Coronavirus (COVID-19)

Statement from Care England regarding COVID-19

Care England is doing its utmost to liaise with the Department of Health and Social Care, NHS England, NHS Digital and other national bodies to ensure that each and every one of your specific queries is answered.  By continuing this regular engagement, we are trying to work with the national bodies in finding out what the sector needs. There is a lot of misinformation being circulated at present and we would recommend that you rely on DHSC guidance. Care England circulates all national guidance when it is issued in our daily Policy Alerts, exclusive to Care England memebrs. Please do this cascade this information to your staff as appropriate. See also the Care Provider Alliance website which which has information and links to all the main relevant guidance for our sector so far. 

Please continue to send all COVID-19 related questions and concerns to info@careengland.org.uk so we can keep can continue to raise such questions with central government. The Care England team is regulalry updating this page in light of member's questions and concerns to allow our membership to see what questions have been asked to Care England. 

The media is very interested in the impact of COVID-19 on care homes. Please be aware that you can pass any media queries to Care England info@careengland.org.uk


Please find 'Social Care Needs You' letter from Professor Martin Green OBE, CEO of Care England stating that social care is open for business but that it needs help and support.  Providers are encouraged to display the poster on their website, their windows or any other appropriate setting. (letter)

 

Questions and concerns that have been raised by Care England

Equipment 

  • Requisitioning of equipment for the NHS, including PPE and thermometers 
  • Staff need be provided with, trained in and fitted for the appropriate PPE in the same way as NHS carers would be. 
  • How will central store of PPE be delivered to staff working in Supported Living settings who are not part of the homecare agency staff? Supported Living settings are people’s own homes and addresses are not stored by CQC so there is no central data base of where these places are.
  • By what method and when will the issue of free PPE from central stores to ICS providers begin?
  • Providers simply do not have enough PPE to provide barrier care if there is suspected outbreaks or we need to take people from the community or hospitals without a “clear” test and need to isolate them.

(click here to download PPE letter from DHSC)

(click here to download COVID-19 contingency planning update: Emergency Coronavirus Bill letter 18. March 2020)

Testing

  • Procedure for screening and assessment of new residents
  • More availability of tests for residents and staff at care homes.
  • Should social care workers be fast tracked for corona testing?

Staffing

  • Whether staff and volunteers will be pooled?
  • Whether staff should be allowed to attend external meetings?
  • Sick pay for staff?
  • Whether care homes can cancel staff leave?
  • What is the procedure if a staff member becomes infected with COVID-19 and has been in contact with other staff members? 
  • The government really need to give the same level of support to providers as they have to the NHS; ASC providers may already have staffing issues which will likely be exacerbated by COVID-19.  
  • Can people be taken on quickly without DBS checks?
  • We need a proactive approach which asks businesses such as restaurants and shops, who might be struggling, if we can temporarily employ some of their staff in care and this must be funded by central government. 
  • The role of nursing students in the delivery of care in light of workforce shortages
  • Guidance of pregnant staff or those immunosuppressant 
  • Government/sector bodies should look into how the system for DBS checks could be adapted to best fit and support the workforce-related needs of the sector in these extremely pressing times
  • What is the guidance for nursing staff who are over 70? Are they supposed to not come to work? How long are they supposed to self-isolate for? 
  • Will over 70s/ pregnant women receive any pay, SSP or OSP?  
  • What happens if someone who is a personal assistant has to self-isolate?
  • Will there be a national communication to attract workers/students that are otherwise unemployed at present?
  • What is the government going to say about agencies working in multiple homes.

 Commissioning 

  • The need to involve providers at national and local level planning. 
  • Are there template comms policies/statements that care homes can use for local communities and the press?
  • Has the DHSC and LA/CCG commissioners got plans to financially support independent care services that have cash flow and sustainability issues due to higher costs/late payments/reduced income?
  • Confirmation is needed from ADASS or government that providers will have relief from contractual staffing obligations as and when we would need to go down to skeleton staffing or curtail activities or visits into the home.
  • Guidance is needed to resolve local authorities shifting the burden of responsibility onto providers to carry out their own contingency plans/ risk assessments.
  • How will LAs/CCGs ensure invoices are paid on time or on proforma
  • Why are LAs sending out lengthy self assessment systems for care homes? What are LAs actually going to do with the info/questions can’t be filled in without more central advice?

CQC

  • Do cases of staff and/or resident confirmed cases of corona need to be notified to CQC?
  • CQC fees should be suspended; they have confirmed inspections inspected. These staff should be re-deployed to assist the NHS. 
  • It is not clear enough about the circumstances in which providers should submit notifications in relation to COVID-19
  • What do providers need to report? When do providers need to report? How do providers report?
  • Although more clarification has now been issued, further clarity and advice is required from CQC in relation to how they will treat staffing challenges.
  • Is it possible that CQC take a central role? Co-ordinating so they don’t have to then report to Las/ PHE?

