Caring for our partners in the community

COVID-19

All referrals for swabs in the community to go to: Care Home Swab Request or 01626 204950 (8am – 5pm, 7 days a week) with a completed referral spreadsheet [Excel].

If you are a care home, please also ensure you notify PHE as well as your local QAIT team on either:

For homes in Torbay: Torbay Quality Assurance and Improvement Team (QAIT)
For homes in South Devon: Devon County Council QAIT

If a staff member is symptomatic please call the Swab Team on: 01803 656590

For antibody tests call: 01803 655783

Current Government COVID-19 guidance:

As part of our commitment to improve quality and safety and to share good practice, we have provided the following resources to support care home providers. The resources have been produced in collaboration with GPs, pharmacists, care homes managers and social care commissioners across Devon.

Enhanced care

The national EHCH framework was initially developed in 2016 and was refreshed in March 2020. This framework aims to improve the health and well- being of people living in care homes through a range of initiatives and changes. No one change will have the desired effect and this has been demonstrated through vanguard sites across England that have demonstrated the range of health and care benefits that can be achieved through working differently together across a system. In January 2020 a launch of the EHCH framework and celebration of the work to date took place in Torquay and was well attended by care home staff and managers from across Torbay and South Devon

We are now reenergising the EHCH work as we come out of the initial wave of Covid-19, and are keen to build upon the learning and collaborative working that has been achieved. There are 3 principal aims to the EHCH model:

delivering high quality personalised care within care homes;
providing, wherever possible, for individuals who (temporarily or permanently) live in a care home, access to the right care and the right health services in the place of their choosing; and
enabling effective use of resources by reducing unnecessary conveyances to hospitals, hospital admissions, and bed days whilst ensuring the best care for people living in care homes

We need to work collaboratively to co-design and co-deliver this model. There are 7 work streams that report progress to an EHCH Delivery Group. If you would like to join a sub group (listed in the Framework for enhanced health in care homes document), the Delivery group, or would be happy to discuss ideas / concerns / recommendations as to how we could work together to identify, achieve and sustain joint improvements and communications, please email Hannah Griffin; email Ann Butts, or phone 07775 027718.

Many thanks, we look forward to increased collaborative sharing of ideas, learning, planning and working.

Day care services

Restore2

Torbay and South Devon NHS Foundation Trust are working collaboratively with South West Academic Health Science Network, and Torbay Council to provide facilitated RESTORE2 and RESTORE2 mini training through interactive training sessions which are being delivered virtually between a qualified trainer to care homes, including domiciliary care.

COVID-19 specific advice

Preparation and protecting residents and staff

Ensure shielding residents are identified and guidance followed including, where possible, en-suite toileting and washing facilities. See shielding guidance. If you are unsure, contact your GP.

Implement social distancing for residents and staff in shared areas such as lounges, dining rooms and staff areas.

Monitor residents daily for symptoms of COVID-19 and be alert to unusual presentations. Residents with COVID-19 may present with a new continuous cough and/or high temperature. Assess each resident twice daily for the development of a fever (≥37.8°C), cough or shortness of breath, lethargy, loss of taste, diarrhoea and vomiting. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness.

Carry out and prepare your COVID-19 Outbreak Business Continuity Plan using this checklist.

Personal Protective Equipment (PPE)

Staff should be clear on Infection, Prevention, and Control (IPC) guidance re: correct handwashing technique. Appropriate PPE should be worn for contact with all residents and staff must understand how to don and doff correctly. See guidance re: PPE and working safely in care homes.

Please see guidance for healthcare providers who require additional PPE supplies to top up their supplies.

Display guidance on handwashing and PPE clearly.

Infection control and PPE online training

Click on the heading below for details on the NHS Devon CCG infection control and PPE online training.

NHS Devon CCG is offering free daily training under the National Getting It Right First-Time programme.

Infection control and PPE online training is a 2-hour interactive session delivered by trainers from NHS Devon CCG clinical team. The training is being offered as part of a national programme of support for care homes, personal care providers and supported living providers. The CCG are also offering the option of face to face interactive training session within the provider setting.

The group size for each session will be small to facilitate interaction and demonstration of correct PPE use.

Once registered you will receive an invitation to join a session via Microsoft teams and it is imperative that you complete the pre session reading attached to your ticket.

It is also essential that you have the correct PPE available for the session as detailed on your ticket. Please speak to your line manager if you do not have this and they will be able to arrange this for you in advance.

