COVID-19: Guidance from other agencies

➥ See guidance from national bodies – including Department for Health and Social Care, Care Quality Commission and Public Health England. Further guidance on specific areas can be found in the sections below.


Commisioning

➥ Social care provider resilience during COVID-19 - guidance to commissioners

Social care providers might find this guidance useful it picks up on points that we know are a concern.

⇨ Read the guidance.


Domiciliary (Home) care

➥ Updated: Coronavirus (COVID-19): providing home care 

This document brings together guidance for social care staff, registered providers, local authorities and commissioners who support and deliver care to people in their own homes in England. The updated guidance now features a new section on how home care providers can support the NHS Test and Trace service and includes updated links to hospital discharge service guidance. 

⇨  Read the updated guidance 

 

➥COVID-19: how to work safely in domiciliary care  

Government guidance on how to work safely in domiciliary (home) care during the COVID-19 pandemic including the uses of PPE and frequently asked questions. 

⇨ Read the guidance.


 

Hospital discharge and admissions

➥ Hospital discharge service: policy and operating model  

This document sets out how health and care systems can ensure that people:  

  • are discharged safely from hospital to the most appropriate place  

  • continue to receive the care and support they need after they leave hospital.  

It replaces ‘Coronavirus (COVID-19) hospital discharge service requirements’ published on 19 March 2020.  

The Department of Health and Social Care has also published Hospital discharge service: action cards to summarise the responsibilities of health and social care staff in the hospital discharge process and sets out how roles will change in line with the policy and operating model.

 


CQC guidance

➥ CQC has launched an emergency support framework

It provides a structured framework for the regular conversations that inspectors are having with providers and covers the following four areas:

  • Safe care and treatment
  • Staffing arrangements
  • Protection from abuse
  • Assurance processes, monitoring, and risk management

⇨ Read the guidance 

 

➥ CQC publishes first insight document on COVID-19 pressures

The CQC have published an insight document focusing on adult social care. It reviews data on outbreaks, deaths and availability of PPE and highlights the impact of COVID-19 on staff wellbeing and the financial viability of adult social care services.  It also outlines future areas of focus, including infection control both within and between services, how local systems are engaging social care organisations in the management of COVID-19, and how care for people from vulnerable groups is being managed through the crisis. 

⇨ Read the insight document 

 

Registration with CQC and changes to statements of purpose during COVID-19

The CQC have developed information for those making an application to change their statement of purpose to meet the demands of COVID-19 by increasing capacity or seeking temporary change of use.

⇨ Find out more
.


 

Individual employers, personal assistants and shared lives

➥ COVID-19 guidance for people receiving direct payments

This Government guidance is for those people who buy care and support through a direct payment, as well as local authorities, clinical commissioning groups and those who provide care and support. 

⇨ Read the guidance.

 

➥ Information for individual employers and their personal assistants

The DHSC confirm that personal assistants (PAs) are included in the definition of key workers. If your PA is being challenged they should follow the steps below:

  • contact their direct payment provider (for example their local authority or care commissioning group) to ask if they have a letter or something that validates the PA is a key worker and can share with their child(ren)'s school
  • provide the school with a copy of their contract of employment.

Want more Information on PAs?
Access our information hub for individual employers and PAs, where they can find our Being a PA guide and a useful YouTube video

 


Medication

➥ COVID-19 guidance on reuse of medicines in a care home or hospice 

This guidance details how to run a safe and effective medicines reuse scheme in a care home or hospice during the COVID-19 outbreak.  It gives details about using medicines labelled for one patient who no longer needs them for another patient. 

⇨ Read the guidance 

➥ Delegating medicines administration

The CQC have produced some updated guidance on delegating medicines administration for care workers.

The CQC have pulled together a page detailing medicines information for adult social care providers which details emergency legislation and changes that are happening due to the COVID-19 outbreak. 


Policy change

➥ RIDDOR reporting of COVID-19

HSE have published information about RIDDOR (The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013) and the reporting of COVID-19. This information provides registered managers guidance on completing a RIDDOR report when staff may have contracted COVID-19 at work. 

 

➥ COVID-19 Changes to the Care Act 2014

The guidance sets out how local authorities can use the new Care Act provisions, created under the Coronavirus Act 2020, to prioritise care and support for those who need it most during the COVID-19 outbreak. 

