Coronavirus (COVID-19)

16.04.2020 No10 Press Conference (Ben Kentish, LBC asking about care homes, Dominic Raab, Secretary of State noted Care England)

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 members. 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) 


Letter to supermarkets
Please click here to download a copy of the letter The Care Providers Alliance (CPA) sent to CEOs of all the major supermarkets. Professor Martin Green, CEO of Care England has written to the Business Retail Consortium.


Admission and Care of Residents during COVID-19 Incident in a Care Home
Care England, in collaboration with the Care Provider Alliance, has today submitted 25 questions to DHSC which we feel need to be answered in light of the ‘Admission and Care of Residents during COVID-19 Incident in a Care Home’ guidance published on the 2nd April. Please click here to download document.


Digital Social Care Helpline launched to provide digital support to social care providers affected during coronavirus pandemic. Digital Social Care helpline will be open between 9am and 5pm Monday to Friday by calling 0208 133 3430 or by email on help@digitalsocialcare.co.uk Please click here to download document.


Automatic visa extensions 
Please download letter from the Cavendish Coalition, a group of 36 organisations from across the UK who are committed to ensuring that the workforce needs of the social care and health sector are considered in future immigration policy to the Home Secretary.


Joint letter from CPA, CQC, DHSC and NHSEI to all registered ASC providers on data collection during the COVID-19 crisis. please click here to download letter.  


 

Questions and concerns that have been raised by Care England members

Equipment 

1)    Requisitioning of equipment for the NHS, including PPE and thermometers. 

2)    Staff need be provided with, trained in and fitted for the appropriate PPE in the same way as NHS carers would be.  

3)    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. 

4)    By what method and when will the issue of free PPE from central stores to ICS providers begin?

5)    Wholesalers must continue to deliver food supplies to care services  

Testing 

1)    Procedure for screening and assessment of new residents 

2)    More availability of tests for residents and staff at care homes. 

3)    There growing number of care home residents with Covid19 symptoms who are not being tested and if they sadly die, are unlikely to count in the Covid19 numbers as their deaths will probably be documented to be as a result of pneumonia or a chest infection. Action is required around this.  

4)    There are issues are the locality of test centres, for non-drivers or staff who don’t like driving far. Also, if they are symptomatic and can’t drive what are they to do? 

5)    If staff aren’t displaying symptoms but caring for someone with confirmed or symptomatic will they be tested? 

6)    New testing requirements/ procedures are being sent directly to staff, how is the provider/ employer able to track this?

7)    CQC, LA and CT are all asking for similar information- there is an administrative burden around duplicating information, how will this be reprimanded? 

8)    CQC are asking for daily impact management assessments which will be challenging in the current context.  

Staffing 

1)    Whether staff and volunteers will be pooled? 

2)    Whether staff should be allowed to attend external meetings?

3)    Sick pay for staff? 

4)    Whether care homes can cancel staff leave? 

5)    What is the procedure if a staff member becomes infected with COVID-19 and has been in contact with other staff members?  

6)    Can people be taken on quickly without DBS checks? 

7)    Can I start someone in their new role before I receive information back from the DBS? 

8)    If someone I want to employ already has an existing DBS certificate, do I still have to apply for a new one?

9)    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. 

10) The role of nursing students in the delivery of care in light of workforce shortages 

11) Guidance of pregnant staff or those immunosuppressant  

12) 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? 

13) Will over 70s/ pregnant women receive any pay, SSP or OSP?   

14) Will there be a national communication to attract workers/students that are otherwise unemployed at present? 

15) What is the government going to say about agencies working in multiple homes? 

16)  Can people on furlough from other sectors be paid to work in the care sector whilst on Furlough? 

17) I employ personal assistants (PAs) through direct payments. If a PA or the whole team needed to be isolated, how would my care needs be met? And if I contracted COVID-19, could my PAs still assist me? This is a worry for a lot of people. 

Commissioning  

1)    The need to involve providers at national and local level planning. 

2)    Are there template comms policies/statements that care homes can use for local communities and the press?

3)    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?

4)    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. 

5)    Guidance is needed to resolve local authorities shifting the burden of responsibility onto providers to carry out their own contingency plans/ risk assessments.  

6)    How will LAs/CCGs ensure invoices are paid on time or on proforma 

7)    I’ve been moved into emergency housing without a care package due to COVID-19. I won’t last long independently as I need help with basic survival such as food etc. What are you doing to help people like me stay safe?  

8)    What will happen if my adult son's care home provision collapses? He has 2:1 support in a specialised care home 70 miles from his family home.

9)    What progress has the Government made in providing emergency staff cover for care homes?

CQC 

1)    Do cases of staff and/or resident confirmed cases of corona need to be notified to CQC? 

2)    CQC fees should be suspended; they have confirmed inspections inspected. These staff should be re-deployed to assist the NHS.  

3)    It is not clear enough about the circumstances in which providers should submit notifications in relation to COVID-19

4)    Although more clarification has now been issued, further clarity and advice is required from CQC in relation to how they will treat staffing challenges. 

5)    Is it possible that CQC take a central role? Co-ordinating so they don’t have to then report to LAs/ PHE? 

6)    We have had to temporary postpone all training, including mandatory requirements that managers. Will anyone be penalised?

7)    If all job roles in Adult Social Care can now be covered by a DBS First check not just Nurses and Care staff.  

8)    Can the Commission urgently delay the time required for providers to return their comments on their Reports indefinitely and until further notice.

9)    Do the actions of volunteers become part of the service’s regulated activity? 

10) Where clients of social care providers are used to having regular checks (such as diabetes, anti-coagulant, etc), these are likely to become a low priority and be dropped temporarily. Is there to be guidance on this?  

11) Q: How will people working in non-registered settings be tested?  

