Detailed new guidance has been issued by the government on the admission and care of people in care homes during the coronavirus outbreak.
The guidance covers the admission of residents, caring with residents with COVID-19, testing, reporting cases and advice for staff, including the wearing of personal protective equipment (PPE).
The document, which has been published by the Department of Health & Social Care, Public Health England (PHE), CQC and NHS, thanks care home providers for their continued support of the COVID-19 Hospital Discharge Service Requirements and in return makes a number of pledges.
These include: ensuring operators have the information and support they need to safely admit and care for patients during the pandemic; ensuring a long-term supply of PPE for care home and home care providers; establishing a Capacity Tracker to report bed vacancies and manage demand during the crisis; working with commissioners to ensure fair and prompt payment for care commitments and additional care as a result of the pandemic; and the provision of NHSMail for secure transfer of information with the NHS.
The document offers detailed guidance on the admissions from hospitals and care home settings, an area that has been a source of increasing tension between services with reports of care homes refusing to admit people from hospitals who have not been COVID-19 tested and operators revealing that many residents who have tested positive were infected in hospitals.
The guidance states: “The Hospital Discharge Service and staff will clarify with care homes the COVID-19 status of an individual and any COVID-19 symptoms, during the process of transfer from a hospital to the care home.”
Priority testing will be given to patients with all patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu like illness or where an outbreak has occurred in a residential or care setting, for example, long-term care facility or prisons.
The guidance was criticised for its failure to commit to testing of all hospital discharges of patients to care homes, however. Simon Whalley, the owner of Birtley House in Bramley, Surrey, told The Guardian the guidance had been issued with a “complete lack of real understanding and no attempt to understand what the care sector can and cannot do”.
The document also includes guidance on PPE, an area where care home providers have complained of inadequate supplies and of preference being given to the NHS. On the latter point, the document states: “No wholesaler has been asked to prioritise NHS provision over the care sector nor should they be doing so. The rationale underlying all PPE distribution and utilisation should be based on clinical risk.”
Providers are instructed to wear PHE recommended PPE, adding every care home and home care provider has received at least 300 masks, something which has not been borne out by CHP’s conversations with operators.
The document includes contact details of PPE distributors as well as a point of contact for those with immediate concern, which is: The National Supply Disruption line Tel: 0800 915 9964 Email: firstname.lastname@example.org
Cllr David Fothergill, health and social care spokesperson for the County Councils Network, welcomed the new guidance on PPE but warned county authorities were facing “real challenges” in securing supplies. The councillor called for a “significant increase” in supplies for care workers and frontline council workers.