⇨ Read the guidance

 

➥ Use of Mental Health Act

This guidance concerns the impact of the COVID-19 pandemic on the use of the Mental Health Act and supporting systems to safeguard the legal rights of people receiving mental health, learning disability and autism services, including specialised commissioned services.

 ⇨ Read the guidance


PPE and infection control

➥ Updated: COVID-19 antibody testing 

The Government guidance has been updated to reflect the launch of the new antibody testing service where care workers can now sign up for antibody tests and have them delivered to their homes rather than having to travel to have them done. 

Antibody tests are used to check whether a person has had COVID-19. Whatever the result from the test, people must continue to follow the same guidelines as everyone else to protect themselves and others from the virus.  

⇨ Read the guidance 

 

➥ UPDATED: COVID-19 Personal Protective Equipment (PPE) plan and guidance

The COVID-19 PPE plan details the government’s plan around guidance, distribution and future supply. 

 

➥ PPE portal - how to order emergency personal protective equipment: The portal can be used by eligible health and social care providers to order and receive PPE

 ⇨ Find out more here

 

➥ Infection prevention and control

This guidance outlines the infection prevention and control advice for health and social care providers involved in receiving, assessing and caring for patients who are a possible or confirmed case of COVID-19.

⇨  Read the guidance

 

➥ Guidance for stepdown of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings

Advice on appropriate infection prevention and control (IPC) precautions for stepdown in hospital or discharge to home or residential settings.

 ⇨  Read the guidance

 

➥ Coronavirus: infection prevention and control in care homes

This recording (3 April 2020) from Public Health England, NHS England and NHS Improvement colleagues in the South East covers protecting yourself and others, PPE, how to isolate residents and caring for those at risk of COVID-19.  

 

➥ Infection Prevention and Control Q&A Session

This Q&A session will give you information and guidance on a range of issues and queries raised by those attending and some submitted in advance. The recording is applicable for all Registered Managers and IPC leads in all services. 

➥ Coronavirus: infection prevention and control in domiciliary care

This recording (April 20) from Public Health England, NHS England and NHS Improvement colleagues in the South East specifically looks at responding to COVID-19 issues for the domiciliary care sector and other care at home environments. It covers the key principles of reducing the spread of COVID-19, understanding how and when to use personal protective clothing, and the changes that you and staff need to make to your daily work.

Duration 1 hour | Coronavirus: infection prevention and control in domiciliary care from Skills for Care on Vimeo.

 

➥ Guidance for safe handling of the deceased

This advice is designed to assist people who are required to manage the bodies of deceased persons during the COVID-19 pandemic. This guidance has been developed to ensure that:

  • the deceased are treated with sensitivity, dignity and respect
  • people who need to come into contact with the deceased or who work in services providing care for the deceased are protected from infection

⇨ See full guidance 

 

➥ Video: Putting on and removing PPE

This video from Public Health England, shows how to safely put on and take off the Personal Protective Equipment when caring for people with symptoms of COVID-19.


 Hospital discharge and admissions

➥ Guidance on hospital discharge service requirements

Guidance on how health and care systems should support the safe and timely discharge of people who no longer need to stay in hospital.

⇨ Read the guidance.


Supported living and extra care

➥ COVID-19: provision of home care
This guidance aims to answer frequently asked questions from registered providers, social care staff, local authorities and commissioners who support and deliver care to people in their own homes, including supported living settings, in England. It includes information on PPE, shielding and care groups, hospital discharge and testing and Government support available. 

⇨ Read the guidance.


Residential care and nursing homes

➥ Updated: Admission and care of residents in a care home during COVID-19  

This guidance, originally published on 2 April 2020, has been updated to reflect the latest information and guidance relating to admission and care of residents in a care home during COVID-19. The summary provides an at a glance view to what has changed.  

⇨ Read the updated guidance

 

➥  COVID-19: how to work safely in care homes 
Government guidance on how to work safely in residential care and nursing homes during the COVID-19 pandemic including the uses of PPE and frequently asked questions

⇨ Read the guidance.

 

➥ Principles for safely welcoming visitors back to care settings: The Care Provider Alliance have developed guidance for care providers around how to allow visits during the COVID-19 pandemic. It provides information around how this can work along with the rights and responsibilities of care providers and visitors. It looks at ideas such as window visits, garden visits, drive-through visits, in-room visits and setting up designated areas.

