Carers, Care Homes & Elderly People

Keeping the most vulnerable away from intensive care

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- healthcare, PPE: 

Once SARS-CoV-2 is introduced in a long-term care skilled nursing facility (SNF), rapid transmission can occur.
"Asymptomatic and presymptomatic SNF residents might contribute to SARS-CoV-2 transmission. Once a facility has confirmed a COVID-19 case, all residents should be cared for using CDC-recommended personal protective equipment (PPE)"

🔗https://www.cdc.gov/mmwr/volumes/69/wr/mm6913e1.htm

🔗https://www.gov.uk/coronavirus-extremely-vulnerable

🔗https://onacard.org/en Card-based communication for COVID-19 treatment teams

🔗https://reimagininghealth.com/a-difficult-conversation-about-covid-19-care-planning/


Guides and Action Plans 

🇬🇧🔗https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-residential-care-provision
This guidance sets out key messages to support planning and preparation for COVID-19. It is aimed at local authorities, clinical commissioning groups (CCGs) and registered providers of accommodation for people who need personal or nursing care.

🇺🇸🔗https://www.cdc.gov/coronavirus/2019-ncov/downloads/novel-coronavirus-2019-Nursing-Homes-Preparedness-Checklist_3_13.pdf
The USA’s CDC. COVID-19 Preparedness Checklist for Nursing Homes and other Long-Term Care Settings. There is a recent addition to the above listed below:

  1. Restrict all visitation except for certain compassionate care situations, such as end of life situations
  2. Restrict all volunteers and non-essential healthcare personnel (HCP), including non-essential healthcare personnel (e.g., barbers)
  3. Cancel all group activities and communal dining
  4. Implement active screening of residents and HCP for fever and respiratory symptoms

COVID-19 is being increasingly reported in communities across the United States. It is likely that SARS-CoV-2 will be identified in more communities, including areas where cases have not yet been reported. As such, nursing homes should assume it could already be in their community and move to restrict all visitors and unnecessary HCP from the facility; cancel group activities and communal dining; and implement active screening of residents and HCP for fever and respiratory symptoms.

🇬🇧🔗https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-residential-care-provision
Residential care provision by the UK Government.

🇬🇧🔗https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-home-care-provision
Home care provision by the UK Government.  

🇺🇸📻http://johnshopkinssph.libsyn.com/how-nursing-homes-and-first-responders-can-address-the-threat-of-covid-19?tdest_id=1899134
How Nursing Homes and First Responders Can Address the Threat of COVID-19. 

🇺🇸🔗https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes. By Center for Clinical Standards and Quality/Quality, Safety & Oversight Group.

🇺🇸🔗https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html
Long-term care facilities and nursing homes guidance to deal with COVID-19. By the USA’s CDC.

🇺🇸📝https://journals.sagepub.com/doi/10.1177/0046958018778636
Nursing Home Infection Control Program Characteristics, CMS Citations, and Implementation of Antibiotic Stewardship Policies: A National Study. By Patricia W. Stone, PhD, RN, Carolyn T. A. Herzig, PhD, MS, Mansi Agarwal, PhD, MPH, Monika Pogorzelska-Maziarz,PhD, MPH, Andrew W. Dick, PhD (2018).

🇺🇸📝https://www.kff.org/medicaid/issue-brief/data-note-how-might-coronavirus-affect-residents-in-nursing-facilities/
How might Coronavirus affect residents in nursing facilities. By Priya Chidambaram (2020). Kaiser Family Foundation (KFF).

🇺🇸🔗https://nursinghome411.org/ltccc-news-alert-protecting-vulnerable-residents-from-coronavirus/
Protecting Vulnerable Residents From Coronavirus. By Long Term Care Community Coalition.

