Care providers Coronavirus help

See the documents below relating to Wiltshire's response to support for Care Homes:

Care home support letter from Wiltshire (PDF) [161KB] (opens new window)

Appendix 1 care home support (PDF) [143KB] (opens new window)

Appendix 2 COVID 19 helpline provider SOP (PDF) [132KB] (opens new window)

Appendix 3 care home support strategy (PDF) [75KB] (opens new window)

Appendix 3b COVID19 infection prevention and control plan Wiltshire (Excel doc) [51KB] (opens new window)

Appendix 4 health care home support (PDF) [222KB] (opens new window)

Appendix 5 sop (PDF) [69KB] (opens new window)

Appendix 6a specification HDSU (Hospital Discharge Support Units) (PDF) [191KB] (opens new window)

Appendix 6b specification HDSU (Hospital Discharge Support Units) (PDF) [193KB] (opens new window)

Appendix 7 copy of capacity tracker wiltshire final (Excel doc) [28KB] (opens new window)

Altura Learning have produced a training video to help with infection control and other issues during the COVID-19 outbreak and with their kind permission we have placed a link to it below.

• Altura Learning - COVID19 training video (opens new window)

Please see the latest guidelines from Government regarding DBS ID checks.

• GOV.UK: News story - COVID-19: Changes to DBS ID checking guidelines (opens new window)

The following advice is from Wiltshire Council HR and particularly helpful if you have staff who need to isolate long term:

This applies to employees who have been asked to stop working, but who are being kept on the pay roll, otherwise described as 'furloughed workers'. HMRC will reimburse 80% of their wages, up to £2,500 per month. This is to safeguard workers from being made redundant.

You will need to:

1. Designate affected employees as 'furloughed workers,' and notify your employees of this change changing the status of employees remains subject to existing employment law and, depending on the employment contract, may be subject to negotiation.
2. Once the new online portal is live, submit information to HMRC about the employees that have been furloughed and their earnings (HMRC will set out further details on the information required).

Guidance for care homes for dealings with media enquiries relating to coronavirus (PDF) [140KB] (opens new window)

Changes to the discharge process during the Covid-19 outbreak (PDF) [107KB] (opens new window)

Message from Helen Jones, Director of Commissioning, Wiltshire Council and Clare O’Farrell Interim Director of Commissioning, Banes, Swindon & Wiltshire CCG (PDF) [110KB] (opens new window)

letter from our CEO for people, Terence Herbert, 20 March 2020 (PDF) [180KB] (opens new window)

Thank you letter from Terence Herbert and Lucy Townsend (PDF) [180KB] (opens new window)

BSW CCG Guidance on PPE (PDF) [36KB] (opens new window)

BANES NHS FAQs care homes and social care (PDF) [155KB] (opens new window)

Provider frequently asked questions (PDF) [93KB] (opens new window)

Children & Families commissioning questions and answers (PDF) [140KB] (opens new window)

Provider frequently asked questions (PDF) [93KB] (opens new window)

• As of the 18 March 2020 GOV.UK: Guidance - COVID-19: guidance for supported living and home care (opens new window) was released for Care Homes, this does not prevent visitors from seeing family. To minimise the risk of transmission, care home providers are advised to review their visiting policy, by asking no one to visit who has suspected COVID-19 or is generally unwell, and by emphasising good hand hygiene for visitors. Contractors on site should be kept to a minimum. The review should also consider the well being of residents, and the positive impact of seeing friends and family.
• Community Provider up-date:

a) We are restricting Visitors and will only allow 1 person to visit per patient on our community wards (we are not allowing any visitors under the age of 18 years old)

b) Where our staff have nursing or therapy appointments with residents in Care Homes, assurance can be given that our normal infection control procedures will be adhered to.

c) If patients were to test positive, we would use normal barrier nursing precautions following clear guidance, this can be provided if helpful.

d) Patients are being screened before transfer to community wards, care homes or intermediate beds, this position will continue to be reviewed as we receive national guidance. We will provide a further BSW position statement on Friday if we have not received national community response guidance by that date.

• Many providers asking us whether customers being discharged from the acutes are being tested. At the point of discharge, the acutes/hospitals will state that the individual being discharged:

1. Has been reviewed by a senior clinician who has approved their discharge
2. Does not have a temperature >37.8
3. Does not have a persistent dry cough

 The  COVID-19 testing policy is determined by the Chief Medical Officer and Public Health England (PHE). This includes any testing requirements for frontline staff. On the 29 March 2020, all NHS organisations were informed by NHSE/I that staff testing was to be increased, starting with those staff working in identified high risk areas, such as intensive care units.