 

➥ NHS Capacity Tracker

The COVID-19 Hospital Discharge Service Requirements guidance requires care homes, NHS community hospital beds and hospice beds to be recorded on the Capacity Tracker. Providers of care homes must register and update it regularly to ensure a clear understanding, locally and nationally, of bed capacity and other business information. 

 

➥ COVID-19: Management of staff and exposed patients and residents in health and social care settings

Provides advice and guidance on the management of staff and patients or residents in health and social care settings who have been exposed to COVID-19. It includes:

  • staff with symptoms of COVID-19
  • staff return to work criteria
  • patient exposures in hospital
  • resident exposures in care settings

⇨ Read the guidance.

 


Redeployment and volunteers

➥ COVID-19 Guidance on redeploying workers and involving volunteers

This guidance provides practical advice on how adult social care employers can safely redeploy workers and involve volunteers during the COVID-19 pandemic when necessary to help meet workforce needs. The guidance is split into four sections:

  • alternatives to redeployment
  • redeploying workers
  • involving volunteers
  • infection prevention and control, personal protective equipment and testing

This guidance will be updated regularly.

⇨ Read the guidance

 


 Testing

Guidance on coronavirus testing, including who is eligible for a test and how to get tested.

There are different routes to arrange testing:

  • Self-referral - All social care workers, personal care assistants and unpaid carers with symptoms. Also available for someone you live with, if they have symptoms, and you are an essential worker.
  • Social care workers and residents in care homes (with or without symptoms) can get tested via an employer portal if the residents are over 65 or have dementia.
  • Care workers and nurses who will be swabbing residents in care homes should complete the online care home swabbing competency assessment before carrying out swabbing.

Self- referrals can be tested at regional drive-through sites, home testing or mobile units. The Government website provides more detail on the routes to get tested, types of test, and has other useful resources such as a video and how to administer them and how your results will be obtained.

The Government introduced a ‘test and trace’ service on 28 May 2020. This service will track the contacts of people who have tested positive for COVID-19 and advise them to self-isolate for 14 days. This applies to the member of staff contacted; the care worker will have to self-isolate for 14 days, as should their non-work contacts. This does not mean that colleagues will automatically need to self-isolate.

However, if a care worker has a positive test, the test and trace team will contact them; their co-workers and residents need to be referred to the Health Protection Team. This does not mean that all the co-workers they came into contact with will have to self-isolate for 14 days if PPE has been used and was not breached. You can find further guidance on managing exposure (including breaching of PPE) to COVID-19 in health and care settings here. This guidance also includes information on undertaking risk assessments in respect of staff exposures in the workplace.

Date: 26 May 2020

  • 1 June 2020 – Getting Tested guidance updated – new courier service to collect home tests
  • 2 June – Getting Tested updated guidance on Randox and non-Randox tests 

 


General

➥ COVID-19: Adult social care winter plan 2020-2021

The Government have released the winter plan which sets out the ambitions for the sector and challenges facing adult social care this winter.

It covers several areas including preventing and controlling the spread of infection in care settings and supporting people who receive social care, the workforce and carers.

The plan applies to all settings and contexts in which people receive adult social care. This includes people’s own homes, residential care homes and nursing homes, and other community settings.

⇨ Find out more here

 

➥ Over £500 million for social care to reduce COVID-19 transmission over winter

The Infection Control Fund, set up in May, has now been extended until March 2021 with an extra £546 million to help the care sector restrict the movement of staff between care homes to stop the spread of the virus. This was announced as part of the adult social care winter plan and the fund can be used to pay staff wages for those self-isolating and hire more staff to restrict movement between homes

⇨ Find out more

 

➥ Overview of adult social care guidance COVID-19  

DHSC has published an overview of the latest guidance and support for adult social care during the COVID-19 pandemic. This page will be updated to reflect new DHSC, NHS and PHE advice. 

 

Updated: COVID-19 guidance for those looking after people who lack mental capacity 

There have been various amendments made to the documents within this guidance, including updated information about professional visits to care home and hospitals and decisions related to elective surgery and other procedures. 

⇨ Read the document.

 

➥ Flu Vaccination winter 2020 to 2021: who should have it and why?

This government guidance provides information on who and why people should have the flu vaccine this winter. It details how you can protect yourself and your family against flu and why it is very important that people who are at increased risk from flu should have the vaccination. 

