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06th April 2022

Updated guidance on Infection prevention and control for adult social care

Safiya Sidat, solicitor at Napthens, rounds up the latest guidance from the Government on IPC and COVID-19 as restrictions continue to ease.

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The UK Government has released an updated guidance in Infection Prevention and Control along with supplemental COVID-19 guidance for the adult social care and care home sector. This guidance applies from 4 April 2022. A snapshot of the guidance is below.

Vaccinations:

To minimise risk to people who receive care and support, health and social care providers should encourage and support all their staff to get a COVID-19 vaccine, booster dose as and when they are eligible, as well a vaccine for seasonal influenza.

Recommended guidance:

  • Providers to carry out risk assessments whether possible, taking into account staff and service users’ COVID-19 vaccination status
  • Providers can put in place arrangements to facilitate staff access to vaccinations, and regularly reviewing the immunisation status of their workforce in line with immunisation against infectious disease (‘the Green Book’)

Testing:

Care homes and homecare organisations that are regulated by Care Quality Commission (CQC) are eligible for free testing.

The updated and detailed testing regime can be located at this link

*Personal protective clothing (‘PPE’):

PPE recommendations when not caring for a person with suspected or confirmed COVID-19    
ActivityFace maskEye protectionGlovesApron
Social contact with clients, staff, visitors

Care or domestic task involving likely contact with blood or body fluids (giving personal care, handling soiled laundry, emptying a catheter or commode)

Risk assess if splashing likely
Tasks not involving contact with blood or body fluids (moving clean linen, tidying, giving medication, writing in care notes)

General cleaning with hazardous products (disinfectants or detergents)

Risk assess if splashing likelyRisk assessRisk assess
Undertaking an aerosol-generating procedure (AGP) on a person who is not suspected or confirmed to have COVID-19 or another infection spread by the airborne or droplet route







✓ (consider a gown if risk of extensive splashing)

PPE requirements when caring for a person with suspected or confirmed COVID-19 (symptoms may include coughing, sneezing, diarrhoea, vomiting, shortness of breath, temperature)    
ActivityFace maskEye protectionGlovesApron
Giving personal care to a person with suspected or confirmed COVID-19
General cleaning duties in the room where a person with suspected or confirmed COVID-19 is being isolated or cohorted (even if more than 2 metres away)
Undertaking an AGP on a person who is suspected or confirmed to have COVID-19 or another infection spread by the airborne or droplet route✓ (consider a gown if risk of extensive splashing)
For tasks other than those listed above, when within 2 metres of a person with confirmed or suspected COVID-19Risk assess (if contact with blood or body fluids likely)Risk assess (if contact with blood or body fluids likely)

*Detailed guidance in relation to recommended PPE can be found at the link here.

Care Home considerations:

Incoming resident testing

  • Admission of care home residents from a care facility or the community, residents should:
  • Take a PCR test within the 72 hours before they’re admitted (or a lateral flow test if they have tested positive for COVID-19 in the past 90 days)
  • A lateral flow test on the day of admission (day 0)

Tests are to be provided to the care home. If the incoming resident rests positive on either test, they should be isolated on arrival and follow the guidance on care home residents who are symptomatic or test positive for COVID-19.

  • Urgent care home admissions from the community:

The care home manager should find out whether the resident being admitted has had a lateral flow or PCR test and, if so, when and what the result was.

If the individual has not been tested or was tested over 72 hours prior, they should be tested by the care home. If the test result is positive, the individual should isolate in the care home and follow the guidance on care home residents who are symptomatic or test positive for COVID-19 found here.

  • Discharge from hospital into a care home:

The individual will have been tested by the NHS, the result should be shared with the care home.

If the test is positive, they may be able to be admitted to the care home, if the home is satisfied they can be cared for safely. They should be isolated on arrival for 10 days and follow the guidance below on care home residents who are symptomatic or test positive for COVID-19.

If the individual was discharged from a hospital where there was an active outbreak, they should isolate for 10 days from the date of admission. Further guidance on ‘Discharge from hospital into a care home’ can be found here.

Visitors in care homes

  • Visitors/visiting professionals should not enter the care home if they are feeling unwell, even if they have tested negative for COVID-19, are fully vaccinated and have received their booster.

If visitors have any symptoms that suggest other transmissible viruses and infections, such as a cough, high temperature, diarrhoea or vomiting, they should avoid the care home until at least 5 days after they feel better.

Where visiting is modified, residents should be enabled to continue to receive one visitor inside the care home. End-of-life visiting should always be supported, and testing is not required in any circumstances for an end-of-life visit.

  • NHS staff can be asked by care homes when they were last tested. The NHS staff should provide evidence of a negative rapid lateral flow test within 72 hours.

If NHS staff have not been tested within 72 hours (or is unable to provide proof) and it is not possible to test prior to entry, the care home will need to make a risk-based decision regarding whether to permit entry, taking into account the reason for and urgency of the visit. As part of this decision, the care home manager must ensure that all infection prevention and control measures are considered and implemented to mitigate any risk.

In emergency visits such as a 999 response it is not appropriate to ask for proof before entry to a care home.

  • CQC inspectors should be able to provide care homes evidence of their lateral flow test. This evidence could be the text or email from NHS or a photo of the rapid lateral flow test cartridge with the time and date stamp or another method of proof.

By law, CQC inspectors have a right to enter a care setting as part of an inspection, they should not be denied access if they do not provide this evidence.

Outbreak management

An outbreak consists of two or more linked positive (or clinically suspected) cases of COVID-19 associated with the same setting within a 14-day period.

If an outbreak is suspected, the appropriate department, according to local protocols, i.e. the Health Protection Team (HPT), Infection Prevention and Control team, local authority or CCG should be informed.

If an outbreak is declared as a result of the risk assessment, some measures to consider are:

  • Testing
  • Temporarily stopping or reducing communal activities
  • Closure of the home to further admissions
  • Restriction of movement of staff providing direct care to avoid ‘seeding’ of outbreaks between different settings; and
  • Changes to visiting: some forms of visiting should continue if individual risk assessments are carried out. One visitor per resident should always be able to visit inside the care home

Further guidance on outbreaks management and testing be found here.

The Government have also released further guidance in relation to managing healthcare staff with symptoms of a respiratory infection or a positive COVID-19 test result, protecting people defined on medical grounds as extremely vulnerable, and managing healthcare staff with symptoms of a respiratory infection.

If you have any queries or in need of specific advice in relation to any employment law query, please contact a member of the Napthens Employment Team who are able to offer 30 minutes of free advice to QCS members.

References:

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Napthens LLP

Employment Law Specialists

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