12) On home testing could these be carried out at the actual service setting e.g. care home to ensure they are done properly?

13) Can a care home mini-bus car be used to get staff to a test centre if PPE used? 

14) Will CQC be able to say how many people go back to work more quickly as a result of having a test

15) How will staff be prioritised for appointments for testing? 

16) Will the result of a test also be sent to the employer? 

17) Based upon PHE guidance staff are encouraged to return to work after 7 days, despite WHO guidance stating that people can remain infectious with Covid-19 for approximately 12 days. What is deemed to be the correct period of infection? And how long should symptomatic staff remain absent from work? 

18) Will there be enough testing for all care workers. We know that NHS staff still haven’t been tested? On this note, will the test centres be able to cope with both social care and NHS staff requiring tests? 

19) There are issues are the locality of test centres, for non-drivers or staff who don’t like driving far. Also, if they are symptomatic and can’t drive what are they to do? 

20) If staff aren’t displaying symptoms but caring for someone with confirmed or symptomatic will they be tested? 

21) New testing requirements/procedures are being sent directly to staff, how is the provider/employer able to track this?  

22) CQC, LA and CT are all asking for similar information- there is an administrative burden around duplicating information, how will this be reprimanded? 

23) CQC are asking for daily impact management assessments which will be challenging in the current context.  

24) How will agency workers be able to access testing. They are mostly working in residential homes, but as they are not permanent staff, I presume they are unlikely to be put forward for testing by the host employer in each instance. https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested.  There is a list of who will get tested, and it doesn’t (as far as I can see) make a distinction about agency workers, so I think there would be an argument to say that they should qualify? Could CQC clarify pleas. 

25) Uber Health - in this scheme the drivers have full PPE and the cars are properly cleansed with an anti-bacterial/anti-viral cleansing process and they have been granted HSE acceptance of this process. However, the current guidance on getting people to test centres clearly states that they have to come in their own car, or a car with one other member of their household.  For many care workers, this is impossible could Uber Health be used? 

26) How reliable are the tests? 

27) Is there a period of time after showing COVID 19 symptoms that is the best time to take a test? 

28) Is there a protocol following screening for providers to follow depending on the results of the tests? i.e. what should providers advise employees when the test is either positive or negative.  

29) Can a member of staff have multiple tests and is a time period between tests recommended?  

Interface with healthcare services 

1)    Why are independent hospitals being consulted nationally about how their capacity can be used and but as yet not the same for care providers? 

2)    Access to homes for health staff including GPs 

3)    What additional infection control measures are required? 

4)    Clarity on Resilience Forum lead contacts for each region would be very helpful to ensure all providers channel questions to the right places. 

5)    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). 

6)    What escalation procedures are there if central directives for support for the ASC sector are not implemented?

7)    Will the Government order supermarkets to prioritise deliveries to care sector? It can take weeks to get a booking.  

Visitation 

1)    Should care homes close their doors to all non-essential visitors? 

2)    The dangers of closing doors to all visitors and impact on residents? 

3)    How can visits at the end of life be arranged? 

Learning Disability  

1)    How to isolate people with learning disabilities? 

2)    Specific guidance for learning disability providers. 

3)    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.   

4)    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? 

5)    Regarding homes registered ‘without nursing care’. A RM whether nurses would be able to train staff to administer insulin (as a nurse visits site each day in her service to administer this). This creates a situation whereby we have someone moving from home to home who potentially could carry the virus.  

6)    What is the latest information in response to concerns about DNAR (DNACPR)? 

7)    Can I exercise more than once a day if I need to due to a significant health condition?  

Funding 

1)    Can the government take steps to postpone PAYE payments to support cash flow for providers. 

2)    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. 

3)    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  

4)    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

5)    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.   

6)    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. 

7)    Guidance is required from PHE around supplier prices for supplies related to the coronavirus 

8)    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 

9)    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

10) Supplementary nurse education funding?  

11) 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.  

12) How will the apprenticeship levy be affected by the COVID-19 crisis and what steps is the Government taking to adapt the policy to ensure that it is fit for purpose in the current context? 

13) 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. 

14) Please give clarity around direct payments. Can we employ someone in the household if the PAs are unable to come due to self-isolation? 

15) Will VAT reliefs be given to adult social care providers?   

Legislation 

1)    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). 

2)    Clarification is needed on what takes precedence, DOLS or the new legislation in relation to enforcing self-isolation. 

3)    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. 

4)    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.

5)    The speed of CRB checks should increase rapidly  

6)    If Homes come to mutually aid in an emergency, they should be supported in doing this e.g. insurance liability, CRB checks.  

7)    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.

8)    Contingency plans need to be in place for if the schools close, similar to the plans for NHS staff. 

9)    Could you please clarify if the Capacity Tracker is a legal requirement or recommendation?

10) The disincentive for part-time staff members to work more than 16 hours per week needs to be removed. HMRC automatically deduct benefits when staff work over the 16 hour threshold. 

Digital

1)    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. 

2)    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. 

3)    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. 

4)    What is the situation regarding Supported Living care services and Capacity Tracker? 

5)    Do I still need to fill in a provider information return (PIR)?

6)    What is the difference between CQC’s data collection tool and Capacity Tracker? 

Lifting Lockdown 

1)    If the Government announce that facemasks must be worn in public places such as supermarkets, public transport etc. as part of the lockdown easements, what reasonable adjustments can we expect for service users who will not tolerate these measures when accessing the community? 

2)    How can we ensure that the furlough scheme is not cut for frontline health and social care workers who are shielding as they cannot come back to work? This is a point which was late to be included in the guidance and will easily be forgotten in the rush to cut the bill to the taxpayer. 

 

Last updated: 21.05.2020