Over time, the Government aims to increase staff testing to other frontline health and care workers, including those staff in the social care setting. Nationally, appropriate testing kits are being sourced to achieve this, together with a planned increase in dedicated laboratory hubs. 

There is currently no national guidance available that advocates use of COVID 19 testing kits from any other sources, as results cannot be validated.

There are also no validated anti-body tests, although there are a number of companies known to be marketing these tests. These also, should not be used.

Further information from a recent Government communication can be found on the GOV.UK: Press release - Government launches new drive on coronavirus tests for frontline NHS staff (opens new window).

 Release from Pandemic flu stock

• Free distribution of fluid repellent facemasks from the pandemic flu stock started on 18 March and will aim to be complete by Tuesday 25 March.
• Every care home and home care provider will receive at least 300 facemasks. 
• Providers don't need to do anything. Stock will be delivered using addresses from the CQC register.

PPE Types

The most recent guidance on PPE has been jointly published by Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS) and Public Health England as official guidance. 

• Based on this, the PPE types for care homes and homecare at this time are:
  Disposable gloves
  Disposable plastic aprons
  Fluid repellent face masks

The COVID-19 team has had some requests for gowns and FFP3 masks. We won't be making these available at this time. This will allow stock to be available where it is most needed. 

However, if you do have a service within Wiltshire that carries out aerosol generating procedures (AGP) please contact our COVID-19 team.

Council Stock 

• The release from pandemic flu stock is to help manage the initial rise in demand following the recent change in guidance. 
• The Council is also buying PPE for social care providers from regular NHS supply chains to support the sector longer term. 
• At 19th March we have orders placed for fluid repellent masks. We are trying to source aprons, gloves as well as antibacterial products (e.g. hand sanitizer). 
• We are working on distribution arrangements for PPE to providers. Allocation of PPE will be based on priority need. Our COVID-19 team may ask you for details of your situation as part of this process. 
• The Council is continuously working with national partners to ensure a long-term supply of all PPE and care equipment. We will update providers as soon as we are able via the webinars, webpage and mailing list. 

Further guidance 

Providers should: 

• Continue to order PPE and other care equipment from their usual suppliers. 
• Use their own available stock and the free pandemic flu stock release, before drawing on Council-held stock.
• Where you can buy stock but at a higher than normal price, please do so and keep clear records of the purchase. Please try to keep costs reasonable though. We aim to support providers with any additional COVID-19 related costs providers may face. Please contact the COVID-19 team if you have any questions about this.
• Contact the National Supply Disruption line if you have immediate concerns about PPE supply. This service will advise on alternative suppliers.
  National Supply Disruption Line
  Tel: 0800 915 9964
  Email: supplydisruptionservice@nhsbsa.nhs.uk (opens new window)

Providers should be aware that all supply chains for PPE - NHS as well as private sector - are under pressure with longer times for delivery than usual. Every part of the health and care system, including hospitals, is experiencing difficulties in getting PPE. No wholesaler has been asked to prioritise NHS provision over the care sector.  

Circumstances and guidance will continue to evolve. The COVID-19 team will keep you updated of any changes. The Council will do all it can to support providers during this time. Please work with us so that we can support the whole sector. Make sure you have signed up for regular updates and join the webinars. 

Please access GOUV.UK: Guidance COVID-19: infection prevention and control (IPC) (opens new window).

Please find the latest PHE (Public Health England): Guidance for stepdown of infection control precautions and discharging COVID-19 patients (opens new window) for step down which includes extra precautionary measures being afforded to these more vulnerable patients.

The guidance provides extra precautionary infection prevention and control measures for Covid-19 patients recovering or recovered and remain in hospital or those being discharged home or to residential care.  The focus is particularly on those who have received critical care and/or those who are immunocompromised and ensuring they complete self-isolation until 14 days from their first +ve test compared with 7 days for Covid+ve patients who don't fall into these categories. 

The guidance goes on to provide specific instructions for those in these groups who have ongoing medical needs where there's been on virological evidence of clearance prior to discharge:

• For those who received critical care - appropriate IPC measures should be used for all medical attendances required for 14 days since first +ve test result
• For those severely immunocompromised IPC measures to continue unless there has been virological evidence of clearance prior to discharge or complete resolution of all symptoms due to their complex health needs and uncertainties about the duration of infectiousness for these patients.