⇨ Find out more

 

Use of air conditioning and ventilation during COVID-19 

HSE have has produced some information about fans, air conditioning and ventilation during COVID-19, which can be found on their website. 

⇨ Read the information here

 

The UK Government’s COVID-19 recovery strategy

This document describes the progress the UK has made to date in tackling the COVID-19 outbreak, and sets out the plans for moving to the next phase of its response to the virus. It outlines aims, approach to a phased recovery and a roadmap to lifting restrictions step-by-step. Section 5 gives the Government’s approach to this within the adult social care sector.

⇨ Read the document.

 

COVID-19 Stay at Home guidance 
This guidance is for households with a possible COVID-19 infection clearly explains how long you and your household must stay at home, how to reduce the spread of infection in your home and what you can do to get better. 

⇨ Read the guidance

COVID-19: DHSC ethical framework for adult social care
Guidance on ethical considerations for local authorities and adult social care professionals planning their COVID-19 response. It’s aimed at planners and strategic policy makers at local, regional and national level to support planning and organisation of adult social care in response to COVID-19.
⇨ Download the framework.

➥ Guidance on key workers
The government has produced guidance for schools, childcare providers, colleges and local authorities in England on maintaining educational provision which defines who a key worker is. 

 

The COVID-19 pandemic is producing new challenges for adult social care and digital working can help services to respond and keep in regular communications.

Access Skills for Care resources on our digital working area. This includes a webinar with Digital Social Care.

 In response to the COVID-19 pandemic, we are sharing information on how technology can be used to support staff and the people you support. This is happening in collaboration with the Department of Health and Social Care, NHSX, NHS England and NHS Improvement, NHS Digital, the Local Government Association and Skills for Care. 

 

➥ Digital Social Care
COVID-19 resources available along with a new helpline that have a team of digital experts to support providers access practical advice to troubleshoot a technical problem or give in-depth one-to-one support.
The helpline is open Monday – Friday 9.00-17.00.| Telephone: 0208 133 3430 

⇨ Visit Digital Social Care website

 

➥  Internet connection deals for care homes

As a care provider you may need to improve your internet connection to use technology more during the COVID-19 pandemic. NHSX and NHS Digital have been working with telecommunications companies and have published a series of offers available specifically for care homes during the pandemic.

⇨ Find out more

 

➥ COVID-19: rapid care technology deployment tool

This practical guide has been developed in collaboration with those leading care technology responses to COVID-19 in councils. It outlines common challenges councils are facing and offers some potential care technology responses. 

⇨ Find out more

 

➥  COVID-19: Quick Access to NHSmail
Secure communication between health and social care services is more important than ever due to the current COVID-19 pandemic. A fast track roll out of NHSMail is available to the care sector, without the need to complete the Data Security and Protection Toolkit.

⇨ Register today

 

➥  Catalyst 

Catalyst is a charitable collective of digital agencies who are focusing on helping companies respond to the challenges of COVID-19 using digital technology. They have lots of useful resources including advice on remote working and video conferencing.

⇨ Download the remote working guide

 

➥   Digital Candle

Digital Candle is a crowd-sourced advice platform for charities. They  introduce people at charities who need digital assistance, to experts who can help. 

A FREE one hour of digital guidance for charities is available. To receive your free hour you will need to book a call  to tell them what your needs and they will assign a digital expert to help you.


 

At a time when the social care sector and its workers are under unprecedented pressure, this section is about looking after yourself and the people you work with.


 Social distancing, self-isolating and shielding

The aim of social distancing, self-isolating and shielding is to protect people whilst slowing the spread of coronavirus and support the Government’s recovery plan to return life to as near normal as we can, in a way that is safe. Social distancing, as far as possible, is very important in care settings, particularly in care homes where visitors from outside the home are permitted.

Social distancing is about limiting the ability of the virus to be transferred from one person to another. Government guidance on social distancing explains what you can do and the distance you should maintain from other people to reduce the risk of the virus being transmitted between people. 

Self-isolation aims to stop the spread of COVID-19 and to allow a person with possible or confirmed coronavirus time to recover from its effects. Anyone who suspects they have symptoms or have tested positive for the virus should follow this guidance about staying at home. They should get tested if they have not done so in the past two days. The guidance was recently updated to extend the self-isolation period to at least ten days from the onset of symptoms or a positive test. If you have a fever at the end of the ten days of self-isolation, you should seek medical advice and continue to isolate. People who live in a household with a symptomatic person should self-isolate for 14 days.

