?

Employers who do not undertake risk assessments or organise suitable alternatives for pregnant staff may be breaching the Management of Health and Safety at Work Regulations 1999 (MHSW).

Current Advice Applicable to pregnant care staff (Royal College of Nursing)
(Public Health have conformed this advice is the same for pregnant care staff)

Please find below the steps you need to follow as an employer:
1. Employers are expected to carry out (or review) pregnancy risk assessments for all pregnant workers.
2. The assessment will look at the role, the work environment and the context of the pregnant person’s health (including any underlying conditions). It must highlight any potential risks and steps to be taken to remove the risk of harm to the member of staff or their unborn child.
3. The clinical advice from the RCOG’s joint statement on Occupational health advice for employers and pregnant women states that ‘social distancing is particularly important for all pregnant women who are 28 weeks and beyond, in order to lessen their risk of contracting the virus’. Employers should take this into account when carrying out the risk assessment.

Royal College of Obstetricians & Gynaecologists advice:
• Updated guidance emphasises that pregnant women of any gestation should be offered the choice of whether to work in direct patient-facing roles during the coronavirus pandemic
• Women who are less than 28 weeks pregnant should practise social distancing but can choose to continue working in a patient-facing role, provided the necessary precautions are taken
• Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact and it is recommended that they stay at home

Please Note: Pregnant women’s choices on whether they work in direct patient-facing roles during the coronavirus pandemic should be respected and supported by their employers, according to updated national guidance from the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

4. Where the risk can't be removed, your employer should look at suitable alternative work, including home working, the use of a single office or redeployment in line with health and safety standards.
5. If suitable alternative work is not available then that staff member should be suspended on full paid leave* for as long as necessary to protect their health and safety, or that of their unborn child.
6. Access Support funding:
Wages for staff suspended on full pay at 28 Weeks of pregnancy is a justified re-claimable expenditure under the Infection Control Fund, Round 2 (Oct-Mar) under the heading of "Ensuring staff who are isolating in line with government guidance receive their normal wages while doing so".
Further details on this fund can be found here: www.hcpa.info/covid-19 and https://www.hcpa.info/guideline/covid-19-12-faqs/

References:
https://www.rcn.org.uk/get-help/rcn-advice/covid-19
https://www.rcog.org.uk/en/news/updated-advice-for-pregnant-women-who-are-working-in-the-nhs-and-other-work-settings-during-the-coronavirus-outbreak/
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/

If you wish to discuss this, please call the HCPA Care Provider Hub 01707 708108 or email assistance@hcpa.info

The staff member should self-isolate for 10 days straight away. If the staff member gets symptoms, then they should be tested by booking in at one of the local test sites via the gov.uk testing portal or requesting a home test kit.
If the staff member remains asymptomatic then they should self-isolate for 10 days from the date of exposure.
The home will need to risk assess for any other staff they have been in contact without PPE.
Guidance from Department of Health and Social Care have outlined 3 potential scenarios where ‘close contact’ occurs:
• a staff member who has been caring for a person who has tested positive for COVID19 or who has symptoms of COVID-19 while the staff member was wearing appropriate PPE. Staff will not need to isolate in these cases, but these contacts will be escalated to the local public health team for further advice if needed • a staff member who has been caring for a person who has tested positive for COVID19 or who has symptoms of COVID-19 while the staff member was wearing appropriate PPE but the PPE has been breached. The member of staff will need to isolate for 14 days in line with the advice to the general population (see advice above for examples of PPE breaches) • a staff member who has been in contact with anyone else who has tested positive for COVID-19 whether at work (most likely a colleague in communal areas) or in the community. The member of staff will need to isolate for 10 days in line with the advice to the general population.

NHS T&T Info: https://www.nhs.uk/conditions/coronavirus-covid-19/testing-and-tracing/?gclid=Cj0KCQiAhs79BRD0ARIsAC6XpaVhrQhL7NeWtaYAJOWvj3GiREYOTC36-2DFfOZf_MImh_NTBumod6UaAgVJEALw_wcB
Gov.uk T&T info: https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works
*IMPORTANT: IF YOU ARE IN ANY DOUBT ABOUT SELF ISOLATION REQUIREMENTS WHEN YOU / CARE STAFF / HOUSEHOLD MEMBERS ARE TOLD TO SELF ISOLATE, OR ARE SYMPTOMATIC, OR HAVE A POSITIVE TEST RESULT, OR HAVE BEEN ALERTED BY TEST AND TRACE, PLEASE CALL THE PROVIDER HUB: 01707 708108 OR EMAIL: ASSISTANCE@HCPA.INFO *

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

Please visit our new Swabbing webpage https://www.hcpa.info/guideline/swabbing/ and in particular check out the FAQs on this webpage. If any doubts, call the Provider Hub 01707 708108 or email assistance@hcpa.info

