Residential and nursing care
Local guidance
Updated care home visiting guidance: Guidance on care home visiting has been updated to reflect the following:
- there is now no limit on visitor numbers
- following a normal visit out, residents do not need to test or self-isolate
- following an emergency hospital stay or other high-risk visit out, residents should self-isolate for 10 days, with testing arrangements to end isolation sooner.
Full guidance available here - Guidance on care home visiting - GOV.UK(www.gov.uk)
Care Homes and COVID-19 Impacts Letter 31.12.2021
Please find attached letter containing important information from Dr Andrew Furber, Regional Director of Public Health.
This letter outlines the move to 'standard variant outbreak management’ of 14 days restrictions after the most recent confirmed case be recommended for the majority of care homes as standard across the region'.
Other key messages in the letter (page 2 onwards) are for the following areas. Please do review and share this information where applicable with your care home community:
- Outbreak criteria
- Admission to Care Homes During Outbreaks
- Visiting during outbreaks
- Staff member receives a positive result
- Vaccination and Boosters
Changes to the Management of confirmed and suspected Omicron outbreaks in care homes
23 December 2021
Today we have been made aware of the latest guidance from UKHSA relating to the management of confirmed and suspected Omicron outbreaks in care homes. Due to the increasing incidence of Omicron in the North West the guidance has been reviewed and all COVID-19 cases are to be considered as Omicron. As such all outbreak restrictions will be in place for 28 days and whole home testing should be undertaken on day 29.
All existing and new outbreaks will adhere to this arrangement.
Risk assessment framework for discharging residents back to care homes with outbreaks
- Risk assessment framework for discharging residents back to care homes with outbreaks v1.0 (PDF 103KB)
This local guidance applies to professionals visiting care settings and covers guidance regarding testing, PPE, IPC and other considerations to enable safe and risk-assessed visiting within care settings.
A letter from the Lancashire Resilience Forum (LRF).
- Covid 19 Discharge flow into care homes (PDF 571 KB)
This document regarding COVID-19 discharges into care homes has been signed off by the Lancashire Resilience Forum; this note and flowchart has been created for care homes in order to simplify and clarify existing national guidance on discharge into care homes (Discharge into care homes: designated settings, which was published in December and updated on 13th January), particularly in relation to people who have tested positive for COVID-19.
- LCC Care Home Visiting Policy update 4 June 2021 (PDF 138 KB)
The purpose of this local policy is to highlight the relevant key messages and guidance for care home visitors which came into effect from 17th May 2021, it has been updated to reflect the updated national visiting out of care home guidance (27th May), which advises that private cars and taxis are acceptable to use for visits out of the care home.
See also the national guidance for visits out of care homes.
- LRF Care Home Visiting 16 December 2020 (PDF 311 KB)
The Local Resilience Forum is mindful of the need to protect our most vulnerable adult citizens from the COVID-19 virus and has taken decisive action to develop and support a range of measures to mitigate this risk since the onset of this pandemic. It understands how vital it is for those in receipt of care and especially those people in care settings, such as nursing or residential homes, to have contact with their family and ideally for this to be face to face not just virtual.
The LFR will continue to work with the care sector and organisations such as Alzheimer's UK and Age UK to establish an agreed system of measures which support and enable safe and suitable visiting arrangements to ensure contact is retained and continues during this winter period and irrespective of how rates may vary across this period between districts and across county.
- Visiting Policy for Care Settings DOCX 181 KB
- Visiting Guidance for all Care Homes DOCX 35 KB
- Acute Respiratory Illness (ARI) Resource Pack for Care Homes (link to Infection, Prevention and Control)
- Terminal clean checklist (DOCX 506 KB)
- Care home testing - updated regarding repeat testing in care homes from 6th July 2020.
- Cohort care - advice for care providers (PDF 312 KB) This guidance has been developed to support care homes to group residents with the same infection within an isolated area, where single room isolation is not practical.
- Guidance for the Management of Challenging Behaviour (DOCX 1.28KB) - the NHS Midlands and Lancashire Commissioning Support Unit has produced guidance for the management of Covid-19 with people who have behaviours that challenge. The guidance is aimed at care homes and supported living settings, which cater for people with dementia, mental health issues and services which support people with a learning disability, an acquired brain injury and autism.
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Letter to care home providers from LCC 7th August 2020 (PDF 527KB)
A letter from Lancashire County Council has been sent to care homes to share updates re:- Testing;
- Swabbing;
- Visiting Guidance;
- Revised Admissions Policy;
- NHS 111
There are two attachments accompanying the letter:
- DHSC testing programme update email (PDF 138 KB)
- LCC revised admissions policy statement (please refer to latest version below)
- LRF Care Settings Admissions Policy Statement 18 January 2021 (PDF 566 KB)
(revised from 16 December 2020 version) - The Adults Social Care Cell of the Local Resilience Forum (LRF) has produced a Statement on Officer Visits to Service Users in Care Homes and in Community Settings and associated appendices. This statement sits alongside and should be read in conjunction with other policies and statements that have been produced by the LRF, e.g. the Testing Policy and the Admissions Policy.