If you have been in close contact with somebody who has the virus, you need to self-isolate for 14 days in line with the test and trace guidance, as do members of your household. There is guidance for those care workers who support someone who has COVID-19. You do not have to self-isolate if you have been protected by PPE, unless it is breached. You must also self-isolate if you, or someone in your household, has returned from certain countries abroad.

⇨  See the full details.

Shielding aims to protect those at greatest risk if they contract COVID-19 by limiting the contact they have with others and reducing risk of infection. Government guidance was relaxed on 1 August and shielding has been paused for those who are clinically extremely vulnerable. The advice for people who live in ‘local lockdown’ areas, where risks are thought to be higher, may be different. For a regularly updated list of areas affected, and for information on what to do and how to manage the outbreak, please see local guidance.

⇨ See local guidance

 


Support for your mental health 

If you're worried about your mental health during the coronavirus outbreak, many organisations have guidance that can help you. There is also support one-to-one if you are feeling stressed or anxious. You might be having more tough days, feeling worried or overwhelmed or you maybe you have things on your mind that you want to talk through.  

➥ Guidance:

A new online section of the Samaritans website helps those struggling with mental health related to COVID-19 emergency. It includes practical tips to help people impacted by social distancing, remote working, worries about friends and family etc.  

Our frontline offers round-the-clock one-to-one support, by call or text, from trained volunteers, plus resources, tips and ideas to look after your mental health. Text FRONTLINE to 85258 for a text conversation or call 116 123 for a phone conversation – all in confidence, with a trained volunteer, at any time.  

Mind has compiled some reliable information and tips to help you cope during this time. It includes practical advice on how to cope when you have to stay at home because of coronavirus, looking after your wellbeing, and where to find more help. It also includes further information about Coronavirus and your rights to social care, bereavement and grief, loneliness etc.  

Every Mind Matters (NHS) has information about looking after your mental health, helping others and where to get urgent support and advice. This online resource covers a range of new resources, designed specifically to help manage mental wellbeing during coronavirus, include a tailored COVID-19 Mind Plan, COVID-19 specific content for individuals and their loved ones, and support for specific mental wellbeing issues such as anxiety, stress, low mood and trouble sleeping. The website signposts people to activities such as mindful breathing exercises, help reframing unhelpful thoughts, and muscle relaxation.   

➥ Support: 

Samaritans have trained volunteers who can help with confidential listening and signposting to specific support you might find helpful. They have introduced a confidential emotional support line for social care staff:

☏  0300 131 7000 available from 7:00am-11:00pm seven days a week. 

Free 24-hour listening support is available so you can talk to them about anything that's troubling you, no matter how difficult. 

☏ Call free on 116 123.  

A Shout service  is available offering confidential 24/7 crisis text support for times when you need immediate assistance. 
Text "SHOUT" to 85258 or visit Shout Crisis Text Line.  

 

 

When your service looks after people with learning disabilities, autism, dementia or mental ill health, you might need specialised versions of guidance. See specific information for people who might have additional needs, and includes some ‘easy read’ information, and activities.


 

Dementia 

COVID-19 may present particular challenges to people living with dementia and those that support them. It’s important that care workers are able to identify the symptoms of COVID-19 in people with dementia so appropriate treatment can be sourced as soon as possible. Care staff also need to be aware that delirium is now recognised as being a condition linked to the presentation of COVID-19 (particularly in older people) as this can present new challenges in terms of recognition and management.

Coronavirus restrictions may be especially difficult for people with dementia. Person-centred care planning and really knowing the person you are supporting will improve understanding regarding why and how a person is reacting to the environment, the situation they are in and the people around them. Working with what the person can do and embracing the positive aspects can support them to make choices and receive care that is meaningful to them.

Maintaining communication and contact where restrictions are enforced is vital to well-being. The care worker’s role is to support this and to provide mental and physical stimulation as appropriate. Reminiscence and life story work is especially effective for people with dementia as tapping into long-term memory can make it possible once again for them to enjoy interacting with others, through their stories.

⇨ See supporting resources 

➥ Supporting families
Staff may have additional caring responsibilities when relatives are not able to visit. Supporting people to understand why their family is not visiting them - and perhaps in some circumstances, when they no longer recognise their own family, is an important role for staff.

⇨ See guidance on supporting families

 

➥ Dementia in care homes and COVID-19 

SCIE has published a quick guide to dementia in care homes and COVID-19 which illustrates four different situations (including helping residents with confusion and managing behavioural challenges) and how these can be managed.

⇨ See 'dementia in care homes and COVID-19' guide

 

➥  Safeguarding adults with dementia 

Safeguarding adults with dementia is an important part of everyday work for providers of adult social care. SCIE has developed guidance on safeguarding adults with dementia during COVID-19. Something else that employers may want to consider in the current circumstances is ensuring that all clients and residents have an Advance Care Plan in place.

⇨ See guidance on 'safeguarding adults with dementia during COVID-19'


➥  Guidance: Supporting people outside of their home 

This guidance is for people who need support outside their home and people who provide this support, which may include: 

  • family or friends 

  • carers 

  • staff in services and shops 

  • volunteers. 

It outlines how the COVID-19 transmission risk can be minimised when support is provided so that people who may have had problems going out on their own while maintaining social distancing, can visit shops, socialise or exercise safely. 

⇨ Read the guidance here 

 


 

Learning disability and/or autism

 ➥  Guidance for care staff supporting adults with learning disabilities and autistic adults

This guidance help care staff and personal assistants to keep people with learning disabilities and autistic people safe, support them to understand the changes they need to make during the COVID-19 outbreak and protect their own wellbeing
⇨ Read the guidance.


 

We know that supporting people often includes supporting families, friends and unpaid carers. See a variety of topics below to help such as isolation, shielding, resilience and using digital devices and systems.

 Carers

A carer is someone who spends a significant amount of their time providing unpaid support to a family member or friend. Social care and health services in particular have an important role in ensuring that carers are at the heart of the social care system and are treated as expert partners in care, this is so relevant and important during this pandemic, 4.5 million people became unpaid carers in a matter of weeks due to the problems that the pandemic presented.

During this unprecedented time many family members have moved in with their loved ones to support them and protect them. Others are permitted to support people they care for, for example by delivering medication or shopping. They may be helping people who are vulnerable and need to be shielded.

Carers UK gives expert information and advice on COVID-19, and also offers support to people who care to protect their wellbeing.

The Government has produced guidance 'Coronavirus (COVID-19): providing unpaid care' for those who care for others. Carers can get a range of support and allowances to help them manage financially.

➥  Guidance for unpaid carers

This guidance is for anyone who cares, unpaid, for a friend or family member who, due to a lifelong condition, illness, disability, serious injury, a mental health condition or an addiction, cannot cope without their support.


 

The human rights of people using care and support haven’t changed during this pandemic. This section looks at mental capacity, deprivation of liberty and decision making, including the Mental Capacity Act and advance care planning.


   Advance care planning

Some provider organisations are concerned about pressure being exerted to ensure that all the people in their care have advanced care planning in place and blanket ‘do not resuscitate’ orders.

joint statement by the Care Provider Alliance, Care Quality Commission, the Royal College of General Practitioners and the British Medical Association makes it clear that advance care planning should be personalised and must not be applied to groups of people.

It’s very important that the wishes of people are respected, taking into account their capacity to make decisions, and unnecessary distress is avoided.

The Resuscitation Council has published some FAQs on ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) and a Quick Guide for Social Care is available from NICE.


 

This area covers what care workers do at the end of life, including palliative care, bereavement and loss and what you need to do when someone in your service dies.

CQC regulation to notify the death of a person using services

The notification form for the death of a person using your service, has been updated to include COVID-19 as a cause of death.

⇨ Find out more and access the form.


Advance care planning

An Advance Care Plan or advance statement is a written statement that sets out someone’s decisions about their future care. It provides a guide to help social care and healthcare professionals, and/or their representative such as an advocate or someone who has a lasting power of attorney, who might have to make decisions about an individual’s care if they become too unwell to make decisions or can’t communicate them.

An Advance Care Plan can cover any aspect of a person’s future health or social care but is especially significant during the COVID-19 pandemic. It could include which people need to be consulted and who can make decisions about treatment, particularly where someone’s mental capacity might affect their understanding. It’s important to remember that the person has rights and that decisions can’t be made by others about their treatment. This includes ‘do not attempt resuscitation’ forms. It is also important to be sensitive, as people and their families are under great stress due to COVID-19 and this might add to their stress.

ReSPECT is a process that creates personalised recommendations for a person’s clinical care in a future emergency in which they are unable to make or express choices. The ReSPECT form includes personalised preferences for a person’s care and health support. The ReSPECT plan is created through conversations between a person or, if the person doesn’t have capacity, their nominated person. This is recorded to help to achieve the outcome that they would want. 


 Bereavement and loss

“How people die remains in the memory of those who live on” 

- Dame Cicely Saunders (1918-2005) Founder of the modern hospice movement.

Bereavement, grief and loss linked to the death of a person, describes the responses we have in acknowledging the significance of the person who has died and how we manage the process of dealing with this.

⇨ See the mourning stages and process of grief and loss experienced.

During the COVID-19 pandemic, you may have experienced the death of a colleague, a family member or friend and people who you provide care for.

⇨ Take time to care for yourself with this ‘supporting yourself and others’ guidance.

 

The British Psychological Society’s COVID-19 bereavement task force has released an online leaflet ‘Continuing Bonds, which suggests alternative ways to help us remember friends and family who die due to the pandemic and being at the funeral isn’t possible.

​For people with learning disability and/or autism communicating and experiencing illness and death will cause additional anxiety. It is possible that the person you care for may experience the death of someone they know during this period.  The links below provide accessible resources to support communicating death:

➥  Dementia
For people with dementia and their families, bereavement and loss may occur before a person has died as well as after a person has died. Helping someone to understand loss when they have dementia can be achieved with compassion.

COVID-19 has meant that people may not have been able to be with their loved one at the time of death. It has also meant that more deaths in a shorter time period have occurred which would be overwhelming for anyone working as a care worker.

It is important to be able:

  • To ask for support
  • To listen and to offer support
  • To provide an opportunity to talk
  • To keep in touch, even though this might be at a distance
  • To mourn the person in a way that is meaningful and dignified and respects their religious and spiritual beliefs.

⇨ Watch our 30-minute Managing Bereavement webinar

 

Resources:

Confidential Adult Social Care bereavement and trauma support line operated by Hospice UK. Call 0300 303 4434 (8am-8pm, seven days a week) - Calls are free to make.

In some social care services you may have staff who have had to shield or staff you have had to furlough. You may need to recruit staff while maintaining social distancing. See below information covering furloughing and government support, recruitment and risk assessment (staff, who are new, who are returning after self-isolation, or at higher risk from COVID-19).   


 Risk assessment

The COVID-19 pandemic has led to many restrictions on care services, due to the risk of infection to the people care services support. In turn, many other risks have been identified – risks to the health of the workforce, around visits to care homes, visits to clients’ homes for domiciliary care, in returning to work after an infection, in using equipment and so on. Being aware of the main principles of risk assessment, and being able to apply them to different hazards, is a valuable skill.

There are five main steps to creating a risk assessment, and these are listed by the Health and Safety Executive

Hazards might include using equipment, such as PPE, incorrectly, or may be to the person, such as stress. Hazards might have different effects on different people, so identifying who is at risk is also important.

Evaluations involve judging the level of the risk and the likelihood of it happening. Precautions can reduce the likelihood and are actions you take for everyone to reduce risk, for example, isolating people with COVID-19 from others, keeping medication in a locked cupboard or making sure that there is an appropriate place and space in someone’s home to put on and take off PPE. Mitigation is an action taken to reduce the potential harm of a known risk, for example providing additional training to someone on infection control.

Sometimes, a person will be at greater risk than others doing the same activity. Each care setting will have a different set of risks, for domiciliary care a considerable risk is sessional use of PPE between clients and whilst driving. We know with COVID-19 that people from black and minority ethnic families, older people, people with underlying conditions and women who are pregnant are at greater risk of harm from COVID-19. In this case, you will need to evaluate the risk as greater and think of ways it can be mitigated. It’s important that you keep a record of your risk assessment activity, and that it is reviewed regularly, or when the context changes. An example of a changed context is when COVID-19 emerged: infection control risks and precautions needed to be reviewed and changed.

There are lots of templates for risk assessment, but it’s important to understand the risks in a specific context, for example a care home, a workforce or an environment. Developing skills in risk assessment helps in improving process. It’s also important to remember that it’s not possible to make all activities risk-free, but knowing what risks there are, and thinking about precautions and mitigations will make your assessments much more effective.