When your request for training is received, a member of the team will contact you to arrange a training session.

We look forward to meeting you and thank you in anticipation of your support in participating and taking forward this programme.

Managing suspected of confirmed COVID-19 in your care home

In the first instance notify the PHE and Care Quality Commission (CQC) if the outbreak is affecting the safety of the service and of course the resident’s own GP:

Ensure Mental Capacity Act and Deprivation of Liberty (DOL) guidance is followed.

Infection Control grant

Click on the heading below to see a number of suggestions on how cares homes can use their Infection Control grant 2020.

Products:

Additional uniforms to enable in house laundering or to allow for more frequent changing
Specialist fogging to decontaminate visiting area
New kitchen equipment – not for the purpose of upgrading kitchen but if it’s to improve infection control then okay
Tablets etc reduce use of paper
iPad/tablets for residents to use, will help in communication with family & reduce infection control measures required for visits
Purchase of a minibus to help with the transporting our staff to stop them using public transport those that don’t drive
Devices to gauge temperature of individuals
Dorgards - keep doors open without having to touch them - easy to fit and fire regs compliant
Bikes for staff – (recommend providers check the position with tax – benefit in kind) can buy bikes and pool them to staff
Electric bikes to be available at each home to encourage cycling
Industrial steam cleaner
Laptops for social distancing working
Electronic care plans to reduce contamination from paper
Alexa devices in all rooms
WIFI boosters and connections for FaceTime etc residents families – within the care home – not for the families
Extra food trollies, skips, bins and microwaves – for separate kit etc but not upgrade
Purchase of new care home furniture, eg armchairs to replace damaged / or to obtain more wipeable furniture
Shower chairs to avoid movement / sharing of existing chairs
CCTV thermostat equipment to help detect this virus from our staff and visitors to the care homes
Purchase of fogging machine to help with disinfection of the home and stopping spread of virus within home
Hospital beds – Please note you could obtain these from the Equipment Service as an alternative
Manual Handling Equipment to avoid transporting equipment around the home
Additional washing machine to help keep laundry of those who might or have confirmed COVID can use solely used

Staffing:

Additional staffing to support safe visiting (providing the staff aren’t also working in other homes)
To pay the difference between SSP and staff pay for staff off sick/self-isolating
Rental of minibus for staff travel, moving between homes or home to work
Taxi transport for staff
Agency usage to support safe staffing whilst people are isolating (providing the agency staff aren’t also working in other homes)
Implementation of changes to recruitment process and system to enable swifter hiring of staff to fill vacancies to manage demands of pandemic
Staff wages and expense of travel whilst testing out of shift hours
Training costs that relate to Infection Control – trainer and staff time back fill
Extra cleaning hours
Recruit costs for temporary workers – providing they aren’t working in other care homes
Paying staff that have had to isolate due to having to follow COVID-19 isolation guidance, contracted COVID-19 or waiting to receive the test results
Induction training costs of new starters
An additional staff member on each shift to reduce the risk of requiring agency workers
Advertising in social media/radio/newspapers for job vacancies so we do not have to use agency
Buying or renting caravans / local hotels to support staff who proactively choose to stay separate from their families in order to limit social interaction outside work

Adaptations to the home:

Changing taps on staff sinks so that they can be operated with the elbow or foot, not the hand
Architect fees if refit required
Walk in en-suites – if they allow better control of infection
Staff accommodation - Using a bedroom to offer staff accommodation and break away from the normal staff area and home during long shifts. Costed at the average weekly fee of the home
Flooring - replacing old carpet with non-slip flooring which is less likely to retain virus
Provision of screens and adaptations to allow safe face to face visits from families and/or between staff and visitors
New showers / taps, shower for staff room
Sluice for laundry room
Update laundry room by means of new easy wipe cupboards and sinks
Install new soap and paper towel dispensers in all residents own bedrooms
Installation of automatic doors openers
Electric key fobs rather than touch keypads
Add en-suite to bedroom
Allocating rooms in care homes for staff to live in

Adaptations to outdoor space at the home:

External visitor section
Changes to garden seating to allow safe distancing
External structure for staff changing room/ staff room
Revamp of garden to aid social distancing
Bike sheds to encourage staff to cycle
Pay to convert a room into a COVID secure visitation area
Increased garden facilities - furniture, specialist activities (raised flower beds, engagement for dementia residents)

Other: