This is a summary on National Clinical and Practice Guidance for Adult Care Homes in Scotland only.
The Cabinet Secretary for Health, Jeane Freeman MSP, released new guidance on 15th May 2020 ‘National Clinical and Practice Guidance for Adult Care Homes in Scotland during the COVID-19 Pandemic’
The document sets out arrangements that must be put in place to ensure appropriate clinical and care professionals across Health and Social Care Partnerships (HSCP) take direct responsibility for the clinical support required for each care home in their Board area.
A) Joint multidisciplinary teams
Professional roles
Every Health Board and its Health and Social Care Partnership colleagues in the Local Authority must put in place a multi-disciplinary team comprised of the following professional roles:
- The NHS Director of Public Health
- Executive Nurse lead
- Medical Director
- Chief Social Work Officer
- HSCP Chief Officer: providing operational leadership
B) Multidisciplinary teams support and role
The Health Board and Local Authority will provide support to the Care Home Clinical and Care Professional Oversight team to enable it, in conjunction with the healthcare associated infection (HAI) lead, to hold daily discussions about the quality of care in each care home in their area, with particular focus on infection prevention and control, but also to provide appropriate expert clinical support to residents who have Coronavirus:
- Care needs of individual residents
- Infection prevention and control measures, including PPE and cleaning requirements
- Staffing requirements including workforce training and deployment
- Testing arrangements for outbreak management and ongoing surveillance
These senior leaders will be responsible and accountable for the provision of professional oversight, analysis of issues, development and implementation of solutions required to ensure care homes remain able to sustain services during this pandemic and can access expert advice on, and implementation of, infection prevention and control and secure responsive clinical support when needed. The Executive Nurse and Medical Directors may devolve these roles where appropriate but will retain accountability through clinical governance arrangements. Close relationships will be maintained between this group and the Care inspectorate relationship manager for the care home.
C) Safety huddle
Based on activity, dependency and acuity care homes will be asked to work through the template to identify care needs and if staffing levels are adequate to be able to deliver safe and effective care. The questions that will be asked are
1) Local information
- H&SCP Name of Residential/Care Home
- Bed Number
- No of Residents
2) Covid-19 related Information
- Total number of positive COVID-19 residents
- Total No of Covid-19 symptomatic residents
- Active outbreak
- Adequate PPE equipment
- Ability to comply with IPC measures
- Total number of deaths (COVID-19 related)
3) Additional Information to aid staffing decision making
- No of 1:1 care
- End of Life Care
- No of deteriorating Residents –
- No of residents with cognitive impairment
4) Workforce Staff absences
- Additional team requirements
- Registered Nurse,
- Senior Social Care Worker,
- Social Care Worker
5) Testing
- How many residents tested
- If not tested why not
- How many staff tested
- If not tested why not
- Testing completed by care home staff yes/no
- Arrangements are being put in place from 18/5/2020 and are clearly covered in Annex A which is found on page 5 of the document and Annex 2 on page 7 & 8
D) What action do you need to take now?
- COVID-19 Testing – If you have not already, please read and print off, Interim guidance on COVID-19 PCR testing in care homes and the management of COVID-19 PCR test positive residents and staff Version 2.4.
- Please ensure it is Version 2.4, and all the relevant staff in the care home are aware of it and its contents.
- Look on the support as a positive one which is there to enhance the great care you are delivering.
- A good idea would be to print off the information above from the safety huddle, this will ensure staff to know what questions will be asked of them, and will help them to have the most recent information available
- Identify someone who will be able to pull this information together to complete the template