Interface with healthcare services

  • Why are independent hospitals being consulted nationally about how their capacity can be used and but as yet not the same for care providers?
  • Access to homes for health staff including GPs
  • What additional infection control measures are required?
  • If members need assistance with accrediting their organisations’ own domain name in order that they are recognised by NHS and Local Authorities as secure they should contact Care England. Once accredited, organisations are white listed and DCB1596 compliant thus easing communication between and within the NHS. 
  • Clarity on Resilience Forum lead contacts for each region would be very helpful to ensure all providers channel questions to the right places.
  • Clarification is needed around the proposed triage systems set up to restrict admission in older persons nursing homes (Systems will be developed to triage patients out of hospital and intensive care support based on likely futility i.e. dementia, frailty and multiple comorbidities).
  • What escalation procedures are there if central directives for support for the ASC sector are not implemented?
  • Will the Government order supermarkets to prioritise deliveries to care sector? It can take weeks to get a booking. 

 Visitation 

  • Should care homes close their doors to all non-essential visitors?
  • The dangers of closing doors to all visitors and impact on residents?
  • How can visits at the end of life be arranged?

Learning Disability services

  • How to isolate people with learning disabilities?
  • Specific guidance for learning disability providers.
  • We need confirmation that in the instance we are caring in the home (or in attendance in an NHS setting as LD specialist support) for a person who has been diagnosed with COVID-19 that our staff would be provided with, trained in and fitted for the appropriate PPE in the same way as NHS carers would be.  We have duties of care as employers under legislation and it is the right thing to do.  Plans need to be in place to demonstrate to providers how this resource and training would be provided and who to contact. Resilience teams or others will need to be given guidance on how to allocate scarce resources.  
  • As a result, many of our customers present with challenging behaviour. Therefore to follow the guidance and isolate them if they are suspected or diagnosed with COVID-19 would not be possible. How then are we to mitigate against the risk of them passing it on to everyone in the home – other clients and staff?
  • How will the sleep-ins court case affect matters?

Funding

  • Can the government take steps to postpone PAYE payments to support cash flow for providers.
  • There are a lot of care organisations in the private and voluntary sector we have more than 250 staff and will therefore not be eligible to receive government support for funding I believe this policy should be changed and all those working in the voluntary and private sector in social care should also receive government funding support for the seven day isolation policy
  • We need some long-term commitments that when the crisis is over, anybody who has been admitted to a care home and needs to stay there will have a guaranteed funding package
  • We need the decisions on FNC to be made immediately, and in the long term, we need a proper timetable that can be part of the Bill so there is accountability
  • Emergency cashflow loans should be made available to the sector (could be based on lost occupancy) – these would be guaranteed by government with suitable repayment terms kicking in after occupancy recovers to pre-crisis levels. 
  • District Nurses are now starting to approach care homes that have nursing registration to ask if the nursing staff can attend to the residential clients. There is a clear need to work together across NHS and Social Care BUT we also need to consider who would be accountable for the care, whether the homes insurance will cover the care and the increase in numbers of nurses homes will need on shift if they are to be accountable for the care of the residential clients needs too.
  • Guidance is required from PHE around supplier prices for supplies related to the coronavirus
  • If the social care bill may include measure to enable the government to mandate providers to take patients into vacant beds if they are paying the care homes normal fee rate or above
  • Supplementary nurse education funding 
  • Applications for Undergraduate Pre-Registration Nursing post Bursary withdraw in Sept 2017 has fallen. This retraction will amplify nursing shortages. The Maintenance Grant introduced from Sept 2020 does not equate to previous level. Review of fee funding is required. 
  • Employers are using levy funds for professional apprenticeships however this is limited by financial modelling. The nature of nursing programmes requires in excess of 20% off the job - attendance to theory and placements. The employers are unable to fund backfill staffing costs. Review of financial apprenticeship modelling is needed 
  • The government has elected to pay pub and restaurants etc staff 80% of their salary to stay at home. At the same time health and social care staff continue to work flat out often on low pay due to local authorities cuts in budgets.

 Legislation

  • There needs to be some legal clarity and potentially relief from elements of current law such as Working Time Directive in the instance of a service that has been ‘locked down’ and staff remain in service to support (and are in isolation themselves).
  • Clarification is needed on what takes precedence, DOLS or the new legislation in relation to enforcing self-isolation.
  • Could the Government extend all SSSC qualification requirements for a period of say 6 months? This would mean we would not lose people off the floor to do training and also avoid us having to dismiss staff who have not met the deadline.
  • Could the Government suspend the requirement to obtain PVGs for new staff as long as we have two references? This would allow providers to recruit staff (even on temporary contracts) far quicker.
  • The speed of CRB checks should increase rapidly 
  • If Homes come to mutually aid in an emergency, they should be supported in doing this e.g. insurance liability, CRB checks. 
  • Social care staff (not only frontline carers, but also occupations that support social care services e.g. cooks and cleaners) need to be under the category of key services in order to create greater parity with the NHS.
  • Contingency plans need to be in place for if the schools close, similar to the plans for NHS staff. 

Digital 

  • We are aware that Digital Social Care has put in a proposal to help support organisations access NHSmail more easily to help with their communications needs. 
  • We would be interested to know of any communication/video conferencing facilities that members are looking to employ and any tech solutions to the issues that they might face. 
  • Capacity Tracker - we really need visibility of the actual data being collected so that we can issue guidance on completion to our front-line teams.

 

Last Updated: 23 March 2020