🇬🇧🔗https://www.carersuk.org/help-and-advice/health/looking-after-your-health/coronavirus-covid-19 
Carers UK - Coronavirus guidance for care workers in UK

🔗https://docs.google.com/document/d/1oyYzJ9PVDYDnJFec_f9ChA0HJFAOqEPjZhbht7bAVUs/edit#heading=h.39h3vpuwzg8i
Top tips and best practices for Youth Work

🇬🇧🔗https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus
Resources to support social workers during the COVID19 Pandemic. Compiled by the National Association of Social Workers, USA.  

🇺🇸🔗https://www.socialworker.com/feature-articles/practice/social-work-in-time-of-pandemic/
Practicing Social Work during a time of pandemic 

Sample Action Plan

WORK IN PROGRESS currently based on actual plan by a nursing home in Southend, Essex, with 18 service users at time of writing.
Status: DONE 17/03, no reply as of 18/03: Reach out to Southend area coordinator by email
In Progress: 


To do:


Possible council requests:
WORK IN PROGRESS currently based on actual plan by a nursing home in Southend, Essex, with 18 service users at time of writing.

Business Advice 

Also see: https://coronavirustechhandbook.com/employers

🇬🇧🔗https://www.communitycare.co.uk/2020/03/15/care-providers-share-staff-get-cashflow-support-councils-tackle-coronavirus-impact-says-guidance/
Providers should share staff and get cashflow support from councils to tackle coronavirus impact

Advice for Carers 

🇬🇧🔗https://www.carersuk.org/help-and-advice/health/looking-after-your-health/coronavirus-covid-19 
Advice for carers. More for family/private home caring than for carers in a care home setting.

🇬🇧🔗https://www.local.gov.uk/social-care-provider-resilience-during-covid-19-guidance-commissioners
Social care provider resilience during COVID-19: guidance to commissioners. Shared guidance to local authority commissioners from the Association of Directors of Adult Social Services (ADASS), the Local Government Association (LGA) and the Care Provider Alliance (CPA).

Templates & Resources 

Posters and Signage

🇬🇧🔗https://www.westsussex.gov.uk/media/14043/11340205_22f_corona_virus_print.pdf
Poster- Hand Washing

🇬🇧🔗https://www.westsussex.gov.uk/media/14061/handwashing-poster-landscape-and-portrait.pdf
Poster- Handwashing advice

🇬🇧🔗https://www.westsussex.gov.uk/media/14055/coronavirus-poster-photosymbols.pdf
Poster- How to stay safe?

🇬🇧🔗https://www.westsussex.gov.uk/media/14053/coronavirus-poster-2-photosymbols.pdf
Poster- Health issues

🇬🇧🔗https://www.westsussex.gov.uk/media/14054/coronavirus-poster-3-photosymbols.pdf
Poster- What if I get ill?

NO VISITORS WITHOUT PRIOR APPROVAL
In order to maximise the safety of the home, no visitors will be allowed from XXX unless the visit is critically needed and agreed in advance. We hope to provide an update by March 28th.

If you have an approved visit or believe you have a critical need to visit urgently then please step away from the entrance (to your car if you drove) and call the us on XXX. We are very busy so please excuse any delay.

This extraordinary measure is because Covid-19 virus is very contagious and poses an especially high risk to the elderly and infirm. 

We have not taken this decision lightly. Social contact is an important part of the well being of those staying at Joseph House so please bear with us while we put considered plans in place to re-enable it.

Requests to local council

WORK IN PROGRESS currently based on actual plans by a nursing home in Southend, Essex, with 18 service users at time of writing.

It must be a huge challenge for the council to meet the home care response guidelines from central government and the LGA. A lot seems to have been pushed down to the local level.

Could we connect care homes willing to work online on drafting and evolving their approach and needs so they can exchange and collaborate.. This will rapidly lead to best practice, sample comms, new protocols and needs/asks.

In the first instance feel free to direct any other care homes wanting to share their response and learn from those of others to this whatsapp group: <link>

Email/Letter templates to Visitors

NO VISITORS WITHOUT PRIOR APPROVAL
In order to maximise the safety of your loved ones we are locking down the home until further notice while we plan, assess and implement long term measures. No visitors will be allowed from XXX unless the visit is critically needed and agreed in advance. We hope to provide an update in a week.

This extraordinary measure is to keep your loved ones as safe as possible. Covid-19 virus is very contagious and poses an especially high risk to the elderly and infirm. 

If you believe you have a critical need to visit urgently then please contact us on [email protected] if at all possible, else you may call and leave a message on XXX and we’ll call you back within a day. If your visit is deemed potentially essential you will be further screened. We would urge that you assist with this and respect any decision by our team which suggests that you should postpone your visit and return home without entering the building.

We have not taken this decision lightly. Social contact is an important part of the well being of those staying at Joseph House so please bear with us while we put considered plans in place to re-enable it.

If Your Facility has COVID-19

🇺🇸📺https://www.wa-paltc.com/covid-19-resources
🗣[email protected]
Your Facility has COVID-19: What You Can Do Now. By Dr. John Lynch and Dr. James Lewis. UW and King County Response Team. (12 March 2020). Washington Society for Post-Acute and Long Term Care Medicine.

Quarantine

🇺🇳🔗https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts
WHO’s guidance for home care of patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts
WHO has developed this rapid advice note to meet the need for recommendations on the safe home care for patients with suspected novel coronavirus (2019-nCoV) infection presenting with mild symptoms and public health measures related to management of asymptomatic contacts.

🇺🇸🔗https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html
Implementing Home Care of People Not Requiring Hospitalization. By the USA’s CDC.

🇺🇸🔗https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html
Preventing COVID-19 from Spreading in Homes and Communities. By the USA’s CDC.

Care Home Responses 

United Kingdom

🇬🇧🔗https://www.mha.org.uk/news/latest-news/news_archive/coronavirus-covid-19/
Corona advice and information from MHA

🇬🇧🔗https://www.chiswicknursingcentre.co.uk/coronavirus-covid-19/n
Chiswick Nursing Centre Coronavirus (COVID 19) – our guidance to service users and families 

🇬🇧🔗https://www.hamberleycarehomes.co.uk/news-events/2020/covid-19-response/
Hamberley Care Homes corona response

🇬🇧🔗https://www.osjct.co.uk/news/covid-19-latest-update-guidance-visiting-our-homes
St John Care Trust advice for visitors

🇬🇧🔗https://www.lep.co.uk/business/coronavirus-preston-care-home-bans-family-visits-protect-residents-covid-19-2450313
A Preston care home has closed its doors to visitors to stem the spread of coronavirus (Covid-19).

🇬🇧🔗https://www.dailymail.co.uk/news/article-8111391/At-100-care-homes-ban-visitors-seeing-relatives.html
At least 100 care home ban visitors in the UK 14th of March 2020

Government Responses

United Kingdom

Local Governments

🇬🇧🔗https://www.devon.gov.uk/document/coronavirus-advice-in-devon/#section-3
Devon County Council response

🇬🇧🔗https://www.westsussex.gov.uk/campaigns/coronavirus-covid-19/#7
The council’s health and adult social care services have provided information and advice to care providers across West Sussex.

🇬🇧🔗https://new.brighton-hove.gov.uk/coronavirus-covid-19/care-homes-vulnerable-and-older-people
Brighton and Hove response to the needs of Care homes, vulnerable and older people

🇬🇧🔗https://www.rbkc.gov.uk/health-and-social-care/coronavirus-covid-19/coronavirus-covid-19-advice-care-homes-clinically
Kensington and Chelsea council advice

🇬🇧🔗https://medicines.necsu.nhs.uk/covid-19-guidance-for-care-homes/
NHS North of England response

Regulatory

🏴󠁧󠁢󠁥󠁮󠁧󠁿🔗https://www.cqc.org.uk/news/stories/routine-inspections-suspended-response-coronavirus-outbreak
CQC stops routine inspections