The Government has announced regular testing process for all residential care homes.
Care Home staff are to be given COVID-19 tests every week and residents monthly, to identify anyone with the virus and to reduce transmission. Register for Whole Home Testing here: https://www.gov.uk/apply-coronavirus-test-care-home
Please click the large blue button on the right of this text to see the most up to date info on all UK swab testing, including Whole Home Testing for Care Homes. - If you cannot access resources online, please call 119
Full details of swab testing can be found here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/906089/Routes_for_Coronavirus_testing_in_adult_social_care_in_England_accessible.pdf

A youtube video has been produced which shows how to carry out nasal and throat swabs for residents: https://www.youtube.com/watch?v=1l0jcv37WzI&feature=youtu.be
Care practitioners and nurses who will be swabbing residents in care homes should complete the online care home swabbing competency assessment before carrying out swabbing.
Individuals can register at www.genqa.org/carehomes or care home managers can create an organisational account by contacting info@genqa.org

If you need any support over accessing the Govt testing portal, please contact the Coronavirus Testing Call Centre on 0300 303 2713 (07:00 to 23:00 every day). If you have any issues with accessing swabs or booking your courier please escalate it through: scas.Covid19TestingComplaints@nhs.net copying in acs.covid@hertfordshire.gov.uk

For any care home testing queries, please refer to testing guidance which can be found at:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/912950/Care_home_testing_guidance_-_non-Randox__England__v24-08.pdf
and
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/933134/Routes_for_Coronavirus_testing_in_adult_social_care_in_England_accessible1.pdf
To find your Unique Organisation Number (UON) by searching your CQC location ID:

https://organisation-number-lookup.test-for-coronavirus.service.gov.uk
To order coronavirus test kits:

https://request-testing.test-for-coronavirus.service.gov.uk
To book a courier collection:
https://test-kit-collection.test-for-coronavirus.service.gov.uk/
To register completed test kits:
https://gov.uk/register-organisation-tests
Sign up to NHS T&T webinar series
"We would like to invite you to our regular care home testing webinars. The weekly webinars last 90 minutes and give detailed information about all aspects of care home testing, including: ordering tests, preparing for testing, test kit delivery, a test kit demonstration, testing certain care groups, registering test kits, booking your collection and results and what they mean for your home.
The session will include a live Q&A with representatives from the national care home testing team, who will be able to answer your questions and address any concerns in the session.
To sign up to attend our new care home testing webinars click here: https://event.webcasts.com/starthere.jsp?ei=1369434&tp_key=296e54cdc9
If you are not able to attend the webinars please sign up and a recording of the session will be made available to you after the session."

Who should you contact in an emergency?
If at any stage someone at your organisation cannot cope with the symptoms, or their condition gets worse, or their symptoms do not get better after 7 days, use the https://111.nhs.uk/COVID-19 service. If you do not have internet access, call NHS 111. In a medical emergency, dial 999.

Message from DHSC
We will be sending Lateral Flow Device (LFD) test kits to all care homes by 18 December. These are sometimes called rapid tests as they produce results very quickly, within 30 minutes. You will receive these tests in addition to the regular PCR tests that we already send you for weekly staff and monthly resident testing.
The LFD test kits will be used for scheduled visitor testing. You will not need to order your first round of LFD test kits. We will send further information as soon as we can with exact details of when your LFD 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. https://hcpa.us3.list-manage.com/track/click?u=7275e7980a25c4f5e4939ee06&id=e62edf07de&e=9b7f8bd309
Gov.uk update 08/12/2020 Sets out how care homes and visitors can prepare for visitor testing with lateral flow devices (LFDs).: https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-of-visitors-in-care-homes?utm_source=534a7f78-bc2f-47e1-9360-5e01e81b0e6b&utm_medium=email&utm_campaign=govuk-notifications&utm_content=immediate
Webinar bokings here: https://event.webcasts.com/viewer/portal.jsp?ei=1408929&tp_key=d2a77c17e3
Recent webinar slides: https://www.hcpa.info/wp-content/uploads/Lateral_Flow_Device_Webinar_09122020.pdf and some questions asked and answered at the webinar: https://www.hcpa.info/wp-content/uploads/LFD-webinar-qs.docx and some useful links: https://www.hcpa.info/wp-content/uploads/Care-Home-Lateral-Flow-testing-useful-links-08122020.docx

Please see FAQs from DHSC: https://www.hcpa.info/wp-content/uploads/DHSC-FAQs-Dec20.docx and slides from recent webinar: https://www.hcpa.info/wp-content/uploads/Homecare_Worker_Webinar_Slides-1.pdf

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