- LRF statement on officer visits DOCX 59 KB
- Appendix A - Risk assessment template DOCX 14 KB
- Appendix B - Guide to donning and doffing PDF 331 KB
- Local Resilience Forum Policy Statement on Testing (PDF 293 KB) for all care home staff and residents. The statement outlines 3 different testing processes for homes with different Covid-19 status.
- NW STAC repeated positive results advice (PDF 503 KB) - The NW STAC has produced advice regarding exclusion and repeated positive results in care home residents and staff, with a note for non-care home based individuals.
- North West ADASS 'Care Home Infection Control Top Tips' Guide - The guide highlights some of the ways in which residential and nursing homes have responded to the current Covid-19 pandemic in order to ensure that residents are safe during what are very challenging and difficult circumstances. The guide is a clear, informative document filled with practical examples of best practice.
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Stockport Council's Health Protection Team has produced a 'COVID-19 Good Practice Guide for Care Homes' (PDF 1MB), which covers good practice within the following areas:• Methods of Social Distancing
• Staffing
• External Visitors to the Home (including visiting professionals)
• Admissions into the HomePlease read this guidance in conjunction with the national and local guidance within this section of the provider portal. - COVID-19 Deep cleaning guidance in care homes (PDF 467 KB) - developed by the Infection Prevention and Control Team at Harrogate and District NHS Foundation Trust. It covers the enhanced programme of decontamination and cleaning processes which complement the routine daily cleaning in a care homes.
- Provider letter 15 May 2020 (PDF 163 KB) - an update on testing, infection prevention control training and stepping up clinical support
- Medicines re-use scheme in a care home or hospice setting (PDF 244KB)
- Briefing note for residential providers 30 March 2020 (PDF 75 KB)
- Provider briefing 25 March 2020 - Health System pressures and current admissions to care homes (PDF 334 KB)
- North West Ambulance Service - revised triage protocol and management of 999 calls (PDF 601 KB)
- Fire safety advice for residential care providers and those managing 'sleep risk' premises during the COVID-19 period (PDF 264 KB)
Financial support
You can find further information in the financial advice and support section.
- Adult social care infection control fund - the Department of Health and Social Care has issued a circular to local councils which provides further information on the grant conditions, reporting and financial management requirements. Below is a copy of the LCC template letter that all care homes will receive in the coming days, about our local grant arrangements.
Infection Control Letter (DOCX 24.8 KB) - The auxiliary workforce - To support both your organisation and the individual on placement, Lancashire County Council has produced the following Guidance on Shadowing Placements. Thank you to all of you who have been in touch so far. We do require as many additional placements as possible so if your care home has the capacity to offer face to face shadowing activity, please do get in touch: contractmgmt.care@lancashire.gov.uk.
- New £600 million Infection Control Fund
National guidance
- Equality and Human Rights Commission briefing (194KB, Word) 20 October 2020. This briefing describes the key issues that have arisen in care homes, and sets out the equality and human rights framework that should be applied to prevent them happening again and improve practice. It is intended to support decision-makers and providers to comply with their obligations and embed equality and human rights considerations in the ongoing response to the pandemic.
- The Care Provider Alliance (CPA) COVID-19 visitors' protocol provides a set of principles and top tips to help people using care and support to have the opportunity to safely receive visitors during the COVID-19 pandemic, while minimising the risk of its introduction to, or spread within, the care setting. In the protocol the CPA states: “Care providers should take a dynamic risk-based approach to how they facilitate and manage visits to care settings, which will need to consider the safety of all their residents, staff and visitors and minimise the risk of any COVID-19 infection. This will have to balance the risk of harm to residents not having visits, with the risk of harm to residents, staff and visitors. Care providers will need to ensure they take a person centred approach to their visiting policy, taking account of individual needs and capabilities”.
- Public Health England – COVID-19: number of outbreaks in care homes (management information)– Weekly number and percentage of care homes reporting a suspected or confirmed outbreak of COVID-19 to PHE by local authorities, regions and PHE centres.
- Office for National Statistics – Number of deaths in care homes notified to the Care Quality Commission, England– Provisional counts of deaths in care homes caused by the coronavirus (COVID-19) by local authority.
- COVID-19: 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 patients recovering or recovered from COVID-19 and being discharged to their own home or residential care.
- Clinical guide for supporting compassionate visiting arrangements for those receiving care at the end of life (PDF 196 KB) - the guidance sets to minimise the risk of infection whilst also allowing close family members or friends to accompany and say goodbye to their loved ones at the end of their life and for visits from faith leaders (including chaplains) if desired.
- GOV.UK: Coronavirus (COVID-19): admission and care of people in care homes
- NHS Advance care planning guidance and template
Supported living services during coronavirus (COVID-19)
Guidance for providers of supported living settings (published 6 August 2020)
This guidance sets out:
- key messages to assist with planning and preparation in the context of the COVID-19 pandemic so that local procedures can be put in place to minimise risk and provide the best possible support to people in supported living settings;
- safe systems of working including, social distancing, respiratory and hand hygiene and enhanced cleaning;
- how infection prevention and control (IPC) and personal protective equipment (PPE) applies to supported living settings