 


 Recruitment and retention

Employers across all social care settings are currently facing additional workforce challenges brought about by coronavirus (COVID-19). Adult social care employers of all sizes have a duty of care to secure the health, safety and welfare of members of staff and people who use services.

To support you to assess and reduce COVID-19 risks to your workforce, the Department of Health and Social Care (DHSC) has published a COVID-19: adult social care risk reduction framework covering measures you could put in place across the workforce and for individuals.

For employers continuing to recruit throughout the pandemic, government agencies have developed emergency processes which support faster recruitment of staff to the sector. CQC COVID-19 interim guidance on DBS and other recruitment checks is for providers recruiting staff and volunteers to health and social care services in response to COVID-19. You may also find the CQC Coronavirus (COVID-19) information page contains further useful information. Right to work checks have been temporarily adjusted during the pandemic, making it easier for employers to carry out checks remotely. And the Disclosure and Barring Service (DBS) has set up a dedicated webpage containing factsheets, updated guidelines and news stories related to DBS and coronavirus.

Employees unable to work because they have coronavirus or coronavirus symptoms, or are self-isolating or shielding, are entitled to Statutory Sick Pay (SSP). Find out if you can claim back up to two weeks of SSP via the Coronavirus Statutory Sick Pay Rebate Scheme.

 For those employers who have been faced with the difficult decision to release staff on temporary leave (‘furlough’) due to COVID-19, find out if you’re eligible to claim employees’ wages through the Coronavirus Job Retention Scheme. The scheme includes employees who are unable to work because they are shielding in line with public health guidance (or need to stay home with someone who is shielding) or have caring responsibilities resulting from COVID-19. HM Revenue & Customs has created a step by step guide to the Coronavirus Job Retention Scheme which explains the information employers need to provide to claim and ACAS has provided a range of furlough letter templates free to download.

 Parents returning to work after statutory parental leave (maternity, paternity, adoption, shared parental leave and parental bereavement leave) will be eligible for the furlough scheme even after the 10 June cut-off date. Find out more here.

 From 1 August 2020, employers will be asked to contribute towards the cost of furloughed employees’ wages. Find out more information on how the Coronavirus Job Retention Scheme is changing.

Both employers and employees should try to be as flexible as they can about holiday during COVID-19, taking into consideration everyone’s physical and mental wellbeing. Where employees have been unable to take their full annual leave entitlement because it is not practicable to do so, rules on carrying over annual leave have been relaxed and workers can carry over up to four weeks’ paid holiday into the next two holiday leave years. Detailed guidance covering holiday entitlement and pay during COVID-19 has been published here.

For employees who may be facing additional hardships at this time, some charitable organisations and Unions are offering financial and welfare assistance. The Care Worker’s Charity, for example, has established a COVID-19 Emergency Fund providing grants related to self-isolation or other unexpected costs, including funeral costs. UNISON has set up a COVID-19 Response Fund and can provide one-off grants of £250 to members in difficulty due to coronavirus, or other financial assistance for those experiencing unexpected hardship.

For providers employing international employees, you can direct staff with any queries or concerns to the Home Office COVID-19 guidance for UK visa applicants and temporary UK residents, which includes contact details of the Coronavirus Immigration Help Centre.

 

 

Please note that while we review guidance that appears in other sections, websites are too big to review in their entirety. We have only linked here to authentic and credible websites, but you should always check that resources online meet your needs. 

  • British Geriatrics Society - Advice around managing delirium in confirmed and suspected COVID-19 cases due to lots of their members having difficulty in managing patients in this situation.
  • Digital Social Care - Guidance and advice in response to COVID-19 on how technology can be used to support staff and the people you support.
  • Hi-VisUK - Access information and resources to help those supporting or caring for an older person with Dual Sensory Impairment (DSI) during COVID-19. Resources include guides and free online learning to help you understand the impacts of DSI.
  • NICE is supporting the NHS and social care by developing a series of rapid guidelines on caring for patients with suspected and confirmed COVID-19 including at the end of life. It also includes recommendations about managing medicines for these patients, and protecting staff from infection.
  • UNISON - See FAQs for care workers, including residential, homecare and community care for both adults and children. It provides advice in relation to the COVID-19 outbreak. 
  • Voiceability - Q&A available on the roles and rights of advocates. The guide (produced 16 April 2020) provides information to ensure people get access to advocacy they need and are entitled to, during the COVID-19 emergency